Supersedes AFL 21-08.8 and provides updated guidance on:

· exposure risk assessment and management of asymptomatic HCP with SARS-CoV-2 exposures

· work restrictions for HCP diagnosed with SARS-CoV-2 infection (isolation)

· incorporates the 9/23/22 updated CDC guidance for managing HCP with SARS-CoV-2 infection or exposure to SARS-CoV-2, and 9/23/22 updated CDC strategies to mitigate HCP staffing shortages.

· SNF’s receipt of annual increase in weighted average Medi-Cal reimbursement rate may be conditioned of SNF’s good faith compliance with AFL’s related to COVID-19

SNFs must use the CDC’s 9/23/22 updated risk assessment framework, to determine exposure risk for HCP with potential exposure to residents, visitors and other HCP with confirmed COVID-19. CDPH guidance for assessing community related exposures, should continue to be applied to HCP with potential exposures outside of work and among HCP exposed to each other while working in non-resident care areas.

SNFs must use the table below to guide work restrictions and testing for HCP with SARS-CoV2 infection and for asymptomatic HCP with exposures based upon HCP vaccination status and facility staffing level.

HCP returning to work between days 5-9 after meeting routine criteria should wear a fit-tested N95 for source control through at least day 10 from symptoms onset or positive test (for HCP who remain asymptomatic throughout their infection).

HCP whose most recent test is positive and are working before meeting routine return-to-work criteria must maintain separation from other HCP as much as possible and wear a N95 respirator for source control at all times while in the facility until at least 10 days from symptoms onset or positive test.

Similarly, all exposed HCP who are working during their post-exposure period should also wear a N95 respirator for source control at all times while in the facility until they have a negative test result on day 5. In addition, make N95 respirators available to any HCP who wishes to wear one when not otherwise required for the care of residents with suspected or confirmed COVID-19.

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