Department of Health Updates COVID-19 “Outbreak” Definition

Department of Health Updates COVID-19 “Outbreak” Definition

The Department of Health has updated the definition of an outbreak in the Long-Term Care setting.  Long-term care settings include:

  • Nursing homes and skilled nursing facilities
  • Adult family homes
  • Assisted living facilities
  • Enhanced Services Facilities
  • Intermediate care facilities for individuals with intellectual disabilities (ICF/IID facilities)

The previous definition of an outbreak was;

  • One resident or HCW with laboratory positive COVID-19 (PCR or antigen test), OR
  • Two or more residents or healthcare workers with new-onset respiratory symptoms consistent with COVID-19 within 72 hours of each other

This definition would immediately place nursing homes in a stop placement position from the local health jurisdiction, unable to admit residents for up to 28 days, depending on the LHJ. 

Through work with the Long-Term Care Advisory Group, DOH and LHJ Health Officers were able to come to agreement on the new definition.  The new definition of an outbreak is

  • > 1 long term care facilities and agencies-acquired COVID-19 infection in a resident
  • > 2 COVID-19 infection in HCWs who were on-site in the long-term care facility or agency at any time during their infectious period OR during their exposure period and has no other known or more likely exposure source.

Please note:

  • Any sudden increase in acute respiratory illness over the normal background rate (e.g., 2 or more cases of acute respiratory illness occurring within 72 hours of each other) in a long-term care facility should be reported to local public health as a respiratory outbreak, even before testing is completed.
  • Every case of COVID-19 diagnosed in a facility should be reported to local public health.

CMS continues to require testing of all staff and residents if a single new case of COVID-19 is identified in any HCW or any long-term care facility acquired COVID-19 in a resident.

See updated Interim Guidance document here




Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804

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