Written by: Drew Graham, Esq.

In May 2020, JAMDA (the official journal of the Society for Post-Acute and Long-Term Care Medicine) published a summary about the variability in state regulations regarding infection control and pandemic response in US nursing homes. The study reviewed existing regulations for all fifty states and the District of Columbia, focusing on the search terms infection control, epidemic, and pandemic.

The study concluded:

  • 32 states referred to infection control in staff training[1],
  • 31 states described infection control policies[2], including:
    • Universal or standard precautions,
    • Guidelines for contact with blood or other bodily fluids, and/or
    • Reportable disease guidelines
  • 10 states used the word “epidemic”[3] (primarily with regard to reporting to local public health authorities),
  • 6 states directly referenced general resident isolation practices[4] for communicable diseases, and
  • 2 states described “pandemic”[5] emergency preparedness.


The article explicitly noted that the range in regulatory detail and requirements raises the potential for confusion in nursing homes trying to implement those rules. Moreover, the “sociocultural model” of assisted living facilities providing home-like settings (which is associated with residents’ quality of life), might conflict with pandemic-related standards, such as the wearing of personal protective equipment. The study concluded that more research is needed to study how COVID-19 affects older residents in nursing homes.

Legal standards for nursing homes in the age of COVID-19 are evolving rapidly throughout the United States. Experienced medical litigators can help the health-care community best manage risk in this volatile time.

[1] Those states are: AK, AZ, AR, DC, FL, GA, HI, ID, IL, IN, IA, KS, LA, ME, MD, MA, MO, NE, NH, NJ, NM, NC, ND, OR, PA, RI, SC, SD, TN, VA, WV, WY

[2] Those states are: CO, DE, FL, GA, HI, ID, IL, IN, IA, KS, LA MA, MN, MO, MT, NH, NJ, NC, ND, OH, RI, SC, SD, TN, TX, UT, VA, WA, WV, WI, WY

[3] Those states are: CA, CO, DE, IN, MA, MO, OR, SC, UT, WV

[4] Those states are: CO, IL, IN, KS, MA, ND

[5] Those states are: MA, OR

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