RCF Comprehensive Mitigation Guidance - Google Docs

Fully Vaccinated HCP and Residents

• Fully vaccinated HCP and residents who remain asymptomatic DO NOT need to participate in routine surveillance testing. 

HCP That Are Not Fully Vaccinated

• Unvaccinated HCP should be included in routine surveillance testing. 

Residents That Are Not Fully Vaccinated

• Residents who are not fully vaccinated DO NOT need to participate in routine surveillance testing UNLESS they have left the facility in the past 14 days.

Staff with Illness or a Positive Test

• Keep screening ALL staff on entry regardless of vaccination status.

Newly Admitted Residents

Unvaccinated Residents 

In general, all new admissions and readmissions should be placed in a 14-day quarantine, even if they have a negative test upon admission. Exceptions are listed below. Residents who leave the facility for 24 hours or longer should generally be managed as a new admission. 

• Unvaccinated new admissions should be included in surveillance and outbreak testing. 

• HCP should wear an N95 or higher-level respirator, eye protection, gloves, and gown when caring for residents on transmission-based precautions (e.g. isolation and quarantine).

Fully Vaccinated Residents

• Quarantine is no longer recommended for residents who are being admitted to a post-acute care facility if they are fully vaccinated and have not had prolonged close contact with someone with SARS-CoV-2 infection in the prior 14 days. Facilities should have a process in place to assess for such risk upon admission.

Return to Work After Travel

Travel may increase an individual's risk of getting and potentially spreading SARS-COV-2.  Those living in a residential care facility are at an increased risk of poor outcomes if they become infected. Facilities should consider the following when assessing risk of those who have recently traveled and will be coming into contact with residents. 

Fully Vaccinated Travelers

• Domestic travelers that are fully vaccinated do not need to get a SARS-CoV-2 viral test or self-quarantine after travel.

• International travelers that are fully vaccinated should get tested with a viral test 3-5 days after travel and isolate if positive.

• Travelers do not need to self-quarantine after international travel.

• In either scenario, the traveler should continue to self monitor for signs and symptoms for a full 14 days.

Unvaccinated or Partially Vaccinated Travelers 

• In general, CDC recommends people delay travel (domestically or internationally) until they are fully vaccinated.  

• Unvaccinated or partially vaccinated travelers should notify the facility of their travel plans prior to departure whenever possible. Facilities should have processes in place to assess traveler risk prior to travelers being allowed to return to work.  

• Domestic travelers are recommended to get tested with a viral test 3-5 days after travel and isolate if positive. HCP should self-quarantine for a full 7 days if testing negative. If testing does not occur, the traveler should be quarantined for 10 days after travel.  

• International travelers should get tested with a viral test 3-5 days after travel AND stay home and self-quarantine for a full 7 days after travel. Even if they test negative, travelers should stay home and self-quarantine for the full 7 days. If they test positive, travelers should isolate themselves to protect others from getting infected.  

• If they don’t get tested, travelers should stay home and self-quarantine for 10 days after travel. 

• International travelers should avoid being around people who are at increased risk for severe illness for 14 days after return, whether they get tested or not. 

• International travelers should self-monitor for COVID-19 symptoms for 14 days, and isolate and get tested if they develop symptoms. 

Testing Frequency

Facilities should monitor their county's two-week test positivity rate every other week (e.g. first and third Monday of each month) using the Colorado COVID-19 dashboard and adjust the frequency of testing as outlined below. The facility should test all required staff and residents at the frequency indicated in the routine testing interval table below. 

Routine Testing Interval Table

Individuals that should participate in routine surveillance testing	County Positivity Rate using CO COVID-19 dashboard	Minimum Testing Frequency utilizing PCR testing
HCP that are not fully vaccinated. Residents that are not fully vaccinated and have left the facility in the past 14 days. *Exclude those that tested positive in the past 90 days.	< 10% two-week test positivity.	Once a week.
HCP that are not fully vaccinated Residents that are not fully vaccinated and have left the facility in the past 14 days. *Exclude those that tested positive in the past 90 days.	>10% two-week test positivity.	Twice a week.