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 aligned their outbreak definition with CSTE, which now defines an outbreak in long-term care as:
    • >1 facility-acquired** COVID-19 case in a resident, though facilities should perform an investigation if one or more of the following criteria are met:
      1. > 1 probable† or confirmed COVID-19 case in a resident or HCP*;
      2. > 3 cases of acute illness compatible with COVID-19 in residents with onset within a 72h period

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 with known/suspected exposure to COVID. What guidance should we follow? 

  • For residents potentially exposed to COVID-19, their quarantine period is based on their vaccination status:
  • For residents that are up-to-date on their COVID vaccines, there are no recommendations to quarantine, but are still recommended to test according to the DOH document Long-Term Care Facility testing for Staff and Residents
  • For residents that are not up to date on their COVID vaccines/are unvaccinated, they should quarantine:
    • 10 days or 7 days with a negative test with a specimen collection date within 48 hours

We have a resident that receives an aerosol-generating procedure. What should we do? 

Aerosol Generating Procedure Sign (Washington State Dept. of Health)

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.

Reporting to Snohomish Health District

The Health District uses the Washington State Department of Health’s online reporting tool, called the Facility Outbreak Notification Tool (FONT) for Healthcare Settings, for facilities to report cases of COVID-19.

  • Reporting using this website is HIPAA compliant and can be completed on a mobile device (such as a phone or tablet) or on a computer
  • Facilities can upload a line list or enter information directly into the webpage
    • If facilities are reporting additional cases, they do not need to re-report cases that have already been reported to the Health District

To report an outbreak of influenza or gastrointestinal illness, please call 425-339-3503 rather than using the FONT tool. 

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

Long-Term Care Facility Testing for Staff and Residents (WA Department of Health, February 2022)

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?

Long-Term Care COVID Response Plan(formerly the Safe Start for Long-Term Care Plan)

Beginning February 23, 2022 the Safe Start for LTC will change to a LTC COVID Response document with recommendations that providers follow CDC, DOH, and, if applicable CMS guidance.  Visitation recommendations will also change to align with this guidance and will open visitation in LTC facilities and homes.  Providers will still need to work with the local health jurisdiction regarding specific visitation restrictions in the event of an outbreak. 


Family/Caregiver support

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