Health Department

CONTACT INFORMATION: Our administration office at 10777 Main Street in Fairfax is open during regular business hours 8 a.m. - 4:30 p.m., Monday - Friday. Clinic services are not offered at this location.
703-246-2411 TTY 711
10777 Main Street
Fairfax, VA 22030
Gloria Addo-Ayensu, M.D., M.P.H.
Director of Health

COVID-19 Prevention and Mitigation for Long-Term Care Facilities

Since the COVID-19 outbreak began, the Fairfax County Health Department has been actively engaged with long-term care facilities to prevent and mitigate the spread of disease within these high-risk settings. Communal living situations, such as skilled nursing facilities and assisted living facilities, are high-risk for spread of COVID-19, as they are for many other respiratory illnesses. The Health Department has a specific role to both prevent and mitigate outbreaks in these settings.

Report COVID-19 Cases

Long-term care facilities should report a new case of COVID-19 to the Fairfax County Health Department when they are identified.

Report cases by emailing

If you are concerned that you or a loved one who is a resident might have been exposed to COVID-19, please contact your facility’s administration.

Strategies to Prevent COVID-19 in Long-term Care Facilities

Residents of long-term care facilities are usually at greater risk for exposure to pathogens such as influenza, norovirus, and COVID-19. Long-term care residents may have chronic medical conditions making them more susceptible to severe outcomes of infection. While visitors and staff are the most likely to introduce COVID-19 into a nursing home, there are steps you can take to protect your loved ones.

These strategies can be used to reduce COVID-19 in long-term care facilities:

  • Deferring visitation if you are positive for COVID-19 or have COVID-19 symptoms.
  • Washing hands, or using alcohol-based hand sanitizer, when entering and exiting a resident's room.
  • Wearing a well-fitting, high-quality mask, especially if you have been exposed to someone with COVID in the past 10 days.
  • Covering coughs and sneezes with a tissue, or coughing/sneezing into your sleeve instead of your hands.
  • Ensuring residents stays up-to-date on COVID vaccinations.

Responding to COVID-19 in Long-term Care Facilities

A single case of COVID-19 in a resident or staff member meets the threshold for public health action.

The Fairfax County Health Department has teams with nursing and infection prevention experience who respond to cases in long-term care facilities. When a case of COVID-19 is reported to the health department we:

  • Conduct a site visit with the facility.
  • Perform contact tracing.
  • Discuss current infection control guidance.
  • Identify opportunities to reduce transmission.

Guidance for Long-term Care Facilities

The following guidance is from infection control resources developed by the Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS) and Virginia Department of Health (VDH). This resource is a general educational guide, and original sources should be consulted for more intricate situations.

Masking, or source control, can be used to cover a person’s mouth and nose to prevent spread of respiratory secretions when they are breathing, talking, sneezing or coughing. Masks should be well fitting, and those wearing respirators must be fit-tested to ensure a complete seal. For healthcare personnel, appropriate masks include N95 or higher-level respirators, KN95s, and surgical masks, not cloth masks.

Regardless of hospital admission level, source control is recommended for anyone who:

  • Has any respiratory infection.
  • Has symptoms of a respiratory infection, e.g., runny nose, cough, sneezing.
  • Has been exposed to someone infected. Exposed individuals should mask for 10 days following exposure.
  • Works in a unit with a COVID-19 outbreak until 14 days have passed with no new cases.

Masking in Long-term Care

For staff, residents, and visitors, masking recommendations are based on the Hospital Admission Level:

  • High: Everyone in the facility should wear masks.
  • Medium or Low: Facilities may choose not to require masking unless the facility is experiencing an outbreak or has been instructed to implement masking by the Fairfax County Health Department.

When a resident is not suspected of having COVID-19, healthcare workers should follow standard precautions, including hand hygiene, respiratory etiquette, cleaning and disinfection, safe injection practices and the safe disposal of sharps. Hospital Admission Level will impact the recommended PPE for staff in a long-term care facility.

