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)
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.”
Table 2: Number of States and DC With Specific Guidance for Assisted Living Facilities Related to COVID-19
(as of June 1, 2020)
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.”
Table 3: State Reporting of Assisted Living Facility Cases and Deaths Related to COVID-19
(as of June 8, 2020)
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 8,058 2,024 2,102 31 2,739 1,413
California1 Cumulative 1,168 472 682 30 96
Colorado Cumulative 500 139 368 0 50
Connecticut Cumulative 2,851 909 233
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.”
Methods