Under the Radar: States Vary in Regulating and Reporting COVID-19 in Assisted Living Facilities
| Table 1: Guidance for Assisted Living Facilities Related to COVID-19, by State (Including DC) (as of June 1, 2020) |
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| Visitation | Screening | Personal Protective Equipment | |
| Alabama | Prohibit | Require | Require |
| Alaska | Recommend prohibit | Recommend | Recommend1 |
| Arizona | Recommend prohibit | Require | Require |
| Arkansas | Prohibit | Require | Recommend |
| California | Prohibit | Recommend | Require |
| Colorado | Prohibit | Require | Require |
| Connecticut | No guidance | No guidance | Recommend |
| Delaware | Recommend prohibit | Recommend | Recommend2 |
| District of Columbia | Prohibit | Require | Require |
| Florida | Prohibit | Require | Require |
| Georgia | Prohibit | Require | Require |
| Hawaii | Recommend prohibit | Recommend | Recommend |
| Idaho | Prohibit | Recommend | Recommend |
| Illinois | Recommend restrict | Require | Require |
| Indiana | Recommend prohibit | Recommend | Recommend |
| Iowa | Recommend prohibit | Require | Recommend |
| Kansas | Recommend prohibit | Recommend | Recommend |
| Kentucky | Recommend prohibit | Recommend | Recommend |
| Louisiana | Prohibit | Recommend | Recommend1 |
| Maine | Recommend prohibit | Recommend | Recommend |
| Maryland | Recommend prohibit | Recommend | Recommend |
| Massachusetts | Prohibit | Recommend | Recommend |
| Michigan | Prohibit | Require | Require |
| Minnesota | Recommend prohibit | Recommend | Recommend |
| Mississippi | Prohibit | No guidance | Recommend |
| Missouri | Prohibit | Require | Require |
| Montana | Prohibit | Require | No guidance |
| Nebraska | Prohibit | No guidance | Recommend |
| Nevada | Recommend prohibit3 | Recommend3 | Recommend3 |
| New Hampshire | Prohibit | Recommend | Require |
| New Jersey | Recommend prohibit | Recommend | Require |
| New Mexico | Prohibit | Recommend | Require |
| New York | Prohibit | Require | Require |
| North Carolina | Recommend prohibit | Recommend | Require |
| North Dakota | Recommend prohibit | Recommend | Recommend |
| Ohio | Prohibit4 | Recommend | No guidance |
| Oklahoma | Prohibit | Recommend | No guidance |
| Oregon | Prohibit | Require | No guidance |
| Pennsylvania | Recommend prohibit | Recommend | Recommend |
| Rhode Island | Prohibit | No guidance | No guidance |
| South Carolina | Prohibit | Recommend | Recommend |
| South Dakota | No guidance | No guidance | No guidance |
| Tennessee | Prohibit | Recommend | Recommend5 |
| Texas | Prohibit | Require | Require |
| Utah | Recommend prohibit | No guidance | Recommend |
| Vermont | Recommend prohibit | Require | Recommend |
| Virginia | Prohibit | Require | Require |
| Washington | Prohibit | Require | Recommend |
| West Virginia | Recommend prohibit | Recommend | Recommend |
| Wisconsin | Recommend prohibit | Recommend | No guidance |
| Wyoming | Recommend prohibit | Recommend | Recommend |
| NOTE: Blue highlights indicate states with requirements for ALFs that match CMS requirements for nursing facilities. Gray highlights indicate states with no guidance in specific area. 1PPE recommended for use with symptomatic residents. 2Recommend for staff providing direct care. 3Per official from the Division of Public and Behavioral Health, Nevada Dept. of Health and Human Services. 4The Governor announced a plan to lift the prohibition on visitation beginning on June 8, 2020 . 5PPE recommended when case identified. SOURCE: KFF analysis of state and DC long-term care facility guidance related to COVID-19; detailed methods available in KFF brief, “Under the Radar: States Vary in Regulating and Reporting COVID-19 in Assisted Living Facilities.” |
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| Table 2: Number of States and DC With Specific Guidance for Assisted Living Facilities Related to COVID-19 (as of June 1, 2020) |
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| Visitation | |
| Prohibit | 27 |
| Recommend prohibit | 21 |
| Recommend restrict | 1 |
| No guidance | 2 |
| Screening | |
| Require | 18 |
| Recommend | 27 |
| No guidance | 6 |
| Staff use of personal protective equipment | |
| Require | 17 |
| Recommend | 27 |
| No guidance | 7 |
| NOTE: Analysis includes 50 states and DC. SOURCE: KFF analysis of state and DC assisted living facility guidance related to COVID-19; detailed methods available in KFF brief, Under the Radar: States Vary in Regulating and Reporting COVID-19 in Assisted Living Facilities.” |
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| Table 3: State Reporting of Assisted Living Facility Cases and Deaths Related to COVID-19 (as of June 8, 2020) |
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| Active or Cumulative Cases | Resident Cases | Resident Deaths | Staff Cases | Staff Deaths | Resident and Staff Cases | Assisted Living Facilities with known Cases | |
| Number of states reporting | 13 | 11 | 9 | 5 | 2 | 16 | |
| TOTAL | 6,248 | 1,452 | 2,102 | 31 | 2,739 | 1,261 | |
| California1 | Cumulative | 1,168 | 472 | 682 | 30 | – | 96 |
| Colorado | Cumulative | 500 | 139 | 368 | 0 | – | 50 |
| Connecticut | Cumulative | 1,041 | 337 | – | – | – | 81 |
| Florida | Active | 758 | – | 447 | – | – | 281 |
| Louisiana2 | Cumulative | 630 | 91 | – | – | – | 122 |
| Massachusetts | Cumulative | – | – | – | – | 2,726 | 206 |
| Mississippi | Active | 14 | 0 | 17 | – | – | 6 |
| Nevada | Cumulative | 98 | 23 | 44 | 1 | – | 28 |
| New York3 | Cumulative | – | 169 | – | – | – | 58 |
| North Carolina4 | Cumulative | 535 | 62 | 225 | 0 | – | 40 |
| North Dakota | Active | 13 | – | 10 | – | – | 10 |
| Ohio | Cumulative | 508 | – | 249 | – | – | 84 |
| Rhode Island | Cumulative | 161 | 29 | – | – | – | 8 |
| South Carolina5 | Cumulative | 86 | 16 | 60 | 0 | – | 41 |
| Texas | Cumulative | 736 | 114 | – | – | – | 145 |
| Utah | Active | – | – | – | – | 13 | 5 |
| NOTE: 1Cases and deaths in Residential Care Facilities for the Elderly. 2Cases and deaths in Adult Residential Facilities. 3Deaths in Adult Care Facilities. 4Cases and deaths in Residential Care Facilities. 5Cases and deaths in Community Residential Care Facilities. SOURCE: KFF analysis of state assisted living facility cases and deaths related to COVID-19; detailed methods available in KFF brief, “Under the Radar: States Vary in Regulating and Reporting COVID-19 in Assisted Living Facilities.” |
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