Instructions - LTCF Resident Impact and Facitlity Capacity

Long-term Care Facility Component

Instructions for Completion of the COVID-19 Long-term Care Facility (LTCF): Resident Impact and Facility Capacity Form (CDC 57.144)

Data Field	Instructions for Data Collection
NHSN Facility ID #	The NHSN-assigned facility ID will be auto-entered by the computer.
CMS Certification Number (CCN)-may be referred to as participation number	Auto-generated by the computer based on the CCN entered during NHSN registration or last updated, if previously edited. Please see NHSN CCN Guidance document for instructions on how to add a new CCN or edit an existing CCN.
Facility Name	Auto-generated by the computer based on the facility name previously entered during NHSN registration.
Date for which “resident impact and facility capacity” responses are reported	Required. Select the date on the calendar for which the responses are being reported in the NHSN LTCF COVID-19 Module.
Facility Type	Auto-generated based on the facility type selected during NHSN enrollment. Selections include: LTC-ASSIST – Assisted Living Residence LTC-DEVDIS – Long-term Care Facility for the developmentally Disabled LTC-SKILLNURS – Skilled Nursing Facility *+ *CMS Certified required for reporting +Includes both skilled nursing facilities and nursing homes Please see NHSN Guidance document for instructions on How to Correct Your Facility Type.
Date Created	Auto-generated based on the first calendar date and time that a user manually enters and saves data or the date the facility first submits a CSV file for a specific pathway. Note: The date and time will automatically generate after the “Save” button is selected and cannot be modified.

Important:

While daily reporting will provide the timeliest data to assist with COVID-19 emergency response efforts, retrospective reporting of prior day(s), unless otherwise specified, is encouraged if daily reporting is not feasible. At a minimum, facilities should report data at least once per week (every 7 days). For questions requiring counts, including Suspected, Confirmed, Total Deaths, and COVID-19 Deaths, only include new counts since the last date these counts were collected for reporting in the NHSN COVID-19 Module.

RESIDENT IMPACT

Note: Answers to the below questions are based on NEW counts for a reporting period. Specifically, reported counts in the NHSN COVID-19 Module must include only the new data collected since the last date these counts were collected for reporting in the Module.

Data Field	Instructions for Data Collection
ADMISSIONS: Residents admitted or readmitted from another facility who were previously diagnosed with COVID-19 and continue to require transmission-based precautions	Admissions is defined as residents admitted or readmitted from another facility who were previously diagnosed with COVID-19 and continue to require transmission-based isolation precautions due to the diagnosis. Recovered residents are excluded. Includes persons under investigation (for example, signs/symptoms and/or pending test results and require transmission-based precautions at admission) If this is the first time Admissions counts are being entered in the NHSN COVID-19 Module: Enter the number of residents newly admitted or readmitted to the LTCF who were previously diagnosed with COVID-19 from another facility this week (during the previous 7 days). For example, if your facility enters data once a week, every Friday, then counts must include new counts from the previous Friday through Thursday of the reporting week. If this is not the first time Admissions counts are being entered in the NHSN COVID-19 Module: Enter the number of residents newly admitted or readmitted to the LTCF who were previously diagnosed with COVID-19 from another facility since the last date Admissions counts were collected for entering in the NHSN COVID-19 Module. To submit Admissions counts prior to May 1, 2020 (OPTIONAL): Using the calendar feature, select any calendar date prior to May 1, 2020 (for example, enter counts on April 30, 2020) and enter the total number of residents admitted or readmitted to the LTCF who were previously diagnosed with COVID-19 from another facility between January 1, 2020 and April 30, 2020. If these data are not available at the time of data entry, leave blank and save the count data that were entered. Example: A LTCF has been reporting COVID-19 data to the NHSN Module since May. The NHSN user enters the COVID-19 data in the Module once a week on Thursdays, which includes new counts from the prior Thursday through Wednesday of each week. The Admissions count includes new admissions and readmissions of residents from another facility with a diagnosis of COVID-19 during the surveillance time period for each week. On Thursday 6/4, 2 new residents with a diagnosis of COVID-19 were admitted to the LTCF and one of the new residents died the following day on 6/5; Sunday 6/7, 5 residents were re-admitted to the LTCF from the hospital and even though the residents did not have a COVID-19 diagnosis and were asymptomatic, the LTCF placed the new residents on preemptive isolation for 14 days; Wednesday 6/10, 1 resident from an Assisted Living Facility with a diagnosis of COVID-19 was admitted to the LTCF. On Thursday 6/11, the LTCF user enters 3 for the Admissions count for the week in the NHSN COVID-19 Module. The 5 readmissions from the hospital on 6/7 were excluded from the Admissions count since they did not have a COVID-19 diagnosis. The resident who died was included in the count since all new admissions and readmissions must be included regardless of not being in the LTCF on the date of data entry in the NHSN COVID-19 Module. Notes: Include only residents who were newly admitted or readmitted since the last date these counts were collected for reporting in the Module; regardless if the resident(s) are physically in the LTCF at the time of data entry. Do not include new Admissions preemptively isolated for 14 days. Only those residents newly admitted or readmitted who were previously diagnosed with COVID-19.
