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“Every single” nursing home will have the ability to have “point-of-care” testing.

By Tom Jeter, R.Ph.

Director of Clinical Services

The Center for Medicare & Medicaid Services Administrator, Seema Verma announced this week that “Every single nursing home across the country will be given ‘Point-Of-Care’ COVID-19 Tests by the federal government starting next week.”  The testing devices are described as “rapid on the spot, 20 tests per hour” devices. They will be given to 2,000 nursing homes initially with the goal to get them to every single one of the 15,400 nursing homes within this country.

The nursing homes will receive the devices in order ranked by Administrator Verma and her team, as determined by the rate of the virus’ spread in the surrounding community known as “hot spot” areas. The priority will also be on those nursing homes with three or more COVID-19 cases.

Verma noted during her announcement that the point-of-care tests will be used for both residents and workers in an effort to save thousands of lives. The current lag time of 4 to 7 days in current lab testing was creating tremendous potential for spread due to inability quickly identify and isolate those exposed by the virus. Dr. Giroir, Assistant Secretary of HHS stated in a report to NPR that because testing has ramped up so quickly, the unprecedented demand has increased wait times for results from laboratories.

President and CEO of American Health care association Mark Parkinson stated, “Regular testing of nursing home and assisted living staff is a vital step in controlling the spread of COVID-19 but is not effective without obtaining timely test results. For nursing homes and assisted living communities to protect residents and staff, we need on-site testing with reliable and rapid results.”

Each facility will receive to begin with 400 test and the ability to secure subsequent test for under $25 apiece. Production capacity for the test devices and associated supplies according to HHS will likely not be fully up and running until October. They also state that by September, the government hopes to have 15 million to 20 million tests available each month, backed in part with federal investment.

Two companies are selling and shipping the test devices. Quidel and BD. They will be setting up a special nursing home ordering portal that will allow operators to receive ordering priority.  Dr. Giroir stated, “We’ve asked them to establish a special concierge service for nursing homes so that you have a single-stop shopping, that you can call one number, make one e-mail, and really get the gold-plated service, because you are those who protect the most vulnerable.”

The assistant secretary acknowledged that the price point remains in flux, he explained that the Antigen tests are the most cost effective available on the market, contrasting them with the $100 to $150 cost of laboratory tests.

The Antigen point-of-care tests are different from the PCR (polymerase chain reaction) test used in laboratories. HHS has indicated that the Antigen test do have a higher risk (15%) of false negatives and the recommend that PCR tests should still be used to confirm negatives, advising nursing homes to treat negative Antigen results for residents with a suspected case as presumptive until a PCR test can back it up. Dr. Giroir while not guaranteeing 100% accuracy, did express serious confidence in the positives that the devices will generate stating, “If you get a positive, these are essentially 100% specific. If you have a positive it is positive: You can bet the farm on it. Never 100%, but literally they are operating at about 99-plus percent specificity. If you get a positive, it’s real.”

In addition to testing for COVID-19 the BD Veritor Plus System is able to test for Flu A+B, Group A Strep, and respiratory syncytial virus (RSV) as well.

Having this rapid testing in place in our centers will provide a finger on the pulse of exactly where we are from day to day with the status of the virus and how well we are doing in protecting our residents and staff. This truly is a game changer.

BD Veritor Plus SARS-CoV-2 Assay Video