Large Long-Term Care Facilities Continue Effort to Meet State Testing Goals

While COVID-19 testing in nursing homes and long-term care facilities remains an emphasis of the state, adequate access to supplies continues to be an issue. 

On May 28, Washington state Secretary of Health John Wiesman required that every nursing home in the state must offer and administer tests to all consenting residents and staff without medical justification for declining by June 12. Additionally, they are required to submit the tests to authorized laboratories in a timely manner and report the positives immediately. 

According to the Washington state Department of Health, more time is needed to completely meet those goals. 

Currently, the requirements only apply to larger facilities, such as nursing homes, according to Department of Health spokeswoman Lisa Stromme Warren. 

“We do anticipate, in the future, being able to release guidance about testing in other kinds of long-term care facilities,” Stromme Warren said. “I don’t yet have a timeline for that, but it’s certainly something that our teams have been working on.”

According to the Washington State Department of Social and Health Services, there are currently 208 facilities in the state that are required to meet these goals. As of June 12, DOH is reporting 187 of those facilities have either completed testing, received testing supplies or have been shipped testing supplies. 

Lewis County is home to three such facilities — Prestige Post-Acute and Rehab Center, Riverside Nursing and Rehabilitation Center and Sharon Care Center — all located in Centralia. 

In a statement, Prestige confirmed all staff and residents at its Centralia facility have been tested. According to Prestige, 90 residents were tested, none tested positive and 144 staff members have been tested, with one test still outstanding as of June 16. 

Requests for comment from CornerStone Health Care, which owns Riverside Nursing Center and Rehab and Sharon Care Center were not returned. 

“We have long advocated for more testing at our center, and we were pleased to learn that broad testing throughout Washington had been approved,” a statement from Prestige Care reads. “We have worked in close partnership with the state and local health authorities to respond to COVID-19 as the situation has quickly evolved, and we believe broad testing will help us continue to make informed and targeted decisions moving forward.”

Additionally, Prestige maintains that its highest priority is the health and safety of patients and staff in centers. 

“We continue to diligently follow all guidance set by the CDC and CMS, including those regarding the use of Personal Protection Equipment,” the statement reads. 

Lewis County Deputy Director of Emergency Management Andy Caldwell said that currently there are no outstanding requests for personal protective equipment from long-term care and adult care facilities. 

“We have that goal of, whatever comes in, making sure that they have their needs met, specifically in the arena of personal protective equipment,” Caldwell said. “The masks, the gowns, the shields, whatever it is they need. We want to make sure they have it.” 

In the meantime, smaller facilities, such as Coffee Creek Adult Family Home, are still standing by for guidance. Owner Melissa Varick is a member of the Adult Family Home Council, a group that represents the group family home providers in the state. 

She said the AFHC is still working on getting clear direction for the state on how the testing initiatives will work for the smaller facilities. 

“Sometimes, they put these things out, but they don’t include us because we can have no more than six residents in an adult family home,” Varick said. “Our setting is a little different than the big nursing homes and assisted living facilities.” 

She mentioned the various questions concerning the rights of residents when administering testing. 

“Because of the residents’ rights, can they decline to have the test, do their powers of attorney need to sign off on it?” Varick said. “There are a lot of questions and so we’re just waiting for those to be answered. We haven’t done anything yet until we’re told.” 

Lewis County Public Health and Social Services Deputy Director John Abplanalp pointed to the initial deadline for the testing efforts in May having to be pushed back. 

“I think there are issues with test kit availability, there are issues with, you know, just the logistics of getting potentially over 100 folks tested within a reasonable period of time,” Abplanalp said. “The residents are not typically mobile, so they need to be tested on-site.” 

He also mentioned the issues with the staff of the facilities and the financial aspect of administering tests. 

“If they don’t have insurance, who’s going to pick up the bill for the testing cost,” Abplanalp said. “Those are some of the concerns just off the top of my head that I’ve heard about. Since state agencies are taking the lead on coordinating this testing, we haven’t been involved in troubleshooting with individual agencies.” 

Lewis County Public Health and Social Services Director J.P. Anderson said the DOH has taken the lead on the testing effort in nursing homes for the entire state. Abplanalp added the Washington state Department of Social and Health Services is also involved in the effort. 

Still, he said the county is able to provide technical assistance for long-term care facilities when they have questions about infection control and what planning for a positive test should look like. 

“If any positive residents or staff are identified, we would be following up with an investigation,” Abplanalp said. 

Anderson continued by saying the response to a potential outbreak in a county long-term care facility is handled by him and his team. 

“We’d work with Valley View and likely send in a testing strike team in order to make sure we’re testing broadly if we started to have an outbreak in a long-term care facility,” Anderson said. 

As of recently, Abplanalp said the county has been in contact with multiple long-term care facilities. He said LCPHSS has been able to help in getting a limited number of test kits outside of the state’s initiative. 

“Overall, that’s been a huge focus,” Anderson said. “To make sure we’re really keyed in, especially for areas like long-term care facilities that could have outbreaks of substantial impact to our community. I think it will continue to be that way, but we’re particularly mindful of potential outbreaks in that area just because the risk factors are so high.”