Coronavirus Disease 2019

Information for
Health Facilities


California Remdesivir Allocation, Distribution and Guidance Documents

The FDA granted an EUA on May 1 allowing remdesivir to be administered by healthcare providers to treat suspected or laboratory-confirmed COVID-19 in adults and children hospitalized with severe disease. The US Department of Health and Human Services (HHS) is allocating remdesivir to state health departments to distribute. Per CDPH, “California's first allocation of remdesivir from the federal government is scheduled to arrive on 5.12.20 and will consist of 30 cases of 40 doses each. Each patient course requires between 6-11 doses. This amount will allow us to treat between 109-200 patients. CDPH is allocating the 1,200 doses proportionately to counties based on the number of hospitalized patients.”

  • CDPH Guidance for Hospitals Regarding Allocation of Scarce Medications for COVID-19 (5-11-20) Guidance
  • CDPH Remdesivir Distribution Fact Sheet (May 11) (5-11-20) Fact Sheet
  • California Remdesivir Allocation (5-11-20) Allocation by County
  • HHS announces shipments of donated remdesivir for hospitalized patients with COVID-19 (5-9-20) Press Release
Discharge/Transfer
  • Interfacility Transfer and Home Discharge Rules (4-23-20) Rules Patient transfer criteria from hospitals to LTCF/SNFs, group settings (including psychiatric and mental health facilities), and home. Also includes guidance on LTCF/SNF transfers to other LTCF/SNFs or Group Settings.
  • Dedicated COVID-19 Facilities: Listing
  • Return-to-Facility & Home Discharge Rules for patients in the Emergency Department (5-8-20) Rules
  • Isolation and Quarantine Housing for Persons Experiencing Homelessness is available for patients who have or who were exposed to COVID-19. The patient must be able to perform Activities of Daily Living (ADLs) independently. The Quarantine and Isolation Intake Call Center is open 7 days a week from 8am-8pm: 833-596-1009.
Long Term Care Facilities Including Skilled Nursing Facilities (SNFs)

Guidance and Resources
LAC DPH
  • Implementing the Active Surveillance Requirement in SNFs: (5-13-20) Guidance Letter
  • Preventing and Managing COVID-19 in LTCFs (e.g. SNFs): Guidance (5-1-20)
  • Health Officer Order-Prevention of COVID-19 Transmission in Licensed Congregate Health Care Facilities: Order (4-24-20), FAQ (5-20-20)
  • Facility-Based Testing Strategies for SNFs: Guidance (5-18-20), FAQs (5-21-20)
  • SNFs with Specific Units, Floors, or Buildings Dedicated to COVID-19 Patients: Baseline Requirements (4-24-20), Listing of SNFs (Updated Often)
CDC
Transfer and Discharge Rules

Interfacility Transfer & Home Discharge Rules: (4-23-20) Rules Page Patient transfer criteria from hospitals to LTCF/SNFs, group settings (including psychiatric and mental health facilities), and home. Also includes guidance on LTCF/SNF transfers to other LTCF/SNFs or group settings.

Emergency Departments Return-to-Facility & Home Discharge Rules (3-23-20) Rules PDF

PPE Shipments from FEMA

FEMA is coordinating two shipments totaling a 14-day supply of personal protective equipment to all 15,400 Medicaid and Medicare-certified nursing homes in America. The first shipments are expected to begin the first week of May. The shipments are meant to supplement existing efforts to provide equipment to nursing homes. See FEMA letter (4-30-20).

Healthcare Personnel Monitoring
  • Monitoring Healthcare Personnel DPH Guidance (Rev. 5-4-20) : Includes recommendations for universal source control, continued daily monitoring of all healthcare personnel (HCP), management of high risk exposures, and testing of HCP.
Reporting

All COVID-19 associated deaths must be reported immediately by healthcare providers. All other COVID-19 cases must be reported by healthcare providers within a day. All SARS-CoV-2 test results must also be reported by laboratories within a day. View Provider Reporting for more information.

