Long-Term Care COVID-19 Response
Long-Term Care (LTC) Facilities
Long-term care facilities serve vulnerable populations that are at higher risk of contracting COVID-19. Residents’ age and health status put them at greater risk for severe COVID-19 complications and death. COVID-19 can quickly spread in congregate care settings.
Benton-Franklin Health District has been working with these facilities throughout Benton and Franklin Counties to ensure strong infection control guidance, availability of testing, and other measures to identify cases and minimize the spread of disease and protect these vulnerable populations. The health district has partnered with pharmacies to vaccinate staff and residents in long-term care facilities.
Please see the following guidance:
- Adult Family Homes, Assisted Living Facilities, Enhanced Services Facilities
- Nursing Homes, Intermediate Care Facilities for Individuals with Intellectual Disabilities
- Certified Community Residential Services and Support
Most current updates:
- Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination (CDC)
- Preventing Transmission of SARS-CoV-2 During Aerosol Generating and Other Procedures (wa.gov)
- Interim Recommendations to Mitigate Health Care Worker Staffing Shortage During the COVID-19 Pandemic (wa.gov)
- All staff, regardless of their position, must use source control at all times regardless of vaccination status
- Group activities:
- If all residents participating in the activity are up to date with vaccinations, then they may choose to have close contact and to not wear source control during the activity.
- If residents who are not up to date with vaccinations are present, then all participants in the group activity should wear source control and those residents should physically distance from others.
- Communal dining:
- Residents who are up to date with vaccinations can participate in communal dining without use of source control or physical distancing.
- If residents who are not up to date with vaccination are dining in a communal area (e.g., dining room) all residents should use source control when not eating and residents who are not up to date with vaccinations should continue to remain at least 6 feet from others.
- “Cohort” activities/dining based on vaccination status
- Recommendations for Cohorting in Long-Term Care Facilities During a COVID-19 Outbreak:
- The facility/home may host separate activities/dining based on vaccination status
- The facility/home must ensure that they continue to comply with Resident Rights requirements
- No visitation restrictions at this time in LTC facilities unless Local Health Jurisdiction limits visitation due to COVID-19 investigation. ESP and compassionate care visit are still allowed when visitation is limited due to investigation.
- Compassionate care visits are allowed at any time, regardless of the resident’s vaccination status. (For more information see compassionate care visitation)
- Visitors and residents must continue to wear face coverings and practice hand hygiene.
- Facilities in outbreak status should follow guidance from state and local health authorities and CMS on when visitation should be paused.
- Visitors should be counseled about their potential to be exposed to SARS-CoV-2 in the facility if they are permitted to visit.
- Quarantine is no longer recommended for residents who are being admitted to a post-acute care facility if they are up to date with vaccinations and have not had prolonged close contact with someone with SARS-CoV-2 infection in the prior 14 days.
- Quarantine residents who are not up to date with vaccination for 10 days or 7 days with a negative test
- CMS Visitation for Skilled Nursing Facilities and CMS Visitation Frequently Asked Questions
Required COVID-19 Reporting
Washington Administrative Code WAC 246-101 requires laboratories to report all COVID-19 results to DOH and their Local Health Jurisdiction within 24 hours (including positive, negative (DOH only), inconclusive; and other results based on State Health Officer Letters). This reporting requirement applies to all facilities using POC or rapid screening tests for COVID-19. This includes clinics that are not traditionally a lab, such as long-term care facilities, schools, and correctional facilities.
Step 1 – Required reporting to DOH:
Option 1: Submit online to DOH via SimpleReports. You can enroll in this process here SimpleReport
Options 2: Submit a Report Form (PDF) via fax to DOH at (206) 512-2126. If you need to submit a line list, please contact BFHD for an approved template.
Step 2 – Required reporting to BFHD-LHJ:
Option 1: Report each case individually OR attach a BFHD approved template via BFHD COVID-19 LTC Reporting Form (iths.org)
Option 2: Call BFHD to report cases
Skilled Nursing Facilities continue to report to NHSN / CDC
Point of Care Testing
Request test supplies: https://app.smartsheet.com/b/form/a026d012a1ec47b78ff15a2f495de863
Reporting POC tests:
- DOH Guidance for Facilities Conducting Point-of-Care (POC) COVID-19 Testing
- Reporting Form
- Electronic Lab Reporting Registration
Washington Administrative Code WAC 246-101 requires laboratories to report all COVID-19 results to DOH and their Local Health Jurisdiction within 24 hours (including positive, negative (DOH only), inconclusive; and other results based on State Health Officer Letters). This reporting requirement applies to all facilities using POC or rapid screening tests for COVID-19. This includes clinics that are not traditionally a lab, such as long-term care facilities, schools, and correctional facilities
- DSHS Family help web page (includes visitation table, compassionate care criteria, risk assessment & more)
- Information for providers and long-term care professionals
- Long-Term Care Facility Visitor Log and Visitor Announcement Poster
- L&I and DOH Respirator and PPE Guidance for Long-Term Care Facilities
- L&I and DOH Respirator and PPE Guidance for In-Home Care Agencies
- COVID-19 Infection Prevention Best Practices for Memory Care Units
- Interim Guidance for Transferring Residents between Long-Term Care and other Healthcare Settings
- Recommendations for Cohorting in Long-Term Care Facilities During a COVID-19 Outbreak
What precautions are in place to prevent outsiders from introducing infection?
Everyone is screened upon entering or re-entering the facility, including staff and other essential healthcare personal such as therapists, home health and hospice staff. Screening may include temperature checks and questionnaires regarding exposure and symptoms. All facility entrants will be required to follow facility safety policy to encompass social distancing, face covering, and additional protective equipment or measures as required. Facilities will post an announcement notifying all visitors of these safety measures.
Do residents that leave facilities for medical and non-medical appointments need to be quarantined?
Facilities will complete an exposure risk assessment for each resident who leaves the facility for community visits. The risk assessment will inform how the facility manages residents upon their return. Residents that leave the facility, as well as those accompanying them (family members, etc.), should be educated on infection prevention.
- Lower-risk: educate on infection prevention, hand hygiene, and respiratory/cough etiquette. Actively screen residents daily for symptoms, before leaving, and after returning.
- Higher-risk: all in lower risk and place in quarantine for 14 days since most recent exposure.
* Transportation to and from medical community activities should be assessed using the non-medical community activities risk assessment template and the medical visit should be assessed using the medical community assessment template. Facilities should follow the guidance associated with the higher risk assessment score.
Are LTC facilities required to notify residents and families if a positive COVID-19 case is identified in the facility?
Yes, DSHS requires facilities to notify all staff, residents, and families when a positive COVID-19 case is identified in the facility.
If I am concerned that a facility or agency policy is unsafe, what can I do?
If you have any concerns, please contact the LTC surveillance team at BFHD. You can contact us by email at email@example.com or call us at 509-460-4200.
If you feel that a LTC facility is in violation of state law, please file a complaint with Residential Care Services. Complaints to the Residential Care Services (RCS) Complaint Resolution Unit (CRU) will inform DSHS of potential violations of Safe Start for Long Term Care criteria. CRU staff will investigate complaints.
The RCS Complaint Resolution Unit may be reached at 1-800-562-6078, or a complaint may be lodged online.
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