cdc guidelines for assisted living facilities after vaccination cdc guidelines for assisted living facilities after vaccination

CDCs guidance titled Prevention Strategies for Seasonal Influenza in Healthcare Settings contains details on the prevention strategies for all healthcare settings. You will be subject to the destination website's privacy policy when you follow the link. Active COVID-19 spread occurring in the facility. Monitor healthcare personnel absenteeism due to respiratory symptoms and exclude those with influenza-like symptoms from work until at least 24 hours after they no longer have a fever. For more information, see Interim Clinical Considerations for Use of COVID-19 Vaccines. Background. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. COVID-19 vaccines may be administered along with and on the same day as other vaccines, such as the flu vaccine. Oseltamivir is the recommended antiviral drug for chemoprophylaxis of influenza in long-term care settings. BMJ Open 2016; 6:e011686. These include: ACIP recommends that LTCF residents be prioritized in the earliest phase of COVID-19 vaccination. Assisted Living Facilities, and Enhanced Services Facilities Page 5 of 20 . Making nursing homes better places to live, work, and visit. More information is available, Recommendations for Fully Vaccinated People, CDCs Infection Prevention and Control Recommendations, more likely to get very sick from COVID-19, characteristics that might accelerate spread, National Center for Immunization and Respiratory Diseases (NCIRD), CDC COVID-19 Response Health Equity Strategy, Upper-Room Ultraviolet Germicidal Irradiation (UVGI), Guidance for Schools & Child Care Programs, Ventilation in Schools and Child Care Programs, Homeless Service Sites & Correctional Facilities, COVID-19 Childrens Eagle Book Coloring Storybook, U.S. Department of Health & Human Services, Facilities that serve unrelated people who live in close proximity and share at least one common room (e.g., group or personal care homes and assisted living facilities) should apply prevention strategies based on, Healthcare services delivered in these settings should be informed by. Specific recommendations are highlighted below. Use of oseltamivir in Dutch nursing homes during the 20042005 influenza season. Saving Lives, Protecting People, Nursing Homes and Assisted Living (Long-term Care Facilities [LTCFs]), Nursing Homes and Long-term Care Facilities, National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination, Tracking Infections in LTCFs Using the NHSN, Other Influenza Resources for Healthcare Providers, Tuberculosis Infection Control in Healthcare, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP), U.S. Department of Health & Human Services. According to requirements, each resident is to be vaccinated unless contraindicated medically, the resident or legal representative refuses vaccination, or the vaccine is not available because of shortage. However, in settings where the initial vaccine supply is insufficient to vaccinate all HCP, sub-prioritization of vaccine doses may be necessary. In the latest guidance, however, the CMS recommends that indoor visit should be limited in cases where an unvaccinated resident is in a county where the coronavirus positivity rate exceeds 10% and. CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Less common symptoms can include new or worsening malaise, headache, or new dizziness, nausea, vomiting, diarrhea, and loss of taste or smell. You can review and change the way we collect information below. As of October 7, 2021, all adult care facility staff must have received at least one dose of vaccine. Facility operators should balance the need for COVID-19 prevention with the impact from reducing access to daily services and programming. Consult with the health department about testing strategies, including whether to implement routine. For newly vaccinated individuals with exposure, antiviral chemoprophylaxis can be considered for up to 2 weeks following inactivated influenza vaccination until vaccine-induced immunity is acquired. Residents found to have SARS-CoV-2 and influenza virus co-infection should be placed in a single room or housed with other co-infected residents. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. If one laboratory-confirmed influenza positive case is identified along with other cases of acute respiratory illness in a unit of a long-term care facility, an influenza outbreak might be occurring. Based on greater reactogenicity observed following the second vaccine dose in phase I/II clinical trials, staggering considerations may be more important following the second dose. G) Encourage residents and HCP to remain up to date with recommended COVID-19 vaccine doses. When there is influenza activity in the local community, active daily surveillance (defined below) for influenza illness should be conducted among all new and current residents, healthcare personnel, and visitors of long-term care facilities, and continued until the end of influenza season. In some cases, facilities may choose to apply Standard Precautions and Droplet Precautions for longer periods based on clinical judgment, such as in the case of young children or severely immunocompromised residents, who may shed influenza virus for longer periods of time. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Because it can be difficult to anticipate potential for coughs and sneezes, facilities might consider having healthcare personnel routinely wear eye protection for the care of residents with influenza. Most COVID-19 deaths occur in people older than 65. COVID-19 Guidance and Resources Nursing Homes and Long-term Care Facilities Vaccine Access in Long-term Care Clinical Staff Information Fact sheets, guidelines, reports, and resources Be a Safe Resident Nursing home residents, including older adults, those who are medically fragile and those with neurological or neurocognitive conditions, may manifest atypical signs and symptoms of influenza virus infection and may not have fever. All information these cookies collect is aggregated and therefore anonymous. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Vaccinating long-term care facility residents, staff, and visitors against COVID-19 is a crucial step in preventing the spread of COVID-19 and protecting others. Restrict healthcare personnel movement from areas of the facility having illness to areas not affected by the outbreak. Clin Infect Dis 2004; 39:45964. The updated guidance, which applies regardless of a nursing home's level of vaccination status, includes the following recommendations: Source control - Everyone in a health care facility. But many assisted living facilities and other senior care communities have implemented policies that mirror much of the federal COVID-19 guidance for nursing homes, including infection-prevention practices and vaccination requirements. Baloxavir is approved for post-exposure antiviral chemoprophylaxis of influenza in persons aged 5 years and older but no data are available from clinical trials of baloxavir chemoprophylaxis of influenza in long term care facility residents. Visitors should call ahead to arrange or schedule a visit. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Consider restricting visitation by children during community outbreaks of influenza. Saving Lives, Protecting People, symptoms of influenza and COVID-19 are similar, healthcare-associated infection program in your state health department, National Institutes of Health COVID-19 Treatment Guidelines Panel, latest recommendations on treatment of nonhospitalized persons with mild-to-moderate COVID-19, Therapeutic Management of Nonhospitalized Adults With COVID-19, Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction, https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html, https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html, https://www.cdc.gov/flu/professionals/diagnosis/table-flu-covid19-detection.html, https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-molecular, https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-antigenhttps://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-antigen, https://www.cdc.gov/flu/professionals/diagnosis/table-nucleic-acid-detection.html, https://www.cdc.gov/flu/professionals/diagnosis/table-ridt.html, https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/type-duration-precautions.html, https://academic.oup.com/cid/article/68/6/895/5369363, https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm, https://www.cdc.gov/flu/highrisk/index.htm, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html, https://www.covid19treatmentguidelines.nih.gov/special-populations/influenza/, https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST, https://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), Reconstruction of the 1918 Influenza Pandemic Virus, 2022-2023 Preliminary In-Season Burden Estimate, Who is at Higher Risk of Flu Complications, Flu and COVID-19 Vaccine Coadministration, Who Should & Who Should NOT Get Vaccinated, Live Attenuated Influenza Vaccine (LAIV)/Nasal Spray Vaccine, Selecting Viruses for the Seasonal Influenza Vaccine, Flu Vaccine and People with Egg Allergies, Frequently Asked Questions on Vaccine Supply, Historical Reference of Vaccine Doses Distributed, Investigating Respiratory Viruses in the Acutely Ill (IVY), Respiratory Virus Transmission Network (RVTN), Randomized Assessment of Influenza Vaccine Efficacy Network (RAIVEN), Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN), How Vaccine Effectiveness and Efficacy are Measured, What People with a Staph Infection Should Know about Flu, Resources for Hosting a Vaccination Clinic, Overview of Influenza Surveillance in the United States, Influenza Hospitalization Surveillance Network (FluSurv-NET), Weekly U.S. Visitors. Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 was released on Dec. 23. Wearing a gown if soiling of clothes with a residents respiratory secretions is anticipated. Antiviral chemoprophylaxis should also be considered in personnel for whom influenza vaccine is contraindicated. Vaccine 2006; 24:66649. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. To limit the potential transmission of antiviral drug-resistant influenza virus, whether in chronic or acute-care settings or other closed settings, measures should be taken to reduce contact between ill persons taking antiviral drugs for treatment and other persons, including those receiving antiviral chemoprophylaxis. Residents often live in their own room or apartment within a building or group of buildings. Post-Vaccination Considerations for Residents. