Information and Precautions

February 19, 2024

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

12/11/23:

In order to protect patients in healthcare facilities and the healthcare workforce, Los Angeles County

Department of Public Health is updating the County’s COVID-19 Response Plan with the following measures:

1. Masking will be required for all healthcare staff, regardless of COVID-19 vaccination status, in patient care areas in licensed in-patient care settings 2 should the Los Angeles County CDC

COVID-19 Hospital Admission Level reach medium or higher.

1. Masking will be required for all visitors, regardless of COVID-19 vaccination status, entering

patient care areas in licensed in-patient care settings should the Los Angeles County CDC COVID-19 Hospital Admission Level reach medium or higher.

Masking in healthcare facilities continues to be strongly recommended for both staff and visitors within healthcare facilities even at low COVID-19 Hospital Admission Level.

Masking within licensed healthcare facilities continue to be required for healthcare workers who are not vaccinated against both COVID-19 and Influenza as required by the LACDPH Health Officer

Order No.2023-04-01 for the duration of the respiratory virus season.

Vaccination against COVID-19 and Influenza is one of the most effective tools in prevention of mortality and transmission of deadly respiratory viruses 3.

NOTE: masking is required in all healthcare facilities currently experiencing an outbreak of COVID-19 regardless of Los Angeles County CDC COVID-19 Hospital Admission Level.

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:

• COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

• The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

• Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

• Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

• Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

• New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

• Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

• New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

• New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

• The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

• COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

• In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

• All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

• The Administrator, in conjunction with the Medical Director and Infection Preventionist has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

• Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

• Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

February 12, 2024

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

12/11/23:
In order to protect patients in healthcare facilities and the healthcare workforce, Los Angeles County
Department of Public Health is updating the County’s COVID-19 Response Plan with the following
measures:
1. Masking will be required for all healthcare staff, regardless of COVID-19 vaccination status, in
patient care areas in licensed in-patient care settings 2 should the Los Angeles County CDC
COVID-19 Hospital Admission Level reach medium or higher.
2. Masking will be required for all visitors, regardless of COVID-19 vaccination status, entering
patient care areas in licensed in-patient care settings should the Los Angeles County CDC
COVID-19 Hospital Admission Level reach medium or higher.
Masking in healthcare facilities continues to be strongly recommended for both staff and visitors within
healthcare facilities even at low COVID-19 Hospital Admission Level.
Masking within licensed healthcare facilities continue to be required for healthcare workers who are
not vaccinated against both COVID-19 and Influenza as required by the LACDPH Health Officer
Order No.2023-04-01 for the duration of the respiratory virus season.
Vaccination against COVID-19 and Influenza is one of the most effective tools in prevention of
mortality and transmission of deadly respiratory viruses 3.
NOTE: masking is required in all healthcare facilities currently experiencing an outbreak of COVID-19
regardless of Los Angeles County CDC COVID-19 Hospital Admission Level.

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

February 5, 2024

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

12/11/23:
In order to protect patients in healthcare facilities and the healthcare workforce, Los Angeles County
Department of Public Health is updating the County’s COVID-19 Response Plan with the following
measures:
1. Masking will be required for all healthcare staff, regardless of COVID-19 vaccination status, in
patient care areas in licensed in-patient care settings 2 should the Los Angeles County CDC
COVID-19 Hospital Admission Level reach medium or higher.
2. Masking will be required for all visitors, regardless of COVID-19 vaccination status, entering
patient care areas in licensed in-patient care settings should the Los Angeles County CDC
COVID-19 Hospital Admission Level reach medium or higher.
Masking in healthcare facilities continues to be strongly recommended for both staff and visitors within
healthcare facilities even at low COVID-19 Hospital Admission Level.
Masking within licensed healthcare facilities continue to be required for healthcare workers who are
not vaccinated against both COVID-19 and Influenza as required by the LACDPH Health Officer
Order No.2023-04-01 for the duration of the respiratory virus season.
Vaccination against COVID-19 and Influenza is one of the most effective tools in prevention of
mortality and transmission of deadly respiratory viruses 3.
NOTE: masking is required in all healthcare facilities currently experiencing an outbreak of COVID-19
regardless of Los Angeles County CDC COVID-19 Hospital Admission Level.

