Surveillance testing (COVID-19 Resident and Staff Surveillance Program (CRSSSP))

Please note, on Friday, June 18, 2021, Kelly Keefe from DHHS Health Facilities Administration announced the following update regarding COVID-19 testing at senior residential facilities:

“The department has filed an emergency rulemaking to exempt nursing homes and residential care facilities from requiring a lab and/or collection station license to perform COVID-19 collections/testing on residents/staff/visitors.  Effective  immediately, nursing homes and residential care facilities may resume COVID-19 collections/testing on residents/staff/visitors.”

On the DHHS LTCF call on June 2, 2021 they announced:

  • CMS-regulated LTC facilities will continue to have all required testing reimbursed by the state through September 30th (or until CMS stops requiring testing, whichever happens first). 
  • DHHS officials confirmed during yesterday’s conference call that testing in facilities that have both an ALF and SNF under one roof will continue to be reimbursed through September 30th (or until CMS stops requiring testing). 
  • Reimbursement for surveillance testing for ALFs who opted-in earlier this spring will end on June 30th. If you have any questions about your final testing date or returning supplies, email ALFTesting@dhhs.nh.gov

Below is historical information. Information on this page may be useful but some NH DHHS guidance is no longer in force. For current guidance, please see Reopening, and visit the NH DHHS COVID-19 web page for Long Term Care Facilities.

Consent

Q: Are consent forms needed for surveillance testing?

A: Yes, if the facility does not have a medical director.

Q: If we have minors in our surveillance testing program do they need parental consent for testing?

A: Minors should use the facility’s internal consent form.

Surveillance testing programs

Q: How do we add new staff to our surveillance testing?

A:  Create a handwritten requisition and label, update the “line list” spreadsheet for the lab, and send it to the lab with notice that it is an updated list, copying either alftesting@dhhs.nh.gov or ltcftesting@dhhs.nh.gov

Q: What are the guidelines that determine when surveillance testing happens and how often?

A: NH’s Department of Public Health Services reopening guidance (note this is a historical document, this guidance no longer in effect as of 5/6/21) including screening recommendations and surveillance testing, has been developed to operate in phases, in accordance with CMS guidelines.

You can find links to CMS’s county positivity data (one measure that determines phases) on the NH Covid Alliance Senior Support Team public page.

Or, on the CMS website, see Nursing Home Data page by scrolling down to the COVID-19 section. Note that your phase is determined by county positivity rate, even if you are in a city that has its own data on the DHHS dashboardDHHS also issued a guide, Navigating Data Dashboards. Again, these data sources are in one place on the NH Covid Alliance Senior Support team main page.

Q: Should residents or staff who have been COVID positive be retested? What about fully vaccinated residents or staff?

A: For those who have had COVID: If they recovered within the last 90 days and are asymptomatic, they may be exempted from testing. See NH DHHS Bureau of Infectious Disease Control Reopening Guidance for Long-term Care Facilities (LCTFs) (note this is a historical document, this guidance no longer in effect as of 5/6/21) testing guidance.

See p. 13 of this CMS guidance. For information about why this is the case, see this CDC article.

For those who are at least 14 days beyond their second dose of a COVID-19 vaccine: they may be exempted from testing, see NH DHHS Bureau of Infectious Disease Control Reopening Guidance for Long-term Care Facilities (LCTFs) ( note this is a historical document, this guidance no longer in effect as of 5/6/21) testing guidance.

AND

Q: Do people who were COVID positive more than 90 days ago need to be retested?

A: Yes, if surveillance testing is required by CMS (see testing in the NH Bureau of Infectious Disease Control reopening guidance (note this is a historical document, this guidance no longer in effect as of 5/6/21). For information about why this is the case, see this CDC article.

Q: What is the surveillance testing program for assisted living facilities and how do we participate?

A: New Hampshire ALF surveillance testing for staff and residents started in August 2020 in Rockingham and Hillsborough counties. Starting Nov. 1, 2020, Strafford, Merrimack, and Cheshire counties will also be included. As of Dec., 2020, testing is available to all ALFs in NH. NOTE: Under testing in the NH Bureau of Infectious Disease Control reopening guidance (note this is a historical document, this guidance no longer in effect as of 5/6/21) updates March 1, 2021: “vaccinated staff and residents at ALFs (not governed by CMS) do not need to participate in CRSSSP.”

This is a separate surveillance testing program for stand-alone assisted living facilities. ALFs in the same building as nursing homes are covered by the LTCF surveillance testing program (see below).

Questions about this program can be directed to to ALFtesting@dhhs.nh.gov  or 603 271-7037 between 8 an 4:30.

Q: What is the surveillance testing program for long term care facilities and how do we participate?

A: NH DHHS has a surveillance testing program for long term care facilities’ staff and residents, including assisted living facilities in the same building as nursing homes. For stand alone ALFs, see above. Facilities should have received information about this program.

The program changed in October 2020; details are here. In December, 2020, DHHS released charts explaining the frequency of testing based on positivity rates. There are 3 different schedules for surveillance testing, based on under 5%, 5-10% or over 10% positivity rates.

Note that facilities in outbreak status must follow a different testing schedule, also explained in the DHHS charts.

Email covidtesting@dhhs.nh.gov and ltcftesting@dhhs.nh.gov or call 603-271-5980 with questions.

Q: Who pays for surveillance testing?

A: The state pays; when the program changed in October 2020, a new invoicing system was put in place. Details are here with December 2020 updates here and May 2021 here. Staff and residents will not be charged.

Test kits and types of testing

Q: Our surveillance test kits arrived and the box says refrigerate, but a sticker on the box says keep at room temperature. OR: check boxes on side of test kit indicate refrigerate, freeze, or room temperature and none are checked. Which is correct?

A: Some sample kits require vials be refrigerated prior to use and others do not. If you receive conflicting or incomplete information, contact the lab that manufactured the test kit.

Q: What are the different kinds of COVID-19 tests?

A: See the Texas Department of State Health Services handout, COVID-19 Testing: PCR, Antigen, and Antibody Tests Explained.

Staff training

Q: Where can I find training materials for staff for the surveillance testing program?

A: Email ltcftesting@dhhs.nh.gov to ask for a training powerpoint for staff that shows how to collect different kinds of specimens for testing, or take this link for the PDF version.

See also: Employee (staff) testing, Residents

This page updated 6/24/21

Information is changing rapidly as the COVID-19 outbreak evolves. Please take the links on these pages, especially the NH DHHS, which coordinates the COVID-19 response in our state, and other public health resources such as your local public health department, the CDC and WHO to find the latest guidance and recommendations.

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