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. This is at the providers discretion; written consent is not required by federal law for COVID-19 vaccination in the United States (U.S.). Recommended Dosage and Duration of Treatment or Chemoprophylaxis for Influenza Antiviral Medications, CDCs influenza antiviral drugs page for health professionals, CDCs seasonal influenza vaccination resources for health professionals page, Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization PracticesUnited States, 202223 Influenza Season, Interim Guidance for Influenza Outbreak Management in Long-term Care Facilities, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), Reconstruction of the 1918 Influenza Pandemic Virus, 2022-2023 Preliminary In-Season Burden Estimate, Who is at Higher Risk of Flu Complications, Flu and COVID-19 Vaccine Coadministration, Who Should & Who Should NOT Get Vaccinated, Live Attenuated Influenza Vaccine (LAIV)/Nasal Spray Vaccine, Selecting Viruses for the Seasonal Influenza Vaccine, Flu Vaccine and People with Egg Allergies, Frequently Asked Questions on Vaccine Supply, Historical Reference of Vaccine Doses Distributed, Investigating Respiratory Viruses in the Acutely Ill (IVY), Respiratory Virus Transmission Network (RVTN), Randomized Assessment of Influenza Vaccine Efficacy Network (RAIVEN), Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN), How Vaccine Effectiveness and Efficacy are Measured, What People with a Staph Infection Should Know about Flu, Resources for Hosting a Vaccination Clinic, Overview of Influenza Surveillance in the United States, Influenza Hospitalization Surveillance Network (FluSurv-NET), Weekly U.S. Planning for personnel to have time away from work if they develop systemic symptoms following COVID-19 vaccination. Thank you for taking the time to confirm your preferences. Residents who receive a COVID-19 vaccine (or their medical proxy) also receive a fact sheet before vaccination. It is designed to assist facilities to improve their infection prevention and control practices, to prevent the transmission of COVID-19, and keep residents and the health care personnel (HCP) who care for them safe from infection. CDC recommends antiviral chemoprophylaxis with oseltamivir for a minimum of 2 weeks and continuing for at least 7 days after the last known laboratory-confirmed influenza case was identified on affected units. Ask a family member or friend to help you schedule a vaccination appointment if you cant get vaccinated on site. Considerations for sub-prioritization, of equal importance, include: Furthermore, given the storage requirements of mRNA vaccines, initial vaccine distribution may be limited to large healthcare systems with ultracold freezer capacity. Examples include: intravenous injections, wound care and catheter care.. In the setting of an influenza outbreak, empiric antiviral treatment should be given as soon as possible to residents with suspected influenza without waiting for influenza testing results, especially if results will not be available on the day of specimen collection. Mask-Wearing and Social Distance Guidance. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. If infection with an antiviral-resistant influenza virus is suspected, the local or state public health department should be notified promptly. CDC guidance for nursing homes generally also applies to other long-term care facilities. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Influenza Surveillance Report (FluView), Previous Forecasts for the 2021-2022 Season, Tools to Prepare Your Practice for Flu Season, Information for Clinicians on Influenza Virus Testing, Multiplex Assays Authorized for Simultaneous Detection of Influenza Viruses and SARS-CoV-2, Information on Collection of Respiratory Specimens for Influenza Virus Testing, Information for Clinicians on Rapid Diagnostic Testing for Influenza, Information on Rapid Molecular Assays, RT-PCR, and other Molecular Assays for Diagnosis of Influenza Virus Infection, Algorithm: Interpreting Influenza Testing Results When Influenza is Circulating, Algorithm: Interpreting Influenza Testing Results When Influenza is NOT Circulating, Guide: Influenza Diagnostic Testing in Closed Setting Outbreaks, Guidance: Standard-Based Electronic Laboratory Reporting, Guidance: Antiviral and Obstetric Health Care, Guidance: Outbreak Management in Long-Term Care Facilities, Guidance: Use of Mask to Control Influenza Transmission, Guidance: Prevention & Control in Peri- and Postpartum Settings, U.S. Department of Health & Human Services. For more information on the antiviral agents see CDCs influenza antiviral medication page for health professionals. Guidance for Infection Control and Prevention for Nursing Facilities: Revised Guidance- March 9, 2020. Cheng HY, Chen WC, Chou YJ, Huang AS, Huang WT. ONeil CA, Kim L, Prill MM et al. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. They help us to know which pages are the most and least popular and see how visitors move around the site. There are no data on baloxavir in these populations. CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Spread of influenza can occur between and among residents, healthcare personnel and visitors. Infectious Diseases Society of America (IDSA) 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza. For those living in a county listed in the Medium/Yellow category . If you have additional questions about how to get a COVID-19 vaccine, talk with your healthcare provider. Evidence suggests that pregnant women are potentially at increased risk for severe COVID-19-associated illness and death compared to non-pregnant women, underscoring the importance of disease prevention in this population. Bush KA, McAnulty J, McPhie K, et al; Southern New South Wales Public Health Unit. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Read the full CDC guidance here. CDC and the Advisory Committee on Immunization Practices (ACIP), recommend that all U.S. healthcare personnel get vaccinated annually against influenza. Essential Caregiver Guidance This interim guidance provides guidelines for nursing homes and other long-term care (LTC) facilities on the appropriate use of essential caregivers (ECs) to provide companionship and assist residents with activities of daily living. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Test for influenza with a molecular assay in the following: Ill persons who are in the affected unit(s) as well as previously unaffected units in the facility, Persons who develop acute respiratory illness symptoms after beginning antiviral chemoprophylaxis. Active surveillance for additional cases should be implemented as soon as possible once one case of laboratory-confirmed influenza is identified in a facility. Learn about COVID-19 mask requirements in Massachusetts. All information these cookies collect is aggregated and therefore anonymous. van der Sande MA, Ruijs WL, Meijer A, Cools HJ, van der Plas SM. You will be subject to the destination website's privacy policy when you follow the link. Baloxavir is not recommended for pregnant women, severely immunosuppressed persons, those with severe disease, or hospitalized influenza patients. 1. They help us to know which pages are the most and least popular and see how visitors move around the site. Saving Lives, Protecting People, Vaccine Recommendations and Guidelines of the ACIP, Pharmacy Partnership for Long-Term Care Program, National Center for Immunization and Respiratory Diseases, Comprehensive Recommendations and Guidelines, Preventing and Managing Adverse Reactions, Vaccine Recommendations for Emergency Situations, CDC's International Travelers Yellow Book, Clinical Travel Notices, Updates, and Vaccine Shortages, U.S. Department of Health & Human Services, HCP with direct patient contact and thus who are unable to telework, including those who work in inpatient, outpatient, or community settings, who provide services to patients or patients family members, or who handle infectious materials, HCP working in residential care or long-term care facilities, HCP with documented acute SARS-CoV-2 infection in the preceding 90 days may choose to delay vaccination until near the end of the 90 day period in order to facilitate vaccination of those HCP who remain susceptible to infection, as. Merritt T, Hope K, Butler M, et al. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Oseltamivir prophylaxis in controlling influenza outbreak in nursing homes: a comparison between three different approaches. Influenza Surveillance Report (FluView), Previous Forecasts for the 2021-2022 Season, Tools to Prepare Your Practice for Flu Season, Multiplex Assays Authorized for Simultaneous Detection of Influenza Viruses and SARS-CoV-2, Information on Collection of Respiratory Specimens for Influenza Virus Testing, Information for Clinicians on Rapid Diagnostic Testing for Influenza, Algorithm: Interpreting Influenza Testing Results When Influenza is Circulating, Algorithm: Interpreting Influenza Testing Results When Influenza is NOT Circulating, Guide: Influenza Diagnostic Testing in Closed Setting Outbreaks, Guidance: Standard-Based Electronic Laboratory Reporting, Guidance: Antiviral and Obstetric Health Care, Guidance: Outbreak Management in Long-Term Care Facilities, Guidance: Use of Mask to Control Influenza Transmission, Guidance: Prevention & Control in Peri- and Postpartum Settings, U.S. Department of Health & Human Services, Infection Prevention and Control Measures, Influenza-related illness and death, especially among people at increased risk for severe influenza complications. Centers for Disease Control and Prevention. These include the following: LTC providers are encouraged to consider the option that works best for their residents and staff when coordinating access to COVID-19 vaccines, either in the local community or on-site. risks and benefits of the vaccines, offer to administer the vaccine, and report residentand staff vaccination data to CDC's National Healthcare Safety Network. CDC twenty four seven. Published: September 23, 2022. covid19@ahca.org. Last updated: December 29, 2022 Changes to visitor guidance Social visits have resumed at long-term care facilities. While highly effective, antiviral chemoprophylaxis is not 100% effective in preventing influenza illness. 2019 Aug 5;19(1):210. doi: 10.1186/s12877-019-1236-6. This care may represent custodial or chronic care management or short-term rehabilitative services. When at least 2 patients are ill within 72 hours of each other and at least one resident has laboratory-confirmed influenza, the facility should promptly initiate antiviral chemoprophylaxis with oral oseltamivir to all non-ill residents living on the same unit as the resident with laboratory-confirmed influenza (outbreak affected units), regardless of whether they received influenza vaccination during the current season. They help us to know which pages are the most and least popular and see how visitors move around the site. When should a facility choose to implement quarantine? lf exposed residents on units or wards with influenza cases in the long-term care facility (currently impacted wards) should receive antiviral chemoprophylaxis as soon as an influenza outbreak is determined (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935). CDPH recognizes the importance that visitation and social . CDC has developed many resources specific to help support long-term facilities during the COVID-19 pandemic. The Quarantine and Isolation Intake Call Center is open 7 days a week from 8am-8pm: 833-596-1009. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. March 10, 2020. On April 27, 2021, CDC released updated healthcare infection prevention and control recommendations in response to COVID-19 vaccination, and CMS issued a revised QSO 20-39-NH (PDF) with updated guidance for visitation, group activities and communal dining in nursing homes accounting for the impact of COVID-19 vaccination. You can review and change the way we collect information below. Persons receiving antiviral chemoprophylaxis should not receive live attenuated influenza virus vaccine (LAIV), and persons receiving LAIV should not receive antiviral treatment or chemoprophylaxis until 14 days after LAIV administration. Therefore, they can add combinations of these enhanced prevention strategies as feasible for a layered approach to increase the level of protection. Cookies used to make website functionality more relevant to you. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. LTCFspdf icon provide a spectrum of medical and non-medical services to frail or older adults unable to reside independently in the community. Guidance for Fully Vaccinated Residents of Assisted Living Facilities Fully vaccinated residents of assisted living facilities may follow the CDC's recommendations for individuals who have been fully immunized against COVID-19 as described below: Fully vaccinated residents can gather with other fully vaccinated residents without masks 2019 Nov;40(11):1309-1312. Since October 2005, the Centers for Medicare and Medicaid Services (CMS) has required nursing homes participating in Medicare and Medicaid programs to offer all residents influenza and pneumococcal vaccines and to document the results. CDC. Interim Guidance for Influenza Outbreak Management in Long-Term Care and Post-Acute Care Facilities. COVID-19 vaccines are safe and effective especially against becoming seriously ill, being hospitalized and dyingand very important for older adults. Cookies used to make website functionality more relevant to you. J Hosp Infect 2008; 68:837. Testing Initiation of antiviral treatment should not wait for laboratory confirmation of influenza. An emphasis on close monitoring and early initiation of antiviral treatment is an alternative to chemoprophylaxis in managing certain persons who have had a suspected exposure to influenza virus. Determine if influenza virus is the causative agent by performing influenza testing on upper respiratory tract specimens (i.e., nasopharyngeal swab, nasal swabs, nasopharyngeal or nasal aspirates, or combined nasal and throat swabs) of ill residents with recent onset of signs and symptoms suggestive of influenza or acute respiratory illness. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Sub-prioritization of LTCF residents for COVID-19 vaccination ACIP recommends that LTCF residents be prioritized in the earliest phase of COVID-19 vaccination. assisted living communities). There are no FDA-cleared influenza diagnostic assays that utilize saliva specimens. their vaccination status or to show proof of vaccination. Infection prevention and-control measures are especially important for patients who are immunocompromised to reduce the risk for transmission of oseltamivir-resistant viruses. D) Test for other respiratory pathogens; if residents with acute respiratory illness test negative for both influenza and SARS-CoV-2 consider additional viral or bacterial testing based on respiratory pathogens known or suspected of circulating in the community. For the latest information on influenza vaccination, see. Since the release of the last Order, millions of vaccinations have since been administered to residential care facility residents and staff, and these vaccines have been shown to help prevent COVID-19 infection. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Effectiveness of post-exposition prophylaxis with oseltamivir in nursing homes: a randomised controlled trial over four seasons. Some patients, such as older adults, children with neuromuscular disorders, and young infants, may have atypical clinical presentations. Thus, coordination between state and local health officials and healthcare administrators is needed to ensure vaccine access to HCP not affiliated with hospitals. Centers for Disease Control and Prevention. Recommendations for treatment of persons with COVID-19 are available from the National Institutes of Health COVID-19 Treatment Guidelines Panel. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. You can review and change the way we collect information below. The previous CMS guidelines, issued in September 2020 and largely adopted by the states, recommended allowing indoor visits if a facility has been case-free for 14 days and is located in a county with a positivity rate on coronavirus tests of less than 10 percent. Treatment should be administered as soon as possible for nursing home residents with mild-to-moderate COVID-19 because they are at high risk of progression to severe COVID-19.