COVID-19 Resources for Skilled Nursing Facilities


   COVID-19 Guidance

   Health System Guidance

   Clinical Management

   Communicable Disease Reporting

   COVID-19 Vaccines 

   Data and Modeling

   Flu Vaccine

   Infection Control

   Lab Testing

   Mental Health & Wellness

   Palliative Care/Goals of Care

   PHE 3-Day Waiver Guidance

   Research Studies


   Telemedicine Resources

   Visitation Guidance

   Workforce Training

   Other Resources



Duke PHMO will continue to collaborate with our SNF providers during this pandemic. The following links represent the best resources for Skilled Nursing Facilities in our community. We will continue to update this page as new information is received. If you have any questions or would like to add any additional resources, please contact:

Additionally, we have assembled a team that includes experts in infectious disease, geropsychiatry, palliative care, and case management to answer questions and find solutions for a variety of situations. To submit a question to the team on one of these topics, please submit your questions using the link below:

Latest Updates:



Duke Health WORDS of HOPE eNewsletter Archive


Update Patient Transfer Instructions for SNFs


SNF COVID-19 Advisory Team FAQs & Question Submission


SNF Resources Box Folder*


Duke Health WORDS of HOPE eNewsletter: If you would like to sign up to receive regular updates from the Duke Health SNF Collaborative, click HERE!



Nursing Homes Care from NCHCFA on Vimeo.



COVID-19 Guidance

American College of Physicians (ACP) Online COVID Guide

American Health Care Association (AHCA)

AMDA (Society for Post Acute and Long Term Care)


CMS COVID-19 Public Health Emergency Tip Sheet

CMS Nursing Home Resource Center

Coronavirus Commission on Safety and Quality in Nursing Homes Final Report

COVID-19: Considerations, Strategies, and Resources for Crisis Standards of Care in Post-Acute and Long-Term Care (PALTC) Facilities [PDF]

COVID-19 Healthcare Resilience Workgroup: Considerations, Strategies, and Resources for Crisis Standards of Care in Post-Acute and Long-Term Care (PALTC) Facilities 

Duke Infection Control Outreach Network (DICON)

Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19

Leading Age

NIH COVID-19 Treatment Guidelines

NC Department of Health and Human Services

North Carolina Healthcare Association

North Carolina Healthcare Facilities Association

Office of Inspector General COVID-19 Portal (updated August 4)



NC Health Systems and Hospitals COVID-19 Pages

Appalachian Regional Healthcare System

Atrium Health

Cape Fear Valley Health



First Health

Granville Health System


Maria Parham Health

Mission Health

NC Specialty Hospital

New Hanover Regional Medical Center

Novant Health

Person Memorial Hospital

Southeastern Health

UNC Healthcare

US Department of Veteran Affairs:



Wake Forest Baptist Health

Wilson Medical Center


Palliative Care/Goals of Care Resources

AMDA: Advance Care Plan Tool—Managing Acute Respiratory Distress During the COVID-19 Pandemic

Being Prepared in the Time of COVID-19 Conversation Guide

Center to Advance Palliative Care

CMS Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes

Completing POLST Forms in Crisis Standards of Care

Go to the hospital or stay here? Decision Guide

HPCO: When Families can Not Be Present at the Time of Death

Institute for Healthcare Improvement: Free Guides from The Conversation Project

My Directives

National Center of Advancing Person-Centered Practices and Systems (NACPPS)

National POLST

Serious Illness Care Program COVID-19 Response Toolkit

The Urgency of Now: Ask your patients about goals of care (Medium article)

Updates to Advance Health Care Directives

Vital Talk COVID Goals of Care video


Infection Control

AIA: Strategies for Safer Senior Living Communities

Alliant Quality

Appropriate PPE During COVID-19 Response (DICON)

Association for Professionals in Infection Control and Epidemiology

COVID-19 North Carolina LTC Healthcare Resource Request Form


CMS QSEP: CMS Targeted COVID-19 Training for Frontline Nursing Home Staff & Management

