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COVID-19 Information for Long Term Care Pharmacy

Long-Term Care Facility (LTCF) Recommendations Related to COVID-19

General Resources

General Information

  • Patients in LTCFs are at a higher risk of acquiring infections spread through droplets, such as influenza and COVID-19, compared to the general population.
  • Because of the close physical proximity of these patients to each other, the infection can spread rapidly throughout a LTCF.
  • Patients who reside in LTCF are often at a higher risk of complications from these infections due to chronic comorbidities.
  • In the United States, an outbreak of COVID-19 occurred in a LTCF in Washington state, which marked some of the first reported cases in the United States.Twenty-nine deaths occurred at this LTCF, with many other patients and healthcare workers diagnosed with COVID-19.

HHS Reporting Requirements:

  • On April 30, 2020, the US Department of Health and Human Services (HHS) issued new rules governing facilities and imposed new notification requirements amending 42 CFR 483.80(g),

CDC Recommendations:

  • The CDC has prepared a checklist to help LTCFs improve their preparedness for the COVID-19 pandemic.
  • The checklist identifies key areas that LTCFs should consider in their planning for dealing with the COVID-19 crisis, and LTCFs can use the list to assess their current strengths and areas for improvement.
  • The checklist does not make mandatory requirements, but identifies areas for review to prepare for the possibility of residents acquiring COVID-19.
  • Additionally, the CDC currently recommends the following:
    • Restrict all visitation except for certain compassionate care situations, such as end of life situations
    • Restrict all volunteers and non-essential healthcare personnel (HCP), including non-essential healthcare personnel (e.g., barbers)
    • Cancel all group activities and communal dining
    • Implement active screening of residents and HCP for fever and respiratory symptoms
  • CDC Preparedness Checklist for LTCFs (pdf)

Centers for Medicaid and Medicare Services (CMS)

  • CMS has issued guidelines to protect LTCF residents from acquiring COVID-19, which are based on CDC recommendations.
  • The focus of these guidelines are to restrict visitors and non-essential personnel and limit communal activities inside the LTCF.
  • See below specific recommendations from the Alabama Nursing Home Association and visit for more information.
  • CMS LTCF Guidance (pdf)


Alabama Nursing Home Association (ANHA)

  • On March 3, the ANHA issued a statement requesting that anyone who is sick should not visit LTCFs and use alternative means to check on patients who reside there in order to minimize risk to both patients and staff.
  • On March 14, the ANHA went a step further to recommend to all LTCFs in Alabama to follow the guidance issued from CMS regarding visiting patients who reside in LTCFs.This includes:
    • Restricting visitation of all visitors and non-essential personnel except in certain compassionate care situations, such as an end-of-life situation
    • In these situations, visitors should be limited to being in only 1 room.
    • Communal dining and group activities should be canceled.
    • Patients and staff should be actively screened for respiratory symptoms.
  • For more information and updates, visit


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