CONFIRMED: Residents with new positive COVID-19 test results from a viral test (nucleic acid or antigen)	Confirmed is defined as a resident with a new positive COVID-19 test result from a viral test (nucleic acid or antigen). Examples include molecular testing, nucleic acid testing, and antigen testing. Positive results from antigen Point of Care test results are included. If this is the first time Confirmed COVID-19 counts for residents are being entered in the NHSN COVID-19 Module: Enter the number of residents who have been newly identified with a positive COVID-19 test result this week (during the previous 7 days). For example, if your facility enters data once a week, every Thursday, then counts must include new positive COVID-19 counts from the previous Thursday through Wednesday of the reporting week. If this is not the first time Confirmed COVID-19 counts for residents are being entered in the NHSN COVID-19 Module: Enter the number of residents who have been newly identified as having a positive COVID-19 test result (for example, a viral test indicating current infection) since the last date that Confirmed COVID-19 counts (positive COVID-19 test results) were collected for entering in the NHSN COVID-19 Module. This includes residents who remain in the LTCF or are no longer in the LTCF on the date of data entry in the Module. For example, Ms. L had a positive COVID-19 test result on 6/1 while in the LTCF and was later transferred to the hospital on 6/3. Ms. L should still be included in the LTCF Confirmed count for that week. To submit Confirmed counts for residents prior to May 1, 2020 (OPTIONAL): Using the calendar feature, select any calendar date prior to May 1, 2020 and enter the total number of residents with a positive COVID-19 test result between January 1, 2020 and April 30, 2020. Example: A facility enters COVID-19 data in NHSN every Friday and includes new counts from the prior Friday through Thursday of each week. On Sunday 6/14, Ms. Hill had a positive COVID-19 test result and was immediately transferred to the hospital; The COVID-19 test result for Ms. U, who was already included in the Suspected count during the previous week due to signs and symptoms suggestive of COVID-19, returned positive on Wednesday 6/17; Mr. Till had a positive COVID-19 test result on Thursday 6/18; There were no other positive COVID-19 test results from Friday 6/12 through Thursday 6/18. On Friday 6/19, the LTCF user entered 3 Confirmed COVID-19 counts for the week. Although Ms. U was included in the Suspected count during the previous week, she will also be included in the Confirmed count this week since she had a positive COVID-19 test result during the surveillance period for this week (6/12 – 6/18). Any newly Confirmed cases from Friday 6/19 through Thursday 6/25 will be included in the data entered in the NHSN COVID-19 Module during the following week on Friday 6/26. Notes: Point of Care testing instruments are considered as molecular testing instruments, which are appropriate for diagnosing current COVID-19 infection. Residents newly positive using this test method must be included in the Confirmed COVID-19 count for the reporting period. Do not include the resident more than once, even if multiple tests are done. CDC-NHSN recognizes positive results from viral (nucleic acid/molecular and antigen) tests appropriate for diagnosing active COVID-19 infection. Antibody test results are not considered appropriate for diagnosis of active COVID-19 infection and therefore positive results from antibody tests (often performed on blood samples) must be excluded from CONFIRMED COVID-19 counts. Each time counts are collected for reporting, only newly confirmed cases should be included in the count (specifically, count each confirmed resident only once during a reporting period). Include residents with new positive COVID-19 test results regardless if the resident(s) is still in the LTCF on the date of data entry. For example, the count should include resident(s) who remain in the facility, were transferred out of the facility, admitted to another facility, as well as those who died prior to or on the date of data entry in to the NHSN COVID-19 Module.