DICON Educational Webinar Q&A with Dr. Edmond - Face Shield Use in Hospitals, Clinics and the Community

Duration of Isolation Precautions of Adults with COVID-19

How to Make your Mask Tighter [Video]

Infectious Diseases Society of America Guidelines on Infection Prevention in Patients with Suspected or Known COVID-19

In Every Space, Cover Your Face (Printable Signage for Facilities)

LeadingAge Infection Control Survey Tool


N95 Seal Check

Prevention and Management of Skin Damage related to PPE (NSWOC)

PPE Conservation Strategies

Preventing and managing COVID-19 across long-term care services: Policy brief, 24 July 2020

Respiratory Etiquette Video


Statewide Program for Infection Control and Epidemiology (SPICE)

Tips for Communicating Through a Mask

Tips for Healthcare Workers Returning Home from Work

Universal Masking

WHO: Infection prevention and control guidance for long-term care facilities in the context of COVID-19 [PDF]


Workforce Training

AHCA free online 8-hour nursing aid training

COVID-19 Healthcare Workforce Toolkit


Lab Testing

AMDA COVID-19 Testing Strategies Statement

AMDA Position Statement on Antigen Testing in Asymptomatic Post-Acute and Long-Term Care Healthcare Staff

AMDA: State Recommendations for Use of Antigen Testing

CDC: Antigen Test Algorithm

CDC: Considerations for Interpreting Antigen Test Results in Nursing Homes

CDC: Guidance for SARS-CoV-2 Point-of-Care Testing

CDC: Testing Guidance for Nursing Homes

CDC: Considerations for Performing Facility-wide SARS-CoV-2 Testing in Nursing Home

CDC: Interim Guidelines for COVID-19 Antibody Testing

CMS: Clinical Laboratory Improvement Amendments (CLIA): Testing Requirements for SARS-CoV-2

CMS: Frequently Asked Questions: COVID-19 Testing at Skilled Nursing Facilities/ Nursing Homes

CMS: Medicare Payment for COVID-19 Viral Testing: Skilled Nursing Facility/Nursing Facility

CMS: New COVID 19 Testing and Reporting Requirements

CMS: Testing of Nursing Home Staff and Residents

COVID-19 Testing Supplies Request Form: NC Division of Public Health

CVS Health Introductory Webinar on Point-Prevalence Surveys in SNFs 

FDA News Release: Abbott ID NOW Point-of-Care Test

FDA FAQs on Testing for COVID-19


NC DHHS: Find My Testing Place

NC DHHS: Using, Interpreting, & Responding to COVID-19 Antigen Tests [PDF]

NCDHHS to Pay for Ongoing Testing of Nursing Home Staff; Codifies Requirement for Biweekly Nursing Home Staff Testing

Nursing Home Data - Point of Care Device Allocation


Updated HHS NHSN Reporting Requirements



Data and Modeling

CDC Case Updates

CDC COVID-19 Forecasts

CDC Nursing Home Data Quality FAQs

CDC Tracker: US COVID-19 Cases Caused by Variants

CMS: COVID-19 Nursing Home Data

COVID-19 North Carolina Dashboard


Data USA

IHME (Institute for Health Metrics & Evaluation)

John Hopkins Coronavirus Resource Center


NC DHHS COVID-19 Ongoing Outbreaks in Congregate Living Settings

The COVID Tracking Project

Research Studies

ACTIV-2 Study

The ACTIV-2 Study is testing different medicines to see if they are safe and can help adults with COVID-19. Finding treatments for COVID-19 is important because the virus is spreading quickly all over the world and can cause serious sickness and even death. More information can be found here.


