Guidance: Long Term Care Facilities (LTCFs) and Residential Care Facilities for Elderly (RCFEs)

CA Safe Reopening

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)


OCHCA Guidance/Resources:

California Department of Public Health (CDPH) Guidance:


  • 11-19-22: "COVID-19 & Flu - The Twindemic?" | PDF
Click to view older webinars


Guidance for the management of reporting and testing for influenza


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:

Additional Resources:

Residential Care Facilities for Elderly (RCFE)

OCHCA Guidance/Resources:

California Department of Social Services (CDSS) Guidance

Link to CDSS Provider Information Notices (PIN):

COVID-Related PINs by Topic:

COVID-19 Vaccines for Long Term Care Residents:


Click to view older webinars

Key CDC Guidance: