Revised infection control and testing guidelines were released last week in a joint statement by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). As noted by the CDC, these updates have been made to reflect the high levels of COVID-19 vaccine- and infection-induced immunity, as well as the general availability of effective treatments and prevention tools.

The key changes outlined in the guidance for COVID-19 infection prevention and control update include:

• Vaccination status is no longer used to inform source control, screening testing, or post-exposure (eg, work restriction, quarantine) recommendations.
• Standalone guidance for nursing homes is being archived and any setting-specific recommendations have been added to Section 3 of the main guidance.
• When community transmission levels are high, source control is recommended for everyone in areas where they could encounter patients. Health care personnel could choose not to wear source control when in areas restricted from patient access.
• Testing changes include recommendations for a series of 3 tests for asymptomatic individuals following exposure to someone with COVID‐19 infection. Testing is generally not recommended for asymptomatic nursing home personnel who have not had a recognized exposure.
• No longer routinely recommending quarantine (for patients) or work restrictions (for healthcare personnel) for asymptomatic individuals following COVID‐19 exposures.

In addition, to help mitigate staffing shortages, updates advise that for the most part asymptomatic health care personnel with higher-risk exposures do not require work or return-to-work restrictions, regardless of their vaccination status.

These guidelines apply to nursing homes. Other long-term care settings that provide non-skilled personal care (such as assisted living or group homes) should follow guidance for high-risk congregate care settings. Visiting or shared health care personnel who enter a community to provide health care to one or more residents (eg, physical therapy, wound care, intravenous injections, or catheter care provided by home health agency nurses) should follow the health care infection control and prevention recommendations in the guidance.

Click here to download a tip sheet with the revised guidelines or read more about the CDC updated guidelines and CMS updates