Skilled nursing facilities nationwide are implementing enhanced respiratory illness protocols as the 2025-2026 season approaches its peak months. With influenza, COVID-19, and RSV all circulating simultaneously, facilities are applying lessons learned from pandemic years while adapting to updated CDC guidance that emphasizes a unified approach to respiratory pathogen prevention.

Vaccination Push

The CDC’s updated guidance recommends that all long-term care residents receive influenza, updated COVID-19, and RSV vaccines (for those 60 and older) unless contraindicated. Early-season data shows resident vaccination rates improving, with influenza coverage reaching 76% and COVID-19 booster uptake at 68% in facilities reporting to NHSN.

RSV vaccination, in its second season of availability for older adults, has seen slower uptake at approximately 52% of eligible residents, though this represents significant improvement from the inaugural season. Facilities report that resident and family education about the relatively new RSV vaccine remains an ongoing effort.

Infection Control Protocols

CMS guidance now recommends that facilities maintain respiratory illness surveillance systems capable of detecting outbreaks early, with defined thresholds for implementing enhanced precautions. Facilities should have protocols for rapid testing of symptomatic residents and staff, cohorting of ill residents when possible, and communication with families and health departments.

The guidance emphasizes that respiratory illness precautions should be scalable based on community transmission levels rather than maintained at peak intensity year-round, acknowledging the need to balance infection control with resident quality of life.

Staffing Considerations

Facilities are also preparing contingency staffing plans for potential illness-related absences among staff. Industry surveys suggest that respiratory illness seasons typically increase staff sick leave by 15-25%, requiring facilities to maintain relationships with staffing agencies and cross-train employees to cover multiple roles.