Coronavirus

In response to the coronavirus (COVID-19) pandemic, we are working with the federal government to ensure nursing homes, assisted living communities, and intermediate care facilities for individuals with intellectual disabilities receive necessary supplies and guidance to prevent the spread of this virus.

Visit this website regularly for the latest information that AHCA/NCAL has to share with long term care providers about COVID-19.

How You Can Help Prevent the Spread of COVID-19

Providers

Please note that skilled nursing providers should consult the guidance put forth by CMS and the CDC, and assisted living communities should consult CDC guidance. Providers should also check their local and state health departments for updates and potentially stricter guidance, but these are general, national prevention and containment tips:

Infection Control: Maintain infection control policies and procedures, updated where needed and increase transmission-based precautions.

Staff: #GetVaccinated! Regularly wash your hands and use PPE where appropriate. Stay home if you're sick.

Limit Interactions: Implement social distancing within the facility where possible to help prevent the spread of infection.

PPE: Regularly review federal and state guidance on appropriate use of masks, gowns, gloves, etc. and maintain your inventory.

Communicate: Report suspected or confirmed cases to authorities. Keep residents, families and staff informed about your developing situation. Prepare for media inquiries.

Engagement: Follow government guidelines for safe in-person visitations, keep residents connected with loved ones remotely, and offer meaningful activities adapted for this situation.

If a staff member shows symptoms of COVID-19: Have them go home immediately.

If a resident shows symptoms of COVID-19: Implement droplet precaution, and contact the local health department.

Families

Coronavirus (COVID-19) poses a serious threat to older adults (especially 80 years old and older) and those with underlying health conditions. This is why in certain circumstances the federal government and many state governments are restricting visitors to nursing homes and assisted living communities. Adaptations (e.g., limited indoor and outdoor visits) and exceptions on a case-by-case basis (e.g., end-of-life or compassionate care visits) may be made. We understand this is difficult, but the safety and wellbeing of your loved one is our top priority.

Here’s how you can continue to stay in touch with them, and how you can help:

Communicate with your loved ones through alternative ways for the time being, whether by phone, video, social media, or other methods. Ask the facility about ways they can help with this.
Make sure your loved one’s facility has your emergency contact information. The facility may need to communicate with you about any developments regarding your loved one or about the facility as a whole.

Many long term care facilities are only permitted to share information about a resident to a designated health representative. Work together as a family unit to share information to keep everyone informed.

If you must come to the facility, coordinate with the staff ahead of time. Learn more about how you can prepare for a visit to a long term care facility.

They may ask you some questions, take your temperature, have you take a COVID test, and/or make sure you’re wearing proper protective equipment (like a mask) when you arrive. This is to make sure you do not pose as a potential risk to residents and staff.
If you are asked to not enter the building, please understand this is for the safety of your loved one and everyone else in the building. Nursing homes and assisted living communities are following direction from the government to prevent the spread of this virus.
If you are permitted in, please wash your hands or use alcohol-based hand sanitizer immediately upon entering and throughout your visit. Wear a mask and any other protective equipment as directed by the facility. Avoid touching your loved ones or other individuals in the building. Again, we know this is difficult, but the virus is very contagious and social distancing is important at this time.

Do your part to help slow the spread of COVID-19. High community spread is linked to outbreaks in nursing homes. Follow the CDC’s recommendations to protect yourself and others. Get the COVID-19 vaccine, when you are eligible.
Warn your loved ones about potential scammers during this crisis and encourage them to be cautious.

Residents

Coronavirus (COVID-19) poses a serious threat to older adults (especially 80 years old and older) and those with underlying health conditions. This is why in certain circumstances the federal government and many state governments are restricting visitors to nursing homes and assisted living communities. We understand this is a difficult and stressful time. Those who work in long term care facilities are focused on your safety and wellbeing.

Here’s how you can continue to stay in touch with your loved ones, and how you can help:

Ask the facility about other ways you can communicate with your loved ones, whether by phone, video or social media.
If you haven't already, get the COVID-19 vaccine. Your facility is working with a pharmacy or state/local officials to offer vaccinations and can provide more specific information about how and when this will work.
Follow everyday preventive actions such as:

Washing your hands or using alcohol-based hand sanitizers
Covering your cough and sneezes
Wearing a mask over your nose and mouth
Keeping 6-feet distance from other residents and staff (when possible)

Ask other individuals (including staff) to avoid touching you with handshakes, hugs or kisses. Ask them to wash their hands. Do not be shy! It’s okay to remind people.
Watch out for potential scammers during this crisis.
If you begin to experience difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste or smell, tell a staff member immediately.

