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)
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:
- 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.
- We prefer testing at the Santa Clara County Public Health Laboratory (PHL) for more rapid turnaround time (1-2 days).
- To arrange testing through the PHL, call the Health Department [(408) 885-4214, ext 3; ask for Provider Branch] before any specimens are sent.
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.
- We will call the facility to assess the situation.
Guidance for hospitals proposing to discharge a patient to a LTCF:
- For patients with fever or respiratory symptoms in the past 7 days who have not yet been tested for COVID-19:
- Hospitals should test patient for COVID-19; and
- Once the test result is available, discharge planning can be pursued with the LTCF following the guidance below, based on the test result.
- For patients who had tested positive for COVID-19:
- Hospitals should call the Health Department [(408) 885-4214, ext 3; ask for Provider Branch] 24-48 hours before the proposed discharge.:
- Before discharge occurs, we need to assess the facility for their readiness to accept the patient following appropriate guidelines.
- 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.