When COVID-19 infection is not suspected in a resident:

  • High: Standard precautions, N95s and eye protection
  • Medium or Low: Standard precautions

When a resident tests positive for COVID-19, health care providers should follow standard precautions, and wear:

  • N95 or higher-level respirator
  • Gown
  • Gloves
  • Eye protection

While routine testing of asymptomatic people is no longer recommended for long-term care facilities, people who are symptomatic or have had an exposure to COVID-19 should be tested. Anyone with even mild symptoms of COVID-19, regardless of vaccination status, should receive a viral test for SARS-CoV-2 as soon as possible.

COVID-19 Symptoms Include:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • Congestion or runny nose
  • Sore throat
  • Nausea or vomiting

Residents who have had a COVID-19 exposure should receive a series of three viral tests to identify if they are infected. With the date of exposure being Day 0, testing should occur on Day 1, Day 3 and Day 5. COVID-19 testing should be discontinued if the resident tests positive at any point in the series.

Timeline of COVID-19 testing on days 1, 3, and 5 following an exposure event if the first and second tests are negative.

Testing on Day 1 should not occur less than 24 hours post the exposure event. COVID-19 testing is not recommended for asymptomatic people who have recovered from SARS-CoV-2 infection in the prior 30 days. Testing of new admissions to nursing homes is at the discretion of the facility.

Isolation and Quarantine are infection prevention and control tools used to reduce the spread of COVID-19 in the general population and in long-term care facilities.

People who have been exposed to a pathogen enter quarantine, while those who have been exposed and tested positive enter isolation. Asymptomatic residents and staff are not required to quarantine following a COVID-19 exposure and should instead be tested according to the testing sequence described above and wear a well-fitting mask for 10 days.

Isolation for Staff

Asymptomatic Mild Symptoms Severe Symptoms

No Symptoms

7 Days Isolation

With a negative test within 48 hours prior to returning to work

Fever, cough, sore throat, etc. 

7 Days Isolation

With improved symptoms, 24 hours since last fever, and a negative test within 48 hours prior to returning to work

E.g., Shortness of breath (>30 breaths per minute)

10 Days Isolation

With improved symptoms, and 24 hours since last fever

Isolation for Residents

Residents who test positive for SARS-CoV-2 infection should be isolated to their rooms for at least 10 days. When possible, this should be a single-person room with a dedicated bathroom and the door should be kept closed (if it is safe to do so).

Staff caring for positive residents should wear an N95 or higher-level respirator, a gown, gloves, and eye protection. Transport outside of the room should be limited to medically essential purposes. Facilities may consider designating units and staff in the facility to positive residents during an outbreak.

Asymptomatic Mild Symptoms Severe Symptoms

No Symptoms

10 Days Isolation

Fever, cough, sore throat, etc. 

10 Days Isolation

With improved symptoms, 24 hours since last fever

E.g.,Shortness of breath (>30 breaths per minute)

10-20 Days Isolation

With improved symptoms, and 24 hours since last fever

Long-term care facilities should encourage everyone to remain up to date with all recommended COVID-19 vaccine doses. Healthcare workers, residents, and visitors should be offered resources and counseled about the importance of receiving the COVID-19 vaccine.

Let's get vaccinated handoutOlder adults and people with weakened immune systems are at increased risk for severe disease, hospitalization, and death from COVID-19 and flu. They rely on YOU to keep them safe and healthy! See answers to the most commonly asked questions from staff working at long term care facilities in Fairfax Health District.

Download and a share a copy today: 

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Healthcare Settings – Places where healthcare is delivered and includes, but is not limited to, acute care facilities, long-term acute-care facilities, nursing homes, home healthcare, vehicles.

Healthcare Personnel (HCP) – All paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances.

Healthcare Services – Includes hospice care, physical therapy, wound care, urinary catheter care, intravenous injections and any other procedures requiring licensed healthcare personnel.

Non-skilled Personal Care – Includes bathing, dressing, toileting, transferring, bowel control, bladder control and eating/feeding.

Source Control – The use of respirators, well-fitting masks, or well-fitting cloth masks to cover a person’s mouth and nose to prevent spread of respiratory secretions when they are breathing, talking, sneezing or coughing.

Up to Date – When a person has received all COVID-19 vaccines recommended to them by CDC. See: Stay Up to Date with COVID-19 Vaccines.

Fairfax Virtual Assistant