COVID-19 test bottle marked 'positive' next to sealed nasal swab

About 20 to 25% of skilled nursing facilities have received false positive results from their COVID-19 point-of-care antigen testing devices, a joint survey conducted by the American Health Care Association and LeadingAge revealed.

Providers said those false positive results were later found to be incorrect after using polymerase chain reaction (PCR) testing. A vast majority of SNFs also reported that they only had one to three “potential false positives,” while just 3% have experienced more than five potential false positive results. 

“While any potential false positive results are concerning, this appears to be consistent with what you would expect to see with widespread testing of many people in communities with relative low rates of COVID-19,” the organizations wrote in a blog post Thursday.

The groups collaborated on the survey to understand the use of the Becton Dickson Veritor and Quidel Sofia-2 point-of-care antigen systems among SNFs — which were sent to all nursing homes by the federal government to aid their testing efforts. It comes after reports that some antigen testing equipment was producing false positive results for some providers.

Both BD and Quidel are conducting investigations to ensure the quality of their equipment and preliminary results haven’t revealed any abnormalities, according to the groups. 

“It’s important for all providers to double check they are following the manufacturer’s protocols and have staff appropriately trained on the use of each analyzer,” they wrote. 

AHCA and LeadingAge encouraged providers to continue using the point-of-care testing systems, and reach out to BD Veritor or Quidel to report any potential false positives. They also encouraged providers to follow federal guidance on when to conduct confirmation testing with PCRs after receiving positive antigen results. 

“Most important, the potential false positive reports emphasize the need for communication from HHS on how to handle these cases, which will happen even with PCR testing,” AHCA and LeadingAge wrote.

“We are working aggressively with HHS to get written information out to address what to do in the case of potential false positives, whether from antigen or PCR tests. This includes recommendations for cohorting and isolation; reporting to the state and to the NHSN; not treating a potential false positive as an outbreak; implications for Provider Relief Fund performance incentive payments,” they added. 

Experts earlier this year stated that one of the benefits of antigen tests is the reliability of a positive result. It was thought that those who tested positive for COVID-19 with the point-of-care tests truly are, while those who test negative may want to double-check the results with the established polymerase chain reaction tests. The study’s findings seem to contradict this earlier notion.