Latest COVID-19 News

AHCA/NCAL Issues Statement On Need For Provider Relief Funds To Be Released To Long Term Care Providers	https://www.ahcancal.org/News-and-Communications/Blog/Pages/AHCANCAL-Issues-Statement-On-Need-For-Provider-Relief-Funds-To-Be-Released-To-Long-Term-Care-Providers.aspx	AHCA/NCAL Issues Statement On Need For Provider Relief Funds To Be Released To Long Term Care Providers	7/23/2021 4:00:00 AM	<p></p><div>As Congress continues negotiations on a bipartisan infrastructure framework, long term care providers are concerned about preliminary discussions that remaining Provider Relief Funds may be used as a pay-for in the final agreement. </div><div> </div><div>The following is a statement from Mark Parkinson, president and CEO of AHCA/NCAL: </div><div> </div><div>“Long term care providers are still facing a historic clinical and financial crisis, and they desperately need assistance to address the impact of the pandemic. We greatly appreciate the Provider Relief Funds that have been distributed thus far, but more is needed as we continue to battle COVID-19. </div><div> </div><div>“The Provider Relief Fund is meant to be used to support health care providers through this pandemic, and we urge policymakers to distribute the remaining funds to help our residents and staff. Repurposing unused funds is responsible, but the remaining Provider Relief Funds should not be considered unused, as they have not been made available in 2021 and are desperately needed. </div><div><br></div><div>“With the Delta variant spreading rampantly throughout the U.S., now is not the time to divert resources away from health care providers in order to pay for other legislative packages. We strongly encourage Congress to look for alternative ways to pay for the infrastructure package and for the Administration to swiftly deliver the aid to providers as it was intended."<br></div><p></p>	As Congress continues negotiations on a bipartisan infrastructure framework, long term care providers are concerned about preliminary discussions that remaining Provider Relief Funds
A Strong Workforce Is Essential In Caring For America’s Long Term Care Residents	https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/A-Strong-Workforce-Is-Essential-In-Caring-For-America’s-Long-Term-Care-Residents.aspx	A Strong Workforce Is Essential In Caring For America’s Long Term Care Residents	7/22/2021 4:00:00 AM	<div><span style="font-size:14.6667px;">During the pandemic, dedicated caregivers worked more than ever before to ensure the safety and wellbeing of their residents. Staff members worked day in and day out to provide additional one-on-one care and help prevent transmission of the virus, all while serving as surrogate family members for their residents. But the pandemic also exacerbated workforce challenges that have plagued long term care facilities for years. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">A recent <a href="/News-and-Communications/Press-Releases/Pages/Survey-94-Percent-of-Nursing-Homes-Face-Staffing-Shortages.aspx" data-feathr-click-track="true" target="_blank">survey </a>from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) found that more than half of the nursing home and assisted living providers have lost key frontline staff due to workers leaving last year, including certified nursing assistants (CNAs) and dietary staff. Close to 75 percent of nursing homes and nearly 60 percent of assisted living communities say their overall workforce situation has gotten worse since 2020.</span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">As our elderly population grows, it is <a href="https://www.marketwatch.com/story/a-quarter-of-65-year-old-americans-will-have-severe-need-for-long-term-care-11624896814" data-feathr-click-track="true" target="_blank">expected </a>that four-fifths of Americans 65 and older will need long term care services. But workforce challenges are a direct threat to access to care. Without enough workers, providers will be unable to meet the anticipated increase in demand, leaving seniors with fewer options for care. Providers are scrambling to fill important roles, but many are struggling just to <a href="/News-and-Communications/Press-Releases/Pages/Survey-Only-One-Quarter-Of-Nursing-Homes-Confident-They-Will-Make-It-Through-to-Next-Year.aspx" data-feathr-click-track="true" target="_blank">keep their doors open</a>. Lack of financial resources prevents providers from being able to invest in strengthening their workforce.</span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Medicaid underfunding is the primary contributor to the workforce challenges. Dr. David Gifford, chief medical officer of the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), <a href="https://www.cnn.com/2021/06/27/us/nursing-homes-staff-shortages/index.html" data-feathr-click-track="true" target="_blank">said</a>, “Everyone knows that Medicaid underpays … Salaries are about 70 percent of our [expenses] overall and so we just can't offer competitive salaries compared to hospitals and other settings.” </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Eighty-one percent of nursing home providers and 75 percent of assisted living communities stated that higher reimbursement to offer better staff pay and benefits would help improve the facility’s ability to recruit and retain staff members.</span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">AHCA and LeadingAge released a comprehensive reform package, the <a href="/Advocacy/Pages/Care-For-Our-Seniors-Act.aspx" data-feathr-click-track="true" target="_blank">Care For Our Seniors Act</a>, which includes a multi-tiered approach to address workforce challenges. This includes solutions that will help recruit and retain the best caregivers to join the front lines, such as loan forgiveness and tuition reimbursement programs for graduates who work in long term care, as well as tax credits and programs for affordable housing and childcare assistance for licensed long term care professionals.</span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Our health care heroes deserve our support. With proper funding, providers can offer meaningful jobs with competitive wages and in turn, enhance the overall quality of care for their residents. It’s time for federal and state governments to make long term care facilities a priority.</span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;"><strong>ABOUT AHCA/NCAL</strong></span></div><div><span style="font-size:14.6667px;">The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit www.ahcancal.org or www.ncal.org.</span></div><div><br></div>	During the pandemic, dedicated caregivers worked more than ever before to ensure the safety and wellbeing of their residents.
