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WashingtonLawHelp.orgWashington LawHelp

Coronavirus (COVID-19): Rules for Nursing Homes

Authored By: Northwest Justice Project
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Questions and answers about how COVID-19 has affected nursing home and long-term care facilities in Washington state. #5204EN


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*Read this only if you live in the state of Washington.


Are there special rules for nursing homes during this pandemic?

Yes. New guidance took effect on February 1, 2021. It is based on county-level community case rates.  

Long-term care facilities must now follow the requirements of the Safe Start for Long-Term Care (LTC) plan.

LTC Phases are based on local public health criteria. Example: as of February 21, 2021, Whatcom County long-term care centers are in Phase 1 of the Safe Start for Long-Term Care plan. The two-week rate of 296.5 newly diagnosed positive cases per 100,000 people in that county was greater than the limit of 75.


How do I find out which phase my loved one's facility is in?

The local health department or the facility can tell you its LTC Phase status and what actions are permitted under that phase. Visit the Department of Health website to find your health department at www.doh.wa.gov/AboutUs/PublicHealthSystem/LocalHealthJurisdictions



In general, only outdoor and remote visits are permitted until a county reaches LTC Phases 3 and 4. 

There are two exceptions to this. Indoor visits are allowed in LTC Phases 1 and 2 if there are "compassionate care circumstances" or a designated "essential support person" is going to visit. You must use masks and practice social distancing.

  • Compassionate Care Circumstances include end-of-life situations and situations where a resident is struggling and would benefit from a visitor who would help address the resident's needs. Examples include grief, social withdrawal, or reluctance to eat or drink.

  • "Essential support persons" (ESPs) are persons at least 18 years old who, before visits were restricted, actively provided the resident companionship and support. Facilities must adopt policies and procedures to make sure that residents appoint ESPs and can start visiting with them again. Facilities must ask residents who they want as their ESP. A resident can have only one person as an ESP at a time.  Other family and friends may not visit again until the facility enters Phase 3.


What are the rules around any permitted visits?

  • Visits may take place in the resident's room, a specially designated "clean" room, or a designated outdoor area, including compassionate care and ESP visits.

  • Follow guidance for outdoor visitation.

  • Visitors must follow precautionary measures. These include, but are not limited to, wearing personal protective equipment such as facemasks and social distancing.

  • Visitors must sign into a visitor's log.

  • Owners and operators must keep the visitor's log for 30 days.

  • Visitors and staff should use "hand hygiene."


Group Activities and Dining

Residents may eat in the same room with social distancing. Facilities should consider additional limitations based on status of COVID-19 infections in the facility.

Group activities may take place for residents who have fully recovered from COVID- 19, and for those not in isolation for observation, or with suspected or confirmed COVID-19 status.

There must be social distancing among residents, appropriate hand hygiene, and use of a face covering.

Facilities may be able to offer a variety of activities while also taking needed precautions. Book clubs, crafts, movies, exercise, and bingo can all take place with alterations to follow guidelines for preventing transmission.


Trips Away from the Facility

Residents may be asked to limit such trips away from the facility as much as they can. However, residents do still have the right to come and go as they wish.

Before and after trips into the community, residents may be assessed to ensure that the proper infection prevention procedures and risk mitigation activities are followed through.


Do these rules cover assisted living facilities?



Can Long-Term Care Ombuds make in-person visits?

Yes. Long-term Care Ombuds support residents of nursing homes and assisted living facilities.

They look into resident complaints involving quality of care, use of restraints, transfer and discharge from the facility, and abuse, neglect and other aspects of resident care and personal rights. Ombuds are not considered visitors. They are allowed access to residents under all circumstances. They must follow proper infection control practices, screening, and wear the appropriate PPE for the status of the facility and the resident.

Call the Long-Term Care Ombuds Program at 1-800-562-6028 if you have any questions or concerns.


Are staff being tested for COVID-19?

Yes. Nursing homes must regularly test staff, based on certain factors, and offer testing to residents.


What happens to a resident who tests positive for COVID-19?


The resident will be isolated from other residents. Staff will keep the person away from other people.


Can the nursing home tell other people about a resident's condition?

No. Owners, operators, staff and volunteers cannot give out protected and confidential health information. There are some legal exceptions to this. It is okay to do so if the resident agrees to let them give out information.

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Last Review and Update: Mar 02, 2021