Nursing Homes

Infection Prevention and Control Practices for Nursing Homes, Assisted Living and Long-Term Care Facilities

Long-term care facilities can take steps to assess and improve their response to COVID-19. Facilities that administer health care may refer to recommended practices for healthcare personnel. In general, however, long-term care facilities whose staff provide non-skilled personal care may refer to community prevention strategies based on COVID-19 Community Levels.

Find Your Your COVID-19 Community Level

COVID-19 Community Level: High

If your COVID-19 community level is high, consider applying the following strategies to mitigate the spread of illness.

• If you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.
• If you have household or social contact with someone at high risk for getting very sick, consider self-testing to detect infection before contact.
• Maintain ventilation improvements.
• Avoid contact with people who have suspected or confirmed COVID-19.
• Follow recommendations for isolation if you have suspected or confirmed COVID-19.
• Follow the recommendations for what to do if you are exposed to someone with COVID-19.

COVID-19 Community Level: Medium

If your COVID-19 community level is medium, consider applying the following strategies to mitigate the spread of illness.

• If you have household or social contact with someone at high risk for getting very sick, consider self-testing to detect infection before contact.
• Maintain ventilation improvements.
• Avoid contact with people who have suspected or confirmed COVID-19.
• Follow recommendations for isolation if you have suspected or confirmed COVID-19.
• Follow the recommendations for what to do if you are exposed to someone with COVID-19.

COVID-19 Community Level: Low

If your COVID-19 community level is low, consider applying the following strategies to mitigate the spread of illness.

• Maintain ventilation improvements.
• Avoid contact with people who have suspected or confirmed COVID-19.
• Follow recommendations for isolation if you have suspected or confirmed COVID-19.
• Follow the recommendations for what to do if you are exposed to someone with COVID-19.
• If you are at high risk of getting very sick, talk with a healthcare provider about additional prevention actions.

Additional Risk Factors

In addition to monitoring COVID-19 Community Levels, facilities may consider factors that would indicate heightened risk, such as:

• A substantial portion of people in the facility are considered high-risk due to underlying health conditions, older age, having certain disabilities, or poor access to care.
• Facility structural and operational characteristics that might accelerate spread, such as a high volume of outside visitors, poor ventilation, areas where many people sleep close together, or resident population’s ability to adhere to COVID prevention strategies.
• Active COVID-19 spread occurring in the facility.

Additional Mitigation Strategies

Facilities may consider implementing the following strategies to mitigate the spread of illness:

• Increase and improve ventilation as much as possible and consider moving activities outdoors, when possible.
• Consult with the health department about testing strategies, including whether to implement routine screening testing.
• Add enhanced cleaning and disinfection protocols.
• Create physical distance in congregate areas where possible and/or reduce movement and contact between different parts of the facility and between the facility and the community, as appropriate.

See more information about setting-specific considerations for COVID-19.