Information for Providers and Long-Term Care Professionals

Information for Providers and Long-Term Care Professionals

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ALTSA Response to COVID-19

The Aging and Long-Term Support Administration (ALTSA) has reacted to the COVID-19 outbreak by securing federal waivers to afford providers much-needed flexibility in care delivery, and by delivering timely guidance to providers and facilities. Our guidance consolidates input from Governor Jay Inslee, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and other authoritative bodies.

Current Guidance

Mandatory Reporting of Suspected COVID-19 Cases

Immediate Reporting of Suspected Cases

You must report suspected or confirmed cases of COVID-19 to the following parties (see list of notifiable conditions)

Semiweekly Status Reporting

ALTSA requests that all long-term care facilities report COVID status twice per week. (See Instructions)

Personal Protective Equipment (PPE)

COVID-19 has strained the supply of PPE - pay close attention to our "Provider/Administrator Letters" for official guidance. Refer procedural questions to your local health department.

Conservation and Re-Use of PPE

The Centers for Disease Control and Prevention has published strategies for the conservation of PPE. The Centers for Disease Control and Prevention has published a checklist specific to the conservation of N95 respirators. This ALTSA Flyer discusses the conservation of PPE, re-use of PPE and alternatives when facing a shortage.

Use of Cloth Face Coverings - Residents and Clients

The CDC recommends the adoption of cloth face coverings by long-term care residents when in the presence of others, even if no symptoms are present. The effectiveness of cloth face coverings relies upon the proper use and sanitation of the covering. The Centers for Medicare and Medicaid Services (CMS) further recommend that residents cover the nose and mouth when staff enter their room, whether by mask or tissue.

Use of Cloth Face Coverings - Professional Use in Care Settings

The CDC recommends staff use of face masks or cloth face coverings within care facilities at all times. These coverings should cover both the nose and mouth. Face masks are preferred to cloth face coverings for healthcare personnel - face masks offer both source control and protection against exposure to infectious material. Cloth face coverings should be washed after every use and may be less effective after 15-25 washes.

Cloth face coverings are not PPE. They are no substitute for proper distancing and hygiene practices. Cloth face coverings should NOT be worn instead of a respirator or face mask if more than source control is required. Cloth face coverings are inadequate for direct care of patients with positive or suspected cases of COVID-19full PPE is required. 

Protocol for Donning (Putting On) and Doffing (Taking Off) PPE

The effectiveness of PPE depends on its proper use. Putting on or removing PPE inappropriately can negate its protective properties. Adhere to CDC guidelines for use of PPE and refer to CDC instructions for properly donning (video) and doffing (video) PPE.

Procurement of PPE through Local Health Departments

Your local health department will be an important partner in requesting and securing PPE.

Recent PPE Updates:

  • Updated Process to Request Personal Protective Equipment (to begin June 29, 2020)
  • One-Time Delivery of Cloth Face Coverings
  • Long-Term Care Facility Revised PPE Guidance
  • Individual Providers, Home Care Agencies
  • Nurse Delegates, Private-Duty Nurses

COVID-19 Testing

On May 28, the Washington State Department of Health issued Order 20-02, requiring widespread testing within long-term care facilities. All residents and staff in skilled nursing facilities will be tested by June 12. All residents and staff in assisted living facilities with memory care units will be tested by June 26. 

Department of Health Order 20-02 - Mandated Testing Within Nursing Homes, Assisted Living Facilities with Memory Care Units

All testing conducted pursuant to DOH Order 20-02 will be funded by the state. Administration of testing will comply with applicable law - residents have a right to be informed of, consent to, or refuse proposed medical treatment (including this testing). More information on testing instruction, reimbursement, submission of samples, and reporting of positive tests can be found in the "Dear Provider" letters above.                          

Further Testing Guidance

The Washington State Department of Health recommends prompt testing for anyone with symptoms of COVID-19. If a resident, client, or staff member at a long-term care facility tests positive for COVID-19, contact your local health jurisdiction for immediate instruction on wider testing.   

Training Staff to Administer COVID-19 Testing

The Department of Health and local health jurisdictions are leading the training of facility staff in performing COVID-19 testing. Contact your local health jurisdiction to inquire about training for viral testing, specimen collection, and reporting.  

Infection Control and Prevention

Wash Your Hands

The World Health Organization has published a visual health care worker handwashing guide. The Centers for Disease Control and Prevention describes a thorough, 20-second process for handwashing - the equivalent of singing the "Happy Birthday" song twice.

Home and Community Services (HCS) - Hospital Surge Guidance

HCS has issued a statewide plan to surge activities at acute care hospitals to determine eligibility, plan services, and find viable community alternatives.

