Midsection of female doctor with swab test sample during COVID-19 crisis. Female medical professional is holding test tube in hospital. She is wearing protective suit.

Rapid-test supply shortages and slow lab turnaround times continue to dog nursing facility operators as they await delivery of a new batch of COVID-19 rapid tests promised by the federal government.

Although the Biden administration reportedly is shipping approximately 2.8 million rapid COVID-19 antigen tests each week to long-term care facilities, there have not been enough to go around. At least one third of LeadingAge members reported trouble accessing tests in a January survey, the news outlet Roll Call reported.

Reliance on PCR tests is not an ideal fallback, with laboratories running behind as they deal with increased demand due to high omicron case rates. As of Jan. 16, fully 25% of nursing homes were waiting three or more days for PCR test results, a jump from 12% in December, according to a Kaiser Health News analysis of CMS data. 

Feds respond with new rapid test shipment

Advocates have urged federal agencies to provide additional tests, and the Department of Health and Human Services is now doing so. HHS will ship five million Celltrion point-of-care tests to facilities nationwide over a period of five weeks, according to the American Health Care Association/National Center for Assisted Living.

These oral-pharyngeal tests will supplement the ongoing BinaxNow rapid test shipments. Allocations will be based on COVID-19 prevalence in the surrounding community, and facility staff and resident counts, AHCA/NCAL reported in a recent blog post

The Celltrion tests are professional kits, distinct from those provided for home use, according to a company representative who spoke and demonstrated a test Tuesday on a Centers for Medicare & Medicaid Services stakeholder call. (Stakeholder call transcripts are posted here).

But these new test shipments may not be enough to meet nursing home testing needs, AHCA/NCAL cautioned. The organization recommends that providers continue to request more testing supplies from state or local health departments and suppliers so that they are aware of demand.

CDC updates infection control, testing guidance

Amid test supply troubles, the nation’s high omicron caseload also means that long-term care providers nevertheless remain under the gun to keep up testing vigilance. Updated guidance released Tuesday by the Centers for Disease Control and Prevention covers new testing recommendations aimed at keeping the quick-spreading variant under control.

The rapid spread of omicron entails close monitoring of residents and staff — vaccinated or not — for any clinical changes, and viral testing remains key to stopping possible outbreaks, a health official reminded clinicians and facility operators in the Tuesday CMS stakeholder call.

A negative rapid test in someone with observable symptoms still should be confirmed with a nucleic acid amplification test (NAAT) such as a PCR test, said Kara Jacobs Slifka, M.D., MPH, division of healthcare quality promotion at the CDC.

The CDC updates also cover testing in newly-admitted residents and residents who have left the facility for more than 24 hours; asymptomatic residents with close contact with an infected person and healthcare personnel with higher-risk exposure.