Long-Term Care Facilities and Other Health Care Settings

Page Last Updated 5/15/24 at 3:45 pm. 

For guidance to preventing and controlling acute respiratory illness outbreaks in Wisconsin long-term care facilities (LTCFs), including skilled nursing facilities (SNFs), community-based residential facilities (CBRFs) and residential care apartment complexes (RCACs).

Bureau of Communicable Diseases (BCD) Memos 2023-04 and 2023-05. These memos went into effect November 1, 2023.

Until the cause of a suspected respiratory illness outbreak is determined, facilities should initiate empiric precautions which includes gown, gloves, fit tested N95, and eye protection (goggles or a face shield).

Per Wisconsin Department of Health Services

A suspected respiratory disease outbreak in LTCFs and other health care settings are defined by the Division of Public Health (DPH) as three or more residents and/or staff from the same unit with illness onsets within 72 hours of each other and who have pneumonia, acute respiratory illness, or laboratory-confirmed viral or bacterial infection (including influenza and COVID-19). For non-LTCF health care settings, only nosocomial cases should be counted.

While this is the definition the Department of Health Services (DHS) is using for COVID-19 and other respiratory outbreaks, CMS (Centers for Medicare & Medicaid Services) is still using the following definition for nursing homes: A single new case of COVID-19 occurs among residents or staff to determine if others have been exposed.

Outbreaks can be closed after two incubation periods have passed with no new cases being identified. For COVID-19 outbreaks, this is 28 days and for all other ARI outbreaks, it is approximately 14 days.

Acute respiratory illness (ARI) is an illness characterized by any two of the following signs and symptoms that are new or worsening from the resident's normal state:

• Fever (temperature two degrees above a resident’s established baseline)
• Cough (productive or nonproductive)
• Runny nose or nasal congestion
• Sore throat
• Muscle aches
• Shortness of breath or difficulty breathing
• Low oxygen saturation in the blood (normal levels are between 95 and 100%, but may vary for people with certain medical conditions)

Reporting requirements
Testing

Treatment

Infection prevention and control

Visitors

Admissions

Staff management and exclusion

Participation in activities, therapy, and communal dining