The California Department of Health issued an All Facilities Letter (AFL) providing interim guidance for skilled nursing facilities (SNFs) regarding the transfer and continuity of care for residents with suspected or confirmed COVID-19 infection. SNFs must accept the return of a resident from a hospital or alternate care site, and residents may be transferred between facilities for the purpose of cohorting COVID-19 patients. The guidance also states that meeting criteria for discontinuation of transmission-based precautions is not a prerequisite for discharge from the hospital or alternate care site. SNFs are encouraged to develop plans for placement and observation of new admissions and readmissions without COVID-19 testing. SNFs should only transfer residents with suspected or confirmed COVID-19 infection to higher acuity healthcare settings when clinically indicated. The letter also highlights the importance of SNFs following the Centers for Disease Control and Prevention (CDC) infection prevention and control recommendations for the care of COVID-19 patients, including adequate supplies of personal protective equipment (PPE).

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