Information for Long-Term Care Facilities

Welcome Long-Term Care Facilities (LTCFs) partners. The resources listed here are for LTCF Administrators, Directors of Nursing (DONs), Infection Prevention (IP) Nurses/IP team members, Directors of Staff Development (DSD), and other LTCF team members that play a role in the prevention and control of COVID-19 infections in LTCFs.

Long-Term Care Facilities (LTCFs) are required to submit to the County BOTH a Case Report Form (Item 1) AND Worksite Case and Contact Form (Item 2, through the Worksite Case and Contact Reporting Portal) of any newly positive (antigen or PCR positive) staff or resident, including staff or residents with a history of previous COVID-19 positive results.

Case Report Form: California Health and Safety Code Title 17 requires healthcare providers to report diagnosed COVID-19 cases to the County via the Case Report Form. When applicable, also identify post-vaccination cases using the Case Report Form by completing the questions in the form about if and when the patient was fully vaccinated. See ‘Report to Public Health patients who tested positive after being fully vaccinated’ section below.

How to submit a Case Report Form to the Public Health Department:
1. Download the fillable form here^1,2
2. Complete all fields^3,4
3. Scan
4. Attach form and supporting labs to email
5. Using a secure email account, send documents to [email protected]
6. If you cannot send via secure email, please fax documents to (408) 224-7046
  
  ¹Do NOT submit a Confidential Morbidity Report (CMR). Please use the Case Report Form instead.
  ² Do NOT submit a report to the Public Health Department if the patient’s residence is outside of Santa Clara County – refer to instructions from the patient’s respective county of residence.
  ³ We recommend prioritizing the following fields if unable to complete the entire form: Contact for next of kin, Resident of congregate setting, Symptom onset date, and Date of admission. If time allows, symptom and comorbidity information should also be completed.
  ⁴ Providers are also asked to provide close contact information on the case report form whenever possible. If close contacts cannot be elicited from the patient, please ensure that contact information of next of kin is included.
Worksite Case and Contact Reporting Portal: Report via PHD’s Worksite Case and Contact Reporting Portal (reporting of resident cases by Case Report Form does NOT fulfill this requirement to notify the County of a potential healthcare-acquired case). County Health Officer Directive requires certain employers and businesses, including all long-term care facilities, to report all staff, resident, and visitor COVID-19 cases and contacts exposed at your healthcare facility or believed to be part of a healthcare facility outbreak.

Instructions for Completing the Worksite Case and Contact Form:

Please complete the Worksite Case and Contact Form using the Worksite Case and Contact Reporting Portal to report all staff, resident, and visitor COVID-19 cases and contacts exposed at your healthcare facility or believed to be part of a healthcare facility outbreak. Please include as much information as you can. Under the Health Officer Order, certain employers and businesses, including all long-term care facilities, are legally required to submit this report within four hours after the facility learns of the positive case(s). If you do not have complete information within four hours, you must report the information that you have obtained. You may update the information you provide if you discover additional information after your initial report. The information you provide on this form will remain confidential and is not reported to law enforcement or immigration. Providing this information helps our local case investigation teams identify and slow the transmission of COVID-19 in our in-person education settings and the community. Thank you for your cooperation.

Additional Reporting Requirements

Congregate Setting Outbreaks:

Providers must report any suspected congregate setting outbreak (3 or more suspected cases of acute illness compatible with COVID-19 in residents and/or staff of a congregate setting with onset within a 72-hour period).

Report by calling PHD at 408-885-4214, ext. 3 (8:00 a.m. – 5:00 p.m.; 7 days a week).

Report to Public Health patients who tested positive after being fully vaccinated:

Providers must report patients who test positive for COVID-19 after being fully vaccinated. Fully vaccinated is defined as: ≥ 14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine. Follow the same procedure as for reporting non-vaccinated patients by using the Case Report Form here, as specified above.

LTCF-SNF Reporting Guidance Chart

Use the chart below to identify when and how to report cases and contacts.

Who Must be Reported	How to Report
1) Any COVID-19 case diagnosed by a facility such that they serve as the diagnosing provider including cases diagnosed after being fully vaccinated Fully vaccinated is defined as: ≥ 14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine.	Submit a Case Report Form to the Public Health Department. Note: When applicable, identify post-vaccination cases using the Case Report Form by completing the questions in the form about if and when the patient was fully vaccinated.
2) All staff, resident, and visitor COVID-19 cases and contacts exposed at your healthcare facility or believed to be part of a healthcare facility outbreak	Report via PHD’s Worksite Case and Contact Reporting Portal (reporting of patient cases by Case Report Form does NOT fulfill this requirement to notify the County of a potential healthcare-acquired case). Note: In addition to row ‘1)’ above, a separate submission to report resident case(s) and contact(s) using the Worksite Case and Contact Form is required.
3) Any suspected congregate setting outbreak (3 or more suspected cases of acute illness compatible with COVID-19 in residents and/or staff of a congregate setting with onset within a 72-hour period)	Report by calling PHD at 408-885-4214, ext. 3 (8:00 a.m. – 5:00 p.m.; 7 days a week). Note: In addition to rows ‘1)’ and ‘2)’ above, a separate submission to report any suspected congregate setting outbreak(s) via calling PHD at the number above is required.

Who Must be Reported

How to Report

1) Any COVID-19 case diagnosed by a facility such that they serve as the diagnosing provider including cases diagnosed after being fully vaccinated

Fully vaccinated is defined as: ≥ 14 days following receipt of the second dose in a 2-dose series, or ≥14 days following receipt of one dose of a single-dose vaccine.

Submit a Case Report Form to the Public Health Department.

Note: When applicable, identify post-vaccination cases using the Case Report Form by completing the questions in the form about if and when the patient was fully vaccinated.

2) All staff, resident, and visitor COVID-19 cases and contacts exposed at your healthcare facility or believed to be part of a healthcare facility outbreak

Report via PHD’s Worksite Case and Contact Reporting Portal (reporting of patient cases by Case Report Form does NOT fulfill this requirement to notify the County of a potential healthcare-acquired case).

Note: In addition to row ‘1)’ above, a separate submission to report resident case(s) and contact(s) using the Worksite Case and Contact Form is required.

3) Any suspected congregate setting outbreak (3 or more suspected cases of acute illness compatible with COVID-19 in residents and/or staff of a congregate setting with onset within a 72-hour period)

Report by calling PHD at 408-885-4214, ext. 3 (8:00 a.m. – 5:00 p.m.; 7 days a week).

Note: In addition to rows ‘1)’ and ‘2)’ above, a separate submission to report any suspected congregate setting outbreak(s) via calling PHD at the number above is required.

LTCFs and Novel Coronavirus Response

Long-term care facilities include skilled nursing, independent living, assisted living and board and care facilities. The danger of COVID-19 transmission in long-term care facilities is particularly high due to facility residents generally being at higher risk of severe illness or death from COVID-19. Visitors to long-term care facility residents and residents returning to long-term care facilities after visits to friends or family in the community increase the risk of introducing and transmitting COVID-19 among residents and staff in the facility.

Note: When there is a difference between local, state, and federal guidelines or health orders; or difference with other regulatory agency guidelines, including guidelines for testing, quarantine, and isolation, the most restrictive guideline or order must be followed.

Resources for LTCFs

COVID-19 Prevention Resources for LTCFs

Please see below resources for important COVID-19 infection prevention information for residents and staff at LTCFs.

Prevention Resources

Testing Guidelines

FAQs

For frequently asked questions such as testing and patient transfer protocols specific to LTCFs, please see the following resources:

Provider Responsibilities and Guidance Page - Guidance for Congregate Care Settings

Provider FAQs Page

Provider FAQs Page – Skilled Nursing Facilities

COVID-19 Vaccine Information

For the latest information on who is eligible to receive a dose of COVID-19 vaccine and how to schedule an appointment, please visit sccfreevax.org. This is the County’s official source for vaccine-related information and is updated frequently.

Information on the State of California’s COVID-19 vaccination guidance and prioritization plan is also available.

For information for providers see County of Santa Clara COVID-19 Vaccine Information for Healthcare Providers.

Mobile Vaccination Clinic Requests

Mobile Vaccination Clinic requests can be submitted by fillable form (preferred) or by phone at (408) 970-2950 (voicemail only).

For facilities with over 10 people requesting vaccination, please complete the SNF/LTCF intake form and email form to [email protected].

For facilities or providers with less than 10 people requesting vaccination, please complete the provider mobile COVID-19 vaccination request form and email form to [email protected].

Useful Phone Numbers

The Provider Response Group (PRG) oversees COVID-19 response and surveillance among LTCFs. They are available Mon-Fri 8am-5pm for general questions related to COVID-19. Call 408-885-4214, select Option 3, and ask for the Provider Branch.

Contact the County about COVID-19, including questions about shelter in place, essential businesses, and more using the Secure Messaging System. See the Public Health Department Directory for more contact information.

Useful Documents

Please review the documents below regarding guidance for residents and staff members of LTCFs.

CDPH and CDSS Documents

For LTCFs, the California Department of Public Health (CDPH) and California Department of Social Services (CDSS) are the licensing bodies for the majority of the LTCFs in Santa Clara County. Below are resources for LTCFs published by these licensing bodies.