Long-term Care Facilities and COVID

To notify Snohomish Health District of a positive case of COVID-19 within your facility please call 425-339-5278 during business hours (Monday through Friday 8 a.m. – 5 p.m.).

You can also send an email to LTC@snohd.org. Please do not send patient protected information. This email box can be used at any time. Staff will work with you to provide a secure portal if patient protected information is needed.

General Information

What steps should our facility take to prepare for COVID?

How do we transfer a resident from our long-term care facility to another healthcare setting?

The Washington State Department of Health has released interim guidance.

What is considered an outbreak?

  • The Washington State Department of Health has defined an outbreak as:
    1. ≥ 1 long term care facilities and agencies-acquired COVID-19 infection in a resident
    2. ≥ 2 COVID-19 infection in HCWs who were on-site in the long-term care facility or agency at any time during their infectious period OR during their exposure period and has no other known or more likely exposure source.

We had an employee test positive at our healthcare facility. What guidance should we follow?

We had a resident test positive. What guidance should we follow?

  • For residents who have tested positive, they should do the following:
    1. Isolate away from others for at least 10 days, or 24 hours after their symptoms improve and fever resolves without the use of fever-reducing medications, whichever is longer
    2. Resident should be placed in a single-person room, or cohort with residents who have the same infection
    3. Signs should be placed outside of the resident's room to notify anyone entering of the need to wear additional PPE.
    4. Healthcare workers should perform hand hygiene when entering and exiting the room, wear a face mask, eye protection, and gown and gloves during resident contact
    5. Identify other residents that may have been exposed (such as roommates) and follow the guidance for residents exposed (in the question below)
  • The Centers for Disease Control and Prevention have issued interim clinical guidance for management of patients with confirmed COVID-19.

We had a resident potentially exposed to COVID. What guidance should we follow?

  • For residents potentially exposed to COVID-19, a 14 day quarantine period is needed.
    1. Residents should be placed in a single-room or in a separate observation area so the resident can be monitored for evidence of COVID-19
    2. Signs should be placed outside of the resident's room to notify anyone entering of the need to wear additional PPE.
    3. Healthcare workers should perform hand hygiene when entering and exiting the resident room, wear a face mask, eye protection, and gown and gloves with resident contact.
    4. If possible, the residents should remain in their room except for medical necessity.

We had a resident leave the facility, do they need to be quarantined?

  • After a resident leaves a facility, upon their return the facility should conduct a risk assessment to determine next steps.

Where can I find frequently asked questions?

Reporting COVID cases within a facility

Sample line list for reporting 

How often do I need to report cases to the Health District?

COVID-19 is an immediately notifiable condition. You should report cases of COVID-19 to the Snohomish Health District as soon as you become aware of a positive employee or resident. Reporting to the Health District is in addition to report you need to do to DSHS or the CDC. The Health District must be notified by your facility of every COVID-19 positive resident or staff member. 

Here is information on how to report to the Health District

How do I report COVID-19 Point-of-Care testing results?

  • Facilities administering point-of-care (POC) testing for COVID-19 must report all their COVID-19 testing results to the Washington State Department of Health (DOH). A POC testing facility is one that administers point-of-care (POC) tests, such as rapid tests for diagnosing COVID-19, which provide results within minutes of the test being administered, allowing for rapid decisions about patient care.
  • Washington Administrative Code WAC 246-101 requires laboratories to report all COVID-19 results to DOH. This reporting requirement applies to all facilities conducting point-of-care or rapid screening tests for COVID-19. This includes clinics that are not traditionally a lab, such as long-term care facilities, schools, and correctional facilities.

How often do I need to report cases to DSHS?

How to report a COVID related death in your facility

If a resident of your facility passes away due to COVID-19 you will need to report that information to the Health District promptly. You can report either through fax to 425-339-8706 or by calling 425-339-5278  and asking to speak with someone regarding a COVID death.

Personal Protective Equipment

How do I order?

  • The Health District may be able to help you find personal protective equipment. For ordering instructions, click here.

What should we use?

What is the proper way to use PPE?

COVID testing

On August 25, 2020, CMS published an interim final rule with comment period (IFC). This rule establishes Long-Term Care (LTC) Facility Testing Requirements for Staff and Residents. Specifically, facilities are required to test residents and staff, including individuals providing services under arrangement and volunteers, for COVID-19 based on parameters set forth by the HHS Secretary.

I would like to test all of my residents, what do I need to do?

  • You will need to contract with a lab to accept your specimens
  • You will need to have an Ordering Physician. This is something your facility will need to hire/contract for. The Health District is unable to help with this at this time.
  • You may need to apply for a CLIA Waiver.
    1. Guidance for Waiver
    2. Application
  • You will need to order testing supplies

Who is authorized to collect nasal swabs for COVID testing?

Guidance from the Centers for Disease Control related to testing

Department of Social and Health Services

Where can I find Dear Provider letters?

Safe Start Guidance

Where can I find the latest guidance from the Governor?


Family/Caregiver support

I have a loved one in a long term care facility, what should I know?



Do patients in hospitals and residents in long term care facilities need to quarantine if they’ve been vaccinated?

  • “Vaccinated inpatients and residents in healthcare settings should continue to quarantine following an exposure to someone with suspected or confirmed COVID-19; outpatients should be cared for using appropriate Transmission-Based Precautions. This exception is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings. Although not preferred, healthcare facilities could consider waiving quarantine for vaccinated patients and residents as a strategy to mitigate critical issues (e.g., lack of space, staff, or PPE to safely care for exposed patients or residents) when other options are unsuccessful or unavailable. These decisions could be made in consultation with public health officials and infection control experts.” (Public health recommendations for vaccinated persons | CDC)

Do healthcare personnel need to quarantine after an exposure if they’re vaccinated?