WASHINGTON — Scrambling to check the spread of COVID-19 in nursing homes, the Trump administration announced Tuesday it will require facilities to test staff regularly or face fines.

The move comes months after the White House first urged governors to test all nursing home residents and staff. With residents, nursing homes are being required to offer them coronavirus tests if there is an outbreak or if any show symptoms.

Long-term care facilities represent less than 1% of the U.S. population, but they account for 42% of the COVID-19 deaths, with more than 70,000 fatalities reported by the COVID Tracking Project.

The plight of frail elders in nursing homes is politically sensitive for President Donald Trump, who is trying to maintain support from older voters amid disapproval of the government’s pandemic response. His administration is distributing fast-test machines to nursing homes, but there are continued reports that cases have been rising and facilities still face shortages of supplies like masks.

“Our recommendations for testing in nursing homes go back as far back as March and April,” said Seema Verma, head of the Centers for Medicare and Medicaid Services, or CMS. “What’s different about today is that this is now a requirement … we want to make sure every single nursing home is complying.”

Independent research indicates that the coronavirus most likely gets into nursing homes via staffers who unwittingly bring it in from surrounding communities where it has started to spread. Staffers who have yet to develop symptoms may have no clue that they’re infected.

Industry Supports Mandatory Testing if Facilities Are Given What They Need

Verma said the testing requirement for staff will be keyed to the level of virus activity in local areas. If the positive rate is below 5%, nursing homes will have to test staff once a month. If the rate is 5% – 10%, testing will be required once a week. If the rate is above 10%, staff will have to be tested twice a week. Florida, Iowa and Nevada are examples of states where the COVID-19 positive rate is now above 10%.

The government will provide $2.5 billion to help nursing homes with testing costs, Verma also announced. The administration’s campaign to distribute fast-test machines and an initial supply of tests is supposed to be done by the end of September.

The nursing home industry said it supports mandatory testing as long as facilities are given what they need to comply with requirements.

Mark Parkinson, head of the industry group American Health Care Association, said nursing homes in many parts of the country still can’t get timely results on COVID-19 tests.

CMS “must factor in the delays that continue to be a reality,” Parkinson said in a statement. “Otherwise facilities could face fines for circumstances beyond their control and be conducting tests that are so delayed that they have little clinical value.”