The Long-Term Care Safe Start Plan Has Been Approved and Will Be Effective on February 1, 2021

The Long-Term Care Safe Start Plan Has Been Approved and Will Be Effective on February 1, 2021

The Long-Term Care Safe Start Plan has been approved by the Governor and linked are the revised Plans for nursing homes and assisted living communities.  These new Guidelines will be effective on February 1, 2021.  Please note, these documents state “draft” on the watermark, this is because they are not effective until Feb. 1st. This will be removed in the Governor’s Proclamation. Be assured, these are the final documents. Please check these guidelines and make sure you have all policies updated and ready to go.

The key metrics used for visitation is the case rate/100,000 for the last 14 days. Currently, as of today, the entire state is above 75/100,000, so all LTC Facilities will remain in Phase 1 of the Safe Start Plan. You will need to refer to the COVID 19 Risk Assessment Dashboard for case rates in the weeks ahead to determine the operating phase.

Of note:

  • Beauticians services are allowed in Phase 1 – must follow social distancing, universal masking, entrance screening, disinfecting before and after each resident, and hand hygiene. The beautician would need to follow for COVID-19 and any other requirements based on the Healthy Washington Roadmap to Recovery for businesses. (For the purpose of these recommendations, the category of workers is beauticians, nail salons, and barbers)
  • Communal Activities and Dining Principles – While adhering to the core principles of COVID-19 infection prevention, communal activities and dining may occur. Residents may eat in the same room with social distancing (e.g., limited number of people at each table and with at least six feet between each person). Facilities should consider additional limitations based on status of COVID-19 infections in the facility. Additionally, group activities may also be facilitated (for residents who have fully recovered from COVID19, and for those not in isolation for observation, or with suspected or confirmed COVID-19 status) with social distancing among residents, appropriate hand hygiene, and use of a face covering. Facilities may be able to offer a variety of activities while also taking necessary precautions. For example, book clubs, crafts, movies, exercise, and bingo are all activities that can be facilitated with alterations to adhere to the guidelines for preventing transmission. Facilities are encouraged to utilize the Interim Supplemental Guidance for Allowing Group Activities and Communal Dining in Long-Term Care Facilities (LTCFs).
  • Compassionate care visits and Essential Support Persons are allowed for indoor visitations during Phases 1 and 2 of the reopening plans.
  • Outdoor visitation is limited to two visitors per person during each visit, with controlled conditions, including screening, social distancing, and face masks, during Phases 1 and 2 of the reopening plans.
  • Outbreaks Visitation – Residents who are on transmission-based precautions for COVID-19 should only receive visits that are virtual, through windows, or in-person for compassionate care situations, with adherence to transmission-based precautions. However, this restriction should be lifted once transmission-based precautions are no longer required per CDC guidelines, and other visits may be conducted as described above. Facilities should consider visitation, group activities, and communal dining limitations based on status of COVID-19 infections in the facility. Facilities have flexibility to determine what is best for resident and staff safety to manage visitation. The facility will take into consideration the scope of residents in isolation and quarantine status. For example, the facility may not allow communal dining, group activities, and visitors, compassionate care, and designated visitors if active COVID-19 throughout the entire physical plant. Or they may restrict these activities and visitation on particular wings/units with COVID-19 spread and allow on non-COVID units. (Outdoor Visitation Guidance for Long-term Care Settings.)
  • Continuing Care Retirement Communities (CCRC) and Independent Living Campuses – State licensed homes that reside on the same campus as CCRCs and independent living settings, must follow these recommendations for Safe Start Long Term Care Recommendations. Refer to the Department of Health guidance for shared recreation:

Residential Care Services will be offering training on the Safe Start Plan on Thursday, January 28th, and may offer a second training opportunity thereafter.  Please make sure to register for this webinar, using the link below, as soon as possible.

Register for the LTCF Safe Start Update on Jan 28, 2021 3:00 PM PST at:

*If the registration links are not working, please copy and paste into your browser to open.

After registering, you will receive a confirmation email containing information about joining the webinar.



Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804