In response to increasing cases of COVID-19 in Virginia's long-term care facilities, Governor Northam established the Virginia COVID-19 Long-Term Care Task Force on April 10 to:
- Ensure long-term care facilities have the resources they need to combat the virus;
- Strengthen staffing, testing and infection control measures at long-term care facilities; and
- Keep stakeholders informed about the impact of COVID-19 on long-term care facilities.
Membership of the task force is broad based, including state agency representatives from the Virginia Department of Health, Virginia Department of Medical Assistance Services, Department of Social Services, Department of Behavioral Health and Developmental Services, Department of Aging and Rehabilitative Services, and Department of Veterans Services; long term care facility representatives including Virginia Health Care Association, Virginia Assisted Living Association, and LeadingAge Virginia; Medicaid managed care organizations, the Virginia Hospital and Healthcare Association, facility medical directors as well as the Virginia National Guard and family members of long-term care facility residents and their advocates.
Issue areas being reviewed by the Task Force include facility staffing and financing, infection control, personal protective equipment and supplies, COVID-19 testing, communications, and discharge planning.
Testing Guidance for LTCFs
Nursing Homes/Skilled Nursing Facilities/Assisted Living Facilities/Other Long-Term Care Facilities:
- (UPDATED) Virginia COVID-19 Long-Term Care Facility Task Force Playbook (7/10/20)
- (UPDATED) VDH Guidance for LTCFs (6/19/20)
- VDH Facility Employee Daily Screening Form
- VDH Optimization Strategies for PPE
- VDH Role of Public Health and LTCFs in Preparedness and Response Efforts (6/15/20)
- VDH Guidelines for Cleaning and Disinfection
- VDH Line List for COVID-19 Outbreaks
- Hospital to LTC Transfers:·
- OSHA COVID-19 Guidance for Nursing Home and Long Term Care Facility Workers
Nursing Homes/Skilled Nursing Facilities:
- (UPDATED) VDH Nursing Home Reopening Guidance (7/17/20)
Assisted Living Facilities:
- Recommendations for Reopening Assisted Living Facilities
- COVID-19 Virginia Personal Protection Equipment (PPE) Weekly Use Survey for Assisted Living Facilities
- Communal Activities Tips and Best Practices
- Transportation Tips and Best Practices
- COVID-19 Mitigation Plan for Assisted Living Facilities
- Barber and Cosmetology Tips and Best Practices
- Communal Dining Tips and Best Practices
- Visitors Tips and Best Practices
Template Letters to Residents and Families – from VHCA and LeadingAge
- VHCA Template Letter for Family Members for Confirmed Case in LTCF (5/4/20)
- LeadingAge – Positive Diagnosis – Letter to Residents and Families (5/4/20)
- LeadingAge – Positive Diagnosis in Staff – Letter to Residents and Families (5/4/20)
- LeadingAge – COVID-19 Death – Letter to Residents and Families (5/4/20)
Primary Resource Links
- Mini Webinar Series - COVID-19 Prevention Training for LTC Staff (6/25/2020)
- Preparing for COVID-19: Long-Term Care Facilities and Nursing Homes
- Responding to Coronavirus (COVID-19) in Nursing Homes
- CDC Considerations for Preventing Spread of COVID-19 in Assisted Living Facilities
- National Healthcare Safety Network (NHSN) LTCF COVID-19 Module
- NHSN Enrollment Webpage for LTCFs
- Requirements for Notification of Confirmed and Suspected COVID-19 Cases in Nursing Homes (5/6/2020)
- Instructions on Conferring Rights to VDH in the NHSN
- Nursing Home COVID-19 NHSN Reporting
- CMS FAQ on Nursing Home Visitation (6/23/2020)
- CMS Nursing Home Reopening Recommendations (5/18/2020)
- CMS Nursing Home Reopening Recommendations FAQ (5/18/2020)
- CMS Guidance for COVID-19 in Long-Term Care Facilities (4/2/2020)
- CMS Nursing Home Five Star Quality Rating System Updates, Nursing Home Staff Counts, and FAQs(4/27/2020)
- CMS Program Guidance and Information About COVID-19
- VDH Long-Term Care Infection Prevention Assessment Tool for COVID-19
- VDH FAQs on COVID-19 in LTCFs
- Project ECHO: Find and Register for a VDH ECHO Session
Nursing Homes, Assisted Living, and Multi-Care Facilities Reporting Outbreaks of COVID-19
The numbers (counts) associated with each outbreak represent both residents and staff, and are based on the information in VEDSS and VOSS. The number of cases and deaths listed per facility are cumulative counts for the COVID-19 pandemic. If fewer than 5 cases or between 0 and 5 deaths are associated with a facility, the counts will be represented by an asterisk (*) in order to preserve patient anonymity.
This information is intended to provide awareness of COVID-19 outbreaks among a vulnerable population. The presence of an outbreak does not indicate a facility’s given capacity to care for their residents.
Comparison of VDH Data to CMS Nursing Home Data:
On June 4, 2020, CMS posted its first report outlining COVID-19 data reported by nursing homes. Nursing facilities report these data to the CDC’s National Healthcare Safety Network (NHSN). The general public is able to view facility-specific data about COVID-19 cases, deaths, and more.
Due to different reporting requirements and case classifications, timelines, and other factors, the CMS data will likely be inconsistent with data reported by VDH.
For NHSN, facilities are being asked to report new confirmed and suspected cases to try to get at the incidence of COVID-19. Meaning, on the day the facilities report data to NHSN, they should only be reporting new confirmed or suspected cases since the last time they reported.
- A Confirmed case is defined as a resident or staff/facility personnel with new laboratory-positive COVID-19
- A Suspected case is defined as a resident (or staff) with signs and symptoms suggestive of COVID-19 as described by CDC’s guidance but does not have a laboratory positive COVID-19 test result. This may include residents (or staff) who have not been tested or those with pending test results. It may also include residents (or staff) with negative test results but continue to show signs/symptoms suggestive of COVID-19.
For VDH, we follow the CSTE Case Definitions for COVID-19. The VDH surveillance case definitions are specific, especially for cases that are considered ‘probable’. The NHSN definitions for residents and staff are not based on epidemiological linkages or other laboratory results that are based on symptoms and possible exposure by being in a facility. Because the NHSN definition for suspected cases is broader and focuses solely on the signs and symptoms suggestive of COVID-19, there will be differences between what is being counted at the state vs. what is being reported to NHSN.
There are some limitations with the CMS nursing home data. Not all nursing homes are reporting in NHSN at this time, and some are experiencing technical difficulties with this data system that are out of their control. As with any new reporting program, some facilities will struggle with their first submissions, and therefore, some of the data from their early submissions may be inaccurate. Since facilities may correct data in future weeks, the data is subject to fluctuations as data for previously reported weeks may change when the website is updated.
Facilities may opt to report cumulative data retrospectively back to January 1, 2020 in NHSN though they are not required to do so. Therefore, some facilities may be reporting higher numbers of cases/deaths compared to other facilities, due to their retrospective reporting.