Clarification of New COVID Restrictions

Clarification of New COVID Restrictions

Since the Sunday announcement of the new Proclamation from Governor Inslee, there have been many questions surrounding LTC visitation as well as communal dining and activities.  We have had new information from RCS today, which hopefully will answer many of these questions.

RCS works with the ALF and NH programs and is only able to speak to the requirements for those providers.  At this time, those programs will continue to follow the same guidance they have been following for dining in phase 1 and 2 of the “Safe Start for LTC” plan. If you had spoken to your local health jurisdiction, had moved to phase 2 of the Safe Start Plan and were doing small group activities and small communal dining programs with social distancing and all infection control standards in place, you can continue these programs.  For dining within the CCRCs, where you have a program that dining is shared between the independent residents and the LTC (ALF or NH) residents, the best course of action is to coordinate with the LHJ for the best response.  Each CCRC or ALF with independent residents is going to have a unique dining environment and set up that will require an individualized response. Together the provider and the LHJ should be able to outline and document a plan that takes into consideration solid infection control practices, safety of staff and residents, as well as the overall intent of the Governor’s Proclamation.

There have been a number of questions raised related to the use of the term “Rollback” in the title of the Proclamation.  LeadingAge WA reached out to the Governor’s office yesterday for clarification regarding this term.  The Governor’s office suggests this is not a change of phases but does affect those activities included in the proclamation. Everything else stays as is. At this time, long term care organizations and counties, overall, will remain in the phase they were in but specific things (such as visitation and perhaps communal dining and perhaps fitness centers) will change.  This would mean any providers who were in phase 2 would still be able to apply phase 2 criteria (unless they are having a widespread outbreak and the LHJ has given different instructions as a result).

Clarifying questions from LeadingAge WA

Does this mean that all facilities must limit visits to end of life and essential support person consistent with August guidelines?  Does that limit the visit to outdoors or to a designated area within the facility? 

  • At this time our understanding of the proclamation is that all indoor visits, would be limited to end of life (which is a more narrow definition of compassionate care than our current safe start document) and essential support persons
  • The indoor visits would take place in the most appropriate setting for the situation (end of life would most likely be the resident room, some ESP may be in the resident room if the ESP provides direct care assistance).
  • It would limit any other visits to outdoors.  Phase 1 outdoor visits are limited to 2 persons per resident (this is already in the Safe Start document).

It seems to also mean then that continuing care retirement communities and AL with independent dining rooms may continue to allow congregate dining as long as LHJ approves and they are in phase 2.  Is that correct?

Yes, this would be correct as long as they can meet all infection control standards and social distancing requirements.

Does the Proclamation change anything in LTC? 
It modifies things slightly for the compassionate care concept because the current Safe Start plan allows compassionate care to be for both end-of-life and psycho-social needs, and if we happen to have any facilities that made it to phase 3, it would be a change for them.

Are limited use pools able to remain open in continuing care retirement communities or other long-term care settings?  
The proclamation should have no impact to pools in the LTC facilities. Facilities should continue to follow the DOH water recreation guidance.

Are fitness centers in continuing care retirement or assisted living communities able to remain open?  
We are still waiting for the answer to this question.




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

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November 18, 2020