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

January 2, 2024

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

November 20, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

November 14, 2023

November 8, 2023

Please allow this email communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:

– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

•      New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•      Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•      Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•      Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

•      Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•      Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•      Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•      New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•      Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•      Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•      Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•      Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

Updated cohorting guidance:

Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.

Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

– The Administrator, in conjunction with the Medical Director and Infection Preventionist has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

November 6, 2023

Please allow this email to serve as an update as to new developments at our facility relative to COVID-19. We have learned that 1 resident has tested positive for COVID-19. As such, we are continuing to work with Public Health and various local agencies to stop the spread of COVID-19.

At this time, we are continuing to implement all the guidelines of the Centers for Disease Control. Should additional safeguards be added, we will provide you with an update.

Our goal is to keep all line of communication open during this difficult time while we ensuring the safety of your loved ones and our employees.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:

• COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

• The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

• Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

• Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

• Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

• New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

• Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

• New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

• New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

• The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

• COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

• New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.

• Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.

• Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.

• Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

• Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.

• Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).

• Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.

• New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.

• Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.

• Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.

• Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.

• Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

Updated cohorting guidance:

Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.

Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

LAC | DPH | Guidelines for Preventing & Managing <br>COVID-19 in Skilled Nursing Facilities

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

• In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

• All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

• The Administrator, in conjunction with the Medical Director and Infection Preventionist has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

• Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

• Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

November 3, 2023

Please allow this email to serve as an update as to new developments at our facility relative to COVID-19. We have learned that 1 employee has tested positive for COVID-19 outside in the community. As such, we are continuing to work with Public Health and various local agencies to stop the spread of COVID-19.

At this time, we are continuing to implement all the guidelines of the Centers for Disease Control. Should additional safeguards be added, we will provide you with an update.

Our goal is to keep all line of communication open during this difficult time while we ensuring the safety of your loved ones and our employees.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:

– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

•      New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•      Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•      Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•      Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

•      Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•      Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•      Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•      New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•      Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•      Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•      Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•      Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

Updated cohorting guidance:

Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.

Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

– The Administrator, in conjunction with the Medical Director and Infection Preventionist has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

November 2, 2023

Please allow this email to serve as an update as to new developments at our facility relative to COVID-19. We have learned that 2 employees have tested positive for COVID-19. As such, we are continuing to work with Public Health and various local agencies to stop the spread of COVID-19.

At this time, we are continuing to implement all the guidelines of the Centers for Disease Control. Should additional safeguards be added, we will provide you with an update.

Our goal is to keep all line of communication open during this difficult time while we ensuring the safety of your loved ones and our employees.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

---

November 1, 2023

Please allow this email communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

October 30, 2023

Please allow this email to serve as an update as to new developments at our facility relative to COVID-19. We have learned that 1 resident has tested positive for COVID-19. As such, we are continuing to work with Public Health and various local agencies to stop the spread of COVID-19. 

At this time, we are continuing to implement all the guidelines of the Centers for Disease Control. Should additional safeguards be added, we will provide you with an update.

Our goal is to keep all line of communication open during this difficult time while we ensuring the safety of your loved ones and our employees.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting weekly testing for residents and staff.

 At this current time, LACDPH updates are mentioned below. 

LAC DPH updates:

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:

– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

•      New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•      Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•      Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•      Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

•      Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•      Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•      Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•      New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•      Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•      Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL22-13.1.
•      Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•      Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

October 27, 2023

Please allow this email to serve as an update as to new developments at our facility relative to COVID-19. We have learned that 3 residents have tested positive for COVID-19. As such, we are continuing to work with Public Health and various local agencies to stop the spread of COVID-19.

At this time, we are continuing to implement all the guidelines of the Centers for Disease Control. Should additional safeguards be added, we will provide you with an update.

Our goal is to keep all line of communication open during this difficult time while we ensuring the safety of your loved ones and our employees.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting weekly testing for residents and staff.

 At this current time, LACDPH updates are mentioned below.

LAC DPH updates:

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:

– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

•      New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•      Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•      Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•      Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

•      Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•      Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•      Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•      New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•      Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•      Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL22-13.1.
•      Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•      Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

October 26, 2023

Please allow this email to serve as an update as to new developments at our facility relative to COVID-19. We have learned that 1 resident has tested positive for COVID-19. As such, we are continuing to work with Public Health and various local agencies to stop the spread of COVID-19.

At this time, we are continuing to implement all the guidelines of the Centers for Disease Control. Should additional safeguards be added, we will provide you with an update.

Our goal is to keep all line of communication open during this difficult time while we ensuring the safety of your loved ones and our employees.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting weekly testing for residents and staff.

 At this current time, LACDPH updates are mentioned below.

LAC DPH updates:

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:

– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

•      New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•      Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•      Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•      Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

•      Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•      Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•      Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•      New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•      Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•      Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•      Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•      Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

October 24, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

At this current time, LACDPH updates are mentioned below.

LAC DPH updates:

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:

– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.

•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.

•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.

•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.

•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).

•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.

•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.

•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.

•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.

•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.

•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4

LAC | DPH | Guidelines for Preventing &amp; Managing <http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4>
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

October 18, 2023

Please allow this notifiation communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

---

October 9, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

---

October 5, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

At this current time, LACDPH updates are mentioned below.

LAC DPH updates:

8/11/23:

-Vaccination guidance is updated to reflect the rescission of the Los Angeles County Health Officer Order COVID-19 Vaccination Requirement for Health Care Workers effective 8/4/23. Healthcare workers (HCW) continue to be strongly recommended to stay up to date with their COVID-19 vaccination per the CDC.

-Infection prevention and control guidance is updated to reflect the rescission of the County Health Officer Order Masking in Healthcare and Direct Care Settings effective 8/11/23. HCW working in settings that serve those who are high risk or immunocompromised, including skilled nursing facilities (SNFs) are strongly recommended to continue wearing well-fitting masks whenever they are indoors in areas where residents may frequent.

-Updated references to CDC’s COVID-19 Community Levels to the current COVID-19 Hospital Admission Level

Added a link to the new guidance from CDPH on Best Practices for Ventilation of Isolation Areas to Reduce COVID-19 Transmission Risk in Skilled Nursing Facilities, Long-Term Care Facilities, Hospices, Drug Treatment Facilities, and Homeless Shelters

04/27/23:

– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.

•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.

•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.

•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.

•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).

•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.

•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.

•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.

•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.

•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.

•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4

LAC | DPH | Guidelines for Preventing &amp; Managing <http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4>
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

July 24, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

July 17, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

July 11, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

July 6, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

June 28, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

June 20, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:

• COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.

• The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.

• Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.

• Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.

• Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.

• New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.

• Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.

• New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.

• New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.

• The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.

• COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22

• New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.

• Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.

• Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.

• Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

• Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.

• Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).

• Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.

• New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.

• Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.

• Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.

• Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.

• Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

• In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

• All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:

• The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

• Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

• Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

June 12, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

June 5, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing for residents and staff as needed.

LAC DPH updates:

04/27/23:
– COVID-19 vaccination section is updated with code of federal regulation references as well as the new state requirement effective Jan 1, 2023, for all healthcare providers in California, including SNFs, to report all immunizations administered at the facility to CAIR2 including but not limited to COVID-19 immunization.
– The LAC DPH Updated Health Officer Order on COVID-19 Vaccination Requirement for Health Care Workers was revised April 20, 2023 following FDA’s deauthorization of monovalent mRNA vaccines to require health care workers newly coming into coming into compliance with this order (i.e., new hires) to receive a single dose of the bivalent vaccine.
– Updated the outpatient COVID-19 treatment section to add that symptomatic residents who are highly suspected to have a COVID-19 diagnosis despite initial negative viral testing should also be considered eligible for an oral antiviral treatment. Please note CDPH AFL 22-20 for outpatient COVID-19 treatments is still in effect.
– Per federal requirements, SNFs now must ensure all staff, including frontline staff, undergo basic infection prevention and control training at hire and annually. Please see the “Infection Prevention and Control Guidance” section for more details.
– Source control continues to be required for staff (surgical/procedure masks or higher) regardless of vaccination status as per the LAC DPH “Masking in Healthcare and Direct Care Settings” Health Officer Order, effective Apr 3, 2023. Please see source control under “Infection Prevention and Control Guidance” for more details on masking guidance for residents and table 2 for visitors.
– New table 1 “Transmission Based Precautions, PPE, and Resident Placement for COVID-19” clarifies recommendations for isolation vs quarantine.
– Table 2 “Infection Prevention & Control Measures for Visitation” has been updated to clarify recommendations on location of visitation and to include masking recommendations for visitors during high CDC COVID-19 community level or outbreak status.
– New table 3 “Summary of Testing Guidance” consolidates testing guidance based on CMS QSO 20-38-NH-Revised and CDC guidance.
– New table 4 consolidates isolation and infection control guidance for residents based on their COVID-19 status or risk status.
– The separate LAC DPH “Inter-facility Transfer Rules During COVID-19 Pandemic” page has been retired. Relevant guidance is now included in the “Inter-facility Transfers” section.
– COVID-19 “Reporting Requirements” is updated to differentiate the various reporting requirements for SNFs, including how to report an outbreak.

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

April 3, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There have been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

---

March 7, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

February 27, 2023

Please allow this notification as a  communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing as needed for residents and staff.

LAC DPH updates:

12/12/22

• New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.

• Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.

• Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.

• Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

• Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.

• Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).

• Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.

• New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.

• Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.

• Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.

• Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.

• Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9/27/22

Routine screening testing is no longer required or recommended for staff who are asymptomatic and do not have higher-risk exposure but may be conducted at the discretion of individual facilities. Facilities should maintain testing capacity and have the ability to ramp up testing in the event routine screening testing is required again at a future date.

9/22/22

Clarified that routine screening testing requirements for staff who are not up to date are dependent on the CDC COVID-19 Community Transmission for Los Angeles County. This is different from the CDC COVID-19 Community Level. Please see COVID-19 Testing for more details.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

Updated cohorting guidance:

Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.

Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

LAC | DPH | Guidelines for Preventing & Managing <br>COVID-19 in Skilled Nursing Facilities

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

• In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

• All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

The facility will continue outdoor visitations and window visits. Outdoor visits pose a lower risk of transmission due to increased space and airflow; therefore, outdoor visitation, window visits, and electronic communications (such as FaceTime and Zoom) are preferred.

In the facility’s policy for visitations under infection control:

• The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

• Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

• Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

February 20, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing as needed for residents and staff.

LAC DPH updates:

12/12/22

• New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.

• Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.

• Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.

• Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.

• Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.

• Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.

• Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.

• Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).

• Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.

• New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.

• Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.

• Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.

• Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.

• Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9/27/22

Routine screening testing is no longer required or recommended for staff who are asymptomatic and do not have higher-risk exposure but may be conducted at the discretion of individual facilities. Facilities should maintain testing capacity and have the ability to ramp up testing in the event routine screening testing is required again at a future date.

9/22/22

Clarified that routine screening testing requirements for staff who are not up to date are dependent on the CDC COVID-19 Community Transmission for Los Angeles County. This is different from the CDC COVID-19 Community Level. Please see COVID-19 Testing for more details.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.

Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.

Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.

Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.

Changes to routine screening testing recommendations for both staff and residents.

Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.

Updated cohorting guidance:

Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.

Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

LAC | DPH | Guidelines for Preventing & Managing <br>COVID-19 in Skilled Nursing Facilities

LAC | DPH | Guidelines for Preventing & Managing

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health

These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:

publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:

• In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.

• All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

The facility will continue outdoor visitations and window visits. Outdoor visits pose a lower risk of transmission due to increased space and airflow; therefore, outdoor visitation, window visits, and electronic communications (such as FaceTime and Zoom) are preferred.

In the facility’s policy for visitations under infection control:

• The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.

• Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.

• Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

February 13, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing as needed for residents and staff.

LAC DPH updates:

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9/27/22

Routine screening testing is no longer required or recommended for staff who are asymptomatic and do not have higher-risk exposure but may be conducted at the discretion of individual facilities. Facilities should maintain testing capacity and have the ability to ramp up testing in the event routine screening testing is required again at a future date.

9/22/22

Clarified that routine screening testing requirements for staff who are not up to date are dependent on the CDC COVID-19 Community Transmission for Los Angeles County. This is different from the CDC COVID-19 Community Level. Please see COVID-19 Testing for more details.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

The facility will continue outdoor visitations and window visits. Outdoor visits pose a lower risk of transmission due to increased space and airflow; therefore, outdoor visitation, window visits, and electronic communications (such as FaceTime and Zoom) are preferred.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

February 6, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center will be conducting testing as needed for residents and staff.

