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U.S. Department of Health and Human Services

Long-term Care Facilities (LTCF)

Distribution of COVID-19 Monoclonal Antibody Therapeutics

Urgent care centers can provide monoclonal antibody (mAb) therapy for non-hospitalized patients that have tested positive for COVID-19 and have mild to moderate symptoms. These treatments are indicated for eligible patients 12 years and older with a high risk of progressing to severe forms of COVID-19 or hospitalization.

Urgent care centers may order casirivimab/imdevimab and bamlanivimab/etesevimab monoclonal antibodies for their facilities. The administration of these COVID-19 therapeutics require intravenous infusion.



​​
​​
Consider becoming an infusion site

Planning
to Administer mAbs


​Ordering
Product



Tracking
Utilization



​Seeking Reimbursement
and Coverage


Staying
Up-to-date



Step 1: Consider becoming an Infusion Site

SPEED supports LTCFs, including nursing homes and assisted living facilities, through partnerships with stakeholder and/or trade associations who assist with educating members and non-members about mAbs. These organizations also identify entities that are able and willing to administer mAbs. Membership in partner associations is not required for participation in SPEED.

SPEED stakeholder/trade association partners include:

  • National Home Infusion Association (NHIA)
    • NHIA coordinates participation of home infusion providers who (through CMS flexibilities) are now able to provide mAb infusion therapy to eligible individuals residing or working in long-term care facilities, including assisted living facilities
    • Participating home infusion providers can also administer mAbs in other SPEED settings, including dialysis centers, FQHCs, and correctional facilities, depending on local needs and priorities.
    • For more information about this program, including a map of participating home infusion providers, and access to their online application and other tools, visit the NHIA Bamlanivimab Pilot Program webpage.

  • American Society of Consultant Pharmacists (ASCP)
    • ASCP coordinates LTCP participation in SPEED

  • AMDA - The Society for Post-Acute and Long-Term Care Medicine
    • AMDA is the association representing medical directors and other clinical providers in nursing homes.
    • AMDA communicates with their members to increase awareness of mAbs and relevant LTC SPEED programs.
    • AMDA helps identify LTCFs that have on-site capacity to receive, store, prepare, and administer mAbs; these sites can then receive mAbs directly through SPEED.

If you are considering having your LTCF offer COVID-19 mAb therapy, you can quickly evaluate your readiness in three steps:

  1. Does your facility have the infrastructure to meet the needs for treatment? If not, is your facility prepared to make the required changes to be ready?
  2. Is your current staff able to support outpatient mAb administration? If not, is your facility prepared to add or reassign staff as necessary?
  3. Are your procedures and processes able to identify and treat mAbs patients within the 10-day recommended timeframe? If not, is your facility prepared to add to or to adjust relevant procedures and processes?

Find a more detailed outline of specifics to review when thinking about offering mAb therapy, check out our guide Becoming a Site to Administer COVID-19 mAb Therapy.


Step 2: Planning for mAbs Administration

Once your LTCF has decided to offer COVID-19 mAb therapy, your facility will need a plan to carry out the following activities:

  1. Allocate dedicated space and develop a patient flow plan as follows:
        • Develop a clear process for patients who are visiting your clinical site, including scheduling requirements;
        • Design your admission process to minimize risk of spread per facility requirements/directions/guidelines.
  2. Obtain infusion components (IV kits, infusion chair/bed, IV pole, vital sign monitoring equipment, emergency medications).
  3. Assign sufficient amount of personnel to meet the expected demand, which includes having plans in place for nurses/IV techs, physicians, pharmacists, or other licensed medical professionals. You will likely need a dedicated team to treat patients.
  4. Prepare for the drug administration process. The treatment typically takes 16 minutes to one hour and is followed by a one-hour post-treatment observation period.
        • o Develop a clear treatment and monitoring plan for the infusion process.;
        • o Define emergency protocols for addressing potential infusion reactions or complications.
        • o Define a clear process for patient follow-up, using telemedicine when possible.
  5. Ensure a process for reimbursement is in place (non-drug administrative costs).
  6. Prepare for reporting adverse events and record keeping.
The HHS/ASPR Monoclonal Antibody Infusion Center Model offers examples of setting up a COVID-19 mAb infusion center at your site, including: facility layout; patient flow, stations, and staffing; supplies; infection control and prevention; and reimbursement.

Step 3: Ordering Product

Sites can order casirivimab/imdevimab and bamlanivimab/etesevimab monoclonal antibodies monoclonal antibodies for their facilities directly from the distributer, AmerisourceBergan (ABC).

For full ordering process details, see the Overview of Direct Order Process for COVID-19 Therapeutics.

Step 4: Tracking Utilization

All sites that use monoclonal antibody therapeutics are required to report on utilization of the product every Wednesday. To learn more about your facility’s reporting requirements, see the process for tracking utilization of COVID-19 therapeutics.

Step 5: Reimbursement and Coverage

Reimbursement and coverage for monoclonal antibody therapeutics varies by provider.

 

Step 6: Stay up-to-date

HHS/ASPR Office Hours

Join us for informative biweekly sessions to learn more about the administration of COVID-19 mAbs. This meeting is an open forum for state and territorial health officer, health care providers and sites of care to ask us your questions on administration of therapies.

      • Date and Time: Every Tuesday from 1:00 - 1:30PM EST and Thursday from 2:00 - 2:30PM EST
      • Event Details: Contact ASPRstakeholder@hhs.gov

Project ECHO Clinical Grand Rounds

Project ECHO, in collaboration with ASPR, has launched the Outpatient Therapeutics Mini-Series for clinical overview and examples of administration models. This mini-series will provide a deep dive on new and emerging COVID-19 outpatient therapeutics, including monoclonal antibodies. The goal of this mini-series is to equip clinicians with the appropriate knowledge, resources, and tools needed to initiate and scale administration of these therapies and reduce strain on the U.S. healthcare system.


Related Pages

 

For Providers
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For Patients
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Infusion Sites
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  • This page last reviewed: May 10, 2021