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COVID-19 Long-Term Care Resources
Topic Collection
November 14, 2023

Topic Collection: COVID-19 Long-Term Care Resources

This Topic Collection focuses on plans, tools, templates, and other immediately implementable resources to help with COVID-19 preparedness, response, recovery, and mitigation efforts, focusing on long-term care.

This Resource Collection was reviewed in Fall 2023. Please refer to CDC’s Coronavirus Disease 2019 webpage for the most up-to-date clinical guidance on COVID-19 outbreak management.

If you have COVID-19 best or promising practices, plans, tools, or templates to share with your peers, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant topic area. Resources specific to long-term care can be placed under the COVID-19 Long Term Care Resources Topic.

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General Resources

Agency for Healthcare Research and Quality. (2021). COVID-19 Resources Catalog for Nursing Homes. (Added 10/7/2021) U.S. Department of Health and Human Services.
This searchable database includes COVID-19 nursing home safety and quality improvement resources.
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American Health Care Association, National Center for Assisted Living, and National Hospice and Palliative Care Organization. (2020). Guidance on the Role of Hospice Services in LTC Facilities During COVID-19 Pandemic.
This joint document from associations representing the long-term care (LTC) and hospice communities provides guidance on the risk-benefit analysis between implementing strong infection prevention measures and the best interests of LTC residents.
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ASPR TRACIE. (2023). Outbreak Considerations for Long-Term Care Communities.
ASPR TRACIE created this resource in 2020 and revised it in 2023 to be relevant to other infectious disease outbreaks in addition to COVID-19. Long-term care communities can incorporate these considerations into infectious disease planning and response. This version includes a new section with links to resources on lessons learned from the COVID-19 pandemic.
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Coronavirus Commission on Safety and Quality in Nursing Homes. (2020). Coronavirus Commission on Safety and Quality in Nursing Homes Commission Final Report: September 2020.. (Added 12/15/2020.) Mitre Corporation.
This document shares lessons learned and recommendations for mitigation, infection control and responsive delivery of care to residents of nursing homes.
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The John A. Hartford Foundation. (2021). COVID-19 Resources for Nursing Homes and Long-Term Care. (Added 6/23/2020.)
This page includes links to governmental and private sector COVID-19 resources for residents and staff of nursing homes and long-term care facilities. Resources include guidance documents, webinar and event recordings, news articles, advocacy information, and links to other organizations. Also included is sign-up information for the daily 20-minute National Nursing Home Huddle.
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Education and Training

Centers for Disease Control and Prevention. (2022). Project Firstline: CDC’s National Training Collaborative for Healthcare Infection Prevention and Control. (Added 1/11/2021.) U.S. Department of Health and Human Services.
This is the homepage for CDC’s collaborative training program for healthcare workers, addressing infection prevention and infection control.
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Centers for Medicare & Medicaid Services. (2020). Targeted COVID-19 Training for Nursing Homes Instruction. (Registration required.) (Added 9/8/2020.) U.S. Department of Health and Human Services.
This page provides instructions to sign up for scenario-based training from the Centers for Medicare & Medicaid Services for frontline nursing home staff and management. The five module training course for frontline clinical staff and ten module course for nursing home management are based on COVID-19 lessons learned and findings from the federal COVID-19 nursing home task force strike teams.
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Infection Prevention

Centers for Disease Control and Prevention. (2022). Infection Control Guidance. U.S. Department of Health and Human Services.
This updated page recommends infection prevention and control (IPC) practices during the COVID-19 pandemic, and particular IPC practices when caring for a patient with suspected or confirmed SARS-CoV-2 infection.
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* Centers for Disease Control and Prevention. (2022). Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating. (Added 1/11/2021.) U.S. Department of Health and Human Services.
This page lists practices to be followed in nursing homes, when both SARS-CoV-2 and Influenza viruses are circulating in the community. Practices may also be adapted to long term care facilities, as appropriate.
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Los Angeles County Department of Public Health. (2023). Coronavirus Disease 2019 Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities. (Added 6/12/2020.)
This web page identifies actions that LTCs should take to ensure their staff is ready to mitigate the spread of COVID-19. It includes planning considerations for infection prevention and control; identification, isolation, and care for COVID-19 patients; and links to additional resources.
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* North Carolina Department of Health and Human Services. (2022). COVID-19 Outbreak Toolkit for Long-Term Care Settings. (Added 4/28/2020.)
This toolkit contains several resources to assist long-term care facilities respond to COVID-19. Resources include: Long-Term Care Infection Prevention Assessment Tool, Infection Prevention Staffing Worksheet, links to infection prevention education resources, strategies to optimize facemasks and gowns, and What to Expect: Response to New COVID-19 Cases or Outbreaks in Long Term Care Settings.
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San Francisco Department of Public Health. (2023). COVID-19 Guidance for High Risk Settings.
This document provides guidance to long term care facilities on measures to implement immediately and additional steps to be taken if COVID-19 infection is confirmed in a facility.
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Plans, Tools, and Templates

