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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 potential death.

Safe Start for Long-Term Care

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:

Most current updates: Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination (CDC)

  • Masking
      • 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 fully vaccinated, then they may choose to have close contact and to not wear source control during the activity.
      • If unvaccinated residents are present, then all participants in the group activity should wear source control and unvaccinated residents should physically distance from others.
  • Communal dining:
      • Fully vaccinated residents can participate in communal dining without use of source control or physical distancing.
      • If unvaccinated residents are dining in a communal area (e.g., dining room) all residents should use source control when not eating and
        unvaccinated residents should continue to remain at least 6 feet from others.
  • “Cohort” activities/dining based on vaccination status:
      • 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
  • Testing
      • HCP and residents should be tested immediately if symptomatic.
      • HCP and residents should not be tested if recovered from SARS-CoV-2 infection in the
        prior 90 days.
      • CMS requires routine testing of HCP in NH according to CDC levels of community
        transmission. DOH recommends routine testing of HCP in NH according to CDC levels
        of community transmission.
      • LTCF should perform unit-wide testing of all HCP and residents present on the unit of
        an identified case.
      • LTCF may test visitors and Essential Support Person (ESP), if resources allow.
      • Any facility driven testing (administration, interpretation, etc.) must be done under a
        CLIA waiver and test result reported
      • CMS new guidance
      • DOH new guidance  (9/30/2021)

LTC Visitation

  • Indoor visitation allowed when either resident or visitor is fully vaccinated, under most circumstances
  • Indoor visitation for unvaccinated residents should be limited solely to compassionate care situations if the COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated (2 weeks post last in vaccine series)
  • Indoor visitation should be limited solely to compassionate care situations, for:
  • Quarantine is no longer recommended for residents who are being admitted to a post-acute care facility if they are fully vaccinated and have not had prolonged close contact with someone with SARS-CoV-2 infection in the prior 14 days.
  • Outdoor visitation still preferred, due to decreased risk of virus transmission. (See: Outdoor Visit Guidance)
          • Compassionate care visits allowed at any time, regardless of 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.

COVID-19 Vaccines

As of 2021, Benton and Franklin County facilities LTC staff and residents have begun receiving COVID-19 vaccinations

For more information about this process:


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 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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