Appendix K Waivers

Appendix K waivers have been filed in response to the COVID-19 outbreak. These waivers temporarily modify some processes of care, provider qualifications, service limitations, and other guidelines. Providers should stay current with these waivers to optimally respond to COVID-19.

Provider Rate Enhancements

The outbreak of COVID-19 has burdened providers with increased costs. Emergency rate enhancements have been extended to providers to offset some of these increased expenses.

Home and Community Services (HCS) Rate Enhancements

Home Care Agencies will receive a 20% rate increase for May and June. HCAs that serve clients with suspected or confirmed cases of COVID-19 will receive an additional $1 per hour.

Individual Providers will receive an additional $3 per hour for hours worked during May and June. They will also receive a one-time $100 stipend, per client, for cleaning supplies. DSHS will make additional contributions towards health benefits and increased training sessions to support social distancing within classrooms.

  • H20-047 details rate enhancements for Home Care Agencies.
  • H20-037 details a rate add-on for Home Care Agencies committed to serving clients suspected or confirmed of COVID-19 infection.
  • H20-043 details rate enhancements for Individual Providers.

Residential Care Services (RCS) Rate Enhancements

The Centers for Medicaid and Medicare Services have increased Federal Match Assistance Percentages (FMAP), resulting in an effective 12-15% rate increase for facilities.

Admitting nursing home facilities will receive an exceptional rate of $100 per client per day atop regular rates for admitting a hospitalized client who transitions to their facility during the surge period.

DSHS has also begun establishing contracts with providers that can establish buildings or wings that can provide services dedicated to COVID+ residents. These COVID+ facilities will receive an enhanced daily rate of $450/day.

ALTSA issued a “Dear Provider” letter on May 4 that details rate increases for Assisted Living Facilities and Adult Family Homes.

Additional Resources

Frequently Asked Questions

Webinar Questions and Answers

ALTSA holds routine webinars to share important guidance and collect questions. Review these documents for answers to common questions.

  • April 16, 2020 Webinar Q&A - FMAP, PPE, training and certification requirements, COVID-19 testing requirements, nurse delegation.
  • May 15, 2020 Webinar Q&A - COVID-19 testing, cohorting, visitation restrictions, clarification of "end-of-life" circumstances.

Additional Guidance for Providers

Guidance for Individual Providers

The work performed by Individual Providers is considered essential under the Governors Proclamation 20-25. Your clients may need you more than ever during this outbreak, but we encourage steps to reduce close contact and require that you contact your client and case manager in the event you feel ill yourself. See our Guide for Individual Providers for more information.

    Help, Hotlines, and Guidelines

    Washington State Department of Health Coronavirus Call Center

    • 1-800-525-0127 and press #.

    Washington State Department of Health Web Resources

    Centers for Medicare and Medicaid Services

    Applicable to federally certified programs such as nursing facilities and ICF/IIDs

    Centers for Disease Control and Prevention

    Washington State Coronavirus Response Website

    DSHS Aging and Long-Term Support Administration

    I need to report abuse or neglect of a vulnerable adult
    I have a question or concern about my living facility
    • Contact Complaint Resolution Unit:
      • Phone: 1-800-562-6078
      • TTY: 1-800-737-7931
    • Respond within a timeframe
      • For phone calls: Respond within 48 hours, or Acknowledge complaint within 48 hours if the issue is being worked on. Attempt to resolve complaint, or make contact with; Refer to another agency if needed.
    • For written contacts: Respond within 7 days
    I want to find a new place to live
    I want to find out more about receiving care in my home
    I have questions about my financial eligibility
    Who do I contact if I want to file a complaint or solve a problem with my long-term care?

    If you do not feel comfortable talking to your case manager or their supervisor, or if you feel your case manager has not adequately addressed your concerns, you can contact the Washington State Long-Term Care Ombuds Program at 1-800-562-6028 or on their website.

    Who do I contact if I want to file a complaint or solve a problem with my in-home care?

    You can contact your local Area Agency on Aging. Find your nearest Area Agency on Aging.

    I need help with ProviderOne

    Call 844-240-1526 or find the direct phone number in other languages. The call center hours are Monday-Friday, 7 a.m. to 7 p.m., and Saturday, 8 a.m. to 1 p.m.

    Who do I contact if I want to file a complaint or solve a problem regarding a DSHS/ALTSA employee or service?
    Who do I contact if I believe I have been discriminated against in the delivery of my services?
    Investigations Unit Administrator Grievance Coordinator for Section 504, Title II and Other Civil Rights Laws
    Department of Social and Health Services Human Resources Division Investigations Unit (IU)
    PO Box 45830
    Olympia, WA 98504-5830

    Voice: (360) 725-5821 or 1-800-521-8060

    TTY: (360) 586-4289 or 1-800-521-8061

    Fax: (360) 586-0500