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State of California—Health and Human Services Agency
California Department of Public Health

AFL 20-61
July 21, 2020

Skilled Nursing Facilities

Dialysis Transportation for Coronavirus Disease 2019 (COVID-19) Positive Residents


​All Facilities Letter (AFL) Summary

This AFL provides recommendations to skilled nursing facilities (SNFs) for transporting COVID-19 positive residents to dialysis clinics for treatment.

NOTE: This AFL is no longer in effect and is for historical purposes only.

Please refer to the most recent CDC guidance. ​

Access to dialysis services is essential to the overall health and safety of dialysis patients. SNFs are responsible for providing care to residents and must ensure residents requiring dialysis treatment are able to attend their appointments. Failure to transport residents to dialysis appointments can not only increase hospital admissions, reduce mitigation efforts to contain the spread of COVID-19, and increase mortality, this patient harm can also result in enforcement actions.

In efforts to eliminate transportation barriers, CDPH recommends SNFs do the following:

  • Timely communicate the appointment scheduling with the dialysis providers, including the availability of sitters if necessary
  • Communicate with the non-emergency medical transportation (NEMT) providers regarding the transportation of COVID-19 positive residents
  • Provide notification to NEMT affiliates regarding county PPE resource allocation
  • Refer NEMT providers to DHCS APL 20-004 (PDF) and COVID-19 Guidance for NEMT and NMT Providers (PDF) for additional information on transporting dialysis patients with COVID-19

If you have any questions about this AFL, please contact your respective district office.



Original signed by Heidi W. Steinecker

Heidi W. Steinecker
Deputy Director

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