With front-line health workers and nursing home residents and staff expected to get the initial doses of COVID vaccines, the thornier question is figuring out who goes next.

With a presidential election less than a week away and a pandemic still raging out of control in many parts of this country, the post-acute and long-term health care landscape finds itself on the brink of what could be both a brutal and potentially transformative winter.

Flu season will look different this year, as the country grapples with a coronavirus pandemic that has killed more than 172,000 people. Many Americans are reluctant to visit a doctor’s office and public health officials worry people will shy away from being immunized.

The Centers for Medicare & Medicaid Services (CMS) on Friday announced a plan to support nursing homes in new “COVID-19 hotspot areas,” with a combined focus on technical support and targeted inspections for facilities with a history of infection control issues.