COVID-19 Deaths
  • Los Angeles County Decedent Management Guidelines (4-7-20) LAC Guidance for hospitals: Regarding decedent care for positive and presumptive COVID-19 cases. From Los Angeles County's Department of Medical Examiner-Coroner, Department of Public Health, and Emergency Medical Services Agency.
  • Certifying COVID-19 Related Deaths in California (3-6-20) CDPH Guidance: When COVID-19 has played a role in a patient’s death, it is important to report it accurately on the death certificate.
  • Reporting Deaths in Los Angeles County: COVID-19 associated deaths must be reported by healthcare providers immediately by phone or email. View Reporting Deaths for more information
Requirement to report COVID-19 to Emergency Responders and Funeral Employees
Key points
  • If an emergency response employee (ERE) has been exposed, the medical facility must provide the name of the infectious disease and the date on which the victim of the emergency was transported by the ERE to the facility.
  • If a patient with COVID-19 dies, the medical facility must notify the funeral director prior to the release of the deceased.
  • These notifications do not violate HIPPA

The National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention have recently added COVID-19, the disease caused by the virus SARS-CoV-2 to the list of infectious diseases and circumstances relevant to notification of Emergency Response Employees (Implementation of Section 2695 (42 U.S.C. 300ff-131) Public Law 111-87: Infectious Diseases and Circumstances Relevant to Notification Requirements). Please note that under Section 2695, if an emergency response employee (ERE) has been exposed, the medical facility must provide the name of the infectious disease and the date on which the victim of the emergency was transported by the ERE to the facility. This does not violate the Health Insurance Portability and Accountability Act (HIPPA).

Emergency response employees (ERE) are defined as: firefighters, law enforcement officers, paramedics, emergency medical technicians, funeral service practitioners and other individuals (including employees of legally organized and recognized volunteer organizations, without regard to whether such employees receive nominal compensation) who, in the course of professional duties, respond to emergencies in the geographic area involved.

The full guidance document can be found here.

In addition, health facilities are reminded that if a patient with COVID-19 dies, they must notify the funeral director PRIOR to the release of the deceased.
California Code, Health and Safety Code - HSC § 1797.188
(h) In the event of the demise of the person afflicted with the reportable communicable disease or condition, the health facility or county health officer shall notify the funeral director, charged with removing the decedent from the health facility, of the reportable communicable disease or condition prior to the release of the decedent from the health facility to the funeral director.
https://codes.findlaw.com/ca/health-and-safety-code/hsc-sect-1797-188.html

Hemodialysis Centers
  • LAC DPH Hemodialysis Guidelines (4-27-20) Guidelines
  • CDC Interim Additional Guidance for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed COVID-19 in Outpatient Hemodialysis Facilities. Guidance
  • CDC Screening dialysis patients for COVID-19 Guidance
Surge and Recovery Planning
Recovery Planning
  • Resuming California’s Deferred and Preventive Health Care (CDPH) Guidance (4-27-20)
  • Resuming Deferred and Preventive Dental Care (CDPH) Guidance (5-7-20)
  • Resuming Deferred and Preventive Health Care in Los Angeles County (LAC DPH) Recommendations and FAQs (5-8-20)
  • Framework for Healthcare Systems Providing Non-COVID-19 Clinical Care During the COVID-19 Pandemic (CDC) Guidance (5-12-20) New!
  • OPENING UP AMERICA AGAIN - Recommendations for Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare (CMS) Phase I Guidance (4-19-20)
  • Best Practices for Reopening a Medical Practice (California Medical Association) Best Practices (4-28-20)
  • Outpatient and Ambulatory Care Settings: Responding to Community Transmission of COVID-19 in the United States (CDC) Guidance
Surge Planning
  • Surge Planning Letter to Healthcare Executives and Chief Medical Officers (3-17-20) Health Officer Letter
  • Guidance for Surge Capacity: California Department of Public Health (CDPH) is encouraging facilities to consider increasing surge capacity for the evaluation of patients for suspected COVID-19 illness. See CDPH All Facilities Letters (AFL): Guidance for Healthcare Facilities on Preparing for Coronavirus and Increased Patient Accommodations Including Medical Surge Tent Use.
  • Adult Elective Surgery and Procedures During COVID-19: Recommendations to limit non-essential procedures including a tiered chart of procedures to cancel from Centers for Medicare & Medicaid Services (CMS) (4-7-20).
  • Non-Emergent, Elective Medical Services, and Treatment During COVID-19: Recommendations from CMS (4-7-20)
Posters for healthcare facilities
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  • COVID-19 PPE Poster: Includes information on proper donning and doffing. English Spanish (updated 3-12-20)
  • LTCF poster – restricting visitors: explains that visitors are not permitted in long term care facilities except for compassionate care. Lists rules for the visitors that are allowed. English
  • Facility poster - symptomatic visitors: instructs visitors with respiratory symptoms to postpone their visit. English Spanish
  • Facility poster - symptomatic visitors and patients: instructs visitors with respiratory symptoms to postpone their visit and patients with symptoms to wear a mask. English Spanish (for other languages visit the print materials page)
  • Facility entrance poster - symptomatic patients: instructs patients with fever and respiratory symptoms to tell staff and request a mask. English  Spanish (updated 4-8-20) (for other languages visit the print materials page)
Page Updated 5-20-2020


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