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.