AHCA/NCAL Issues Statement On Need For Provider Relief Funds To Be Released To Long Term Care Providers	https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/AHCANCAL-Issues-Statement-On-Need-For-Provider-Relief-Funds-To-Be-Released-To-Long-Term-Care-Providers.aspx	AHCA/NCAL Issues Statement On Need For Provider Relief Funds To Be Released To Long Term Care Providers	7/22/2021 4:00:00 AM	<div><strong>WASHINGTON, D.C. </strong>– As Congress continues negotiations on a bipartisan infrastructure framework, long term care providers are concerned about preliminary discussions that remaining Provider Relief Funds may be used as a pay-for in the final agreement. <br></div><div> </div><div>The following is a statement from Mark Parkinson, president and CEO of AHCA/NCAL: </div><div> </div><div>“Long term care providers are still facing a historic clinical and financial crisis, and they desperately need assistance to address the impact of the pandemic. We greatly appreciate the Provider Relief Funds that have been distributed thus far, but more is needed as we continue to battle COVID-19. </div><div> </div><div>“The Provider Relief Fund is meant to be used to support health care providers through this pandemic, and we urge policymakers to distribute the remaining funds to help our residents and staff. Repurposing unused funds is responsible, but the remaining Provider Relief Funds should not be considered unused, as they have not been made available in 2021 and are desperately needed. </div><div><br></div><div>“With the Delta variant spreading rampantly throughout the U.S., now is not the time to divert resources away from health care providers in order to pay for other legislative packages. We strongly encourage Congress to look for alternative ways to pay for the infrastructure package and for the Administration to swiftly deliver the aid to providers as it was intended."</div><div><br><span style="font-size:11pt;"></span><br></div><div><strong>ABOUT AHCA/NCAL</strong></div><div><strong><br></strong></div><div>The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit www.ahcancal.org or www.ncal.org.<br></div><div><br></div>	As Congress continues negotiations on a bipartisan infrastructure framework, long term care providers are concerned about preliminary discussions that remaining Provider Relief Funds may be used as a pay-for in the final agreement.
Long Term Care Must Be Included In Infrastructure Package	https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Long-Term-Care-Must-Be-Included-In-Infrastructure-Package.aspx	Long Term Care Must Be Included In Infrastructure Package	7/21/2021 4:00:00 AM	<div>As Congress continues to negotiate a bipartisan infrastructure package, America’s seniors must be prioritized. Lawmakers must allocate support for providers to make capital improvements to nursing homes and assisted living communities across the country, so residents can receive the highest quality of care and additional protection against infectious diseases and other emergency events.<br></div><div><br></div><div>Too many facilities remain in dire need of upgrades. Nursing homes would like to evolve and make infrastructure investments, like improving technology, indoor air quality and energy backups, but many cannot afford to do so.</div><div><br></div><div>Chronic Medicaid underfunding left the average nursing home barely able to break even—even before the pandemic. Now, the industry is grappling with an economic crisis brought on by the COVID-19 pandemic. Only <a href="/News-and-Communications/Press-Releases/Pages/Survey-Only-One-Quarter-Of-Nursing-Homes-Confident-They-Will-Make-It-Through-to-Next-Year.aspx" data-feathr-click-track="true" target="_blank">one-quarter</a> of nursing homes and assisted living communities are confident they will make it through to next year due to the financial strain caused by responding to the crisis. Facilities are struggling just to make ends meet—they cannot afford to provide much needed infrastructure improvements without additional help from lawmakers.</div><div><br></div><div>There must be significant upgrades to ensure long term care residents are protected, connected, and well cared for. Specifically, AHCA/NCAL is advocating that the infrastructure package include funding for long term care to make improvements in:</div><div> </div><div><ul><li><strong>Indoor Air Quality</strong><strong>:</strong> Upgrading heating, ventilation and air conditioning systems, as well as humidification and air pressure helps prevent the spread of airborne infectious diseases and reduces respiratory issues, improving the health and comfort of both residents and staff.</li><li><strong>Technology: </strong>Expanding access to broadband would help rural long term care providers ensure residents stay connected with their loved ones as well as enhance telehealth options.</li><li><strong>Emergency Preparedness: </strong>In the face of escalating, unpredictable weather events and other natural disasters, long term care facilities need back-up energy solutions to maintain day-to-day operations, such as enhanced generator capacity, additional battery power sources, and solar panels. </li><li><strong>Enhanced Sanitization & Monitoring: </strong>Long term care facilities could implement more infection control best practices with UVC lighting and wastewater monitoring to catch and address potential risks more efficiently.</li></ul></div><div><br></div><div>With the proper government support, nursing homes can invest in their workforce, clinical services, and infrastructure to continue to improve residents’ quality of life. AHCA and LeadingAge’s <a href="/Advocacy/Pages/Care-For-Our-Seniors-Act.aspx" data-feathr-click-track="true" target="_blank">Care For Our Seniors Act</a> includes immediate and long-term strategies to address Medicaid underfunding for nursing homes, as well as other reforms that will help boost the workforce, modernize physical structures, and enhance infection control procedures. </div><div><br></div><div>We must learn from this pandemic and other national emergencies. Congress must prioritize our seniors in the infrastructure package and help provide much needed funding so long term care facilities can provide better care and be better prepared. Every resident deserves a modern, clean facility that will offer them safety and connectivity. <br></div><div><br></div><div><div><strong>ABOUT AHCA/NCAL</strong></div><div>The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit www.ahcancal.org or www.ncal.org.<br><br></div></div>	As Congress continues to negotiate a bipartisan infrastructure package, America’s seniors must be prioritized.

