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COVID-19 Long Term Care Resources
Topic Collection
June 29, 2020

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.

Please refer to CDC’s Coronavirus Disease 2019 webpage for the most up-to-date clinical guidance on COVID19 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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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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Birdsall, J., Lind, L., and Lane, J. (2020). How to Provide Telehealth in Nursing Homes. American Psychological Association.
This article describes practical tips about how to provide psychological services to older adults living in nursing homes during the COVID-19 pandemic.
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California Association of Health Facilities. (n.d.). Surge Strategies for SNFs (Space/Staff/Stuff). (Accessed 3/26/2020.)
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. (2020). COVID-19: Guidance for Skilled Nursing Facilities.
These slides from a March 13, 2020 webinar provide information on prevention and detection of the introduction of COVID-19 in skilled nursing facilities, preparing to receive and care for residents with suspected or confirmed COVID-19, preventing transmission of COVID-19 within facilities, infection prevention strategies, and donning and doffing personal protective 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 Disease Control and Prevention. (2020). Preparedness Checklist for Nursing Homes and Other Long-Term Care Settings. U.S. Department of Health and Human Services.
This page includes a checklist guide the preparedness and response efforts of nursing homes and other long-term care settings. It also includes a link to infection control guidance for these settings.
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This fact sheet - updated as needed - describes flexibilities available to long term care facilities participating in Medicare or Medicaid.
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Centers for Medicare & Medicaid Services. (2020). Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit.
This toolkit assists Medicare providers in understanding regulatory flexibilities associated with provision of telehealth visits, virtual check-ins, and e-visits during the COVID-19 pandemic. It provides information that may be helpful in establishing a telemedicine program, including policy guidance, implementation guidance, links to state statutes, telehealth setup basics, technical assistance sources, vendor selection information, and resources for nursing homes, patients, and the community.
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Centers for Medicare & Medicaid Services. (2020). 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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County of Santa Clara Public Health Department. (2020). Long-Term Care Facilities COVID-19 Toolkit.
This toolkit is a resource to assist long term care facilities in responding to COVID-19. It includes recommended steps to immediately implement, frequently asked questions, sample signage, a fact sheet, and links to additional resources.
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COVID-19 Healthcare Resilience Task Force. (2020). Managing the Effects of Social Distancing in Older Adults During COVID-19.
This document provides guidance and resources to address the behavioral health implications of social distancing and isolation for older adults due to current social distancing guidance in place for senior living facilities.
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Davis, C.. (2020). How to Manage Residents Who Receive Dialysis When COVID-19 is at the Door. American Association of Post-Acute Care Nursing.
This article offers advice to nursing homes that need to send residents to other facilities for dialysis treatment during the COVID-19 pandemic. The author discusses cohorting dialysis patients, limiting tub use, surveillance frequency, transport protocols, symptom reporting, masking, adherence to care plans, and collaborating with dialysis providers.
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Florida Health Care Association, Florida Hospital Association, and Leading Edge Florida. (2020). Hospital to Post-Acute Care Facility Transfer - COVID-19 Assessment.
This form guides hospitals through the assessment of patients prior to transfer to a post-acute care facility.
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Florida Health Care Association, Florida Hospital Association, and Leading Edge Florida. (2020). Post-Acute Care and Behavioral Health to Hospital Transfer - COVID-19 Assessment and Communication.
This form guides assessment of post-acute care and behavioral health patients prior to transfer to a hospital.
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This document provides criteria on which hospitalized patients should be evaluated and tested prior to release to a post-acute care facility, when hospitals can discontinue transmission-based precautions for infected patients, when patients can safely be transferred to post-acute care facilities, and if infected patients whose condition has improved can be discharged to their homes.
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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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This document 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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Los Angeles County Department of Public Health. (2020). Interfacility Transfer and Home Discharge Rules.
This document 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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This one-pager summarizes discharge rules for emergency room patients suspected to have COVID-19, but who do not require hospital admission. The document includes information for residents of long-term acute care, skilled nursing, and group living facilities.
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Meyer, D., LaFave, S., Hart, A., et al. (2020). Recommendations for a Metropolitan COVID-19 Response Special Emphasis Series: Guidance on Protecting Individuals Residing in Long-Term Care Facilities. (Added 5/13/2020.) Johns Hopkins Bloomberg School of Public Health.
