August 14, 2020

Re:  Updated Directives from Health Authorities on Visitation and other Matters             

Dear Residents and Families of Cascade Living Group in Washington:

Effective Wednesday, August 12, 2020 the Washington State Department of Social and Health Services issued updated guidance regarding visitation, testing and screening, Personal Protective Equipment and group activities, including communal dining.   This guidance was issued based on Governor Inslee’s Safe Start Plan.  The guidance was incorporated into a recent Proclamation from the Governor and has the force of law behind it.   A summary of the new guidance accompanies this letter.

We understand how difficult the restrictions we have in place have been for our families, and more so on residents, in particular the visitation restrictions.   We want nothing more than to reconnect our residents with their loved ones in person.   But we must stay the course and follow all directives and guidance, as well as best practices.

This new guidance has a four phase process.    Please be aware that the four phases do not necessarily correspond to what particular phase a county is in.   The burden has been placed on providers to make daily checks of the State Department of Health Risk Assessment Dashboard, which gives county by county data.    Unless and until a county no longer has a “heightened” transmission risk, all providers must follow the Phase 1 guidance, even if a county is otherwise in phase 2 or 3 for other purposes.  Heightened transmission risk means an infection rate of greater than 75 persons per 100,000 of population.        Moreover, we cannot advance to the next phase if any of our communities had a positive resident of staff member in the preceding 28 days.

We operate in Skagit, King, Kitsap and Mason counties.  Kitsap county is currently just under the 75 per 100,000 population metric, but the other counties are still in the heightened risk transmission category.   However, our campus in Kitsap county did have positive cases within the last 28 days and remains in phase 1.

Visitation.  The good news is that outdoor visits, under strict safety protocols, are allowed for phase 1.  We intend to allow outdoor visits as soon as possible, beginning next week.  Our plan will include up to two pre-scheduled visitors, screening of those visitors and visits will take place in a designated outdoor space.  Look for a communication from your Executive Director on the details for the visits.

We will continue to offer virtual visits and closed window visits if you prefer.   And please also note that we have discretion under the latest guidance to impose more restrictive visitation protocols if we believe that would be appropriate.   That is certainly something we do not want to do, but if outdoor visits present a health or safety concern, we may have to.  Similarly, local health authorities have the discretion to impose more restrictive visitor protocols than found in the latest guidance.

Screening and Testing.  We are fully compliant with the testing and screening summarized in the attachment, and will remain so.

PPE.   We are also compliant with the PPE requirements.  We have been stockpiling PPE for many months and have an adequate supply to meet our needs.   Staff members are wearing face masks, face shields or other eye protection and gloves when interacting with residents.   When we have had outbreaks, the designated staff caring for positive residents are additionally  supplied with N95 masks and protective gowns.  All residents are being asked to wear masks when out of their apartments.

Communal Activities and Communal Dining.   Communal dining is not recommended under the new guidance, but is not entirely prohibited.    For the time being we are going to follow the recommendation until we are confidant limited communal dining can be done safely.   Life Enrichment activities will continue to be done with all precautions for social distancing, masks and small groups.

We remain vigilant and on high alert.   We will continue with our enhanced monitoring, screening, deep cleaning and testing as necessary.   And given the increasing COVID-19 cases in Washington,  we ask that everyone be mindful of the basic precautions that we are all aware of:   wearing masks, maintaining social distancing and hand hygiene.

Thank you for your patience and trust in us.  We will keep you updated as things develop, but outdoor visitation is a positive step in our gradual and phased return to normality.

Sincerely, `

Thomas E. Stanley

Founder and Principal

Cascade Living Group

DSHS Summary of August 12, 2020 guidance for LTC