AFL 20-43.1 From the California Department of Public Health
April 24, 2020
TO: Skilled Nursing Facilities (SNFs)
SUBJECT: SNF Coronavirus Disease 2019 (COVID-19) Daily Reporting
AUTHORITY: Proclamation of Emergency (PDF); QSO 20-26 (PDF)
All Facilities Letter (AFL) Summary
- This AFL requires all SNFs to report daily updates regarding current staffing levels, the number of COVID-19 patients, and equipment availability to the California Department of Public Health (CDPH) via an online survey. This reporting is to ensure that California has the information necessary to respond to the COVID-19 outbreak and to provide resources and support to SNFs.
- This AFL has been updated to reflect upcoming federal regulatory requirements; the Centers for Medicare and Medicaid Services (CMS) will be requiring SNFs to:
- Report COVID-19 data to CMS and the Centers for Disease Control and Prevention (CDC); CDPH will collect this information on behalf of facilities through the SNF COVID-19 Survey.
- Notify residents’ and their representatives to keep them up to date on the conditions at the facility, such as when new cases of COVID-19 occur.
CDPH requests reporting information from SNFs regarding staffing levels, the number of COVID-19 patients, confirmed positive and suspect patients, equipment availability, and other needs of the facility. In preparation for the new rulemaking, facilities must submit this information no later than 12:00 P.M. Pacific Time daily.
To ensure consistent reporting across the state CDPH is including a data dictionary (PDF). SNFs are encouraged to review the data dictionary (PDF) in its entirety before inputting data into the COVID-19 Survey.
To access the survey, follow the instructions below:
If you are completing this survey from a browser:
- Select here to launch the survey (Google Chrome is recommended; it does not work in Internet Explorer).
- Start to type your Skilled Nursing Facility and select from the drop down to auto populate facility specific information and continue to fill out the remaining questions.
Note:Some questions are conditional and will appear based on your answers, so please try to answer accurately.
If you will be completing this survey from the Survey123 field application on a mobile device:
- Ensure that you have downloaded Survey123 from your mobile device’s App Store
- From the device you will be using to fill out the form, click on the survey link here.
- On the landing page, select “Open in the Survey123 field app”
- This will launch the Survey123 Application and automatically download the survey to your App
Note:The next time you want to fill this survey out, simply open your Survey123 App, select the previously downloaded Skilled Nursing Facility Survey form, and select “Collect”.
You can also access this survey by scanning the QR code below with your phone:
Submissions of this reporting information will take the place of daily reporting to CDPH district offices and CMS/CDC, related to the information specified above. All other reporting requirements to CDPH district offices will continue using the standard reporting process. CMS and CDC will soon provide skilled nursing facilities with specific direction on standard formatting for reporting this information through the CDC’s National Health Safety Network (NHSN) system. As this information becomes available CDPH may revise the types of information collected by issuing subsequent AFLs to align with the additional guidance. Please note, that even if you are already receiving assistance from the CDPH Healthcare Acquired Infection (HAI) Infection Control strike teams, you should still fill out this survey daily.
Information from this survey will be shared with the local public health office emergency teams so we can work collaboratively with facilities to quickly find solutions. However, you should still notify your local Medical Health Operational Area Coordinator (MHOAC) for personal protective equipment (PPE) resource requests.
It is vitally important for facilities to notify family members and resident representatives when there are COVID positive residents or healthcare workers in your facility to keep them informed of the conditions of the facility and to comply with upcoming CMS requirements. At a minimum, facilities must inform residents and their representatives within 12 hours of the occurrence of a single confirmed infection of COVID-19, or three or more residents or staff with new-onset of respiratory symptoms that occur within 72 hours. This notification will provide an opportunity to inform families of the safety measures your facility is taking to protect their loved ones. Constant communication and transparent information are useful tools for all facilities to use with their healthcare worker staff, residents, and community.
Failure to report resident or staff incidences of communicable disease or infection, including confirmed COVID-19 cases (or Persons Under Investigation for COVID-19), or provide timely notification to residents and their representatives of these incidences, as required, could result in an enforcement action.
For the purposes of this AFL the following definitions apply:
- “COVID suspect” means, persons with symptoms of COVID-19 or persons who are asymptomatic that have been exposed to a lab-confirmed case of COVID-19.
- “COVID confirmed positive” means, an individual who has at least one respiratory specimen that tested positive for the virus that causes COVID-19 by a Centers for Disease Control and Prevention (CDC) laboratory, state or local public health laboratory, or commercial laboratory using Food and Drug Administration (FDA)-validated COVID-19 nucleic acid amplification (NAA) test.
If you have any questions about this AFL, please contact the CDPH Duty Officer at CDPHDutyOfficer@cdph.ca.gov.
Original signed by Heidi W. Steinecker
Heidi W. Steinecker