Medical Test Site Waiver Regulatory Requirements

As of July 1, 2023 RCS Licensors will be looking to see if you have a Medical Test Site Waiver if you are doing any medical testing for your residents. 

Certain types of medical testing require a state Medical Test Site Waiver (MTSW) license. One type of activity requiring a MTSW license is testing residents for COVID-19. Other types of medical testing requiring a MTSW license include, but are not limited to, blood glucose tests and urine tests. This letter explains federal and Washington state MTSW licensure requirements and how to decide if the medical tests conducted in your facility require a MTSW license. 

Federal and state Medical Test Site Waivers
In Washington state, a Medical Test Site Waiver license is required to perform certain medical tests where Centers for Medicare and Medicaid Services federal regulations require a Clinical Laboratory Improvement Amendments (CLIA) waived certificate. The Washington state MTSW
license meets both federal and state requirements and includes both the state license number and a CLIA number to meet requirements.

How do I decide if a MTSW license is required? 

MTSW licensure is required when the AFH or ESF provider administers a medical test (such as a COVID-19 test or blood glucose test), or interprets the test result, or acts upon the test results.

Examples of activities performed by providers or staff that require a MTSW license are when a

  • Uses rapid COVID-19 tests for residents.
  • Tests blood glucose for a resident.
  • Dips test sticks in urine to test for ketones or other analytes.
  • Reports a test result to a medical provider who may adjust a resident’s diet or medication in response to a test result.


When is a MTSW license NOT required?
MTSW licensure is not required if a person performs and interprets their own medical test or shows their test result to someone else.

For example, when:

  • A staff person takes a rapid COVID-19 test and interprets the result, then calls the provider to report they will or will not be coming to work.
  • A resident independently takes the medical test and acts upon the results themselves
    (such as by adjusting their own diet or medication or calling the medical provider).

What do I do if a MTSW is required?
If the AFH or ESF is testing residents using a medical test, then a MTSW license is required.
The provider must apply for a MTSW license through the Department of Health (DOH) to be compliant with state and federal regulations.

  • Providers must mail the completed MTSW license application to the Olympia address listed on the application.
  • Providers that have submitted a MTSW license application with fee payment may conduct testing activities while their MTSW license is pending. Once the application is
    processed, providers will receive an email with their Medical Test Site and CLIA Number
    from DOH.
  • A provider who already has a MTSW license to perform COVID-19 testing must submit a
    Test Menu Change Form 505-088 to add to their license any other tests they are already
    conducting (such as blood glucose monitoring) to their existing MTSW license.
    • For more information on how to apply for a Washington state MTSW license, use this
    link: Medical Test Site Licensing Applications 

Are there reporting requirements related to medical testing?
There are reporting requirements related to COVID-19 testing. For information about reporting
COVID-19 test results to DOH, use this link: Reporting Covid-19 Test Results for Point-of-Care Testing Facilities

Click here to read the entire Dear Provider Letter. 

6 Responses

  1. Hi Karen, if we are not doing any of the point of care testing that creates a requirement for the waiver do we need to add to our contract or care plan that covid tests will be available but must be performed by Residnet or family? or can we just tell a licensor that we do not perform theses tests and that be satisfactory?

  2. What is the rejdent tests thier own blood glucose at our home does that still mean that we need the waiver?

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