AFL 20-25.2 From the California Department of Public Health
April 15, 2020
TO: Skilled Nursing Facilities
SUBJECT: Preparing for Coronavirus Disease 2019 (COVID-19) in California Skilled Nursing Facilities (This AFL supersedes AFL 20-25.1)
AUTHORITY: Executive Order N-27-20 (PDF)
All Facilities Letter (AFL) Summary
- This AFL provides resources for skilled nursing facilities (SNFs) on preparing for COVID-19.
- This AFL has been updated to provide a toolkit for management of exposures and recognized cases in SNFs and congregate living settings.
The California Department of Public Health (CDPH) strongly recommends SNFs prepare for COVID-19. Elderly persons and those with chronic medical conditions may be at higher risk for severe illness and death from COVID-19. All California SNFs should take steps to:
- Prevent introduction of COVID-19 into their facility;
- Detect COVID-19 in their facility;
- Prepare to receive residents with suspected or confirmed COVID-19 infection;
- Prepare to care for residents with suspected or confirmed COVID-19 infection;
- Prevent spread of COVID-19 within their facility; and
- Notify residents’ family members or the resident’s representative, if there is a COVID-19 positive health care worker or resident in their facility.
In collaboration with the California Department of Social Services (CDSS), CDPH has developed a toolkit for management of exposures and recognized cases in SNFs and congregate living settings. Please refer to the following guidance for prevention, containment, and mitigation measures for COVID-19:
- Preparing for COVID-19 in California Skilled Nursing Facilities (PDF) – guidance for SNFs on how to prevent, detect, and prepare for COVID-19
- Assessment of California Skilled Nursing Facilities to Receive Patients with Confirmed COVID-19 Infection (PDF) – guidance for SNFs planning to designate a specific wing/unit to care for residents with suspected or confirmed COVID-19
- Detection and Management of COVID-19 Cases in Skilled Nursing Facilities (PDF)
- Infection Control Guidance for Local Public Health Response to Congregate Living Facilities with Suspected or Confirmed COVID-19 Cases (PDF)*
- Detection and Management of COVID-19 Cases in Congregate Living Facilities (PDF)*
*CDPH and CDSS are jointly conducting onsite visits to Adult and Senior Care licensees; these documents are intended for these licensees.
If you have any questions about infection prevention and control of COVID-19, please contact the CDPH Healthcare-Associated Infections Program via email at HAIProgram@cdph.ca.gov or novelvirus@cdph.ca.gov.
Please remember to immediately report confirmed cases of COVID-19 to your local public health department and your district office. If there are any urgent PPE or staffing needs, please report them immediately to your district office.
Sincerely,
Original signed by Heidi W. Steinecker
Heidi W. Steinecker
Deputy Director
Resources
- Preparing for COVID-19 in California Skilled Nursing Facilities checklist (PDF)
- Assessment of California Skilled Nursing Facilities to Receive Patients with Confirmed COVID-19 Infection checklist (PDF)
- Detection and Management of COVID-19 Cases in Skilled Nursing Facilities flowchart (PDF)
- Infection Control Guidance for Local Public Health Response to Congregate Living Facilities with Suspected or Confirmed COVID-19 Cases checklist(PDF)
- Detection and Management of COVID-19 Cases in Congregate Living Facilities flowchart (PDF)
- Executive Order N-27-20 (PDF)
- CDPH COVID-19 Guidance for California SNF webinar recording
- CDPH COVID-19 webpage
- CDC Preparing for COVID-19: Long-term Care Facilities, Nursing Homes
- CDC Nursing Homes and Assisted Living (Long-term Care Facilities [LTCFs]) Infection Prevention Training
