Washington State is experiencing an exponential growth in COVID-19. Not surprisingly, as community wide cases increase so do opportunities for virus spread in LTC facilities.  As a result, we are again experiencing significant COVID outbreaks among staff and residents.  Numerous staff are testing COVID positive and many are symptomatic.  In turn, this is causing devastating staffing shortages in a number of facilities throughout the state.  LeadingAge WA had a member building in crisis standards of staffing last week, with nearly all licensed nurses, several nursing assistants, housekeeping and the administrator Covid positive.  This widespread and deep staffing impact has revealed there is little to no support available through volunteer programs or even staffing agencies and there is no planned staffing support provided by local or state agencies.

LeadingAge Washington brought this urgent concern to light on November 4th on a call with Amber Leaders from the Governor’s office.  Later that same day, this staffing crisis was also discussed with the LTC Advisory Committee.  On behalf of the advisory committee, LeadingAge drafted a letter to Bill Moss, Assistant Secretary at  ALTSA, urging him to submit a program and funding request to OFM and legislative leaders to create and implement regionally-based emergency staffing teams.  These teams will consist of approximately eight members each and will be stationed around the state to help provide emergency staffing for LTC facilities.  If the teams are idle, they can be deployed to provide respite relief to exhausted staff.  The teams would likely include RNs, LPNs, NACs and ancillary staff, including administrators.  Assuming the request is approved, it will likely 2-4 weeks to finalize the program and form and station the teams.

In the meantime, please make sure you have all of the following in place:

1. A dedicated infection control nurse
2. An infection control plan, including cohorting and isolation procedures for COVID (+) residents
3. A dedicated unit for new admissions for 14-day monitoring of COVID symptoms after admission-including staffing and PPE guidelines
4. A thorough screening process for all staff, including a symptoms log and frequent (each shift) review process
5. An emergency preparedness plan that includes pandemic planning
6. An emergency staffing plan. Document movement from conventional staffing to contingency or crisis staffing.  Follow CDC Strategies to Mitigate Healthcare Personnel Staffing Shortages and document all attempts to obtain more staff.
7. A PPE plan for moving from conventional to contingency or crisis levels of PPE. Follow CDC PPE Optimization guidance.  Document all attempts at PPE conservation and attempts to obtain PPE
8. A process for notifying RCS, your LHJ,  all county state officials, residents, family, and staff of outbreaks
9. A DOCUMENTATION log of all policy/procedures you have put in place since start of outbreak

If you are in an outbreak situation and you are moving from conventional staffing to contingency or crisis levels of staffing, here are suggestions for the possibility of obtaining help:

1. Send an 213RR form to your County Emergency Management requesting staffing assistance
2. If you need any PPE, put that on the 213RR form as well, and tell them you are COVID (+) in the building (You’ll need N95 masks)
3. Let your RCS Field Manager know you need staffing assistance immediately-tell them you need access to the emergency volunteer list-you can bring these volunteers in with only a WSP background check. Copy Candy Goehring on your email candace.goehring@dshs.wa.gov
4. Alert your Local Health Jurisdiction you need staffing assistance immediately-ask them to call the local Medical Reserve Corp for any additional staffing
5. Contact Andrew Rose at DOH andrew.rose@doh.wa.gov and ask for a strike team to be deployed. Copy Sara Podczervinski on your email sara.podczervinski@doh.wa.gov
6. If you need to move residents to the hospital, please contact the Washington Medical Coordination Center (WMCC) to coordinate transfer to a hospital accepting admissions
7. If you need to send residents out due to COVID related staffing shortages, these are the designated COVID units that may be able to take some admissions.  Please be aware that these COVID designated facilities/units may be at capacity.  

Questions?

Contact:

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