AHCA: COVID-19 Update #32 - Revised Resources on Cohorting and When COVID-19 Gets In

Jackie Pappalardi and Amy Kennedy in Clinical & Quality

In This COVID-19 Update:

  • When COVID Gets into Your Facility
  • Cohorting
  • The Census and COVID-19
  • New AL Data from the CDC 

Updated: When COVID-19 Gets into Your LTC Facility (Assume It's Already There)

AHCA/NCAL has updated this resource as COVID-19 is rapidly spreading across the country and is increasingly impacting nursing homes and assisted living communities. Due to the rapid progression of this virus, centers should assume it is already in their surrounding community and may be in their facility. This resource outlines four action steps.

Updated: Cohorting Residents During COVID-19

AHCA/NCAL has updated this cohorting consideration guide, as CMS released new guidance on April 2 related to this topic.

All nursing homes and assisted living communities should make plans for cohorting residents now, even before COVID-19 enters the building per CMS guidance. Cohorting is imperative to help control the spread of the virus. If possible, nursing homes and assisted living communities should also begin preparing wings, units or floors as “isolation units”. Isolation unit should be a separate, well-ventilated area, ideally with a separate entrance. 

COVID-19 Update on 2020 Census for Health Care Group Quarters Administrators

The 2020 Census is underway, but due to concerns about accepting visitors to a skilled nursing facility, assisted living community, ICF/IID facility, or other group quarters, some adjustments to their approach are being made. 

If you have elected to use the “In-Person” or the “Drop-off/pick-up” method for reporting data on individuals in your building, the Census Bureau will be reaching out to ask you to select either the “eResponse” or the “Paper Response Data Collection” options. These would entail the following:

  1. Electronic Response Data Transfer (eResponse) – The group quarters administrator fills in a template with group quarters data and respondent level data for each person who is staying at the facility on Census Day (April 1, 2020). The group quarters administrators electronically send the census response data to the Census Bureau. Please note: the eResponse option is not available for service-based administrators.
  2. Paper Response Data Collection – A census worker meets with the administrator of the facility to obtain a paper listing of census response data for each person who is served or staying at the facility on April 1, 2020.

More detailed information on enumeration types may be found in our previous blog post or on the Census Bureau website. More extensive explanations on how and why changes are being made may be found in a Census Bureau memo and on their COVID-19 Monitoring Page.

CDC Issues Report on Assisted Living COVID Experience in Seattle 

CMS released a Morbidity and Mortality Weekly Report (MMWR) yesterday (April 3) on an assisted living and independent living community in Seattle related to the COVID-19 outbreak. The report found that early intervention, increased social distancing among residents, and less contact with health care providers were possibly effective at minimizing the spread of the virus in an assisted living setting. More specifically:

  • residents were isolated in their rooms with no communal meals or activities 
  • no visitors were allowed in the facility
  • staff members were screened and symptomatic staff members were excluded from entering 
  • enhanced hygiene practices were put into effect, including cleaning and disinfection of frequently touched surfaces and additional hand hygiene stations in hallways for workers to use 

Among the 142 residents and staff members tested during the initial phase, three of 80 residents (3.8%) and two of 62 staff members (3.2%) had positive test results. 

The report also found that symptom screening is unlikely to be sufficient to identify all persons infected. Three of four residents who had positive test results were asymptomatic. 

All assisted living providers are strongly encouraged to review CDC guidance for LTC Facilities as well as AHCA/NCAL’s guidance for ALs on limiting the spread of COVID-19, and are encouraged to minimize the number of interactions with residents by reducing the number of various (non-essential) people entering the building, targeting the number of interactions with residents, and instituting non-communal dining.


Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16

Amy Kennedy
Executive Director, NYSCAL
518-462-4800 x17