Guidance on prevention and management of COVID in LTCFs and RCFEs is changing rapidly, so check this webpage for the latest updates and for local guidance.
Skilled Nursing Facilities (SNFs)
COVID:
OCHCA Guidance/Resources:
- Guidance on COVID in SNFs (03-08-22) | PDF
- PPE Guidance by Zone (03-09-22) | PDF
- COVID Testing Resources for Staff or Visitors: https://occovid19.ochealthinfo.com/covid-19-testing
California Department of Public Health (CDPH) Guidance:
- Link to CDPH All Facility Letters (AFL): https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/LNCAFL.aspx
- AFLs by Topic: https://beta.clearpol.com/AFL/topics/
Webinars:
- 12-16-21: “COVID-19 Update for SNFs” | PDF | Video
- 11-03-21: “COVID-19 Update for SNFs, Boosters, and CRAB” | PDF | Video
- 07-29-21: "C. Auris and COVID Updates" | PDF | Video
- 06-12-21: “Getting Back to Normal” | PDF | Video
- 03-18-21: "Considerations for the Red Tier" | PDF | Video
- 01-22-21: "COVID-19 Treatment - First Do No Harm" PDF, "COVID-19 Vaccine Update" PDF, Video (of both presentations)
Hospital Acquired Infections and Multi-Drug Resistant Organisms in LTC (HAI/MDRO)
Communicating the MDRO status of patients between healthcare facilities continues to be an issue in Orange County. All MDROs should be clearly communicated between facilities. OCHCA strongly recommends both 1) using an interfacility transfer form to notify the receiving facility they are admitting a patient with a known MDRO, and 2) making a call to the receiving facility to confirm they know the patient’s status.
| Types of Testing Available through OCHCA and/or ARLN | ||
|---|---|---|
| Type | C. auris | CRAB, CRE, CRPA |
| Admission screenings | Admissions to vSNFs who have history in another LTACH or vSNF; axilla/groin swabs provided. | none |
| Response to exposure event | vSNFs, SNFs, and select units in ACHs; axilla/groin swabs provided. |
Contact to confirmed CP-CRAB, CP-CRE, or CP-CRPA case; rectal swabs provided. If CP testing for the first case is pending, the facility is encouraged to retrieve an isolate from the contact through a private lab and submit the isolate to PHL for carbapenemase testing. |
| Isolates | Route all clinical isolates1 to PHL for confirmatory testing | Route all isolates to PHL for carbapenemase testing. |
1 Results obtained through testing done as ordered by the practitioner in the diagnosis and treatment of the resident; does not include axilla/groin screening swabs
- Please note there are also private labs that can provide PCR testing for C. auris.
Useful printouts:
- Enhanced Standard Precautions Trifold for families
- 6 moments sign – hang outside of rooms to designate ESP
Additional Resources:
- Antibiotic Resistance Threats in the United States, 2019 (cdc.gov)
- AFL 19-22 (ca.gov)
- Enhanced Standard Precautions for Skilled Nursing Facilities (SNF), 2019
- Precautions | Appendix A | Isolation Precautions | Guidelines Library | Infection Control | CDC
Residential Care Facilities for Elderly (RCFE)
OCHCA Guidance/Resources:
- OCHCA Guidance on COVID in RCFEs 03-14-22 | PDF
- Monitoring Elderly COVID Patients in Non-Medical Settings 07-03-20 | PDF
- COVID Testing Resources for Staff or Visitors: https://occovid19.ochealthinfo.com/covid-19-testing
California Department of Social Services (CDSS) Guidance
Link to CDSS Provider Information Notices (PIN): https://www.cdss.ca.gov/inforesources/community-care-li-censing/policy/provider-information-notices/adult-senior-care
COVID-Related PINs by Topic: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/covid-19-information-and-resources/covid-19-asc-pins
COVID-19 Vaccines for Long Term Care Residents: https://www.cdc.gov/vaccines/covid-19/toolkits/long-term-care/index.html
Webinars:
Key CDC Guidance:
- HCW Shortage Mitigation Strategy: https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.htm
- Infection Prevention and Control Recommendations: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html
- Duration of Isolation and Precautions for Adults with COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
- COVID Vaccine considerations https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
- Interim Public Health Recommendations for Fully Vaccinated People: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html
- After International Travel: https://www.cdc.gov/coronavirus/2019-ncov/travelers/after-travel-precautions.html
