Outpatient COVID-19 treatments for long-term care facilities

This resource is for long-term care facilities considering therapeutic antiviral treatments for residents with a current diagnosis of mild-to-moderate COVID-19 and are at high risk for progression to severe COVID-19, including hospitalization or death.

What are COVID-19 therapeutic treatments?

COVID-19 therapeutic treatments are antiviral medications that can help prevent severe illness for people who get infected with COVID-19. The Food and Drug Administration (FDA) authorized or approved several treatments for certain patients with COVID-19. To learn more about different types of COVID-19 treatment, visit our COVID-19 medicine and information about outpatient COVID-19 therapeutics for health care providers webpages.

Who can receive outpatient COVID-19 treatments?

Outpatient treatment is for people with a current diagnosis of mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death. It is important to test or see a provider early if you think you may have COVID-19, as these medications must be given within a few days of when symptoms begin. There may be different treatments available for people who are currently hospitalized for COVID-19. To learn more about eligibility for treatment, visit CDPHE's information about outpatient COVID-19 therapeutics for health care providers page.

What should a facility do when a resident has a current diagnosis of mild-to-moderate COVID-19?

Early testing or evaluation by a health care provider for treatment is important because these medications must be given within a few days of when symptoms begin.

If a resident tests positive for COVID-19 or has a current diagnosis of mild-to-moderate COVID-19, contact the resident’s health care provider and/or your facility medical director and ask about treatment as soon as you can. The resident will need a prescription (or order) from a health care provider or a Test to Treat center. This may include telehealth and home delivery options (possibly at an additional cost).

For additional information about the Test to Treat program, visit ASPR's main Test to Treat webpage, Test to Treat fact sheet, or Test to Treat FAQ. The federal government expanded the Home Test to Treat program, a virtual community health program that offers free COVID-19 health services – at-home rapid tests, telehealth sessions and at-home treatments – to eligible participants nationwide.

Where can a facility get COVID-19 treatment for a resident?

Contact your long-term care pharmacy, a local pharmacy typically used for resident medications, and/or review the list of locations with inventory on CDPHE’s COVID-19 treatments for providers webpage.

You can find Test to Treat centers on the ASPR Test to Treat Locator. This locator includes telehealth and home delivery options. You may also use the federal Home Test to Treat telehealth program.

Make a plan now with the resident’s health care team so you’ll be ready to access treatment options if they test positive for COVID-19. Keep up-to-date medication lists and ask their health care team if there are any drug interactions or necessary modifications with COVID-19 medications. Find the closest pharmacy to the resident carrying COVID-19 therapeutics so you can easily provide this information to the prescribing provider. ASPR’s COVID-19 Treatments: Information for Long‑Term Care Facilities webpage has information on availability and use of COVID-19 treatments for outpatients with mild-to-moderate COVID-19.

To prevent delayed treatment, discuss treatments with your residents and residents’ decision makers now. For example, some residents may need a plan for stopping or modifying their current medications. Working with their health care providers ahead of time to determine the best course of action is helpful, especially if someone gets sick on a weekend or over the holidays. This conversation can be used to obtain consent for treatment in case a resident tests positive for COVID-19.

How can my skilled nursing facility or long-term care pharmacy order COVID-19 therapeutics?

Long term care facilities can order some COVID-19 therapeutics (nirmatrelvir with ritonavir [Paxlovid] and molnupiravir [Lagevrio]) directly from their manufacturers on the commercial market.

To learn more about the commercialization of COVID-19 therapeutics, see the U.S. Department of Health & Human Services’ webpages Sunsetting the U.S. Government COVID-19 Therapeutics Distribution Program and COVID-19 Therapeutics Transition to Commercial Distribution: Frequently Asked Questions. Patient assistance programs are being developed by the manufacturers of some COVID-19 treatments to help with the cost of medication. Pfizer has initiated a Paxcess program to assist patients in obtaining Paxlovid and Merck has a similar program to assist patients in obtaining molnupiravir.

Facilities which aren’t enrolled as COVID-19 treatment providers can still prescribe treatments for their residents and have the prescriptions filled at a pharmacy.