This report offers six overarching recommendations for support teams to aid COVID-19 preparedness and response in long-term care facilities.
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Minnesota Department of Health. (2020). COVID-19 Toolkit: Information for Long-Term Care Facilities. (Added 6/4/2020.)
This comprehensive toolkit provides information for long-term care facilities to prepare for and respond to COVID-19. Appendices include checklists, logs, signage, a sample risk assessment, and forms.
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This one-page grid indicates the types of personal protective equipment that should be worn by residents, visitors, and various staffing roles in long term care facilities under contingency standards of care for COVID-19.
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States and localities across the U.S. are seeking effective ways to provide high-quality care to as many nursing home patients as is possible without transporting them to the hospital, while ensuring nursing home staff have the appropriate personal protective equipment and are trained how to use, and how to implement infection prevention and control measures on site. This webinar from the National Academy of Sciences highlighted how the states of Maryland and Massachusetts are addressing a number of challenges in nursing homes, including staffing shortages, expanding access to COVID-19 testing, and maintaining transparent communications with residents’ families and the public. Nursing home residents who exhibit symptoms of the COVID-19 virus are often taken immediately to the hospital, which may lack the capacity to provide appropriate care for them. Often they are not allowed to return to the nursing home for fear of spreading the infection to other vulnerable residents and staff. The webinar highlights innovative approaches to address these complex challenges that are currently being implemented in the state of Maryland. The collaborative approach involves health care professionals at Johns Hopkins University School of Medicine, the state department of health, emergency medicine professionals, and newly formed “strike teams” made up of members of the National Guard. Access slides at https://www.nationalacademies.org/event/04-22-2020/keeping-nursing-home-residents-and-staff-safe-in-the-era-of-covid-19-a-webinar * or https://www.nationalacademies.org/event/04-22-2020/docs/D20B4F2AD00C95EC8FA23857D28DE0FB6C87B4736573 * The State of Massachusetts has leveraged existing programs such as ombudsman and has created new temporary processes to support long-term care facilities during the pandemic. Massachusetts has launched a long-term care portal to match individuals who have registered through the portal with the staffing requests submitted by the long-term care facilities. The state is also holding weekly calls with long term care facilities, where it hears firsthand about structural challenges, including staffing, PPE and supports needed. Access more information at https://www.mass.gov/news/baker-polito-administration-announces-new-funding-outlines-ongoing-steps-to-support-long-term *
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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 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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New York State Department of Health. (2020). Recommendations to Protect Nursing Home Residents.
This advisory provides recommendations to support the physical health of nursing home residents through social distancing, infection prevention, and information sharing activities. It also provides links to virtual resources that may support the mental and emotional health of residents.
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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. (2020). 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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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: Long Term Care Facilities (5/1/2020). (Added 5/14/2020.) U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This special session focused on long term care facilities and featured speakers from FutureCare and GRECC VA Pittsburgh Healthcare System.
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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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San Francisco Department of Public Health. (2020). COVID-19 Preparedness and Management Toolkit for Skilled Nursing Facilities. (Added 6/12/2020.)
This toolkit based on lessons learned during the successful response to a COVID-19 outbreak in a hospital provides guidance to skilled nursing facilities to prevent, contain, and mitigate COVID-19 in their facilities.
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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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Spokane Regional Health District. (2020). Long-Term Care – Social Distancing Checklist for COVID-19.
This planning checklist may be used by long term care facilities to guide their implementation of social distancing measures. It includes general planning assumptions and steps to take: 1) before COVID-19 transmission is confirmed in the community, 2) once locally acquired cases are present in the community, 3) when outbreaks are reported in other facilities or institutions in the community, and 4) when there is a possible outbreak in your facility.
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The John A. Hartford Foundation. (2020). 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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Washington State Department of Health. (2020). Long Term Care Facilities.
The state health department established this web page to collect resources to assist LTC facilities in their response to COVID-19. Included is a sample visitor announcement; guidance for persons at higher risk for serious illness, for LTCs, and for transfers between LTCs and other healthcare settings; LTC facility outbreak criteria; a nursing home infection prevention assessment tool; information on the state’s point prevalence testing order; and LTC reporting requirements.
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Agencies and Organizations


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The Society for Post-Acute and Long-Term Care Medicine. AMDA Update on COVID-19.
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