The COVID-19 pandemic ravaged United States skilled-nursing facilities (SNFs). Novel strategies that maximize the safety and quality of life for SNF residents with ADRD and staff who care for them are urgently needed. Thus, the study's objectives are:

1. To rapidly plan and pilot test an intervention that leverages COVID-19 antibody and PCR status to pair SNF staff with residents in the safest way possible
2. To reduce reduced COVID-19 incidence rate compared to SNFs not using this novel staff-resident assignment strategy.

Inclusion Criteria for Staff Stakeholders:

• Must be employees of ArchCare
• Must be members of included unit staff or those that float on those designated units
• Willing to participate in focus groups or semi-structured interviews with study team

Inclusion Criteria for Family Participants:

• Family members of residents who reside at either TCC or MMW (ArchCare facilities)
• Family member of resident who is on designated study unit or eligible to be transferred to such unit
• Willing to participate in focus groups or semi-structured interviews with study team

Inclusion Criteria for Resident Participants:

• Resident has ability to communicate and follow simple commands
• Resident has ability to communicate and follow simple commands
• English- or Spanish-speaking
• Resident has capacity to consent assessed with standard questions used to assess capacity or having a surrogate who can provide consent.
• Must agree to have serologic testing for COVID-19
• Agrees to remain on one of the facility units of study or to be transferred to such unit

Exclusion Criteria for Staff Stakeholders:

• Not employees of ArchCare
• Not members of included unit staff or those that float on those designated units
• Not willing to participate in focus groups or semi-structured interviews with study team

Exclusion Criteria for Family Participants:

• Not family members of residents who reside at either TCC or MMW (ArchCare facilities)
• Not family member of resident who is on designated study unit or eligible to be transferred to such unit
• Not willing to participate in focus groups or semi-structured interviews with study team

Exclusion Criteria for Resident Participants:

• Resident is not living in the unit of intervention
• Resident does not have ability to communicate and follow simple commands
• Not English- or Spanish-speaking
• Resident lacks capacity to consent assessed with standard questions used to assess capacity and does not have a surrogate who can provide consent.
• If resident lacks capacity, that resident does not assent with surrogate who provides assent
• Does not agree to have serologic testing for COVID-19
• Refuses to agree to remain on one of the facility units of study or to be transferred to such unit

Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices) will be shared upon reasonable request.

Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.

The investigator who proposed to use the data will have access to the data upon reasonable request. Requests should be directed to Joshua.Chodosh@nyulangone.org. To gain access, data requestors will need to sign a data access agreement.

The "Intervention Group (Cohorting) - Residents" and "Control Group (No Cohorting) - Residents" arms comprise residents at SNFs. The "Intervention Group (Cohorting) - Staff" and "Control Group (No Cohorting) - Staff" comprise staff at corresponding SNFs.

Deaths, serious adverse events, and non-serious adverse events were not assessed in this study.