COVID-19 UPDATE #197
October 19, 2021
HHS EXTENDS COVID-19 PUBLIC HEALTH EMERGENCY THROUGH JANUARY 2022
The US Department of Health and Human Services Secretary Xavier Becerra extended the ongoing COVID-19 public health emergency (PHE) for an additional 90 days. The new expiration date for the COVID-19 PHE is now set for mid-January 2022. Any decision to allow the PHE to lapse would come with 60 days prior notice. Telehealth flexibilities, enhanced FMAP, SNF-specific waivers (3-Day Stay, Spell of Illness) and other COVID-19 related Medicare, Medicaid, and regulatory waivers remain in place.
UPDATED GUIDANCE ABOUT AEROSOL GENERATING PROCEDURES FOR ALL PROVIDERS
A Dear Administrator letter dated October 8, 2021, shares updated information about infection control precautions during and after Aerosol Generating Procedures (AGP) for all long term care settings. The Centers for Disease Control and Prevention (CDC) published recommendations for healthcare personnel during the COVID-19 pandemic. The Department of Health (DOH) has published updated AGP guidance Preventing Transmission of SARS-CoV-2 During Aerosol Generating and Other Procedures (September 13, 2021).

The letter explains how and why AGPs result in risk to healthcare personnel, lists commonly performed AGPs, provides precautions for during and after AGPs are performed, and has a list of frequently asked questions and answers. All providers are reminded that they must follow DOH guidance in relation to PPE and AGP. If providers have questions, they can email Katherine Ander.
DEAR PROVIDER LETTERS UPDATE SNFs ON TB TESTING, FIRE DRILLS, AND TRANSFER & DISCHARGE OF SNF RESIDENTS
TB Testing and Test Records
In a Dear Administrator Letter dated October 8, 2021, skilled nursing providers are notified that CDC guidance now indicates that the COVID-19 vaccination should not be delayed because of testing for TB infection. The Department rescinded WSR 21-18-064 under WSR 21-20-018 on September 23, 2021, as the separation of the TB test and COVID-19 vaccine is no longer recommended.

QA/Fire Drills/Windows in Resident Rooms
In a Dear Administrator letter dated October 8, 2021, skilled nursing providers are informed that in June 2020, the Department filed an emergency rule related to fire drills, windows in resident rooms, and quality assurance requirements in response to the significant threat of COVID-19. This rule has been extended once more and will expire on February 3, 2022, unless extended. What is says:
  • WAC 388-97-1740 waives the requirement for periodic fire drills. Training on responding to a fire is still required.
  • WAC 388-97-1760 reduces the scope of quality assurance activities. Facilities must continue to review adverse events and infection control.
  • WAC 388-97-2400 waives the requirement for a transparent glass window. This will increase the ability for facilities to increase capacity temporarily by utilizing windowless space for resident rooms.

30-Day Extension Approved of Proclamation 21-15 Related to the Transfer and Discharge of Nursing Home Residents
In a Dear Administrator letter dated October 8, 2021, skilled nursing professionals are informed that on October 1, 2021, the Washington State Legislature extended Proclamation 21-15 which waives a provision in current law so that COVID-19 positive nursing home residents may be immediately transferred or discharged by a nursing home that is unable to treat COVID-19 positive patients to facilities that are equipped to treat the disease. The extension has been approved for 30 days.

Each statutory and regulatory provision or portion thereof as specified below is hereby waived and suspended until 11:59 p.m. on November 1, 2021:
  • RCW 74.42.450(6) in its entirety, related to when a resident appeals a department decision to discharge due to level of care and waiting at least 30 days after a final order is entered
  • WAC 388-97-0140(1)(c)(ii) in its entirety, related to a skilled nursing facility/nursing facility-initiated transfer or discharge, once an appeal has been requested
  • WAC 388-97-0140(2) in its entirety, related to when a facility must suspend a transfer or discharge pending the outcome of a hearing with the office of administrative hearings

If providers have questions on any of these topics, they can email Molly McClintock, Nursing Home Policy Program Manager, or call her at (360) 742-6966.
DOH PROVIDES SURGE STAFFING FACT SHEET
The Department of Health (DOH) is providing a fact sheet on surge staffing to help long term care facilities. DOH also provides Hospital Surge information on their website to support the continuum of care for patients. The fact sheet provides background information, current needs, and resource options available to healthcare providers. For additional information on healthcare surge support and resources, please email healthcare.prep@doh.wa.gov.
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.