SUSPECTED: Residents with new suspected COVID-19	Suspected is defined as a resident who is being managed as though COVID-19 positive because of signs and/or symptoms suggestive of COVID-19 as described by CDC’s guidance but does not have a positive COVID-19 test result. Includes residents who have not been tested or those with pending test results. The count may also include residents with negative test results but who continue to show signs/symptoms suggestive of COVID-19 per CDC guidance. If this is the first time Suspected COVID-19 counts for residents are being entered in the NHSN COVID-19 Module: Enter the number of residents who have been or are newly managed as though they have COVID-19, but do not have a positive COVID-19 test result this week (during the previous 7 days). For example, if your facility enters data in the Module once a week on Wednesdays then counts must include residents with newly suspected COVID-19 from the previous Wednesday through Tuesday of the reporting week. If this is not the first time Suspected COVID-19 counts for residents are being entered in the NHSN COVID-19 Module: Enter the number of residents who have been or are newly managed as though they have COVID-19 (but do not have a positive COVID-19 test result) since the last date that Suspected COVID-19 counts were collected for entering in the NHSN COVID-19 Module. This includes residents who remain in the LTCF, as well as residents who were transferred out of the facility, admitted to another facility, or died on or before the date of data entry. To submit Suspected counts for residents prior to May 1, 2020 (OPTIONAL): Using the calendar feature, select any calendar date prior to May 1, 2020 and enter the total number of residents who were managed as though they had COVID-19 (but did not have a positive COVID-19 test result) between January 1, 2020 and April 30, 2020. If these data are not available at the time of data entry, leave blank and revise counts later.   Example: DHR Skilled Nursing facility uploads a weekly CSV file in NHSN with their COVID-19 data every Friday and includes new counts from the prior Friday through Thursday of the reporting week. Here are the surveillance results for this week (Friday 6/12-Thursday 6/18): On Saturday 6/13, Ms. Jo had a fever, verbalized that she could not smell anything and began coughing, so she was placed on COVID-19 isolation and a nasal swab was collected; On Sunday 6/14, Mr. Red had a high fever and complained of cough and shortness of breath, the nurse was unable to obtain a nasal swab on Mr. Red and he was placed on COVID-19 isolation; On Monday 6/15, Mr. Ki had a fever and was placed on COVID-19 isolation and a nasal swab collected; Tuesday 6/16, 5 asymptomatic residents were preemptively placed on COVID-19 isolation precautions since they were on the same pod as Mr. Red; No other residents exhibited new signs or symptoms of COVID-19 through Thursday 6/18, although, the LTCF still had 6 Suspected residents on COVID-19 isolation from the previous week (all 6 were included in the count during the previous week); On Friday 6/19, the nasal swab collected from Ms. Jo returned as positive for COVID-19 and the result from Mr. Ki returned negative for COVID-19. After a very busy week, on Friday 6/19, the LTCF user entered a total of 3 newly Suspected COVID-19 counts for the week (Ms. Jo, Mr. Red, Mr. Ki). Since Ms. Jo subsequently had a positive COVID-19 test result on 6/19, which is outside of this reporting week, she will be counted in the Confirmed count for the following week but will NOT be removed from the Suspected count for this week. The 5 asymptomatic residents who were preemptively placed on COVID-19 isolation on 6/16, due to possible exposure, were not included in the count since they did not meet the definition of Suspected COVID-19 (missing signs/symptoms). Since only newly Suspected residents are included each week, the remaining 6 Suspected residents from the previous week were not included in the count for this week. Notes: Each newly suspected COVID-19 resident should only be counted once during a reporting period since the goal of this count is to collect incidence (new cases). Include residents with newly suspected COVID-19 regardless if the resident remains in the LTCF. For example, the count should include Suspected resident(s) who remain in the facility, were transferred out of the facility, admitted to another facility, as well as those who died on or before the date of data entry in the NHSN COVID-19 Module.
