​Requirements for Testing of Residents and Staff in Long-Term Care Facilities Order

 Per the Order of the Secretary of the Pennsylvania Department of Health Directing Testing at Long-Term Care Facilities, issued June 26, 2020, Personal Care Homes (PCHs), Assisted Living Residences (ALRs), and Intermediate Care Facilities (ICFs) are required to complete a baseline universal test for SARS-CoV-2, the virus that causes COVID-19, of all residents and staff no later than August 31, 2020. Universal testing includes: any resident or staff person who has never been tested, and any resident or staff person who was tested prior to June 12, 2020 and whose test result was negative. Facilities should not test residents or staff with a history of a positive test for SARS-CoV-2. If a facility has not had any known cases among residents or staff, the facility is still required to perform baseline universal testing of all residents and staff. While not mandated through the Order of the Secretary, facilities should follow guidelines in PA HAN 509 - 05/29/20 - Testing Guidance for COVID-19 in Long-term Care Facilities Residents and Healthcare Personnel when a new confirmed case is identified for follow-up testing. 

In order to be compliant with this Order, a facility that is unfamiliar with how to test is expected to pursue contracting with an external vendor to support universal testing. If a facility requires assistance obtaining appropriate resources, the facility should send an email to ra-dhCOVIDtesting@pa.gov. The facility will receive an auto-reply with a link to a form to request support, including assistance with performing testing, from the Department of Health. The form must be completed in its entirety. Note that support services are limited and should be considered a last resort. 

In order to be compliant with this Order, a facility lacking testing supplies can send an email to 
ra-dhCOVIDtesting@pa.gov. The facility will receive an auto-reply with a link to a form to request support, including supplies, from the Department of Health. The form must be completed in its entirety. Shipments will be based on the quantities available at the time of request review. In order for requests to be fulfilled, a physician who will order the testing, and be able to report the results to the facility, must be identified on the form. A facility that does not have a physician on staff or contract who can order the tests should consider identifying a physician from a local health system or from the annual medical examination forms filled out for its residents. It may also contact the Department of Human Services licensing program office for additional consultation and support; the Office of Developmental Programs at
RA-PWODPEMRGNCYSPRQ@pa.gov or the Office of Long-Term Living at RA-pwarlheadquarters@pa.gov.. Additionally, the Regional Response Health Collaborative Program (RRHCP) will be able to provide support with testing after it is operational at the beginning of July. 

In order to be compliant with this Order, a facility is expected to enter into a contract with a commercial laboratory to meet testing needs of the facility. A laboratory must have a current Pennsylvania laboratory permit and be approved to perform COVID-19 testing. A facility may verify licensure and approval by emailing RA-DHPACLIA@pa.gov.
If the facility has residents who are enrolled in Medicare or Medical Assistance, the laboratory the facility contracts with should be enrolled with Medicare and the Medical Assistance program to ensure payment for testing. If timely commercial testing is not available, the State laboratory may be used as a last resort if needed to comply with this Order. 

In order to be compliant with this Order, if a resident refuses to be tested, the facility should care for the resident in a COVID-potentially exposed area until at least 14 days after refusal (see PA-HAN-509). If the resident develops symptoms consistent with COVID-19, testing is recommended, and the testing request should be re-visited with the resident or responsible party. 

In order to be compliant with this Order, a facility should develop a policy to address staff members who refuse to be tested. The policy should be based on the risk of exposure, community spread, and staffing needs. In order to be compliant with this Order, the facility must follow its own policy. Additionally, these staff persons should not care for unexposed residents. If these staff develop symptoms consistent with COVID-19, testing is recommended, and the staff person should be excluded from work and follow return to work criteria in PA HAN 501. 

In order to be compliant with this Order, a facility is required to report baseline testing to the Department of Human Services. Facilities must report in a manner and through a system designated by the Department of Human Services within 48 hours of completing the baseline testing, or within 72 hours of issuance of the Order if baseline testing occurred within 14 days of the issuance of the Order (since June 12, 2020). Facilities can report their test results via online form.

In order to be compliant with this Order, a facility must implement best practice infection control measures (such as those found in PA HAN-509) based upon the results of the baseline testing. This may vary from facility to facility, but the focus of baseline testing is to enable a facility to establish initial infection control practices that will prevent further spread of COVID-19 within the facility and to establish facility readiness. 

If a facility has questions on these requirements, it should consult the Frequently Addressed Questions (FAQs) that accompany this document, as well as PA HAN 509. If a question is not addressed in either of those resources, the facility may reach out to their respective licensing program office, the Office of Developmental Programs at RA-PWODPEMRGNCYSPRQ@pa.gov or the Office of Long-Term Living at RA-pwarlheadquarters@pa.gov.