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Long-term care residents and staff with symptoms or signs of COVID-19 must be tested immediately — regardless of vaccination status — under updated testing requirements for facilities by the Centers for Medicare & Medicaid Services. 

The memo, which was revised Thursday, also calls for residents and staff to be tested if they had close contact or exposure to someone in the facility that has tested positive for the disease. Group testing also should occur, regardless of vaccination status, if the positive case can’t identify close contacts.

The guidance also suggests that routine testing of staff, who are not up-to-date on their vaccinations, should be based on the extent of the virus in the community. “Up-to-date” means a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible, CMS stated. 

If there are low levels of transmission (less than 5%) in the community, then no routine testing is recommended; if there’s moderate transmission (between 5 and 7.99%), testing should be done once a week; and if there’s high community transmission (greater than 10% spread), testing should be conducted twice a week for those staff. 

“Staff, who are up-to-date, do not have to be routinely tested,” according to the memo.