Information for Long-Term Care Facilities

Reporting COVID-19 Cases

Long-Term Care Facilities (LTCFs) are required to submit to the County BOTH a Case Report Form when serving as the ordering healthcare provider (Item 1) AND a report submission via the Shared Portal for Outbreak Tracking (SPOT) Reporting Portal (Item 2, through the Shared Portal for Outbreak Tracking reporting form) of any newly positive (antigen or PCR positive) staff or resident, including staff or residents with a history of previous COVID-19 positive results.

 

1. Case Report Form: California Health and Safety Code Title 17 requires ordering healthcare providers to report diagnosed COVID-19 cases to the County via the Case Report Form. Case Report Form (CRF) requirement must be met within 1 business day instead of within 24 hours.

   NEW - As of 7/28/2021, case report form submission is required only for COVID-19 cases who are (1) hospitalized, (2) deceased, or (3) in a congregate living setting (e.g., jail, shelter, or LTCF) during their illness or incubation period. Case report form submission is no longer required for post-vaccination cases, unless case meets one or more of the criteria above. In addition, a new question has been added to this form to ascertain if the patient was hospitalized for COVID-19 illness. Note: Providers should use their best judgment to determine whether the patient was hospitalized in an inpatient bed for symptoms clinically compatible with COVID-19 and not explained by an alternate diagnosis.

2. Shared Portal for Outbreak Tracking (SPOT): Report via the Shared Portal for Outbreak Tracking reporting form (reporting of resident cases by Case Report Form does NOT fulfill this requirement to notify the County of a potential healthcare-acquired case). Long-term care facilities, should 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. Consult AFL 20-75 (ca.gov) for threshold for reporting to PHD (>1 probable or confirmed COVID-19 case in staff or resident).
   
   NEW - SPOT Video provides an overview and demonstration of the SPOT (Shared Portal for Outbreak Tracking) reporting process for healthcare facilities.
3. 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).
   
   For more instructions on reporting COVID-19 cases and contacts, please go here.

 

Testing Guidelines for COVID-19

Please see below testing resources for LTCFs. 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.

NEW: For SNF-LTCF testing information and guidance, please review the CDPH testing guidelines located online here, and AFL 20-53.5.

See the updated SNF COVID Plus Letter for relevant resources and guidance on testing for COVID-19.

Guidelines for Residents and Staff

• CDC -Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes (3/29/21)
• CDC - COVID-19 Testing Resources for Nursing Homes
• CDPH AFL 20-53.5 Coronavirus Disease 2019 (COVID-19) Mitigation Plan Recommendations for Testing of Health Care Personnel (HCP) and Residents at Skilled Nursing Facilities (SNF) (8/3/21)
• CDPH - AFL 20-22.9 Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities  (8/1/21)

Guidelines for Persistent Positives

• SCCPHD - Persistent Positive - Reinfection Diagram (2/23/21)
• CDC - Interim Guidance on Duration of Isolation and Precautions for Adults with COVID-19 (2/19/21)

Antigen Testing vs. PCR Testing

• CDPH Antigen Testing Program: CDPH - Antigen Testing Playbook (3/8/21)
• CDPH - Diagnostic Algorithm for SARS COV-2 (11/30/20)
• CDC - Antigen Testing in LTCFs (1/7/21)
• Laboratory Resources: COVID-19 CA Testing Task Force Laboratory List

 

 

Surveillance of Variants of the Virus that Causes COVID-19

For information about COVID-19 variants including variant definitions, number of variant cases, and more, please visit the COVID-19 Variant Dashboard.

For information on frequently asked questions about COVID-19 variants, please go here.

 

Vaccine-Related Resources and 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.

NEW: Please review the Order of the State Public Health Officer Health Care Worker Vaccine Requirement for information about the health care worker vaccine requirement.

Note: Please review the Ascertainment of Vaccination Status of Employees FAQ and see QSO-21-19-NH (cms.gov) that specifies reporting requirement to NHSN. A template Certification of Vaccination Status is available here.

Guidelines for HCP

• Work Restriction and Quarantine Guidelines for Vaccinated HCP
• CDPH – AFL 21-08.5 Guidance on Quarantine for Health Care Personnel (HCP) Exposed to SARS-CoV-2 and Return to Work for HCP with COVID-19 (10/11/21)

 

Mobile Vaccination Clinic Requests

Mobile Vaccination Clinic requests can be submitted by fillable form (preferred) or by phone at (408) 970-2950 (voicemail only). Visit sccmobilevax.org for more information.

• 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].

