Updated federal rules loosen many rural nursing homes' requirements for employee coronavirus testing

Updated federal rules mean many rural nursing homes won't have to test their employees for the coronavirus as often. That could be problematic because the pandemic is increasingly shifting to rural areas.

On Tuesday the Centers for Medicare and Medicaid Services changed some definitions of its color-coded county ranking system, which determines how often nursing homes must test employees, Alex Spanko reports for Skilled Nursing News. The "stoplight" system bases testing requirements on a county's percentage of residents testing positve for the virus, among other factors. Those with less than 5 percent positivity are green, between 5% and 9% is yellow, and 10% and above is red. 

The new rules loosen testing thresholds. "Counties with 20 or fewer tests over 14 days will now move to ‘green’ in the color-coded system,” CMS said in a press release. "Counties with both fewer than 500 tests and fewer than 2,000 tests per 100,000 residents, and greater than 10 percent positivity over 14 days — which would have been ‘red’ under the previous methodology — will move to 'yellow'."

"The difference between a 'red' county and a 'yellow' county is substantial: Under new rules announced at the end of August, providers in 'red' counties must test their staffers twice weekly, as compared to weekly for 'yellow' areas and once per month in the lowest-level 'green' counties," Spanko reports.

CMS made the change after governors of rural states complained that some rural counties seemed to have relatively high positivity rates because of low testing numbers. That meant nursing homes had to conduct staff testing "at a higher frequency than necessary," according to the CMS press release.