Visitor Limitations Guidance

AFL 20-38.7 From the California Department of Public Health June 16, 2021 TO: All FacilitiesSUBJECT: Visitor Limitations Guidance(This AFL supersedes AFL 20-38.6) All Facilities Letter (AFL) Summary This AFL revision updates and consolidates California Department of Public Health’s (CDPH’s) visitation guidance into single set of recommendations for all facilities in all counties, considering California is moving Beyond the Blueprint for a Safer Economy framework effective June 15, 2021.This AFL also provides updated visitation guidance based upon CDC’s updated healthcare infection prevention and control recommendations in response to COVID-19 vaccination for non-long-term care facilities (e.g., General Acute Care Hospitals, Acute Psychiatric Hospitals).Long-term care (LTC) facilities should continue to refer to AFL 20-22.8 for updated LTC visitation guidance.

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Coronavirus Disease 2019 (COVID-19) Vaccine Recommendations for Eligible Individuals Prior to Discharge

AFL 21-20 From the California Department of Public Health June 9, 2021 TO: General Acute Care Hospitals (GACHs)Acute Psychiatric Hospitals (APHs)SUBJECT: Coronavirus Disease 2019 (COVID-19) Vaccine Recommendations for Eligible Individuals Prior to Discharge All Facilities Letter (AFL) Summary This AFL recommends GACHs and APHs offer COVID-19 vaccinations to eligible individuals prior to discharge. The California Department of Public Health (CDPH) recognizes that not all GACHs and APHs currently have the ability to take these steps.

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Annual Notice of Grant Opportunity to Benefit Nursing Facility Residents and Update to Application Requirements

AFL 21-19 From the California Department of Public Health June 8, 2021 TO: Skilled Nursing FacilitiesNursing FacilitiesSUBJECT: Annual Notice of Grant Opportunity to Benefit Nursing Facility Residents and Update to Application Requirements ​AUTHORITY:     Title 42 Code of Federal Regulations section 488.433 All Facilities Letter (AFL) Summary This AFL serves as an annual notice to skilled nursing facilities (SNFs) and nursing facilities (NFs) regarding the availability of federal civil money penalty (CMP) funds that may be used to support projects that benefit and improve the care of residents.Applicants may submit a CMP grant application to the California Department of Public Health (CDPH) electronically or by mail.

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GACH Reporting Requirements of Specified Health-Associated Infections (HAI)

AFL 21-18 From the California Department of Public Health June 8, 2021 TO: General Acute Care Hospitals (GACH) SUBJECT: GACH Reporting Requirements of Specified Health-Associated Infections (HAI)  (This AFL supersedes AFLs 07-37, 08-10, and 13-03) ​AUTHORITY:     Health and Safety Code sections 1288.5 and 1288.8 All Facilities Letter (AFL) Summary This AFL informs GACHs of the discontinuation of the following process measure reporting requirements pursuant HSC section 1288.8:Central Line Insertion Practices (CLIP) reporting requirements to the California Department of Public Health (CDPH) via the National Healthcare Safety Network (NHSN)Surgical Antimicrobial Prophylaxis Measures reportingGACHs must continue to report the following to CDPH through the NHSN:Central line associated bloodstream infection (CLABSI)Clostridium difficile infection (CDI)Influenza vaccination of healthcare personnel (HCP)Methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI)Surgical site infection (SSI)Vancomycin-resistant enterococci (VRE) BSI Background Health and Safety Code 1288.8 requires that each GACH report to CDPH on infection prevention process measures that have been recommended by the Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC).

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Requirements for Application Submission for Online or Distance Learning Nurse Assistant Training Programs (NATPs)

AFL 20-89.1 From the California Department of Public Health June 7, 2021 TO: Skilled Nursing FacilitiesIntermediate Care FacilitiesEducational InstitutionsSUBJECT: Requirements for Application Submission for Online or Distance Learning Nurse Assistant Training Programs (NATPs) ​AUTHORITY:Health and Safety Code (HSC) section 1337.1, 1337.15, 1337.16 and 1337.3 All Facilities Letter (AFL) Summary The eLearning Review Unit was created as a result of the chaptering of Assembly Bill (AB) 2850 (Chapter 769, Statutes of 2018), allowing NATPs to offer 60 hours of California Department of Public Health (CDPH) approved classroom training in an online or distance learning format.