TOTAL DEATHS: Residents who have died for any reason in the facility or another location	Total Deaths is defined as residents who have died from any cause in the facility or another location. This count includes new COVID-19 related deaths AND non-COVID-19 related deaths. Includes residents who died in another location, such as a hospital. If this is the first time Total Death count for residents is being entered in the NHSN COVID-19 Module: Enter the total number of residents who have died for any reason in the LTCF or another location this week (during the previous 7 days). For example, if your facility enters data in the Module once a week on Tuesdays then counts must include residents who died for any reason from the previous Tuesday through Monday of the reporting week. If this is not the first time the Total Death count is being entered in the NHSN COVID-19 Module: Enter the number of residents who died for any reason (including COVID-19 deaths) in the LTCF or another location since the last date the Total Deaths counts were collected for data entry in the NHSN COVID-19 Module. To submit Total Deaths counts for residents prior to May 1, 2020 (OPTIONAL): Using the calendar feature, select any calendar date prior to May 1, 2020 and enter the total number of deaths for residents who died for any reason (including COVID-19) in the LTCF or another location between January 1, 2020 and April 30, 2020. If these data are not available at the time of data entry, leave blank and revise counts later.   Example: A facility enters COVID-19 data in NHSN twice per week, on Tuesdays and Fridays. The Tuesday count includes new counts from the prior Friday through Monday, with data being entered in Module on Tuesday. The Friday counts include new counts from Tuesday through Thursday of each week with these data being entered on Friday. Here are the surveillance results for this week (Friday 6/5 -Thursday 6/11): On Friday 6/5, the facility had 2 deaths related to COVID-19 (Mr. R and Mr. P); Monday 6/8, 1 non-COVID-19 resident died from cancer (Mr. G). On Tuesday 6/9, the LTCF user enters 3 for the Total Deaths count in the NHSN COVID-19 Module (for counts collected from Friday 6/5 through Monday 6/8). After entering data in the NHSN COVID-19 Module on Tuesday, the user knows the counts for the remainder of the week must include new counts only. They will not include the counts already entered in the Module on Tuesday 6/9. On Tuesday 6/9, 1 resident on COVID-19 isolation died sometime during the night; The next day, on Wednesday 6/10, another resident not on COVID-19 isolation died; No other deaths occurred during the reporting week (Thursday 6/11). On Friday 6/12, the LTCF user enters 2 for the Total Deaths count in the NHSN Module, which includes the new deaths since the last time Total Deaths counts were collected for entering in the Module. This means, for the reporting week of 6/5 - 6/11, the LTCF reported a total of 5 new Total Deaths. Notes: Each resident death should be included only once. Important: The Total Deaths count should NEVER be lower than the COVID-19 Deaths count in a reporting week.