Margolis Center for Health Policy

A team at the Margolis Center for Health Policy at Duke University is currently working on a Robert Wood Johnson Foundation-funded research project to study skilled nursing facilities’ experiences during the COVID-19 pandemic, which includes a focus on the pandemic’s effect on recent payment reforms and how new payment models can help facilities in the short and long term. Given the significant challenges post-acute care facilities have faced during the pandemic, the team hopes to determine what strategies have helped facilities to provide high-quality care during this time and how policies, particularly those focused on payment, can be designed to assure SNFs have the resources necessary to continue caring for individuals. The research team is interested in discussing this topic with SNF facilities and chains, trade associations, and other experts in the field to develop an issue brief to be published in early 2021. The Duke-Margolis team would like to learn more about facilities’ experiences during 1-hour interviews with SNF leadership. If your facility is interested in participating, please contact Rachel Roiland at to learn more.


Pandemic Response Network Study: Duke Community Health Watch

The Pandemic Response Network (PRN) is a network of organizations working with public and private partners to connect people with the critical and supportive resources they need. PRN’s mission is to help people stay safe and connected during pandemics. Launched in April 2020, the PRN’s principal service offering is the Community Health Watch COVID-19 symptom support program. Community Health Watch uses a web-based survey and a team of healthcare professionals who provide feedback and guidance to participants on how to care for themselves. The team calls people across North Carolina when symptoms of are serious enough to seek care at a hospital or a healthcare facility.


Investigating the Unintended Impacts of COVID-19 Isolation and Uncertainty in Long-Term Care Settings 
A new pilot study within the Duke Population Health Management Office is aiming to improve the quality of care in SNFs during the COVID-19 pandemic. SNF staff will be asked to participate in a 30-minute teleconference or phone interview to discuss challenges they have faced promoting mobility and social interaction among residents while implementing COVID-19 mandated infection control procedures.

  • Participants will be compensated for their time.
  • Participation will have no bearing on employment in SNF
  • Individual staff members may contact Dana Guggenheim at

For a printable flyer, click here: Full Color or Black & White


Healthcare Worker Exposure Response & Outcomes (HERO) Registry

The HERO-HCQ trial is still enrolling healthcare providers (HCP).  As of June 18, approximately 900 HCP across the country enrolled. Approximately 50 of these have been enrolled at Duke University.

Why participate? HCP remain at risk for COVID-19.

  • COVID-19 is increasing in the community and in the hospital. For example, the number of patients hospitalized with COVID-19 in Duke University Hospital this week has been as high as ever. 
  • COVID-19 cases in HCP are increasing in the Raleigh-Durham.
  • We have revised study procedures and can now offer participants a $25 voucher.

Enroll for the registry at!



Covidentify is a new Duke study investigating whether your smartphone and smartwatch could determine whether or not you have COVID-19 or Influenza (flu). All we ask is that you answer two simple questions each day for up to 12 months: Were you within 6 feet of other people? Do you feel sick? If you feel sick, we will ask you a few more questions. 

If you have a Fitbit, Garmin, or Apple Watch, you can connect that too. We have a limited number of wearable devices to give out (Apple Watch, Garmin, Fitbit) for participation in the study for those who are most at risk for COVID-19 infection. This includes front line workers and family members of those who may be infected. Please email us at Signup on your smartphone, tablet, or computer at and receive the daily questions by an iPhone app, text message, or email. By joining, you will play a pivotal role in helping our team learn how to detect COVID-19 early in order to facilitate better outcomes for all. Even those who do not display symptoms can spread the disease.


Probiotics to Prevent COVID-19

Join the clinical trial investigating Probiotics to Prevent COVID-19. Researchers Paul Wischmeyer and Anthony Sung at Duke University have identified a probiotic (live bacteria, as is present in yogurt) that has the potential to decrease COVID-19 infection by 30-50%. They are currently developing a clinical trial to use this probiotic to prevent COVID-19 in skilled nursing facilities for residents and staff. If you are interested in working with them, please contact



Vendors Contacts Phone #s
Medical Staffing Network Michele Spangler 919-876-3490
Dzeel Clinical Healthcare Staffing Christina Truelove 919-398-6333
Favorite Healthcare Rodney Jones 919-294-9999 ext: 2903
Interim Healthcare Diane Nelson 919-493-7575
Nurse Care of North Carolina Tammy Parrish 919-309-4333
Accountable HC Patricia Best 919-436-4352
Advantage RN Anne Donlin 513-603-3747
Supplemental Healthcare Kathryn Patchel 716-541-2627 
National Health Care Solution LLC Laura Fisher 919-459-6427
Superior Medical Staffing Christie Carlsen 919-554-2586
Nurse Finders Kellee Falin 336-794-4013

CDC: Strategies to Mitigate Healthcare Personnel Staffing Shortages NEW!


