September 28, 2020
The CDC has recently announced a new Point of Care (POC) Laboratory Reporting Pathway through their National Healthcare Safety Network (NHSN) LTC COVID-19 Module. The new reporting pathway will be released on October 15, 2020.

Skilled Nursing Facilities need to begin the process of upgrading their security level to Level 3 as soon as possible as this is a very lengthy process. More than one facility representative should be identified. Information to begin the NHSN registration security process can be found here.

WHCA has sought clarification from DSHS regarding Assisted Living facilities that have received and plan to use the Abbott BINEXNOW antigen testing kits. At this time it is thought that ALs will also need to report the results the same as SNF. Until more information is received, it would behoove ALs planning to use the BINEXNOW antigen tests to begin the NHSN registration process as well.

To check to make sure your facility does not already have Level 3 access or if you have questions, please email Larissa Lewis at the Department of Health or call her at (206) 418-5632. When more information becomes available, WHCA will make sure you are notified. If you have questions, please email Vicki McNealley or Elena Madrid or call them at (800) 562-6170. Read more.
With test kits being distributed to SNF and ALs, there are several considerations to take into account around screening employees and testing both employees and residents for COVID-19.

The Society for Human Resource Management (SHRM) recommends employees be screened privately. Medical information, including an employee’s temperature and answers to screening questions will need to be maintained as a private medical record.

Time spent waiting for the health screening and testing should be recorded as time worked for non-exempt employees.

The US Equal Employment Opportunity Commission (EEOC) reminds employers that typically, measuring an employee’s body temperature is a medical examination. Employers may measure employees’ body temperature because the CDC and state/local health authorities have acknowledged community spread of COVID-19 and issued precautions. Read more.
As promised, WHCA will continue to keep you informed regarding the status of the guidance on visitation released by CMS on September 17. DSHS is communicating with CMS regarding the need for clarification related to CMS’s release of QSO 20-39 and is meeting with CMS this week to seek clarification. While awaiting direction, it remains important that skilled nursing facilities understand the following guidance outlined in the CMS memo.

Federal Disability Rights Laws and Protection & Advocacy Programs
It is a requirement of participation under the Code of Federal Regulation (CFR) section 483.10(f)(4)(i)(E) and (F) that the facility must allow immediate access to a resident by any representative of the protection and advocacy systems, as designated by the state, and as established under the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act), and of the agency responsible for the protection and advocacy system for individuals with a mental disorder (established under the Protection and Advocacy for Mentally Ill Individuals Act of 2000). In our state, this includes Disability Rights Washington (DRW) and the Developmental Disabilities (DD) Ombuds.

Protection & Advocacy (P&A) programs authorized under the DD Act protect the rights of individuals with developmental and other disabilities and are authorized to “investigate incidents of abuse and neglect of individuals with developmental disabilities if the incidents are reported or if there is probable cause to believe the incidents occurred.” Representatives of P&A programs are permitted access to all facility residents, which includes “the opportunity to meet and communicate privately with such individuals regularly, formally and informally, by telephone, mail and in person.”

Each facility must comply with federal disability rights laws such as Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA). For example, if a resident requires assistance to ensure effective communication (e.g., a qualified interpreter or someone to facilitate communication) and the assistance is not available by onsite staff or effective communication cannot be provided without such entry (e.g., video remote interpreting), the facility must allow the individual entry into the nursing home to interpret or facilitate.

Entry of Health Care Workers and Other Providers of Services
Health care workers (HCW) who are not employees of the facility but provide direct care to the facility’s residents, such as hospice workers, Emergency Medical Services (EMS) personnel, dialysis technicians, laboratory technicians, radiology technicians, social workers, clergy, etc., must be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or show signs or symptoms of COVID-19 after being screened. EMS personnel do not need to be screened so they can attend to an emergency without delay. All staff, as well as volunteers, must adhere to the core principles of COVID-19 infection prevention and must comply with COVID-19 testing requirements.
On Wednesday, September 30, at 12:00 noon PST, AHCA/NCAL will host an “office hour" to answer your questions about the new Department of Labor Coronavirus leave requirements. Department of Labor (DOL) consultants from Jackson Lewis, Craig S. Roberts, Principal, and Henry Shapiro, Associate, will present an overview and updates to leave requirements in the Families First Coronavirus Response Act impacting long term care. This overview will include the new definition of healthcare workers. After their presentation, the consultants will be available for your questions. Please note, this is not meant to take the place of guidance from your legal counsel.

No pre-registration is required but you will need to log in using your computer or WebEx app as questions will be accepted using the chat function. All lines will be muted. Read more.

•   Meeting number (access code): 172 101 3462 
•   Meeting password: Pb3V8xmJJW2
On Thursday, October 1, from 10:30 to 12:00 noon PST, there will be an ECHO National Nursing Home COVID-19 Action Network webinar on Coronavirus testing in nursing homes.

Speakers include: 
  • Nimalie Stone MD, Medical Epidemiologist and Lead for COVID-19 response in LTC at the CDC 
  • Richard Feifer MD, CMO of Genesis HealthCare and President of Genesis Physician Services 

Following each brief presentation there will be a moderated Q&A. Registration is required and can be done here. Read more.
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.