COVID-19 DEATHS: Residents with a suspected or positive COVID-19 test result who died in the facility or another location	COVID-19 Deaths is defined as a resident with suspected or a positive COVID-19 test result who died in the facility or another location as a result of COVID-19 related complications. If this is the first time COVID-19 Death counts for residents are being entered in the NHSN COVID-19 Module: Enter the number of deaths for residents with suspected AND confirmed COVID-19 (positive COVID-19 test result) this week (during the previous 7 days). For example, if your facility enters data once a week, every Monday, then counts must include new COVID-19 Deaths from the previous Monday through Sunday of the reporting week. This count includes residents who died in the LTCF or another location. If this is not the first time the COVID-19 Death counts for residents are being entered in the NHSN COVID-19 Module: Enter the number of new deaths for residents with suspected AND confirmed COVID-19 (positive COVID-19 test result) since the last date COVID-19 Death counts were collected for data entry in the NHSN COVID-19 Module. This includes residents who died in the LTCF or another location. Note: Include only new deaths since the last time these counts were collected for data entry into the Module. To submit COVID-19 Death counts for residents prior to May 1, 2020 (OPTIONAL): Using the calendar feature, select any calendar date prior to May 1, 2020 and enter the total number of deaths for residents with suspected AND confirmed COVID-19 (positive COVID-19 test result) between January 1, 2020 and April 30, 2020. This includes residents that died in the LTCF or another location. If these data are not available at the time of data entry, leave blank and revise counts later.   Example: CDR Skilled Nursing facility submits weekly CSV files every Friday for COVID-19 data collected from the prior Friday through the Thursday of the reporting week. This week (6/5 – 6/11), the following deaths occurred among residents: Friday 6/5, 2 residents die from COVID-19 related complications; Sunday 6/7, 1 non-COVID-19 resident dies of a heart attack; Monday 6/8, Ms. Jay, who is a suspected COVID-19 resident is transferred to the local hospital where she later dies on Tuesday 6/9; Tuesday 6/9, Ms. W, who had COVID-19 two months ago, but fully recovered died from heart related complications; Thursday 6/11, 1 resident with suspected COVID-19 dies from respiratory failure. On Friday 6/12, the LTCF includes a total of 4 COVID-19 Deaths and 6 Total Deaths in their CSV file for the weekly upload; knowing that COVID-19 related resident deaths that occur outside the LTCF must be included in COVID-19 Death count for the reporting week. Additionally, deaths among Confirmed and Suspected residents must be included in the COVID-19 Death count. Ms. W was included in the Total Death count, but not the COVID-19 Death count since she fully recovered from COVID-19 prior to her death. Notes: If a resident without known or suspected COVID-19 dies and the facility later finds out the resident was positive for COVID-19 (for example, COVID-19 found in autopsy result), the LTCF must updated the previously reported data by clicking on the original calendar date the Total Deaths was reported and add the count to the COVID-19 Deaths count. This means, on the day of death, the resident must be counted in both the Total Deaths and COVID-19 Deaths counts. Suspected is defined as a resident who is being managed as though he/she has COVID-19 because of signs and symptoms suggestive of COVID-19 as described by CDC’s guidance but does not have a positive COVID-19 test result. This may include residents who have not been tested or those with pending test results. The count may also include residents with negative test results but whom continue to show signs/symptoms suggestive of COVID-19. If a resident previously had Confirmed (positive COVID-19 test result) or Suspected COVID-19 but recovered and is no longer being treated as having COVID-19 (for example, resolved signs/symptoms and removed from isolation) at the time COVID-19 death counts are being collected, do not include the resident in COVID-19 death count. Instead, include the resident in the Total Deaths count. Important: The COVID-19 Deaths count should not be higher than the Total Deaths count in a reporting period.

FACILITY CAPACITY AND SARS-CoV-2 TESTING

Note: Answers to the below questions are based on the calendar date in which the questions are being answered in the NHSN COVID-19 Module.

Data Field	Instructions for Data Collection
ALL BEDS: (FIRST SURVEY ONLY)	Enter the total number of resident beds in the facility. Notes: Include the number of beds the facility in which the facility is licensed, which may include a combination of private and non-private pay beds. After the first time All Beds for a facility is entered, the count will auto-populate for future sessions. If the licensed resident bed count changes, the user may update the count.
CURRENT CENSUS: Total number of beds that are currently occupied.	On the date responses are being reported, enter the total number of residents that are occupying a bed in the facility. Current Census may include a combination of private pay and non-private pay occupied beds. Note: The count must include total residents occupying a bed in the reporting facility, including non-licensed beds (for example, additional beds had to be brought in to handle increased capacity of residents or residents are being moved to other parts of the facility that are not normally included in the LTCF bed count).