LAC DPH updates:

12/12/22
•     New definitions section including case (confirmed, suspect), close contacts, isolation, quarantine, up to date, and essential visitors.
•     Many parts of the guidance now depend on Los Angeles County’s CDC COVID-19 Community Level, which can be located here and is currently High as of Dec 8, 2022.
•     Vaccination guidance now includes CDC’s recommendation for everyone ages 5 and older to get an updated (bivalent) booster 2 months or more after their last COVID-19 vaccine dose once their primary series has been completed. This is the new up to date definition as of Sep 1, 2022.
•     Updated personal protective equipment (PPE) recommendations for staff caring for residents in isolation, whether in the Red Cohort or in-place. Please see Figure 1 “PPE for COVID-19” and the “Infection Prevention and Control” section for complete details.
o     Effective Dec 2, 2022, all staff must wear N95 respirators in all areas of the facility where residents are present or where residents may have access to for any purpose.
o     Eye protection is no longer indicated for all staff and is a consideration when CDC Community Level is high. Public Health may require eye protection on a case-by-case basis for facilities in active outbreaks.
•     Revised visitation guidance to remove distinction between general and essential visitors. Facilities must support visitation for all residents regardless of COVID-19 status, vaccination status, or the facility’s outbreak status.
•     Effective Dec 7, 2022, all visitors are expected to test within 24 hours before an indoor visit. If testing is not done prior to arrival at the facility, facilities should offer antigen tests for visitors to self-test prior to entry. Proof of a negative viral test is not a condition for visitation. Essential visitors are exempt from this testing recommendation (please see definitions below for more details).
•     Clarified that if COVID-19 antigen testing is used, facilities should confirm with PCR/NAAT testing when an asymptomatic individual tests positive via antigen or a symptomatic individual tests negative via antigen.
•     New guidance on post-exposure and response testing based on AFL 22-13.1 released Oct 5, 2022. Figure 2 “Post-exposure and Response Testing” details when close contact testing, group-level testing, and facility-wide testing strategies are appropriate and when to broaden the testing approach to help mitigate transmission.
•     Revised routine screening testing for staff: while still not required, facilities are encouraged to consider routine screening testing of all staff, regardless of vaccination status, once or twice per week when the CDC Community Level for LA County is Medium to High. Clarified the guidance for usage of antigen tests for routine screening testing.
•     Testing of residents who are new admissions, re-admissions, and returning after leaving the facility >24 hrs is now on days 0, 3, and 5 after admission (day 0) as per AFL 22-13.1.
•     Figure 3, “Testing Schematic” has been updated to reflect all changes for new admissions/re-admissions testing, routine screening testing, and post-exposure and response testing.
•     Quarantine is not routinely recommended for residents who are close contacts, included in group-level or facility-wide post-exposure and response testing, new admissions, re-admissions, or returning after leaving the facility >24 hours. However, these resident groups should wear well-fitting face masks when not in their rooms for 10 days after admission or last exposure. Public Health may direct facilities to quarantine these resident groups on a case-by-case basis.

9/27/22

Routine screening testing is no longer required or recommended for staff who are asymptomatic and do not have higher-risk exposure but may be conducted at the discretion of individual facilities. Facilities should maintain testing capacity and have the ability to ramp up testing in the event routine screening testing is required again at a future date.

9/22/22

Clarified that routine screening testing requirements for staff who are not up to date are dependent on the CDC COVID-19 Community Transmission for Los Angeles County. This is different from the CDC COVID-19 Community Level. Please see COVID-19 Testing for more details.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

The facility will continue outdoor visitations and window visits. Outdoor visits pose a lower risk of transmission due to increased space and airflow; therefore, outdoor visitation, window visits, and electronic communications (such as FaceTime and Zoom) are preferred.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

January 3, 2023

Please allow this notification communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive or Influenza residents or employees other than what was reported throughout the week.

At this time, we are continuing to implement all the guidelines of the Centers for Disease Control. Should additional safeguards be added, we will provide you with an update.

Our goal is to keep all line of communication open during this difficult time while we ensuring the safety of your loved ones and our employees.

The facility is continuing to implement all the necessary safety precautions that are consistent with the CDC guidelines as well as those of the recommendations of Public Health. As always, our priority is to ensure the safety and well-being of residents and employees while keeping the lines of communication open with you and your family.

Valley Palms Care Center is conducting testing for residents and staff.

