Outbreak Management

The NYMDA COVID-19 Resource Project’s mission is to ensure that you have access to reliable and up-to-date information that will help you navigate the complexities of COVID-19 outbreak management in NYS.

Initial Response

Outbreak Investigation & Management

New Resident Case

New Resident Case One case of COVID-19 in a nursing home is considered an outbreak. The goals of outbreak investigation are (1) to...

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New Employee/Staff Case

Testing of symptomatic staff should be performed regardless of the outbreak investigation or exposure history. Complete Contact Tracing...

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New Visitor Case

Complete Contact Tracing Complete Contact Tracing beginning 48 hours prior to the Onset Date and continuing until the 14 days after the...

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Cohorting Considerations

Review the COVID-19 Cohorting Decision Support Tool.

Cleaning & Disinfection

Project Firstline from the CDC offers training resources for environmental cleaning and disinfection.

Staff Issues

Staff Exposed to COVID-19 Inside or Outside of the Facility

An exposure is defined as being within 6 feet for a cumulative total of 15 minutes or more over a 24-hour period to the COVID-19-positive person.

  • All staff are educated to notify the facility if they are exposed to COVID-19 outside of the facility.
  • For each staff member identified as having an exposure, calculate the date through which they need to wear a respirator or well-fitting mask at all times, usually 10 days after the Last Exposure Date. Notify the staff member(s) of their masking requirements:
    • Must wear a respirator (KN95 or N95) or well-fitting mask at all times when in the facility, removing the respirator or mask only when eating or drinking.
    • Eating and drinking are only permitted in areas where residents are unlikely to enter, and while physically distanced from all other people. Exposed staff members may not eat or drink in a resident care area.
  • Exposed staff members should self-monitor for fever and symptoms of COVID-19 and not report to work when ill or if testing positive for COVID-19 infection.
  • Test exposed staff, with a nasal specimen (Antigen (preferred) or PCR) every other day starting 1 day after the First Exposure Date and continuing until 6 days after the Last Exposure Date (usually a total of 3 tests).
  • Do not test staff within 30 days of testing positive for COVID-19.

Staff Returning to Work After Testing Positive to COVID-19

Staff with Symptoms of COVID-19

  • Staff who report new onset of any symptoms of COVID-19 should be excluded from work unless a negative PCR test for COVID-19 is obtained or two negative Antigen tests for COVID-19, 48 hours apart, are obtained.
  • Staff with chronic conditions that mimic symptoms of COVID-19, such as allergies, COPD, headaches, and irritable bowel syndrome should, when experiencing the symptoms of their chronic condition:
    • Self-monitor for other symptoms of COVID-19.
    • Perform a Point-of-Care Antigen COVID-19 test every 2-3 days.
    • Wear a respirator or well-fitting mask at all times, except when eating or drinking.
    • Not eat or drink in resident care areas.
    • Be restricted from work if they test positive or develop other symptoms of COVID-19, such as fever or chills, fatigue, muscle or body aches, or new loss of taste or smell, unless a negative PCR test for COVID-19 is obtained.
Young nurse attending to elder patient


The New York State Department of Health described the best practices for nursing home visitation in this memo, which contains links to relevant CDC guidance.

Care Transitions


For residents being admitted to the nursing home or returning to the nursing home, see the Admissions section on our Precautions page.


When coordinating a planned discharge to another congregate living setting, consider conducting a test for COVID-19 to avoid spreading COVID-19 to a negative environment.


When transferring a resident for acute care or specialty consultation, notify the receiving facility of the resident’s exposure to COVID-19 infection and current COVID 19 infection status.