Communicable Disease Reporting

5-step Enrollment in NHSN for Long-term Care Facilities

CMS Communicable Disease Reporting Requirements Memo 4/19/20

CMS COVID-19 Nursing Home Reported Data

CMS Interim Final Rule for SNFs and COVID-19 Reporting

Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes

Long Term Care Facility Reporting Data Summary

National Healthcare Safety Network (NHSN)

NHSN Long Term Care Facility Enrollment Guide Training 

NHSN Long Term Care Facilities COVID-19 Module


Telemedicine Resource

Alliant Quality Telehealth 101 - A Tip Sheet for Patients

CMP Funds Application Template COVID-19 Communicative Technology Request

CMS Telehealth Toolkit

Duke Health Telehealth Options

JAMDA: Standards for the Use of Telemedicine for Evaluation and Management of Resident Change of Condition in the Nursing Home

The Keys to Effective Telemedicine for Older Adults

West Health: A practical guide to implementing health in PALTC


Mental Health and Wellness

Colorado Dementia Partnership develops tools to support PA/LTC staff during COVID-19 #1: Supporting You, Supporting Us

Colorado Dementia Partnership develops tools to support PA/LTC staff during COVID-19 #2: Have You Changed?

Compassion Fatigue/Burnout Assessment Tool

Coping with Disaster or Traumatic Event (CDC)

Grief Leadership During COVID-19 (CSTS)

Heroes Health Initiative: Mental Health Resources for Healthcare Workers

HOPE4Healers Hotline

How to Deal with the Death of a Patient (ANA)

Keeping People Connected with and Infection Prevention and Control Mindset (NHCA/NCAL)

Psychological First Aid Field Operation Guide for Nursing Homes

SAMHSA Disaster Distress Helpline

Self-Compassion Guided Meditation and Exercises

Strategies to Support the Health and Well-Being of Clinicians During the COVID-19 Outbreak (NAM)

Supporting Frontline Staff Cheat Sheet

The Well-Being Initiative APNA

VIA Character Strengths Survey

Vibrant Emotional Health Safe Space Website


Visitation Guidance

CMS Nursing Home Reopening Recommendations for State and Local Officials

CMP Reinvestment Application Template for COVID-19 In-Person Visitation Aids Request


Clinical Management

AMDA and ASCP: Monoclonal Antibody Treatment in Senior Care Environments

AMDA: Guidance on Anticoagulation with COVID-19 in PALTC

CDC: Clinical Care Guidance for Healthcare Professionals about Coronavirus

CDC: Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19)

CMS Toolkit for COVID-19 Monoclonal Antibody Infusion

CMS Infographic on COVID-19 Monoclonal antibody treatment coverage

COVID-19 Monoclonal Antibody Treatments: Using Evolving Evidence to Improve Care in the Pandemic [White Paper]

COVID-19 Self Management Zone Tool [PDF]

ECHO COVID-19 Global Conversations Webinar on Monoclonal Antibody Treatment [Video]

ECHO Outpatient Therapeutics Mini-Series 

Eli Lilly BLAZE-2 COVID-19 Prevention Trial Press Release

HHS/ASPR Bamlanivimab webpage

HHS/ASPR Casirivimab/Imdevimab webpage

NICA COVID-19 Antibody Therapy Resource Center

NIH: COVID-19 Treatment Guidelines


COVID-19 Vaccines

AHCA: Accessing COVID-19 Vaccine in Long Term Care [PDF]

