COVID-19 UPDATE #102
November 17, 2020
NO IMMEDIATE CHANGE TO FACILITY DINING AND GROUP ACTIVITIES
Governor Inslee’s recent Proclamation caused a great deal of concern among WHCA members regarding facility dining rooms and group activities. Many WHCA members were concerned that they would be forced to close their dining rooms and discontinue any group activities.

These questions prompted a great deal of back and forth dialogue with WHCA, RCS, and the Governor’s office. All parties agreed that assisted living facilities and skilled nursing facilities continue to be governed by the “Safe Start for LTC Recommendations and Requirements” for assisted living and for skilled nursing.  

The Governor’s recent Proclamation did not change the requirement that WHCA members follow the “Safe Start for LTC Recommendations and Requirements.” Nor did the Proclamation change the directions for communal dining and group activities found within the “Safe Start for LTC” documents. Therefore, since WHCA members followed the LTC Safe Start guidance before the Governor’s Proclamation, they will continue to follow the same safe start guidance going forward.

If a facility is properly following the safe start guidance and its LHJ guidance, there should be no change between what a facility is doing today and what it is does after 12:01 AM tomorrow morning with respect to communal dining and group activities (barring any unforeseen changes or developments such as an outbreak or change in official interpretation). 

It is important to note that the Governor’s Proclamation does make changes that directly impact visitation in both skilled nursing and assisted living facilities. The Governor directs that if current guidance (the Safe Start for LTC Requirements and Recommendations) is more restrictive than the identified proclamation restrictions, the most restrictive guidance shall apply.

According to the proclamation, “Outdoor visits are permitted. Indoor visits are prohibited, but individual exceptions for an essential support person or end-of-life care are permitted.” Currently, “essential support persons” can only visit a facility that is in Phase 2 or higher. That limitation remains in effect.

The Governor’s recent Proclamation does impose a more restrictive standard on “compassionate care” visits. Before the Governor’s recent Proclamation, Phase 1 indoor visitation was prohibited, except for “Compassionate care situations restricted to end-of-life and psycho-social needs.” The Governor’s most recent Proclamation is more stringent, eliminating any reference to “compassionate care” and “psycho-social needs” and instead clearly stating visitations for “end-of-life care are permitted.

According to RCS Director Candace Goehring, the Department will be issuing clarification guidance in the form of a Dear Administrator/Provider letter in the very near future. The Department of Health is in the process of finalizing documents that will assist facilities to put safety measures in place related to these activities.

As soon as more information becomes available, WHCA will let you know. In the meantime, if you continue to have questions please email Vicki McNealley or Elena Madrid.
PLEASE COMPLETE THE AHCA/NCAL COVID-19 IMPACT SURVEY
AHCA/NCAL is asking providers (SNF, AL, ID/DD) to complete a 15-20 minute survey regarding COVID-19’s impact on your facility/company. Providers will be asked about several topics, including workforce, personal protective equipment, testing, and finances. You may download a copy of the questionnaire if you wish to gather the necessary information before filling it out online. 

Information from this survey will help AHCA/NCAL address questions from policymakers and advocate for ongoing resources to the profession. Please complete the survey by end of the day on Friday, November 20. Complete the survey now.
DSHS TO IMMEDIATELY IMPLEMENT A SNF ADMISSION INCENTIVE
On Monday, November 16, 2020, DSHS announced a new program meant to incentivize hospital-to-nursing home transfers. This effort is similar, but not identical, to a program launched last March to move difficult-to-place residents out of hospitals and into nursing homes. The current effort is in response to a critical need to create capacity in acute care hospitals to serve those who need emergency and intensive care during the current ongoing outbreak. Patients who no longer have a need for acute care in a hospital may transition to alternative settings. This will create capacity for hospitals to serve individuals who need acute care that can only be provided in a hospital setting. 

The program applies to individuals with both Medicare and Medicaid (dual eligible) newly admitting to nursing facilities from acute care hospitals. During this period, the skilled nursing facility will receive a one-time incentive payment of $6,000 when:
  1. The individual admits on or before 12/31/2020;
  2. The Department receives a Nursing Facility Notice of Action confirming admission date; and,
  3. The Department has confirmed that this is a new admission. Readmissions are not eligible for this incentive.

For additional information please email Candace Goehring at Residential Care Services.
INFORMATION TO HELP SNFs EXCLUDED FROM SEPTEMBER'S HHS PERFORMANCE PAYMENTS
AHCA/NCAL previously shared details of the HHS Quality Incentive Payment program for skilled nursing facilities. If you are a SNF that did not receive a September incentive payment, download this zip file of an Excel spreadsheet to help understand why your center specifically may not have received a payment. (Member login required.Read more.
NHSN TO UPDATE REPORTING PATHWAYS
The National Healthcare Safety Network verbally announced there will be updates issued to two reporting pathways. The Resident Impact and Facility Capacity Pathway and the Staff and Personnel Impact Pathway will undergo a variety of changes in November. Read more.
OSHA RELEASES FREQUENTLY-CITED STANDARDS RELATED TO COVID-19 INSPECTIONS
OSHA released a one-pager on frequently-cited standards related to COVID-19 inspections. Some of these include fit tests for respirators, providing a medical evaluation before fit testing or using a respirator, PPE availability, training on properly using PPE, and more.  Read more.
ADDITIONAL RESOURCES
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.