For most people with COVID, isolation and precautions can be discontinued 10 days after symptom onset with symptom improvement and resolution of fever.
For most people a test based strategy to determine when to stop using isolation and precautions is no longer recommended; for those who are immunocompromised, a test based strategy could be considered in consultation with infectious disease experts.
For people who had symptomatic COVID and remain asymptomatic, retesting is NOT recommended within 3 months. Quarantine for these people is not recommended if they come in contact with someone who has COVID.
These individuals MAY require retesting if they develop new symptoms.
Except for rare situations, a test based strategy is no longer recommended to determine when to continue transmission based precautions. In addition to resident issues blow, this potentially allows staff to come back to work if they are no longer symptomatic;
Transmission based precautions can be discontinued if the person has no fever for 24 hours and an improvement in symptoms after:
10 days after symptoms first appeared for those with mild to moderate illness who are not immunocompromised;
20 days since symptoms first appeared for those with severe to critical illness; and
20 days after the first positive viral test for severely immunocompromised patients who were asymptomatic.
Specifically related to discharge of patients TO a nursing home or other LTC facility (e.g., assisted living), patients can be discharged:
If transmission based precautions are still required, the patient should go to a facility that can care for COVID patients or designated for them;
If transmission based precautions are not required, the patient does not require further restrictions.
A test based strategy is NO LONGER RECOMMENDED to determine when to allow health care personnel with COVID to return to work.
Health care personnel with severe to critical illness or who are severely immunocompromised can return to work 20 days after their positive test.
Health care personnel with mild to moderate illness can return to work 10 days after symptoms first appeared and at least 24 hours since their last fever.
UPDATE: The date for Medicaid providers to apply has been extended to August 3 to apply for funds from the approximately $15 billion Medicaid Distribution of the Provider Relief Fund. Eligible providers include but are not limited to assisted living, Medicaid-only nursing facilities, home and community-based services, and adult day centers, as long as they or their parent organization under the same Tax Identification Number (TIN) did not receive a General Distribution from the Provider Relief Fund. Providers paid by Medicaid managed care and/or under Medicaid waivers are also eligible to apply for this distribution. For more information on applying, providers can check out the LeadingAge Provider Relief Fund Explainer and HHS resources on CARES Act Provider Relief Fund website including their FAQs, and fact sheet.
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