State Actions Addressing COVID-19 in Long-Term Care Facilities

This table provides an overview of notable state actions to address COVID-19 in long-term care facilities.

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This table provides an overview of notable state actions to address COVID-19 in long-term care (LTC) facilities, including links to relevant guidance or related resources for each state. For the purposes of this table, LTC facilities include nursing facilities (including post-acute), assisted living, and other residential care settings.

The list below does not include every strategy or action states have pursued. Additional state actions and examples will be added to this table on an ongoing basis. Given the robust and rapid nature of state response efforts, we welcome feedback on state actions that may be missing or have evolved since the release of this table. If there are approaches or examples you believe should be added or amended, please contact Michelle LeBlanc at mleblanc@nga.org.

For additional information on these and other steps states are taking to address COVID-19 in LTC facilities, as well as home and community-based settings, please see NGA Strategies for COVID-19 Response for Populations Receiving Long-Term Care and COVID-19 Testing In Long-Term Care Facilities

ActionsTotalStates/Territories
Testing Supports and Requirements^37AL, AR, AZ, CA, CO, DE, FL, GA, IN, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, NE, NJ, NM, NY, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WI, WV
-Resources have been prioritized to support testing in LTC facilities 34AL, AR, AZ, CA, CO, DE, GA, IN, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, NE, NJ, NY, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WI, WV
-Hospitals are required to test prior to discharge to LTC facilities10AL, CA, FL, MI, NM, NY, ND, OK, PA, WI
Dedicated Support Teams±28AL, CA, CO, FL, GA, IA, ID, IL, IN, KY, MA, MD, MI, MN, MT, NC, ND, NJ, NM, OH, OK, OR, PA, RI, TN, TX, UT, WI
-Teams include National Guard personnel 18AL, CA, CO, FL, GA, MA, MD, MI, MN, MT, ND, NJ, NV, OH, OK, PA, RI, WI
-Teams focus on testing 11CO, FL, IA, MI, MN, MT, OH, OK, PA, TX, WI
Workforce Supports and Capacity Building26AR, AZ, CA, CT, FL, GA, IA, IL, IN, KS, LA, MA, ME, MI, MN, MT, NC, NH, NY, OK, OR, RI, SC, VA, WI, WV
-Supporting new and expanded roles~12AZ, CT, FL, GA, IA, IL, IN, KS, MA, OK, SC, WI
-Increased payments and other incentives for staff10AR, CA, MA, ME, MN, NC, NH, OK, OR, RI
-System or process to match job seekers to LTC facilities with staffing needs11CA, IN, LA, MA, MI, MN, MT, NC, NY, RI, WV
Prohibited or Restricted Visitation 52AK, AL, AR, AS, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, USVI, UT, VT, VA, WA, WI, WV, WY
-Visitation is prohibited9AK, AL, HI, KS, LA, NV, USVI, WA, WI
-Visitation is allowed under certain circumstances (e.g. outdoors) 43AR, AS, AZ, CA, CO, CT, DE, FL, GA, IA, ID, IL, IN, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WV, WY
Cohorting Residents by COVID-19 Status 46AK, AR, AZ, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV
 -State-Designated COVID-Only Facility# 4CT, NM, RI, UT
Additional Payments to LTC Facilities 23AL, CA, CO, CT, GA, KS, KY, LA, ME, MA, MN, MT, NM, NC, OH, OR, PA, RI, SC, TN, VA, WA, WI
LTC Facilities Addressed in State Reopening Plans 36AK, AZ, CO, CT, DE, FL, HI, IA, ID, IN, KS, LA, ME, MD, MA, MN, MO, MT, NE, NV, NM, NY, NC, ND, OH, OK, OR, PA, RI, SD, TN, TX, UT, WA, WV, WI

^ The Centers for Medicare & Medicaid Services (CMS) began requiring requiring testing of residents and staff in LTC facilities on August 26, 2020. CMS updated the methodology that determines required frequency of testing on September 23, 2020. Prior to federal requirements, many states required facilities to test residents and staff, including: AK, CA, CT, FL, IL, MD, MA, MI, MN, MT, NJ, NY, NC, OH, PA, TN, VA, VT, WA, WV.  

± State-led teams deployed to assist LTC facilities in preventing and mitigating outbreaks, which may include local and state health officials, clinicians, providers from local hospital systems, and members of the National Guard.

~ Examples of new and expanded roles include temporary nurse aides and personal care attendants.

*  Indicates visitation guidance differs between nursing and assisted living facilities.

# The current operational status of COVID-only facilities in these states is not entirely clear and there are at least two states (MA, FL) that operated COVID-only facilities that have since closed or ceased operation.

Originally published 2 Oct 2020, last updated 15 Oct 2020.


All NGA coronavirus memos can be found here, or visit Coronavirus: What You Need To Know for current information on actions States/Territories are taking to address the COVID-19 pandemic; as well as advocacy, policy, and guidance documents for protecting public health and the economy.