COVID-19 UPDATE #253
July 8, 2022
"EDUCATION ONLY" PERIOD APPROVED FOR MTSW LICENSING IN ASSISTED LIVING
DSHS/Residential Care Services (RCS) became aware of the need for Medical Test Site Waived (MTSW) licensing (also referred to as a CLIA waiver) and in April they informed Adult Family Home (AFH) and Enhanced Services Facilities (ESF) providers of the requirement. DSHS offered training to providers and RCS staff and the recorded webinar training is available here. The implementation involves an initial education period where RCS will not cite homes and facilities that are performing tests that require a waived license. WHCA requested the same or similar training for assisted living providers, as well as the same grace period offered to the other home- and community-based care settings. The “education only” period was recently approved to extend until July 1, 2023.
 
Some Assisted Living regulatory staff attended the MTSW training and had questions about regulating in assisted living facilities. To clear up the confusion, DSHS will be sending a Dear Administrator letter to ensure assisted living facility providers are aware of the MTSW requirements. DSHS will be using the same implementation timetable for assisted living facilities as with AFHs and ESFs. They will make the training materials available to assisted living facilities. Department of Health (DOH) has also agreed to include this information on the Thursday LTC call agenda for an assisted living Q&A; this will likely be addressed in a September call. DSHS will also provide training and written guidance to RCS AL licensors and complaint investigators to clarify the requirements and timeframes.
 
To be clear, there will be no citations initially. After July 1, 2023, RCS will regulate to RCS rules related to following state and federal requirements. This would be done as part of a complaint investigation or other regulatory activity when indicated. RCS will refer to DOH any unlicensed medical test sites only when they find the assisted living facility has not applied for the MTSW by the time of the follow up visit after the citation. RCS has no plans to add MTSW to the routine inspection process.
 
The training materials are located here. This training will be posted on the DSHS assisted living page soon. If your assisted living facility does not yet have a Medical Test Site (CLIA) Waiver and you are conducting any laboratory tests onsite (including but not limited to COVID antigen tests, blood glucose monitoring, and/or urinalysis) you can apply for a MTSW here. For questions regarding this process, review the FAQs. If you have questions, please email the DSHS/RCS Policy team.
DEAR ADMINISTRATOR LETTER REGARDING TIMELINES FOR CERTAIN RESIDENT ASSESSMENTS | ASSISTED LIVING
In a Dear Administrator letter dated July 8, 2022, assisted living providers were notified the department filed a CR-103E to extend emergency rules regulating the timelines for completing CARE assessments for current residents in adult family homes, assisted living facilities, and enhanced services facilities. The emergency rules amend WACs 388-76-10350, 388-78A-2100, and 388-107-0080 to allow facilities to continue using a CARE assessment for a current resident whose care is state-funded for an additional twelve months. At this time, these emergency rules are scheduled to expire on October 20, 2022.

Assessments are still required when there is a significant change to a resident’s condition, and HCS continues to conduct those assessments. Negotiated care plans or negotiated service agreements must continue to be updated as needed according to the schedules in WAC 388-78A-2150 for assisted living facilities. If you have questions, please email the RCS Policy Unit.
DEAR ADMINISTRATOR LETTER EXPLAINS PROPOSED AMENDMENTS TO REINSTATE INSPECTION SCHEDULES
In a Dear Administrator letter dated July 8, 2022, all providers are notified the Department of Social and Health Services (DSHS) is proposing to add sections to chapters 388-76 (adult family home minimum licensing requirements), 388-78A (assisted living facility rules), 388-97 (nursing homes), and 388-107 (licensing requirements for enhanced services facilities) WAC. The proposed rules implement sections in Engrossed Substitute House Bill J(ESHB) 1120 (Chapter 203, Laws of 2021) related to re-establishing inspection timelines that were suspended due to the COVID-19 pandemic. On June 17, 2022, DSHS filed the CR-102 to formally propose rules for adoption.

You may submit comments in person at a public hearing or in writing to the DSHS Rules and Policies Assistance Unit.
  • The Public Hearing will be held July 26, 2022, at 10 AM via Microsoft Teams. Click here for meeting information.
  • You may email comments to the Rules and Policies Assistance Unit.
  • You may submit written comments via the USPS to: DHS Rules Coordinator/RPAU, PO Box 45850, Olympia, WA 98504.

If you have questions, please email Libby Wagner, Lead Policy Program Manager, or call (360) 464-0487.
REMINDER: AL FINGERPRINT BACKGROUND CHECKS MUST BE COMPLETED
All newly hired assisted living administrators, nurses, and caregivers must have federal fingerprints done upon receipt of the state background check results. While fingerprinting was waived during the pandemic, it is now back into effect and must be done for all existing staff who did not receive them during the waived period. See the Dear Administrator Letter on this topic for more details on specific timelines.

Washington State continues to work with different locations throughout the state to ensure fingerprinting sites are available. As of today, the updates include:

Site Openings:
  • Sequim, WA-Center Park Way – New site in Sequim will be opening on July 20, 2022.
  • Yakima Update - The permanent Yakima site is building a new facility. Although they anticipated opening at the end of June, they are still under construction. The fingerprint vendor will continue to have a host site to provide coverage for that area. They are currently reviewing the schedule and plan to add more dates/slots soon.
NATIONAL NURSING HOME STAKEHOLDER CALL | JULY 13
The Centers for Medicare and Medicaid Services (CMS) invites skilled nursing professionals to join their stakeholder call on July 13, 2022, at 12:00 noon PST. This call is designed for long term care facility staff and resident advocates. The event is open and registration is required.
TACOMA-PIERCE COUNTY HEALTH SHARES RESOURCES FOR LTC PROVIDERS
On July 10, 2022, the Tacoma-Pierce County Health Department emailed information and resources for long term care providers. Their email includes insight on the COVID-19 vaccine, test kits available for long term care facilities, the medical test site waiver application, infection control, COVID-19 treatments, emergency preparedness, and more. Click here to review resources available through Tacoma-Pierce County Health for providers in Tacoma and Pierce County.
ADDITIONAL RESOURCES
WHCA continues to post resources and information as it becomes available on our website. If you have questions or need additional information, please call the WHCA office at (800) 562-6170.