Agency for Healthcare Research and Quality. (2021). Invest in Trust: A Guide for Building COVID-19 Vaccine Trust and Increasing Vaccination Rates Among CNAs. (Added 10/7/2021) U.S. Department of Health and Human Services.
This guide is intended to help nursing home administrators build trust in vaccines among their certified nursing assistants and overcome barriers to vaccination.
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California Association of Health Facilities. (n.d.). Surge Strategies for SNFs (Space/Staff/Stuff). (Accessed 10/17/2023.)
This three-page color-coded table provides an overview of surge strategies that skilled nursing facilities may implement to address limitations in space, staffing, and supplies and equipment.
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California Department of Public Health (CDPH) and the California Association of Health Facilities (CAHF). (2017). NHICS: Nursing Home Incident Command System. American Health Care Association.
This webpage includes information on the nursing home incident command system (NHICS), which can be used by facilities regardless of size or resident care capabilities, and is intended to assist with their emergency planning and response efforts for all hazards. Links to the NHICS guidebook, forms, response guides, Job Action Sheets (JAS), and training are included.
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Centers for Medicare & Medicaid Services. (2022). Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes. (Added 5/14/2020.) U.S. Department of Health and Human Services.
This toolkit is a compendium of innovative actions that states implemented to protect nursing home residents during the COVID-19 pandemic.
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Centers for Medicare & Medicaid Services. (2023). COVID-19 Nursing Home Data. U.S. Department of Health and Human Services.
This resource page displays data reporting by certified Medicare skilled nursing facilities and Medicaid nursing facilities. Users may view individual facility data as well as view maps of total resident cases and deaths by state and resident cases and deaths per 1,000 residents by state.
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* Centers for Medicare and Medicaid Services. (2020). Medicare Payment for COVID-19 Viral Testing: Skilled Nursing Facility/Nursing Facility. U.S. Department of Health and Human Services.
This document contains an algorithm and supplementary pages about how testing for COVID-19 is paid for in US nursing facilities.
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Healthcare Resilience Task Force. (2020). Nursing Home Concepts of Operations for Infection Prevention and Control.
This Concept of Operations document provides an overview of recommendations and resources for nursing homes that can help reduce the impact of COVID-19 on residents and staff.
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Minnesota Department of Health. (2022). COVID-19 Source Control (Masking), PPE, and Testing Grid. (Added 6/4/2020.)
This webpage indicates the types of personal protective equipment that should be worn, and testing undergone by residents, visitors, and various staffing roles in long term care facilities under contingency standards of care for COVID-19.
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Minnesota Department of Health. (2022). Long-Term Care: COVID-19. (Added 6/4/2020.)
This comprehensive toolkit provides information for long-term care facilities to respond to COVID-19.
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Minnesota Department of Health. (2023). Long-Term Care (LTC) Emergency Preparedness. (Added 9/4/2020.)
This resource page for LTC owners, administrators, and staff and their emergency preparedness partners includes downloadable Word templates to create contingency staffing and testing plans for LTCs. Also included are webinar recordings describing how to use each of the plan templates and guidance on effectively developing a testing plan using the template. While developed for the COVID-19 pandemic, these resources may be used for other epidemics that stress staffing and testing resources.
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New Jersey Hospital Association (2010). Planning Today for a Pandemic Tomorrow: A Tool for Nursing Facilities.
This tool is intended to assist nursing facilities in developing their pandemic preparedness and response plans. It consists of several modules, which are to be used as a guide to facilitate discussion and to ensure that key points related to a specific topic, such as human resources, are identified and addressed in the planning process. It also includes sample policies and procedures and a module on ethics/values.
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New Jersey Hospital Association. (2020). COVID-19 Updated Toolkit of Resources for Long Term Care Facilities. (Added 5/22/2020.)
This toolkit collects various resources to support New Jersey's long term care facilities responding to COVID-19. It contains state level guidance, checklists, a hospital discharge tool, guidance on discontinuation of transmission-based precautions, donning and doffing resources, information on the state's long term care capacity portal, copies of state executive orders, and links to a competency checklist and additional educational information.
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North Carolina Area Health Education Centers Program. (2020). COVID-19 Preparedness Checklist: Planning Considerations for Acute Care and Long-Term Care Populations. (Added 5/22/2020.)
This checklist for acute and long term care facility administrators offers guidelines for evaluating capacity and capabilities and applying structures to maximize them in preparation for increased patient volumes.
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* North Carolina Department of Health and Human Services. (2022). COVID-19 Outbreak Toolkit for Long-Term Care Settings. (Added 4/28/2020.)
This toolkit contains several resources to assist long-term care facilities respond to COVID-19. Resources include: Long-Term Care Infection Prevention Assessment Tool, Infection Prevention Staffing Worksheet, links to infection prevention education resources, strategies to optimize facemasks and gowns, and What to Expect: Response to New COVID-19 Cases or Outbreaks in Long Term Care Settings.
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Peter Lamy Center on Drug Therapy and Aging. (2020). Optimizing Medication Management during the COVID-19 Pandemic: Implementation Guide for Post-Acute and Long-Term Care. (Registration required.) (Added 5/1/2020.) University of Maryland School of Pharmacy.
This guide provides recommendations on reducing unnecessary medications, simplifying medication management, and reducing opportunities for transmission of COVID-19 between residents and staff of post-acute and long-term care facilities.
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Testing

