Report

Risk Assessment and Testing Considerations for SARS-CoV-2 Transmission in Congregate Care Facilities

With over two million seniors and Americans with disabilities currently living in nursing homes and other congregate care facilities (CCFs) across the United States, this at-risk group has been disproportionately impacted by the Covid-19 pandemic: 140,000 residents and 1,000 staff have died since March 2020. In response, a new report by the Duke-Margolis Center for Health Policy, with support from The Rockefeller Foundation, provides technical guidance to develop testing protocols to significantly reduce the risk of Covid-19 transmission and protect residents, staff, and visitors, as vaccination efforts scale up.

CCFs, which also encompass assisted living facilities, memory care units, and independent living communities, serve those who require support services but do not need the high level of consistent medical care provided in nursing homes. Although vaccinations can reduce the risk of Covid-19 transmission in these facilities, testing should continue to be prioritized as the consequences–death and severe morbidity –remain high in these communities.

While the federal government has released testing guidance for federally regulated nursing homes, there is no guidance for CCFs that take into consideration different risk factors in these settings. A distinguishing feature of many CCFsis that they provide residential and care services but are not inherently medicalized facilities. The culture and regulatory requirements de-emphasize the medical model, which often results in fewer infection control procedures and medical resources.  Furthermore, CCFs are lower on the vaccination prioritization list than nursing homes.

To help CCF administrators address these risks, this report provides detailed guidance on testing, an important added layer of protection to reduce risk of Covid-19 and better inform decision making should an outbreak occur. Building off the Covid-19 testing framework published in September 2020, the report recommends that testing protocols be customized for individual facilities based on a risk assessment and provides testing strategies based on low, moderate, higher, and highest risk.

 

  • Report

    Risk Assessment and Testing Considerations for SARS-CoV-2 Transmission in Congregate Care Facilities

    With over two million seniors and Americans with disabilities currently living in nursing homes and other congregate care facilities (CCFs) across the United States, this at-risk group has been disproportionately impacted by the Covid-19 pandemic: 140,000 residents and 1,000 staff have died since March 2020. In response, a new report by the Duke-Margolis Center for […]
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