Guidance & Resources

By Source

AHCA/NCAL

Guidance

pdffas fa-file-pdf
How to Prevent and Manage Outbreaks
pdffas fa-file-pdf
Admissions from and Discharges to Hospitals
pdffas fa-file-pdf
Communal Dining
pdffas fa-file-pdf
Hospice Services
pdffas fa-file-pdf
Where to Ask for Help

Emergency Preparedness

docxfas fa-file-word
Template After-Action Report / Improvement Plan
Members can use this template to document their response and recovery efforts during the pandemic in order to meet Emergency Preparedness requirements from CMS

Screening

zipfas fa-file-archive
Screening Checklists for Visitors & Personnel (.zip)
English and Spanish versions

Confirmed Cases

pdffas fa-file-pdf
Cohorting Residents
pdffas fa-file-pdf
Nebulizer Treatment for COVID-19 Infected Residents with Severe Respiratory Symptoms
aspx#covid-dashboardfas fa-link
COVID-19 Nursing Home Dashboard

Residents

pdffas fa-file-pdf
Keeping Residents Engaged
pdffas fa-file-pdf
Offering Compassionate Care
pdffas fa-file-pdf
Alzheimer's Association: Caring for Persons Living with Dementia in a Long-Term or Community-Based Care Setting During COVID-19

CDC

Overview of COVID-19

htmlfas fa-link
Coronavirus (COVID-19)
htmlfas fa-link
FAQs

Prevention Resources

Reporting Resources

htmlfas fa-link
LTCF COVID-19 Module
html?deliveryname=uscdc_1052-dm21038fas fa-link
Evaluating and Reporting Persons Under Investigation (PUI)

Health Care Facility Resources

htmlfas fa-link
Resources for Health Care Facilities
html&deliveryname=uscdc_1052-dm21038fas fa-link
Health Care Infection Control Guidelines
html?deliveryname=uscdc_1052-dm21038fas fa-link
Clinical Care Guidance
aspfas fa-link
Clinician Outreach and Communication Activity (COCA) Calls & Webinars
html?deliveryname=uscdc_1052-dm21038fas fa-link
Disposition of Non-Hospitalized Patients with COVID-19
htmlfas fa-link
Criteria for Return to Work for Healthcare Personnel

