Coronavirus Update: CDC Updates Guidance on Discharging Patients with COVID-19

The Centers for Disease Control and Prevention (CDC) March 23 clarified that patients with COVID-19 can be discharged from a health care facility when clinically indicated. This information can be found under the blue heading, Disposition of Patients with COVID-19. For such patients, a discharge does not require that the patient meet CDC criteria for the discontinuation of COVID-19 transmission-based precautions (TBP). The discontinuation guidance also was updated yesterday and is posted on the CDC’s website under the blue heading, Discontinuation of Transmission-based Precautions for Patients with COVID-19.

Patients Discharged to Home

CDC’s guidance specifies that the decision to discharge a COVID-19 patient to home should be made in consultation with the patient’s clinical care team and local or state public health departments. In addition, the discharging facility should consider the home’s suitability for and patient’s ability to adhere to home isolation recommendations – isolation should be maintained at home if the patient returns home before discontinuation of TBP. The CDC also has issued related guidance on implementing home care of persons who do not require hospitalization and the discontinuation of home isolation for persons with COVID-19.

Patients Discharged to Long-term Care (LTC) or Assisted Living Facilities

The guidance addresses three patient scenarios for COVID-19 patients discharged to an LTC facility or an assisted living facility.

1. Transferred COVID-19 patients for whom TBPs are still required should go to a facility with adequate personal protective equipment and an ability to adhere to infection prevention and control recommendations for the care of COVID-19 patients. Preferably, the patient would be placed at a facility that has already cared for COVID-19 cases, in a specific unit designated to care for COVID-19 residents.
2. Transferred COVID-19 patients for whom TBPs have been discontinued, but continue to have persistent symptoms of COVID-19 (e.g., a persistent cough) should be placed in a single room and be restricted to their room.
3. Transferred COVID-19 patients for whom TBPs have been discontinued and the symptoms have resolved do not require further restrictions.

In addition to the updated discharge guidance, CDC issued COVID-19 guidance for LTC facilities and nursing homes, including updated visitor restriction guidelines: Preparing for COVID-19: Long-term Care Facilities, Nursing Homes.

CDC notes that this update is based on the latest available information and subject to change as new information becomes available.