Who this is for: Hospitals, Skilled Nursing Facilities (SNF), and any Congregate Residential/Congregate Care facility involved in the discharging, transferring, and accepting of patients with and without COVID-19.
What this is for: To allow hospitals to discharge medically stable patients while preventing the introduction of SARS-CoV-2 in receiving institutions and to enable interfacility transfers between SNF and other Congregate Residential/Care facilities.
What is provided: Discharge/transfer criteria for a variety of patient scenarios and receiving facility settings based on CDPH and Los Angeles County Department of Public Health (LAC DPH) COVID-19 guidance.
Skilled Nursing Facilities (SNFs) include nursing homes and skilled nursing facilities. All SNFs are required to be able to maintain Transmission-Based Precautions.
Congregate Residential/Care Facilities, also known as community care facilities (CCFs) include the following:
If patient is a NEW ADMISSION to a SNF or is being RETURNED to the SNF of origin:
Transmission-based precautions should continue until isolation is completed starting from date of symptom onset or date of positive test. Patient should be placed in a location designated to care for COVID-19 patients. The patient may be placed in a shared room with other confirmed COVID patients.
Patient may be transferred when clinically indicated.
The receiving SNF may not require a negative test result for COVID-19 as criteria for admission or readmission of residents hospitalized without a diagnosis of COVID-19 as stated in CDPH AFL 22-31.
The receiving SNF must follow the COVID-19 testing instructions for the admissions and readmissions in LAC DPH Guidelines for Preventing and Managing COVID-19 in Skilled Nursing Facilities. .
Note: SNFs experiencing outbreaks may admit new patients without COVID-19 at the discretion of Public Health; they should continue to re-admit returning residents.
Per AFL 22-31, receiving SNFs may not require a negative test result for COVID-19 as criteria for admission or readmission of residents as stated in CDPH AFL 22-31. Additionally, hospitals should proactively communicate with SNFs early to facilitate transfers. SNFs should work collaboratively with hospital discharge planners and local Public Health to facilitate the safe and appropriate placement of SNF residents. SNFs should be prepared to provide care safely without putting existing residents at risk. Please contact LAC DPH at LTC_NCoV19@ph.lacounty.gov for questions and/or help with transfers related to COVID-19 infection control.
In cases of hospital overload, this discharge guidance may be adjusted by the Department of Public Health.
CDPH Movement of Patients/Residents in the Healthcare Continuum During Seasonal Surges and the Coronavirus Disease 2019 (COVID-19) Pandemic AFL 22-31 (supersedes AFL 20-87.1)
Patients with confirmed COVID-19 may be transferred to a receiving facility once they are clinically stable. Facilities must be willing and prepared to accept COVID-19 positive patients if they have the ability to appropriately care for them in isolation (Red Zone).
A negative COVID-19 test result should not be required for admitting or readmitting patients from hospitals.
Note: Persons with laboratory-confirmed COVID-19 can continue to have positive test results for several weeks after they resolve their infection therefore re-testing within 90 days of recovery is not recommended. With the exception of severely immunocompromised persons, patients are considered non-infectious once they meet the above criteria for time since symptom onset (or date of initial positive test).
The patient may be transferred to the receiving facility when clinically stable.
Refer to LAC DPH Community Care Facilities guidance for placement of new admissions and readmissions.
In cases of hospital overload, this discharge guidance may be adjusted by the Department of Public Health.
Please refer to the LAC DPH COVID-19 Provider Isolation and Quarantine Guidelines for more details.