RESIDENTS
TESTING: Does the LTCF have the ability to perform or to obtain resources for performing COVID-19 viral testing (nucleic acid or antigen) on all current residents within the next 7 days, if needed?	Answer “YES” if on the date responses are being reported, the LTCF Can either perform COVID-19 viral testing (molecular/nucleic acid or antigen) on all residents in the facility within the next 7 days, if there was a need to do so OR Is able to obtain resources needed from outside sources, such as laboratories, outbreak response team, health department, etc. to perform COVID-19 viral testing (molecular/nucleic acid or antigen) on all residents in the facility within the next 7 days, if there was a need to do so. Otherwise, select, “NO” and select one or more reasons from the list. Check all that apply: Lack of recommended personal protective equipment (PPE) for personnel to wear during specimen collection Lack of supplies for specimen collection Lack of access to a laboratory for submitting specimens Lack of access to trained personnel to perform testing (includes internal and external resources) Uncertainty about testing reimbursement Other: Specify: __________________________________ Notes: Responses to this question are important to improve understanding of the barriers to mass testing. If “Other” is selected, please manually document the reason(s) COVID-19 viral testing cannot be performed on all residents in the next 7 days if there was a need (for example, an outbreak). When considering lack of access to trained personnel to perform testing to perform testing, include internal resources, such as staff and facility personnel, as well as external resources, such as personnel from laboratories, public health department, emergency response teams or other outside resources. Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for COVID-19 can be found on the following web-link: https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html
TESTING: During the past two weeks, on average how long did it take your LTCF to receive COVID-19 viral (nucleic acid or antigen) test results of residents?	On the date responses are being reported, select one of the responses below to answer the following question: During the past two weeks, on average how long did it take your LTCF to receive COVID-19 viral (nucleic acid or antigen) test results of residents? Check ONE: Less than one day 1-2 days 3-7 days More than 7 days No resident testing performed in the last two weeks Note: Responses to this question are important for informing timeliness of test results. For example, are test results received in a manner that would allow effective response, if needed?
TESTING: Since the last date of data entry in the Module, has your LTCF performed COVID-19 viral testing on residents?	Answer “YES” if on the date responses are being reported, your LTCF has performed COVID-19 testing on one or more residents in your facility. Otherwise, select “NO” Conditional: If “YES” is selected, select one or more reasons from the list to indicate the reason(s) COVID-19 viral (nucleic acid or antigen) testing was performed on one or more residents Check all that apply: Testing residents with new signs/symptoms consistent with COVID-19 Testing asymptomatic residents on a unit/section of the facility in response to a new case with COVID-19 Testing asymptomatic residents, facility-wide in response to a new case with COVID-19 Testing asymptomatic residents without a known exposure to COVID-19 as part of surveillance None of the above: testing of another subgroup of residents occurred
STAFF AND PERSONNEL Includes anyone working or volunteering in the facility, such as contractors, temporary staff, resident care givers, shared staff, etc.
TESTING Does the LTCF have the ability to perform or to obtain resources for performing COVID-19 viral testing (nucleic acid or antigen) on all staff and/or facility personnel within the next 7 days, if needed?	Answer “YES” if on the date responses are being reported, the LTCF Can either perform COVID-19 viral testing (molecular/nucleic acid or antigen) on all staff and/or facility personnel in the facility within the next 7 days, if there was a need to do so OR Is able to obtain resources needed from outside sources, such as laboratories, outbreak response team, health department, etc. to perform COVID-19 viral testing (molecular/nucleic acid or antigen) on all staff and/or facility personnel in the facility within the next 7 days, if there was a need to do so. Otherwise, select, “NO” and select one or more reasons from the list: Check all that apply Lack of recommended personal protective equipment (PPE) for personnel to wear during specimen collection Lack of supplies for specimen collection Lack of access to a laboratory for submitting specimens Lack of access to trained personnel to perform testing (includes internal and external resources) Uncertainty about testing reimbursement Other: Specify: __________________________________ Notes: Responses to this question are important to improve understanding of the barriers to mass testing. If “Other” is selected, manually document the reason(s) COVID-19 viral testing cannot be performed on all residents in the next 7 days if there was a need (for example, an outbreak). When considering lack of access to trained personnel to perform testing to perform testing, include internal resources, such as staff and facility personnel, as well as external resources, such as personnel from laboratories, public health department, emergency response teams or other outside resources. Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens for COVID-19 can be found on the following web-link: https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html
TESTING: On average how long did it take your LTCF to receive COVID-19 viral (nucleic acid or antigen) test results of staff and/or facility personnel?	On the date responses are being reported, select one of the responses below to answer the following question: On average how long does it take your LTCF to receive COVID-19 viral (nucleic acid or antigen) test results of staff and/or facility personnel? Check ONE Less than one day 1-2 days 3-7 days More than 7 days Note: Responses to this question are important for informing timeliness of test results. For example, are test results received in a manner that would allow effective response, if needed?
