The California Department of Health has issued an All Facilities Letter (AFL) providing guidance to skilled nursing facilities (SNFs) for evacuating and transferring residents in emergency situations during the COVID-19 pandemic. SNFs are required to develop and maintain an emergency preparedness plan, which must be reviewed and updated at least annually. The letter recommends that facilities review their emergency plans to ensure they address COVID-19 infection control measures, establish relationships with multiple healthcare facilities for emergency transfers, and provide emergency preparedness training to staff. When transferring residents, facilities should prioritize transporting COVID-19 positive residents separately and ensure all residents wear PPE during transport. Facilities receiving emergency transfers should designate areas for evacuated residents and cohort them by COVID-19 status. Evacuated facility staff who test negative for COVID-19 may work in another facility to support relocated residents during an emergency.

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