How to Safely Manage a Nursing Home Facing a Surge in COVID-19 Cases

safely managing nursing home during covid19

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Nursing homes or assisted living homes have been one of the hardest hit facilities due to COVID-19. While accounting for only 5% of California’s total coronavirus cases, 35% of deaths related to COVID-19 are attributed to nursing homes since early spring. In total, there have been 7,422 deaths reported at nursing home facilities in California.


In light of these statistics, nursing homes must take careful precautions to protect their residents. The introduction of vaccines certainly offers a glimmer of hope. But, until there is widespread distribution among the public, nursing facilities must not let their guard down in protecting the most vulnerable.


Four-Pronged Strategy

In an article published by the International Journal for Quality in Health Care, health experts break down the safety management process during a COVID-19 outbreak within nursing homes in four phases:

  • Protection of healthcare professionals: Assisted living workers and staffing within the care home require adequate training to handle an outbreak. Supplies of PPE must be sufficient to prevent operators from being vehicles of infection. There should also be adequate support in terms of proper staffing, break times, and the staffs’ mental health.
  • Management of COVID-19 cases: Upon an outbreak, it’s recommended to provide single-room isolation, keeping doors closed. Maintain adequate ventilation in both the rooms and the facility. Medical devices for monitoring should also be left in the room.
  • Prevention of spreading among guests: Preventing spread among the guests involves a variety of measures, including controlling movements between different areas, reorganizing the facility into separate operating areas, and promoting hygiene. 
  • Management of visitors’ access: Limit visits by family members, authorizing visits only if compliance with all precautions is possible. It’s still important to allow alternative means of communication between guests and family members through phone, video chats, etc.


Implementing an Infection Prevention and Control (IPC) Program

One key way to protect both assisted living workers and residents is to have a strong infection, prevention, and control (IPC) program in place. The CDC recommends having at least one individual with training in infection prevention and control to implement an IPC program within a nursing home. The IPC program entails developing policies, performing infection surveillance, offering training, and auditing of IPC practices.

According to the CDC, this should be a full-time role for a person in facilities with over 100 residents. Other facilities should also consider having this role if they provide on-site ventilator services, hemodialysis services, or smaller facilities deemed to be high risk.


Recommended Practices for Nursing Homes Facing COVID-19

As the surge in COVID-19 intensifies, nursing homes need to be diligent in their measures, including abiding by state guidelines and regulations. Below we list some general guidelines for nursing homes facing COVID-19. 



Regularly relay up-to-date information to residents, staff, and families. This includes updating them on the current measures taken at the facility and actions they must take to protect themselves.

For staff, clearly communicate sick leave policies. Remind them not to report in for work if they have any symptoms. Keep staff updated with any new policies or procedures.

For residents and family members, educate them on current measures. Communicate any visitor restrictions and ways to protect themselves when inside the facility. Advise on best practices to fight against COVID-19 like hand-washing, social distancing, and source control.



Visitation must abide by all California state requirements, including adhering to the core principles of COVID-19 infection prevention. Outdoor visitation is preferred due to the lower risk of transmission. However, if outdoor is not possible, indoor visitation is permitted given proper measures are taken. These measures include social distancing, barriers, and meeting in large communal indoor spaces. 

Visitors entering the facility must be screened for COVID-19 symptoms. Facial covering and proper hand hygiene are also mandatory. Indoor in-room visitation is allowed if they meet various criteria set out by the state of California. Nursing homes should monitor these criteria carefully as cases progress to ensure they are adhering to the requirements.


Infection Prevention

Nursing homes should take various infection prevention measures to fight against COVID-19 spread. Here are some general guidelines for infection prevention:

  • Ensure sufficient signage on COVID-19 educational material is located throughout the facility
  • Screening of anyone who enters the facility for symptoms of COVID-19
  • Social distancing of 6 feet should be maintained at all times
  • No hand-shaking, hugging, or physical contact
  • Include physical barriers to reduce risk of transmission when possible
  • Disinfection of rooms immediately after a resident visit
  • Frequent disinfection of high-touch surface areas
  • Staff must wear a mask when interacting with residents
  • Develop a process for decontamination of PPE
  • Allocate dedicated space for residents with COVID-19



Testing in nursing homes plays a key role in fighting COVID-19. It helps detect current infections among residents and staff, allowing you to respond effectively in mitigating further spread.

Nursing homes should develop a testing plan for assisted living staff and residents in accordance with Title 42 CFR 483.80(h). The plan should address issues, such as triggers for performing testing, a process for the testing, and a procedure for those who refuse or are unable to be tested. Facilities should arrange for access to testing and laboratories to process the tests.


Supplies & Equipment

Hand hygiene supplies should be available and well-stocked. Sanitizer should be 60-95% alcohol-based. They should be located in each resident room and common areas. Trash cans should also be near the exit inside the residents’ room to allow staff to easily dispose of PPE.

Carefully monitor personal protective equipment (PPE) inventory. Supplies of facemasks, respirators (if applicable), eye protection, gloves, and gowns should be readily available.


Joynus: Staffing Solutions for the Healthcare Industry

For a detailed list of recommended guidelines, refer to the California Department of Public Health and CDC’s guidance in preparing for COVID-19 in nursing homes.

Joynus works with various healthcare providers to ensure their staffing needs are met. We are a data-driven agency utilizing state of the art software, search algorithms, and data analysis to provide you with staffing solutions.

Contact us today to see how we can help you.