COVID-19 UPDATE #66
August 7, 2020
GOVERNOR ANNOUNCES PHASED PLAN FOR VISITATION AT LONG TERM CARE CENTERS
Yesterday Governor Jay Inslee announced guidance for long term care facilities to offer visitation and other activities for residents and patients. Long term care facilities were required to limit visitation and curtail social activities for residents and visitors earlier this year due to COVID-19. Inslee was joined by Department of Social and Health Services (DSHS) Secretary Cheryl Strange, DSHS Assistant Secretary Bill Moss, and Secretary of Health John Wiesman at a press conference for the announcement.

The plan goes into effect August 12, and even after it becomes effective, individual facilities must meet additional parameters related to staffing, PPE and testing prior to opening visitation. The plan includes a number of public health metrics that must be met in order for facilities to move through the phases. It is modeled after the Safe Start Plan. While Inslee mentioned that providers would have to submit applications for phased-in visitation, this is not the case. There is no formal application process required for opening visitation and other social activities.

To move forward in phases, long term care facilities must go 28 days without a resident or staff member testing positive for COVID-19. Facilities must also have at least a 14-day supply of PPE on hand.

A facility cannot move forward a phase in the long term care plan unless the county it is located in has advanced to at least that phase in the Safe Start plan. For example, if a facility is in a Phase 2 county, it cannot move to Phase 3 in the long term care plan before the county moves to Phase 3 in the Safe Start plan.

Additionally, for every facility, there must be a review of key metrics evaluating a county's COVID-19 risk. Higher disease transmission rates will keep a facility at an earlier phase, even if other criteria are met.

For a quick review of the long term care phases, click here. Click here for a quick description of what is allowed in long term care. Additionally, the Department has offered guidance and analysis of risk for use with residents and families for trips into the community.

Detailed Resources:
Resident Risk Assessment – travel in the community
DOH RELEASES GUIDANCE ON LTC OUTDOOR VISITATION
The Washington State Department of Health recognizes the serious effects isolation can have on the health and well-being of residents in long term care facilities/agencies. The risk of COVID-19 transmission in long term care facilities and the need for family, partner or close friend interaction can be balanced under certain conditions. This document contains recommendations that long term care facilities/agencies are encouraged to follow and implement to mitigate the risk of COVID-19 transmission when allowing visits according to the Washington State Phased Reopening Recommendations and Requirements for long term care facilities.
DEAR ADMINISTRATOR LETTER ADDRESSES POINT PREVALENCE TESTING IN ASSISTED LIVING
DSHS issued a Dear Administrator Letter on August 6, 2020, instructing all assisted living facilities that have not previously done point prevalence testing of staff and residents to complete this testing by September 11, 2020. Exceptions relate to facility-wide testing conducted since July 1, and assisted living centers that completed facility-wide testing during the time memory care units conducted testing.

Representatives from the Department of Health (DOH) will contact your facility to determine the total number of test kits and PPE you will need; be sure to have a number that includes all residents and staff, as well as any contracted staff (home health and/or hospice for example) that may be onsite during your testing time frame. Directions will be provided on how to complete the testing, and to which lab you need to mail your completed test kits.

You must have prescriber orders for all residents and staff in order for the lab to process the tests. Likewise, you will need staff capable of completing the tests; this may include licensed nurses and/or delegated nursing assistants or home care aides. The cost of staff testing will be covered by the state; resident testing will be covered by their insurance or, if the resident is uninsured, the state will pay.

There is a webinar scheduled on August 11 from 1:00 – 2:30 PM that will address the issues related to testing. You can register for that webinar here. For questions regarding this testing, please send an email to DOH-CBTS@doh.wa.gov.
DSHS TO HOST WEBINAR ABOUT RATES AND RETAINER PAYMENTS FOR ASSISTED LIVING
Enhanced service rates and retainer payments related to COVID-19 will be available through September 30, 2020. The Department of Social and Health Services (DSHS) staff will be hosting a webinar on August 10, 2020, at 1:00 PM related to this topic. The presentation will review information about the additional rates and service codes and what to do when they are available. You can register for the Residential Provider COVID-19 Rate webinar here.
CMS CLARIFIES NATIONAL COVID-19 TRAINING FOR ADDITIONAL FUNDING
CMS again stated that this training is not yet available. The CMS/CDC COVID-19 training requirement for the Provider Relief Fund program is a separate, online training which will be in the format of an on-demand module that will be released in the near future (potentially September). Read more.
AHCA/NCAL SURVEY REGARDING FINANCIAL IMPACT OF COVID-19
The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) is asking providers (SNF, AL, ID/DD) to complete a survey on the financial impact of COVID-19. Information from this survey will help AHCA/NCAL address questions from policymakers and advocate for ongoing resources to the profession. Thank you for taking a few minutes of your time to assist us. Please complete the survey by Monday, August 10. Take the survey now.
LONG TERM CARE IN THE NEWS
On August 6, Governor Inslee announced guidance that allows long term care facilities to offer visitation and other activities. Below are some of the news articles covering the Governor’s plan.
 
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.