General Interest

CDPH Guidance for Transfers of Residents with Suspected or Confirmed COVID-19

CDPH has released subsequent guidance that updates the prior AFL 20-33 for Transferring Residents with Suspected or Confirmed COVID. Please note there are signifcant updates below. This guidance supersedes AFL 20-33.

Updated guidance is as follows:

Patients hospitalized, or receiving treatment at an alternate care site, with COVID-19 can be discharged to a SNF when clinically indicated.

SNFs must hold a transferred patient’s bed for at least 14 days, and, accept the return of a resident from a hospital or alternate care site unless CDPH determines otherwise.

SNFs should prepare to receive patients that are clinically stable for discharge from hospitals or alternate care sites in the following scenarios:

· Patients with no clinical concern for COVID-19  may be transferred from hospitals or alternate care sites to SNFs following usual procedures.

  • SNFs may not require a negative test result for COVID-19 as criteria for admission or readmission of residents hospitalized or receiving treatment at an alternate care site with no clinical concern for COVID-19.
  • Hospitals and alternate care sites are NOT required to perform COVID-19 testing on patients solely for discharge considerations unless the patient develops new respiratory infection symptoms, in which case the patient is not likely to be ready for discharge.
  • SNFs are encouraged to develop plans for placement and observation of new admissions and readmissions without COVID-19 testing, such as single rooms or a separate observation unit, wing or building. 
  • Patients investigated for possible COVID-19 , with negative test results may be transferred from hospitals or alternate care sites to SNFs following usual procedures.
  • Patients with confirmed or suspected COVID-19  should not be sent to a SNF via discharge without first consulting the local health department.
    • SNFs can be expected to accept a resident diagnosed with COVID-19 and who is still requiring transmission-based precautions for COVID-19 as long as the facility can follow CDC infection prevention and control recommendations for the care of COVID-19 patients, including adequate supplies of PPE
      • LHD may direct placement of the patient at a facility that has already cared for COVID-19 cases, or that has a specific unit designated to care for COVID-19 residents.
    • Hospital discharge planners and alternative care sites should provide advanced notice to the SNF for any transfer of a patient with COVID-19. If transmission-based precautions have been discontinued* AND patients’ symptoms have resolved, patients can be discharged back to the facility they came from, regardless of the facility’s PPE supply and ability to adhere to infection prevention and control recommendations for the care of COVID-19 patients.
  • Patients under investigation (PUI) for COVID-19, but test results pending : At this time, PUIs should NOT be transferred to SNFs until test results are available.