The NHSN LTCF COVID-19 Module will soon show changes across several items in the “Resident Impact and Facility Capacity” and “Staff and Personnel Impact” pathways. These changes are expected by the end of the month, and may show up as early as the end of this week.

Confirmed tests: The data element for “confirmed” tests will be changed to “positive” tests. The reason for this change is to more accurately capture testing practices, including the confirmation of antigen tests. “Positive tests” will be further broken down as follows: positive test, antigen test only; positive test, PCR test only; positive antigen test followed by negative PCR test; any other combination of testing involving at least one positive test result. Note that in order to be considered a confirmatory test, tests must be conducted within 48 hours of one another. A test that is conducted more than 48 hours after a prior test is considered a separate test and is not confirmatory of the prior test.

Reinfection: The data element for positive tests will further collect information on those tests that are considered to be a reinfection, meaning the individual has tested positive after previously recovering from COVID-19. This data element will be broken down into positive test results obtained from symptomatic individuals and positive test results obtained from asymptomatic individuals.

COVID-19 deaths: COVID-19 deaths will now be reported as a subcategory of overall deaths. The reason for this change is to address confusion in the way this data is currently collected. COVID-19 deaths should be equal to or less than total deaths. The number reported for COVID-19 deaths should not exceed the number reported for total deaths.Deaths and total deaths has been a common error identified since the beginning of NHSN reporting.

Non-COVID respiratory illness: CDC is adding data elements to collect information on non-COVID respiratory illness. This will include break-downs for respiratory illness diagnosed as influenza, those that are not flu, and co-infections of COVID-19 and flu.

Testing: Several data elements will be broken out to distinguish between point-of-care antigen testing and lab PCR testing. This includes the data element that asks about testing in the prior week, the data element that evaluates turn-around times for test results, and the data element about the ability to obtain supplies.

We expect training and resource documents to be available shortly after these changes take effect.