Critical Step 3

Prevent spread of COVID-19

  • Actions to take now:
    1. Cancel all indoor group activities and communal dining.
    2. Enforce social distancing among residents.
    3. Do not allow quarantined, exposed, symptomatic, or COIVD+ residents (unless convalescent) to participate in outdoor visitation programs.
    4. Ensure all residents wear a cloth face covering for source control whenever they leave their room or are around others, including whenever they leave the facility for essential medical appointments.
    5. Ensure all staff wear a facemask for source control while in the facility.
      • Cloth face coverings are not considered personal protective equipment (PPE) because their capability to protect healthcare personnel (HCP) is unknown. Cloth face coverings should NOT be worn instead of a respirator or facemask. Staff should wear FDA-approved surgical or procedure masks. 
    6. If COVID-19 is identified in the facility,  restrict all residents to their rooms as much as possible and have HCP wear all recommended PPE for care of all residents (regardless of symptoms) facility-wide. This includes: a facemask or N95 respirator, eye protection (preferably a face shield), gloves, and gown (when indicated). HCP should be trained on PPE use including putting it on and taking it off.
      • When a case is identified, public health can help inform decisions about testing asymptomatic residents on the unit or in the facility.
      • This approach is recommended because of the high risk of unrecognized infection among residents. Recent experience suggests that a substantial proportion of residents could have COVID-19 without reporting symptoms or before symptoms develop.

Tools and Resources

    • If COVID-19 cases are identified at the facility, contact/droplet precautions should be implemented for all residents. LTCF staff must be provided with the personal protective equipment (PPE) needed to keep themselves and the residents safe, including gloves, gowns, facemasks, and eye protection.
    • Through the Quality Improvement Organization (QIO) Program, CMS holds a weekly webinar series every Thursday from 3-4 p.m. CT to provide training for infection control processes in nursing homes.
  • Personal Protective Equipment (PPE) Guidance
  • Cleaning and Disinfection Guidance
      • LTCFs should be cleaned and disinfected according to CDC guidance using hospital-grade disinfectants. The Environmental Protection Agency has provided a list of products (called List N) to use against SARS-CoV-2.
    • Cleaning and Disinfection Guidelines: English | Spanish courtesy of King County, WA
      • Guidelines and best practices for preventing COVID-19
      • ​CDC video for frontline staff covering environmental cleaning and disinfection practices to prevent the spread of COVID-19 in LTCFs
  • Hand Hygiene Guidance
      • ​​​​​​CDC video for frontline staff covering hand hygiene best practices to prevent the spread of COVID-19 in LTCFs

LTFC Reporting

How To Report COVID-19 Cases To CDPH:

**NEW** Updated CDPH SNF Case Report Form

1. Report lab-confirmed resident and staff cases within 24 hours.
2. Facilities with no new cases must report at least once a week, by Thursday 12 pm (Noon).
3. Effective immediately facilities should not longer submit weekly facility summary reports, enter cases in the Case & Cluster form, or enter cases into the Breakthrough Case Report Form.

LTFC contact

For COVID-19 Long-Term Care Guidance And Support:


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