California recommends testing all residents and staff at nursing homes

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By Rachel Swan, San Francisco Chronicle, May 23 2020

Men donning hazmat suits bring a body out of Gateway Care and Rehabilitation in Hayward in early April. Nursing homes have been hard hit by the coronavirus outbreak, and the state wants more widespread testing. Photo: Yalonda M. James / The Chronicle

California is recommending coronavirus testing for residents and staff in nursing homes across the state.

The new guidelines, made public Friday evening, are meant to address what many see as a failure to react quickly to COVID-19, which has taken a heavy toll on nursing homes.

To date, 35% of coronavirus fatalities in California occurred at senior living facilities, a number that has angered advocates and families.

San Francisco and Los Angeles County have already required testing of all nursing home residents and staff, but the vast majority of California counties have not.

The state guidelines recommend testing for all residents, all health care workers, anyone transferred from a hospital or other facility, anyone showing symptoms and anyone exposed to the virus.

Residents who test positive and show symptoms should be isolated until at least three days after they recover. Those who test positive but show no symptoms should be isolated for 10 days. Health care workers who are sick and test positive should be sent home, while those who test positive but have no symptoms should be restricted to working only with COVID-19 patients.

Once a case is confirmed in a facility, all residents who tested negative should be retested every seven days, as should all staff. The guidelines advise dividing residents into three separate cohorts: those who test positive, those who test negative but were exposed to the virus in the last 14 days, and those who test negative and were not in contact with an affected person for 14 days.

The facilities should have a procedure for anyone who declines or cannot be tested, and a protocol for follow-up tests, the guidelines say.

And in facilities with no known virus cases, a quarter of health care staff should be tested every week, thus ensuring that the entire staff gets tested once a month.

With elderly residents who may need hands-on work, nursing homes were inevitably at high risk for the virus. But critics also blame the state for giving facilities too much leeway. The California Department of Public Health has required each of the state’s 1,224 nursing homes to submit a plan by June 1, a deadline that some say is too late given the wide circulation of the disease.

Heidi Steinecker, deputy director of the Department of Public Health, acknowledged the perils in a letter directed to all facilities Friday.

“The vulnerable nature of the (skilled nursing facility) population, combined with the inherent risks of congregate living in a healthcare setting, requires aggressive efforts” to stave off the disease, she wrote.

Rachel Swan is a San Francisco Chronicle staff writer. Email: Twitter: @rachelswan