According to CMS QSO Memo 20-38, skilled nursing facilities must have procedures in place to address staff who refuse testing. For this requirement, staff is defined by CMS to include employees, consultants, contractors, volunteers, and caregivers who provide care and services to residents on behalf of the facility, and students in the facility’s nurse aide training programs or from affiliated academic institutions.

To recap this issue, WHCA has previously informed members of the necessity of implementing a Respiratory Protection Program in your facility. As described in the program, the medical evaluation form is a questionnaire that solicits information that must be reviewed by a physician or other licensed healthcare professional (PLHCP) to determine an employee’s ability to use a respirator. The medical evaluation must be completed before initial fit testing is performed and before the decision is made that an employee is required to use a respirator in the work environment. It is mandatory that employees be evaluated by a physician or other PLHCP who provides a written recommendation regarding their ability to use respirators. The PLHCP needs to be an individual whose legally permitted scope of practice allows them to independently provide, or be delegated the responsibility to provide, some or all of the healthcare services required in the medical evaluation.  If an RN is performing this function and there are any problems or physical limitations noted, the employee should be referred to a PLHCP for further consultation.

WHCA is now offering free Fit Testing Train the Trainer sessions around the state. Click here to view a list of training dates. A comprehensive list of fit testing resources can be found here.

If you have further questions regarding this issue, please email Diana Hitchings.

This issue brought up questions from our members regarding the direction of King County as opposed to the CMS regulatory requirement for staff testing. Currently, according to the CMS county positivity rates, King County facilities without an outbreak or suspected case of COVID-19 would be required to conduct monthly testing of all staff.

Keep in mind that the CMS requirements are a minimum standard and must always be met as a requirement of participation. See F866 and CMS QSO 20-38 for additional information. If you have questions, please contact Elena Madrid.

In a Dear Administrator letter to assisted living, adult family home, enhanced services facilities, and certified community residential services and supports providers dated September 10, 2020, the Department of Social and Health Services (DSHS) shares changes to the Safe Start for Long Term Care Recommendations. One change for all provider types is related to medically and non-medically necessary trips during Phase 1. The other change is related to adult family homes. The letter also clarifies recommendations and requirements related to outdoor visits at homes and facilities that have a staff or resident test positive for COVID-19.

If you are a private pay or Medicaid-certified assisted living/memory care community, ensure that you apply for the HHS Phase 2 General Distribution round of Provider Relief Funds. HHS announced last week that private pay assisted living operators are eligible to apply. Non-skilled nursing facility Medicaid providers are also eligible. Note that the deadline for the application is this Sunday, September 13, and we do not expect this deadline to be extended. Read more.

Some professions are not able to renew late online at this time. You can find a list of professions who are able to renew after their normal expiration date on the License Expiration Extension Frequently Asked Questions page.

The Centers for Medicare and Medicaid Services (CMS) launched an initiative to distribute rapid point-of-care antigen COVID-19 testing devices to nursing homes across the country. Recently, the Department of Health and Human Services (HHS) hosted training sessions on the testing devices to help providers understand the devices and limitations and cautions on their use in nursing homes. Below are links to the slides from each training session. Read more.

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.