CDC’s NHSN provides healthcare facilities, such as long-term care facilities (LTCFs), with a secure reporting platform for reporting outcomes and process measures in a systematic way. Reported data are immediately available for use in strengthening local and national surveillance, monitoring trends in infection rates, assisting in identifying resource insecurities, and informing progress toward infection prevention goals.

The NHSN Long-term Care Facility Component supports the nation’s COVID-19 response through the LTCF COVID-19 Module. Facilities eligible to report data to NHSN’s COVID-19 Module include nursing homes/skilled nursing, long-term care for the developmentally disabled, and assisted living facilities.

Data reported into the LTCF COVID-19 Module Surveillance Reporting Pathways facilitate assessment of the impact of COVID-19 through facility reported surveillance data. Examples of data reported in the pathways include:

• Counts of residents and facility personnel newly positive for COVID-19 based on viral test results.
• COVID-19 vaccination status of residents newly positive for COVID-19.
• Re-infections in residents and facility personnel previously infected with COVID-19.
• COVID-19 related death counts among residents and facility personnel.
• Staffing shortages.
• Availability and surge capacity use of personal protective equipment (PPE) and alcohol-based hand rub.
• Monoclonal therapeutic availability and use.
• Ventilator capacity and supplies for facilities with ventilator-dependent units.

The Point-of-Care (POC) Test Reporting Tool is a separate reporting option for LTCFs to report SARS-CoV-2 test results provided by a POC device. NHSN routes reported POC laboratory test result data to the public health agency at the local or state level with jurisdictional authority and responsibility for receiving those data. Important: the reporting of POC test result data in this tool does not take the place of answering POC related questions in the Resident Impact and Facility Capacity surveillance reporting pathway.

Weekly reporting of COVID-19 vaccination data for residents and healthcare personnel is another option available to LTCFs. Additional information about surveillance and vaccination reporting, please visit the Weekly HCP & Resident COVID-19 Vaccination webpage.

LTCF data submission options include manual data entry, CSV file submission by individual facilities or bulk CSV file upload for multiple facilities, and/or NHSN DIRECT CDA Automation for the Point-of-Care (POC) Test Reporting Tool. Information about the Direct protocol can be found here. Send questions to NHSNCDA@CDC.GOV with Subject line “Direct Submissions for POC data.”

For additional information about the LTCF COVID-19 Module, reporting options, data collection forms, form instructions, archived and upcoming trainings, and future updates, please review the resources on this page.

Guidance released March 10, 2021 regarding Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination | CDC affects only select elements of the current Nursing Home ICAR tool until an updated version of the tool is available. Please reference this guidance when using the ICAR tool to ensure alignment with updated considerations for COVID-19 vaccination status (e.g., visitation, HCP work restriction, resident quarantine).

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Infection Control Assessment and Response (ICAR) tools are used to systematically assess a healthcare facility’s infection prevention and control (IPC) practices and guide quality improvement activities (e.g., by addressing identified gaps).

Note from staff: This lawsuit, brought by the now director of the U.S. Department of Health and Human Services, not only alleges problems with the discharge process, it alleges that SNFs submitted false data to Five-Star, specifically nurse staffing data.

Attorney General Becerra Sues Nursing Home Chain for Misrepresenting its Quality of Care and Putting Seniors, People with Disabilities at Risk

Today's lawsuit pertains to Brookdale's current and former California skilled nursing facilities located in the cities of Bakersfield, Camarillo, Carlsbad, Northridge, Rancho Mirage, San Diego, San Dimas, San Juan Capistrano, Santa Rosa, and Yorba Linda 

March 15, 2021

SACRAMENTO – California Attorney General Xavier Becerra today joined a coalition of District and City Attorneys, led by Kern County District Attorney Cynthia Zimmer, in filing a lawsuit against Tennessee-based Brookdale Senior Living, Inc. (Brookdale), the nation’s largest senior living operator. Today’s lawsuit, which concerns Brookdale’s ten California skilled nursing facilities, alleges that Brookdale ignored laws that protect patients' safety when they are discharged from a facility. The lawsuit also alleges that Brookdale gave false information to the Centers for Medicare & Medicaid (CMS), information which CMS uses to award “star ratings” to skilled nursing facilities so that consumers can choose a quality facility. By lying to CMS, Brookdale fraudulently increased its star rating in several categories to attract prospective patients and their families.

The lawsuit alleges that Brookdale failed to properly notify its patients and families of transfers and discharges. Skilled nursing facilities are required to give notice of transfer or discharge at least 30 days in advance, or as soon as practicable. Brookdale failed to timely provide this required notice to its patients, with a copy to the local ombudsmen. Brookdale also failed to properly prepare its patients for transfer or discharge. As a result of these actions, Brookdale endangered the health of its patients and also left families scrambling to find other places to care for their loved ones.

The lawsuit also alleges that Brookdale misrepresented the quality of its care to the public by reporting false information to CMS. As a means of helping the public to choose a skilled nursing facility, CMS rates facilities on several quality measures on a scale of one to five stars, which are then posted to the CMS website. The lawsuit alleges that Brookdale over-reported its nursing staffing hours to CMS, and by doing so, Brookdale was awarded undeserved four-and five-star ratings. In the lawsuit, the coalition argues that by engaging in these unfair business practices, Brookdale violated both the Unfair Competition Law and False Advertising Law.

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Summary

·         What is already known about this topic?

Skilled nursing facility (SNF) residents, generally older and with more underlying medical conditions than community-dwelling adults, were not included in COVID-19 vaccine clinical trials. Little is known about COVID-19 vaccine effectiveness in SNF residents.

·         What is added by this report?

A retrospective cohort analysis in two Connecticut SNFs found partial vaccination with Pfizer-BioNTech COVID-19 vaccine (from >14 days after dose 1 through 7 days after dose 2) to be 63% (95% confidence interval = 33%–79%) effective against SARS-CoV-2 infection.

·         What are the implications for public health practice?

Even with partial vaccination, Pfizer-BioNTech COVID-19 vaccine provides protection to SNF residents. To optimize vaccine impact among this population, high coverage with the complete 2-dose series is recommended.

On March 10, 2021, the Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). Today, CMS is releasing a graphic to further explain the expanded visitation options.

According to the updated guidance, facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise that would limit visitation.

CDC guidance for SARS-CoV-2 infection may be adapted by state and local health departments to respond to rapidly changing local circumstances.

On this page

Visitation

Work restriction for asymptomatic healthcare personnel and quarantine for asymptomatic patients and residents

SARS-CoV-2 Testing

Use of Personal Protective Equipment

Introduction

This guidance applies to all healthcare personnel (HCP) while at work and all patients and residents while they are being cared for in a healthcare setting.

CDC has released public health recommendations for vaccinated persons, which describe circumstances when non-pharmaceutical interventions (e.g., quarantine) could be relaxed for fully vaccinated persons in non-healthcare settings. CDC continues to evaluate the impact of vaccination and the emergence of novel SARS-CoV-2 variants on healthcare infection prevention and control recommendations; updated recommendations will be added to this page regularly as new information becomes available.

Except as noted in Updated Recommendations, HCP should continue to follow all current infection prevention and control recommendations, including those addressing work restrictions, quarantine, testing, and use of personal protective equipment to protect themselves and others from SARS-CoV-2 infection.