ISDH and FSSA Issue State Requirements and Guidance for Creating Dedicated COVID-19 Long-Term Care Facilities

By: Jennifer L. Strange

On April 8, 2020, the Indiana State Department of Health (“ISDH”) and Family and Social Services Administration (“FSSA”) issued State requirements and guidance for creating dedicated COVID-19 long-term care facilities.  See guidance here.  This guidance was issued after the Centers for Medicare & Medicaid Services (“CMS”) recently recommended that long-term care facilities partner with State and local community leaders to identify and create COVID-19 designated facilities to help hospitals with surge management and facilitate the transfer of residents from other nursing homes having difficulty managing COVID-19 outbreaks on site. 

The proposed benefits to creating dedicated COVID-19 LTC facilities include:

  • Conservation of personal protective equipment (“PPE”)
  • Facility expertise
  • Provide facilities/spaces for workers with COVID-19 to continue working
  • Allow rapid transitions of patients requiring skilled nursing out of hospitals

To support the creation of these dedicated COVID-19 LTC facilities, ISDH and FSSA are offering the following support:

  • Waivers (several are already in place addressing transfer or discharge, structural and/or bed changes, and staffing.  Additional waivers will be expedited for review). 
  • Enhanced rates (50% increase to the current average nursing facility rate applicable for the duration of the public health emergency and a to-be-determined transition period afterward).
  • Liability protection (ISDH is following CMS guidance and conducting only regulatory surveys for immediate jeopardy complaints). 
  • Data support
  • Testing
  • Training
  • PPE

To be designated as a dedicated COVID-19 LTC facility, the facility must:

1)   Develop a mutually agreed upon plan with hospitals for transfers and care of residents at

COVID-19 facilities requiring acute care;

2)   Be approved by the State as a COVID-19 dedicated facility;

3)   Have only residents who require nursing home level of care;

4)   Identify the building dedicated to the care of COVID-19 patients;

5)   Be currently open and operational with sufficient beds, equipment and support to meet the anticipated number of dedicated beds;

6)   Be able to staff dedicated facilities or areas;

7)   Have a written plan of operation addressing defined criteria, and submit the plan for ISDH approval within 30 days of implementation;

8)   Be State-licensed and CMS-certified;

9)   Maintain documentation that tracks COVID-19 patients, as well as a detailed understanding of the Minimum Data Sets;

10)  Update daily COVID-19 available beds and PPE stores in EMResource; and

11)  Communicate their plans with hospitals and ensure all families are notified of the timing and location of resident transfer prior to implementation. 

During the transition process, ISDH expects transparent communication from facilities to residents and their families, cooperation between transferring facilities and receiving facilities, and compliance with the rules governing resident transfers.

Those interested in transitioning a nursing facility into a dedicated COVID-19 building should email Dr. Daniel Rusyniak ( and Matt Foster ( to begin the process. 

If you have additional questions, please contact your DSV attorney or Jennifer L. Strange at

***The information contained on this website is for informational purposes and is not intended as formal legal advice and cannot be relied upon as such.  No attorney client relationship is established or intended as a result of the information contained on this website.***