COVID-19 in skilled nursing facilities (SNFs)

Track the number of covid cases and deaths in residents of skilled nursing facilities.

A SNF is a type of long-term care facility. SNFs provide care to individuals, generally in their 60s and older, who need help in their daily lives.  

Residents of these facilities are more likely to go to the hospital or die from COVID-19. This may be because of:  

  • Pre-existing medical conditions 

  • Close physical contact with caregivers 

  • Older age 

Facilities can be run by:  

  • Local or federal governments

  • Private for-profit companies 

  • Non-profits  

All SNFs must follow regulations from the State and the City. The federal Veterans Affairs (VA) SNF is the only exception. 

As of July 2021, 19 SNFs operate in San Francisco. In January 2020, there were 20 facilities. Together the 20 facilities reported a total of 2,524 beds.

Data notes and sources

Data notes and sources

View source data on cases
View source data on deaths

Facilities are mandated to report COVID-19 cases or deaths among their residents. The City follows up with these facilities to confirm.  

The data are lagged by five days to allow for this follow up. Historical data may be updated whenever the data is validated. 

There may be differences between the SNF data on this dashboard and on the California Department of Public Health (CDPH) dashboard. The difference may be because the City and the State use different methods to collect and validate data.  

Preventing COVID-19 in SNFs


Residents and staff of skilled nursing facilities were prioritized in the first tier of the State’s vaccination rollout plan. 

The City helped SNFs work with pharmacy partners to vaccinate most of their residents and staff. The program resulted in high vaccination rates for SNF residents and staff. As a result, outbreaks at SNFs dropped drastically. 

Guidance and training  

The State and the City issue public health orders for SNFs. These orders ensure all SNFs operate safely during the pandemic. They are based on scientific evidence.  

The City trained staff on following COVID-19 public health orders. The City visited sites to help with ventilation. 

Personal protective equipment (PPE)  

Without proper personal protective equipment, COVID-19 can spread rapidly between people.   

SNF staff cannot maintain physical distance from residents when caring for them. So, SNFs must provide staff with appropriate PPE. The City supplied rapid PPE when it was difficult to find. The City supports staff on how to use PPE correctly.

Visitor policies

In March 2020, the City limited visitors to reduce risk of COVID-19 in staff and residents.  

In September 2020, a new public health order allowed outdoor, window, and car visits.  

In March through June 2021, the City removed many prior restrictions on visitors. Find the latest City updates here.

Testing and contact tracing  

In September 2020, the State mandated that all SNFs test all staff and residents during the pandemic.  

They also mandated regular testing strategies:  

  • Test any new resident 

  • Test any resident or staff member exhibiting symptoms 

  • Test staff regularly, even if they show no symptoms 

  • Test exposed residents and staff after outbreaks

In June 2021, the City removed prior mandates on testing in SNFs. SNFs must still follow State mandates on testing. 

Cases and outbreaks in SNFs

If a staff member or resident tests positive, the SNF must report to the City. The City then advises the facility on how to respond.   

An "outbreak" at a SNF is when 1 resident or a cluster of 3 or more staff test positive. 

The facility must communicate daily with the City throughout the outbreak. The facility must report:  

  • New staff or residents with symptoms  

  • Staffing levels and shortages  

  • PPE supply 

  • Staff or resident hospitalizations and deaths  


There are many resources for those with loved ones in a SNF.  

These links may help you learn more: