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COVID-19 Guidance for Long-Term Care Facilities

Guidance for Long-Term Care Facilities

Licensed Skilled Nursing Facilities and Other Long-Term Care Facilities; Assisted Living Facilities and Independent Living Facilities; Residential Care and Crisis Residential Facilities in Santa Clara County – Memorandum 4/5/2020

Movement of Patients between Hospitals and Long-Term Care Facilities (LTCFs) (including Skilled Nursing Facilities)

Purpose:

Provide COVID-19-specific guidance on moving patients between Hospitals and Long-Term Care Facilities (LTCFs), including Skilled Nursing Facilities, and acceptance of patients by LTCFs.

Guidance for hospitals receiving a patient from a LTCF:

  1. Hospitals should test all patients that reside or recently resided (within the last two weeks) in a LTCF with fever or respiratory symptoms (cough, shortness of breath or sore throat) for COVID-19 unless an alternate diagnosis has been clearly established. COVID-19 testing should be considered for patients with gastrointestinal symptoms (nausea, vomiting or diarrhea) or change in mental status without an alternate diagnosis.
    1. We prefer testing at the Santa Clara County Public Health Laboratory (PHL) for more rapid turnaround time (1-2 days).
      1. To arrange testing through the PHL, call the Health Department [(408) 885-4214, ext 3; ask for Provider Branch] before any specimens are sent.
    2. Call the Health Department [(408) 885-4214, ext 3; ask for Provider Branch] to inform us about a confirmed or suspect COVID-19 case that recently resided (within the last two weeks) in a LTCF. Call the Health Department even if COVID-19 testing will be performed through a private laboratory.
      1. We will call the facility to assess the situation.

Guidance for hospitals proposing to discharge a patient to a LTCF:

  1. For patients with fever or respiratory symptoms in the past 7 days who have not yet been tested for COVID-19:
    1. Hospitals should test patient for COVID-19; and
    2. Once the test result is available, discharge planning can be pursued with the LTCF following the guidance below, based on the test result.
  2. For patients who had tested positive for COVID-19:
    1. Hospitals should call the Health Department [(408) 885-4214, ext 3; ask for Provider Branch] 24-48 hours before the proposed discharge.:
      1. Before discharge occurs, we need to assess the facility for their readiness to accept the patient following appropriate guidelines.
      2. We will then call you back (within 24 hours) with our assessment on whether the discharge can proceed as proposed.

Note: No Health Department notification is needed for transfers between hospitals.​​​​​

Last updated: 4/7/2020 12:26 PM