If the state works out kinks in a new plan, all nursing homes could get similar widespread testing.

• By Rachel Riley
• Sunday, May 17, 2020 1:30am
• LOCAL NEWSCORONAVIRUS OUTBREAKEVERETT

EVERETT — Blanket testing for the new coronavirus has taken place at more than a dozen nursing homes and assisted living facilities in Snohomish County and could be coming to more soon under a plan the state is developing.

The Snohomish Health District partnered with 13 facilities to conduct widespread testing. It found that at least 20% of residents who were tested for COVID-19 were positive at five of those homes: Cedar Creek Memory Care Community in Edmonds, GenCare Lynnwood at Scriber Gardens, Heritage Court Assisted Living in Everett, Rosewood Courte Memory Care in Edmonds and Sunrise View Convalescent Center and Retirement Villa in Everett.

COVID-19 test results for residents and staff in Snohomish County long-term care facilities as of May 14, 2020.

SOURCE: Snohomish Health District

The highest infection rate was found at Rosewood Courte Memory Care, where 44% of the 50 residents and staff members who were tested were positive, district data shows. Of the 29 residents there tested for COVID-19, about 20 had the illness.

Gov. Jay Inslee has directed state officials to develop a plan to test residents and staff of all of the state’s long-term care facilities, where many people are especially vulnerable to infection because of advanced age and underlying health conditions. But officials are still working out key elements of the plan, including the time frame for that goal and sources for testing supplies, said press secretary Mike Faulk.

Nursing home industry advocates have for weeks pushed for widespread testing at long-term care facilities, saying it’s the only way to truly understand how widely the virus is spreading.

“Long term care facilities need testing to properly identify cases, and then implement proper infection control procedures,” leaders from organizations that represent nursing homes across the state wrote in an April 13 letter to the state director for COVID-19 Health System Response Management. “Anything that can be done to prioritize tests for long term care residents, staff, and independent contractors will save lives.”

Deb Murphy, who signed the letter, said Inslee’s plan is good news. But the virus has been spreading, largely unchecked, for months.

“It’s a little bit like kind of closing the barn door after the horse has left the stable,” said Murphy, president and CEO of LeadingAge Washington, which represents nonprofit long-term care facilities throughout the state.

The COVID-19 death toll associated with long-term care facilities has soared. Nearly 600 coronavirus deaths — more than 60 percent of the statewide total — were linked to long-term care facilities as of May 9, according to the Washington State Department of Health.

As of Friday, nearly 60 people connected to long-term care facilities in Snohomish County had died of the illness, accounting for almost half of the county’s death toll, according to the local health district.

State officials, however, say the rate of new cases at nursing homes and assisted living facilities is falling.

“One thing that we have been able to do better recently is to do more aggressive testing of everybody in (a) facility,” said Dr. Kathy Lofy, the state’s health officer, at a May 5 press conference. “For a long time, we just didn’t have the swabs and the test kits to be able to do that. And now, I do feel like we’re getting in more quickly and being able to test all of the residents and all of the health care providers at a particular site.”

The state still has critical hurdles to overcome if it wishes to test residents and staff at all long-term care facilities, said Laura Hofmann, LeadingAge’s director of clinical and nursing facility regulatory services. Officials must not only ensure that enough tests are available, but also iron out other important details, such as how the system will handle an influx of positive cases that testing could discover.

“The numbers are going down. But once you start testing, you don’t know where those numbers are going to go,” Hofmann said. “It’s a huge undertaking.”

Personal protective equipment, known as PPE, needed to administer the tests also remains in short supply, Hofmann added.

“There’s just not enough PPE in the pipeline to do this,” she said.

The county is home to more than 600 long-term care facilities. Most of them are adult family homes, 19 are nursing homes and 45 are assisted living facilities. Forty-four of those sites have reported a positive case among residents or staff, according to the state’s Department of Social and Health Services.

The health district is now doing a few hundred tests per week at local long-term care facilities, said Dr. Chris Spitters, the district’s health officer, at a Friday news briefing.

Locally, widespread testing coordinated by the health district has also found positive cases at Bethany at Pacific, Bothell Health Care, Chateau Pacific Assisted Living in Lynnwood, Lynnwood Post Acute Rehabilitation Center, Mountlake Terrace Plaza and Pacifica Senior Living Lynnwood.

More than 100 residents and staff members were tested at Brookdale Arbor Place and Vineyard Park at Mountlake Terrace, but none were positive, according to the health district.

Additional long-term care facilities in the county may have conducted surveillance testing independent of the health district, said district spokeswoman Kari Bray.

“There may be other facilities where staff or residents were tested separately,” Bray said in a statement. “For example, someone who works in long-term care might get tested through their healthcare provider. The Health District also works with facilities to help them get testing supplies if they want to coordinate testing internally.”

The state Department of Social and Health Services informed long-term care facilities in an April 9 letter that every resident and staff member would be tested in facilities where there was at least one positive case.

But, after the letter was sent, state officials decided to let local health jurisdictions determine who should be tested for the coronavirus, said Amy Blondin, a spokeswoman for the Washington State Health Care Authority.

“Some facilities have separate wings. If residents and staff don’t interact they all may not need testing,” Blondin explained in an email late last month. She added that “each facility is different and we wanted to allow for flexibility in the approach that allows limited or blanket testing as appropriate.”

Nursing homes and assisted living facilities have had to navigate a continuous flow of ever-changing guidance from a patchwork of government agencies, said Robin Dale, president and CEO of the Washington Health Care Association. The group represents hundreds of nursing homes and assisted living facilities across the state.

Determining who to test and how to test them has been a constant challenge, he said.

“There needs to be consistency around the state, and I’m not seeing that,” Dale said in a recent interview. “I don’t want to call out any one agency. There just seems to be a lot of overlap.”

The pandemic is progressing, but long-term care facilities are still grappling with the same problems that they’ve been struggling with since the beginning, Dale said.

One is access to testing.

The other is a dearth of protective gear for health care providers and staff members.

“This is like Groundhog Day for us,” he said. “Every day, it’s the same issues.”

Rachel Riley: 425-339-3465; rriley@heraldnet.com. Twitter: @rachel_m_riley.

Questions?

Contact:

Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 324-231-4804