The California Department of Health has issued an All Facilities Letter (AFL) notifying General Acute Care Hospitals (GACHs) of the availability of Residential Alternate Care Sites (R-ACSs) as a potential discharge option for COVID-19 positive patients needing residential level of care. R-ACSs are low-acuity sites designed to accommodate individuals from residential care facilities for the elderly (RCFEs) and adult residential facilities (ARFs) that can no longer care for them due to staffing shortages or level of care needs beyond their capacity. These sites also support the decompression of hospitals by providing additional beds for temporary housing. GACHs can refer eligible individuals to an R-ACS by contacting the California Department of Social Services (CDSS) Regional Office. The decision-making process for individual placement into an R-ACS may vary depending on local COVID-19 prevalence and hospital capacity. R-ACSs will coordinate appropriate transportation for the individual once placement is approved. If an individual's condition deteriorates, they may need to be transferred from the R-ASC to a skilled nursing facility (SNF) or GACH through a direct admit or via the 911 emergency system.

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