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The California Department of Public Health (CDPH) issued a Public Health Officer Order on Dec. 31, 2021, requiring skilled-nursing and other long-term care facilities to adopt a boosted-and-tested policy for indoor visitors. This is an update to the Aug. 5 and Aug. 26, 2021, State Public Health Officer Orders that required general acute care hospitals and long-term care facilities to adopt a vaccinated-or-tested policy for visitors. Minor changes were also made to visitor requirements for general acute care hospitals, as described below.
The revisions included in the most recent order are:
- For general acute care hospitals, unvaccinated or incompletely vaccinated visitors are eligible for indoor visits only with evidence of a negative COVID test within one day of visitation for antigen tests, and two days for PCR tests. Unvaccinated or incompletely vaccinated visitors with history of COVID within the prior 90 days may provide documentation of recovery and release from isolation in lieu of testing.
- For skilled-nursing and other long-term care facilities, requirements for visitors differ depending on whether the visit will be indoors or outdoors. For indoors, visitors must be vaccinated, boosted if eligible for a booster, and provide evidence of a negative COVID test within one day of visitation for antigen tests, and two days for PCR tests. These visitors must also wear a well-fitting face mask (surgical mask or respirator) and physically distance from facility personnel and other patients/residents who are not part of their group. There are special provisions for residents who are unable to leave their room or otherwise go outdoors. For outdoor visitation, visitors must provide evidence of a negative COVID test within one day of visitation for antigen tests, and two days for PCR tests.
- The order includes a grid showing when boosters are required based upon the brand of vaccine and time elapsed since the primary vaccine series was administered.
- For visitors who visit on multiple consecutive days, proof of a negative test is required only every third day (that is, day one, day four, day seven, etc.). This applies to all facility types.
- Outpatients and persons who accompany outpatients in a support capacity are not considered visitors.
- The following visitors are exempt from the vaccination/testing requirements:
- A visitor visiting a patient in critical condition when death may be imminent
- In emergent situations: parent or guardian visitors of pediatric patients; a support person for a labor and delivery patient; support persons for a patient with a physical, intellectual, developmental disability, or cognitive impairment; and a person visiting for bonding visits, including in-room stay with a newborn and hospitalized parent. Visitors in emergent situations must comply with the vaccine-or-test requirement as soon as reasonably possible after the emergency ends, which must be no longer than 72 hours, and on subsequent visits.
- The order does not apply to acute psychiatric hospitals.
Facilities must be in full compliance on Jan. 7 at 12:01 a.m. The order will remain in effect until Feb. 7, at which time CDPH will reassess the situation. CDPH has not updated its All Facilities Letters regarding visitation.