On Tuesday, the California Department of Public Health (CDPH) posted an All Facility Letter (
AFL 20-73) with important guidance to skilled nursing facilities (SNFs) on the subject of Advance Care Planning, Physician Orders for Life Sustaining Treatment (POLST), and Coronavirus Disease 2019 (COVID-19).
The Coalition for Compassionate Care of California (CCCC) led a group of stakeholders who joined in drafting recommended language and requesting that CDPH issue the AFL, including California POLST physician leaders, skilled nursing medical directors, advocates, and representatives from Health Services Advisory Group (HSAG), California Association of Long-Term Care Medicine (CALTCM), California Association of Health Facilities, and LeadingAge California.
Signed by CDPH Deputy Director Heidi W. Steinecker, the AFL states, “Residents have a right to receive care consistent with their preferences. In light of COVID-19, each facility should prospectively confirm residents’ treatment preferences, develop care plans and obtain requisite orders to reflect residents’ goals, values and preferences, and put policies and procedures in place to support resident treatment wishes being recognized and honored. Facilities should recognize that residents have a right to create advance care planning documents but cannot be required to do so. Facilities should ensure that information is effectively communicated to residents and decision makers and provide auxiliary aids and services to residents with disabilities as needed to facilitate communication.”
To view the AFL, including detailed recommendations for SNF providers,
click here.
Marin County Issues Similar Advisory
Marin Health and Human Services Department issued its own Public Health Advisory directed at medical directors and administrators in SNFs and residential care settings (Residential Care Facilities for the Elderly, Intermediate Care Facilities, and similar settings) with recommendations to “recognize the urgent need for discussing, reviewing, and documenting the goals of care for individual residents who are at increased risk for serious illness or death due to COVID-19.”
To view the Marin County Public Health Advisory,
click here.