LAC DPH updates:

9/27/22

Routine screening testing is no longer required or recommended for staff who are asymptomatic and do not have higher-risk exposure but may be conducted at the discretion of individual facilities. Facilities should maintain testing capacity and have the ability to ramp up testing in the event routine screening testing is required again at a future date.

9/22/22

Clarified that routine screening testing requirements for staff who are not up to date are dependent on the CDC COVID-19 Community Transmission for Los Angeles County. This is different from the CDC COVID-19 Community Level. Please see COVID-19 Testing for more details.

9-19-22

COVID-19 vaccination “up to date” definition now includes receipt of the updated (bivalent) booster dose at least 2 months after completion of the primary series or last monovalent booster dose per CDC recommendations released Sep 2, 2022.
Entry screening guidance is updated to clarify visitor entry screening and allow other options besides in-person screening at the facility.
Updated communal dining and group activities guidance to clarify which cohorts are permitted to participate in these activities.
Vaccine status and negative test verification is a consideration, and not a requirement, for general visitors seeking indoor visitation at this time.
Changes to routine screening testing recommendations for both staff and residents.
Asymptomatic residents who are close contacts/exposed and are 31-90 days from their prior COVID-19 infection are now recommended, but not required, to be tested with a point-of-care antigen test.
Updated cohorting guidance:
Yellow Cohort: revised duration of quarantine, testing interval recommendations, and which residents should be quarantined in this cohort.
Red Cohort: clarifies isolation duration for residents with critical illness due to COVID-19 or residents with severely immunocompromising conditions.

http://publichealth.lacounty.gov/acd/ncorona2019/healthfacilities/snf/prevention/#fig4
LAC | DPH | Guidelines for Preventing & Managing
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

LAC | DPH | Guidelines for Preventing & Managing COVID-19 in Skilled Nursing Facilities – Los Angeles County Department of Public Health
These guidelines outline actions that Skilled Nursing Facilities (SNFs) should take to help prevent and manage COVID-19, based on the current status of and trends in community transmission in LA County. We ask that you continue to ensure that your staff is trained, equipped, and capable of practices needed to:
publichealth.lacounty.gov

In addition, the following apply to all visitors, of SNFs in Los Angeles County:
– In a visitor log, visitors should document their name, contact information, and locations within the facility premises they are visiting in order to assist with contact tracing if needed.
– All visitors should be instructed to notify the facility if they develop COVID-19 signs and symptoms and/or have a positive test within 14 days of visiting the facility. Facilities should take all necessary actions including infection control precautions based on the findings.

The facility will be conducting visitations through different means based on the facility’s structure. All visitors and residents should wear appropriate facial covering during their visit and should maintain 6-ft physical distancing. The visitor visiting the facility must adhere to the following: Be screened for fever and COVID-19 symptoms, wear appropriate facial covering, and perform hand hygiene when in the facility.

The facility will continue outdoor visitations and window visits. Outdoor visits pose a lower risk of transmission due to increased space and airflow; therefore, outdoor visitation, window visits, and electronic communications (such as FaceTime and Zoom) are preferred.

In the facility’s policy for visitations under infection control:
– The Administrator, in conjunction with the Medical Director and Infection Preventionist, has the authority to restrict or ban facility visitation during outbreaks, whether these originate in the facility or in the community.
– Visitors who are symptomatic of communicable diseases may be denied visitation at the discretion of the Charge Nurse until appropriate evaluation and treatment of the visitor has been established.
– Visitors must follow instructions from the Charge Nurse on duty regarding facility infection control practices and visitation restrictions. – The facility does not have an age restriction policy. However, visitors under the age of twelve (12) must be strictly supervised. The FACILITY has the right to restrict or ban visitors as indicated.

---

December 12, 2022

Please allow this email communication to serve as our weekly update. At this current time, there has been no change from our last communication. There has been no new cases of COVID-19 positive residents or employees other than what was reported throughout the week. There were 3 residents who had influenza A last week.

At present, those residents that are exhibiting symptoms are being kept in isolation. All employees that are exhibiting symptoms are being quarantined in their homes.

We will keep you updated as to this new development. Please be assured that during this time we will keep the lines of communication open to give you peace of mind while we work to ensure the safety of your loved ones and our staff

The facility is continuing to implement all the nece