TESTING: Since the last date of data entry in the Module, has your LTCF performed COVID-19 viral testing on staff and/or facility personnel?	Select “YES” if on the date responses are being reported, your LTCF has performed COVID-19 viral testing on one or more staff and/or facility personnel? Otherwise, select “NO” Conditional: If “YES” is selected, select one or more reasons from the list to indicate the reason(s) COVID-19 viral (nucleic acid or antigen) testing was performed on one or more staff and/or facility Check all that apply: Testing staff and/or facility personnel with new signs/symptoms consistent with COVID-19 Testing asymptomatic staff and/or facility personnel on a unit/section of the facility in response to a new case with COVID-19 Testing asymptomatic staff and/or facility personnel facility-wide in response to a new case with COVID-19 Testing asymptomatic staff and/or facility personnel without a known exposure to COVID-19 as part of surveillance None of the above: testing of another subgroup of staff and/or facility personnel occurred
IN-HOUSE, POINT-OF-CARE COVID-19 TESTING
Does the LTCF have an in-house point-of-care test machine (capability to perform COVID-19 testing within your facility)?	Select “YES” if on the date responses are being reported, your LTCF has at least one point-of-care testing machine available in the LTCF for COVID-19 viral testing. If “Yes” provide responses to the next 3 questions. Otherwise, select “NO” and skip the remainder of the questions below. Note: In-house is defined as available for use within your LTCF
**Since the last date of data entry in the Module, how many COVID-19 point-of-care tests has the LTCF performed on residents?	Conditional: If “YES” is selected, since the last date of data entry in to the NHSN COVID-19 Module, how many COVID-19 in-house point-of-care tests has the LTCF performed on residents using the in-house point-of-care test machine(s), regardless of the test results obtained? Notes: Only include the total number of in-house point-of-care COVID-19 tests performed on residents using the point-of-care test machine since the last time this count was reported in the Module, regardless of the test results obtained. If this is the first time reporting these counts to the NHSN COVID-19 Module, enter the total number of in-house point-of-care COVID-19 tests that have been performed on residents using the point-of-care test machine(s), regardless of the test results obtained.
**Since the last date of data entry in the Module, how many COVID-19 point-of-care tests has the LTCF performed on staff and/or facility personnel?	Conditional: If “YES” is selected, since the last date of data entry in to the NHSN COVID-19 Module, how many COVID-19 in-house point-of-care tests has the LTCF performed on staff and/or facility personnel using the in-house point-of-care test machine(s), regardless of the test results obtained? Notes: Only include the total number of in-house point-of-care tests performed on staff and/or facility personnel using the point-of-care test machine(s) since the last time this count was reported in the Module, regardless of the test results obtained. If this is the first time reporting these counts to the NHSN COVID-19 Module, enter the total number of in-house point-of-care COVID-19 tests that have been performed on staff and/or facility personnel using the in-house point-of-care test machine(s) regardless of test results obtained.
**Based on this week’s inventory, do you have enough supplies to test all staff and/or facility personnel for COVID-19 using the point-of-care test machine?	Conditional: If “YES” is selected above, select “YES” if your LTCF has enough in-house point-of-care supplies to test all staff and/or facility personnel for COVID-19. Otherwise, select “NO”

Last Modified August 2020 3