 

Transmission-Based Precautions for COVID-19

To protect against the transmission of the virus that causes COVID-19, there are specific personal protective equipment (PPE) requirements and other transmission-based precautions that are applicable to any facility, entity, or individual that provides inpatient or outpatient healthcare services. For more information about how to prevent the transmission of COVID-19, please visit CDC’s updated webpage on how the virus spreads.

Personal Protective Equipment

Please see below links to resources for important information on personal protective equipment (PPE) for LTCFs.

• CDPH - COVID-19 PPE Considerations (9/22/20)
• CDPH - Respiratory Protection – Resources for Health Care (3/24/21)
• Healthcare Facility Resources Requests - 213 RR Forms

Visitation Requirements

NEW: Consult the State Public Health Officer Order of August 5, 2021 to review requirements for visitors in acute health care and long-term care settings.

Resources for LTCFs

Please see below links to resources for important information for residents and staff at LTCFs.

Note: PIN 21-17.2-ASC, dated May 14, 2021, supersedes PIN 21-17.1-ASC, providing specific updates to the statewide waiver related to face coverings, vaccination status, visitation, communal dining, group activities, and residents returning from outings and entertainment.

Infection Prevention Resources

• Lab and Specimen Collection Slide Deck (10/29/20)
• Nasal Swab Poster
• Daily Symptoms and Temp Check Tracker​ (10/29/20)

 

Infection Prevention Training

• CDPH - HAI Program
• CDPH - HAI IP Certification Course (4/16/21)

 

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.
 

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.

• CDPH – All Facilities Letters
• CDPH - Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities
• CDPH - Visitation Fact Sheet - Skilled Nursing Facilities
• CDPH - Coronavirus Disease 2019 (COVID-19) Mitigation Plan Recommendations for Testing of Health Care Personnel (HCP) and Residents at Skilled Nursing Facilities (SNF)
• CDPH - Blueprint for a Safer Economy
• CDSS - Provider Information Notices (PINs) for CCLD-licensed Providers
• CDSS - CCR Resident Association and Resident and Family Councils
• CDSS - CCRC Resident Right to Submit a Complaint
• CDSS - Notification Requirements
• CDSS - Continuing Care Contract Approvals
• CDSS - Waiver of Advance Notice Requirements and Information on Federal Small Business Lending for COVID-19 Crisis

 

Guidance for LTCFs on Movement of Patients

Consult AFL 20-48 (ca.gov) for testing and quarantine guidance when receiving transfers of patients with COVID-19 and AFL-20-53 (ca.gov) for testing and quarantine guidance when receiving patients not known to be COVID-19 positive from the hospital.

Consult AFL 20-22 (ca.gov) for testing and quarantine guidance when readmitting LTCF patients (who resided in a LTCF prior to hospitalization) from the hospital, and AFL-20-53 (ca.gov) for testing and quarantine guidance when patients go to the Emergency Department, clinic visits or dialysis. 

FAQs

Do hospitals need approval from PHD before discharging or releasing a suspected or confirmed COVID-19 patient to a skilled nursing facility?

No. Proposed discharge of a confirmed COVID-19 case to a Long-Term Care Facility (including skilled nursing facilities) or other congregate setting no longer requires notification or approval of the Public Health Department.

What are the testing requirements for discharges from hospitals to skilled nursing facilities?

Consult AFL-20-53 (ca.gov) for testing requirements for discharges from hospitals to skilled nursing facilities (SNFs).

For patients who are hospitalized for COVID-19 and have fulfilled the isolation period, no further testing or repeat quarantine is needed prior to transfer to the skilled nursing facility.

Consult AFL-20-53 (ca.gov) for additional testing guidance for patients being readmitted to skilled nursing facilities after hospitalization or ambulatory care (e.g., emergency department or clinic).

What are the quarantine requirements for new admissions to skilled nursing facilities?

Consult AFL-20-53 (ca.gov) for the quarantine requirements for new admissions to skilled nursing facilities.

How can LTCFs interpret and manage positive molecular tests in asymptomatic, fully vaccinated residents and staff in residential congregate settings?

Several factors must be considered here. Moreover, all cases are unique and should be approached accordingly with the appropriate tools and variables. One factor to consider in decision making is “Cycle Threshold” (CT) values. For more information, see the FAQs about CT Values from COVID-19 PCR Tests Resource or visit California’s COVID-19 Testing Task Force’s Webpage on Testing for COVID-19: PCR, Antigen, and Serology.  

For general frequently asked questions for all providers, please go here.