Alliant Quality COVID-19 Vaccine Resources

AMDA: State Strategies for Ongoing Post-Acute and Long-Term Care Resident and Staff COVID-19 Vaccination [PDF]

AMDA – The Society for Post-Acute and Long-Term Care Medicine

Centers for Disease Control and Prevention

Center for Medicare & Medicaid Services (CMS)

COVID-19 Vaccination Video Update for Long-term Care Employees (Iowa Health Care Association)

Duke Health

NEW! Durham County: COVID-19 vaccines for homebound patients residing in Durham County are now available through a partnership between the Durham County Community Paramedics and the Durham County Health Department. Referrals for Duke patients can be emailed to Elissa Nickolopoulos, MSW, LCSW-A. For non-Duke facilities, send your email request to Capt. Helen Tripp of the Durham County Community Paramedics. Please include in your email the patient's contact information and whether or not the patient has verbally consented.

Greater Than COVID: The Conversation [Video]

HCA/NCAL COVID-19 Vaccination Toolkit

Immunization Action Coalition

Janssen COVID-19 Vaccine Questions (Johnson & Johnson)

JHU-UW Vaccine Symposium [video]

MMWR: The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Janssen COVID-19 Vaccine

NC Department of Health and Human Services

Presentation: What Clinicians Need to Know About the Pfizer-BioNTech COVID-19 Vaccine [PDF]

Pfizer-Biontech Vaccine Fact Sheet (for vaccination providers) - Click Here to download [PDF] and Click Here to check for updates.

Product information: Janssen COVID-19 Vaccine (Johnson & Johnson)

The Advisory Committee on Immunization Practice (ACIP) Meeting Information

The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020

US DHHS Tell Me More | Episode 1 | Tell Me More About Vaccines [video]

Vaccine and Related Biological Products Advisory Committee (VRBPAC) Meeting Information


Flu Vaccine

AMDA Flu Resources

CDC: Toolkit for Reaching Healthcare Professionals

CMS Flu Vaccine Partner Toolkit

Duke Health: Dispelling Myths About the Flu Vaccine

Recommendations for Mandatory Influenza Vaccinations for Health Care Personnel From AMDA's Infection Advisory Subcommittee


PHE 3-Day Waiver Guidance

AHCA/NCAL: 3-Day Stay and Benefit-Period Waivers for Medicare Part A SNF PPS

COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing (8/26/2020 update) See Section Y: Skilled Nursing Facilities

COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (8/20/2020 update) 

Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities): CMS Flexibilities to Fight COVID-19 (7/9/2020 update) 

MLN Matters Article Number SE20011 titled Medicare Fee-For-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)

Public Health Emergency Declarations


Other Resources

AHRQ ECHO National Nursing Home COVID-19 Action Network

Alliant Quality Discharge Screening Tool

CDC: Toolkit for Older Adults & People at Higher Risk

CMS COVID-19 Partner Toolkit

COVID Rapid Response Network for Nursing Homes

COVID Resources for Seniors

Duke Medicine Grand Rounds: COVID-19 and Older Adults: Resilience, the Congregate Living Crisis and the Community Response

IHI COVID-19 Resources: Care of Older Adults

International Long Term Care Policy Network

JAMDA Collection of COVID-19 Articles

John A. Hartford COVID-19 Resources for Nursing Homes and Long-Term Care

LeadingAge Pandemic Playbook

National Long Term Care Ombudsman Resource Center

National Nursing Home Training Series

NC AHEC Reoccurring Webinar Series

North Carolina COVID Action Network (NC CAN) for NC SNFs

OPTIMISTIC Project: LTC to Hospital Transfer Best Practices

The Stanford COVID Surge Handbook


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DISCLAIMER: The information is provided as a consultative resource in response to inquiries from facilities and professionals who remain responsible for determining whether and how to apply it to the circumstance of any facility or individual, and accordingly is not rendered as medical advice or direction for any facility or individual and is not intended to create a physician-patient relationship with any individual.