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Coronavirus Disease 2019 (COVID-19) Mitigation Plan Recommendations for Testing of Health Care Personnel (HCP) and Residents at Skilled Nursing Facilities (SNF)

AFL 20-53.4 From the California Department of Public Health June 7, 2021 TO: Skilled Nursing Facilities SUBJECT: Coronavirus Disease 2019 (COVID-19) Mitigation Plan Recommendations for Testing of Health Care Personnel (HCP) and Residents at Skilled Nursing Facilities (SNF)(This AFL supersedes AFL 20-53.3) All Facilities Letter (AFL) Summary This AFL provides updated recommendations from the California Department of Public Health (CDPH) for SNFs conducting diagnostic screening testing of SNF health care personnel (HCP), and response-driven testing of SNF residents and HCP to prevent spread of COVID-19 in the facility informed by CDC recommendations and CMS requirements.This revision updates and clarifies CDPH routine diagnostic screening testing guidance for SNF HCP based upon their individual COVID-19 vaccination status and the SNF’s percentage of residents and HCP that are fully vaccinated.  Updated Testing Guidance Based Upon Progress with COVID-19 VaccinationRoutine SARS-CoV-2 diagnostic screening testing of SNF HCP, and response testing of SNF residents and HCP have been essential to protect the vulnerable SNF population.

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Coronavirus Disease 2019 (COVID-19) Testing Recommendations for Patients and Health Care Personnel (HCP) at General Acute Care Hospitals (GACHs)

AFL 20-88.1 From the California Department of Public Health June 7, 2021 TO: General Acute Care Hospitals SUBJECT: Coronavirus Disease 2019 (COVID-19) Testing Recommendations for Patients and Health Care Personnel (HCP) at General Acute Care Hospitals (GACHs) ​All Facilities Letter (AFL) Summary This AFL provides updated recommendations from the California Department of Public Health (CDPH) for weekly SARS-CoV-2 diagnostic screening testing for healthcare personnel (HCP) in hospitals, and recommendations for the testing of newly admitted patients.

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Expiration of Concentra Contract for Fit-Testing Services

AFL 21-17 From the California Department of Public Health June 3, 2021 TO: Skilled Nursing Facilities SUBJECT: Expiration of Concentra Contract for Fit-Testing Services ​All Facilities Letter (AFL) Summary This AFL notifies skilled nursing facilities (SNFs) that the Concentra contract, used to request fit-testing resources, will expire June 30, 2021. All fit-testing services provided by Concentra must be completed by that date.  Background On January 13, 2021, CDPH issued AFL 21-05 which introduced a process for SNFs to request fit-testing assistance for staff respiratory protection.

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Suspension of Regulatory Enforcement of Specified ADHC Requirements

AFL 20-34.4 From the California Department of Public Health June 2, 2021 TO: Adult Day Health Care Centers (ADHCs) SUBJECT: Suspension of Regulatory Enforcement of Specified ADHC Requirements(This AFL supersedes AFL 20-34.3) ​AUTHORITY:     Executive Order N-35-20 (PDF) All Facilities Letter (AFL) Summary This AFL notifies ADHCs of a temporary waiver of specified regulatory requirements due to the state of emergency related to the Coronavirus Disease 2019 (COVID-19) outbreak.This revision notifies ADHCs that the waiver allowing ADHCs to provide services using alternate methods including remote services contained in this AFL is valid until the end of the public health emergency.

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Suspension of Regulatory Enforcement of Specified Skilled Nursing Facility Requirements

AFL 20-32.3 From the California Department of Public Health June 2, 2021 TO: Skilled Nursing Facilities  SUBJECT: Suspension of Regulatory Enforcement of Specified Skilled Nursing Facility Requirements(This AFL supersedes AFL 20-32.2) ​AUTHORITY:     Proclamation of a State of Emergency (PDF) and Executive Orders N-27-20 (PDF) and N-39-20 (PDF) All Facilities Letter (AFL) Summary This AFL notifies skilled nursing facilities (SNFs) of a temporary waiver of specified regulatory requirements due to the state of emergency related to the COVID-19 outbreak.This AFL is providing advance notice that effective July 17, 2021, the temporary waiver of specified regulatory requirements in this AFL will expire and this AFL will be rescinded.  Pursuant to the Governor’s Executive Order N-39-20 (PDF) related to COVID-19 state of emergency, the Director of the California Department of Public Health (CDPH) may waive any of the licensing and staffing requirements of Chapter 2 and Chapter 2.4 of Division 2 of the Health and Safety Code and accompanying regulations with respect to any hospital or health facility identified in Health and Safety Code section 1250.

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