Communication Resources

aspfas fa-link
CDC's Crisis and Emergency Risk Communication (CERC)
pdffas fa-file-pdf
CERC in an Infectious Disease Outbreak

CMS

Memos & Guidance

pdffas fa-file-pdf
LTC Facility Testing Requirements and Revised COVID19 Focused Survey Tool
QSO Memo 20-38 revised April 27, 2021
pdffas fa-file-pdf
Updating Requirements for Reporting of SARS-CoV-2 Test Results by Clinical Laboratory Improvement Amendments of 1988 (CLIA) Laboratories
QSO Memo 20-37-CLIA, NH issued August 26, 2020
pdffas fa-file-pdf
Requirements for Notification of COVID-19 Cases Among Residents and Staff in Nursing Homes
CMS is requiring nursing homes to report COVID-19 facility data to the CDC and to residents, their representatives, and families of residents. This memo also includes updated survey tools and a FAQ on new reporting requirements.
pdffas fa-file-pdf
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes
Guidance on: screening visitors and who should be restricted; screening employees and contractors and who should be asked to stay at home; when patients should be managed in the facility vs sent to the hospital; what to do when transferring residents with suspected COVID-19, and; what criteria to use in accepting patients from the hospital with COVID-19.
pdf-1fas fa-link
Prioritization of Survey Activities
Announces that CMS will re-prioritize surveys to conduct focus surveys about infection control for facilities that have had an infection control deficiency in the past to assure that they are in compliance with the new regulations.
pdf-2fas fa-link
Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage, Placement and Hospital Discharge
Guidance to hospitals on screening visitors, employees and when to admit and discharge residents.
pdffas fa-file-pdf
Nursing Home Visitation
Revised April 27, 2021 - The guidance provides reasonable ways a nursing home can safely facilitate in-person visitation to address the psychosocial needs of residents.
pdffas fa-file-pdf
Interim Final Rule - COVID-19 Vaccine Immunization Requirements for Residents and Staff
This includes new requirements for educating residents or resident representatives and staff regarding the benefits and potential side effects associated with the COVID-19 vaccine, and offering the vaccine. Furthermore, LTC facilities must report COVID-19 vaccine and therapeutics treatment information to NHSN.

Resources

zipfas fa-file-archive
COVID-19 Focused Survey for Nursing Homes
A zip file from CMS with updated survey forms in the COVID-19 Focused Survey subfolder. Providers should use the revised “COVID-19 Focused Survey for Nursing Homes” to perform their self-assessment.
docxfas fa-file-word
1135 Waiver Request (AHCA Template)
Providers unable to meet certain federal requirements due to COVID-19 should file an individual 1135 waiver for flexibility with regulations that cannot be met due to shortages in capacity or resources such as staffing or that conflict with other guidance, needs, and expectations during the pandemic.
pdffas fa-file-pdf
Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit

Other Federal Agencies

htmlfas fa-link
AHRQ's Nursing Home COVID-19 Action Network
The Agency for Healthcare Research and Quality (AHRQ) has compiled resources that address staff and resident well-being and safe operations in nursing homes and long term care facilities.
about-list-n-disinfectants-coronavirus-covid-19-0#file-534797fas fa-link
EPA: Registered Disinfectant Products
Coronaviruses are enveloped viruses, meaning they are one of the easiest types of viruses to kill with the appropriate disinfectant product.
standardsfas fa-link
Occupational Safety and Health Administration (OSHA) Standards for COVID-19
OSHA recordkeeping requirements at 29 CFR Part 1904 mandate covered employers record certain work-related injuries and illnesses on their OSHA 300 log. While 29 CFR 1904.5(b)(2)(viii) exempts recording of the common cold and flu, COVID-19 is a recordable illness when a worker is infected on the job.

State & Local

lhd-directoryfas fa-link
Find Your Local Health Department
htmlfas fa-link
Find Your State Health Department

Guidance & Resources

By Topic

Finance & Reimbursement

General

pdffas fa-file-pdf
Grant & Loan Management Primer
AHCA/NCAL has developed a basic primer for organizing oversight and day-to-day management of various federal grants and loans.
zipfas fa-file-archive
COVID-19 Related Loss and Cost Calculator
This excel workbook allows members to assess allowable costs already reimbursed by pre-COVID-19 payers (Medicare and Medicaid) and compare such reimbursement to shortfalls where grants and loans fill funding gaps.

CARES Act Provider Relief Fund