Centers for Disease Control and Prevention. (2022). COVID-19 Specimen Collection. U.S. Department of Health and Human Services.
These updated guidelines detail processing and handling of clinical specimens for COVID-19 by specimen type and priority, and address storage and shipping.
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Centers for Disease Control and Prevention. (2022). Point-of-Care & Rapid Testing. U.S. Department of Health and Human Services.
This updated page offers guidance about the regulatory requirements for Point-of-Care (POC) testing, specimen collection & handling, help with performing POC tests, reporting requirements and frequently asked questions about POC Testing.
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* Centers for Disease Control and Prevention. (2022). Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating. (Added 1/11/2021.) U.S. Department of Health and Human Services.
This page lists practices to be followed in nursing homes, when both SARS-CoV-2 and Influenza viruses are circulating in the community. Practices may also be adapted to long term care facilities, as appropriate.
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* Centers for Medicare and Medicaid Services. (2020). Medicare Payment for COVID-19 Viral Testing: Skilled Nursing Facility/Nursing Facility. U.S. Department of Health and Human Services.
This document contains an algorithm and supplementary pages about how testing for COVID-19 is paid for in US nursing facilities.
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Sanchez, G., Biedron, C., Fink, L., et al. (2020). Initial and Repeated Point Prevalence Surveys to Inform SARS-CoV-2 Infection Prevention in 26 Skilled Nursing Facilities - Detroit, Michigan, March-May 2020. Morbidity and Mortality Weekly Report. 69(27):882-886.
The authors describe facility-wide point prevalence testing for SARS-CoV-2 at 26 skilled nursing facilities in Detroit. Overall, 55% of those with symptom data available were symptomatic at the time of their first positive test. The authors suggest that symptom-based screening is inadequate to detect infection in skilled nursing facilities and repeated point prevalence surveys can improve identification of asymptomatic cases, implementation of infection prevention practices, and prioritization of resources.
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Transfer/Discharge

Los Angeles County Department of Public Health. (2020). Interfacility Transfer and Home Discharge Rules.
This web page summarizes rules for: 1) interfacility transfer for patients with laboratory confirmed COVID-19 to a long-term acute care, skilled nursing, or group living facility, 2) interfacility transfer for patients with suspected COVID-19 to a long-term acute care, skilled nursing, or group living facility, and 3) discharge of patients with laboratory confirmed COVID-19 to their home or a non-congregate, non-healthcare setting.
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Agencies and Organizations

American Health Care Association. How You Can Help Prevent the Spread of Coronavirus (COVID-19) in Long Term Care Facilities.
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The Society for Post-Acute and Long-Term Care Medicine. AMDA Update on COVID-19.
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