PDFWAC 388-106-0355

Am I eligible for nursing facility care services?

You are eligible for nursing facility care if the department:
(1) Assesses you in CARE and determines that you meet the functional criteria for nursing facility level of care which means one of the following applies:
(a) You require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis;
(b) You have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010:
For each Activity of Daily Living, the minimum level of assistance required in
 
Self
Performance is:
Support
Provided is:
Eating
N/A
Setup
Toileting
Supervision
N/A
Bathing
Supervision
N/A
Transfer
Supervision
Setup
Bed Mobility
Supervision
Setup
Walk in Room
or
Locomotion in Room
or
Locomotion Outside Immediate Living Environment
Supervision
Setup
Medication Management
Assistance Required
N/A
Your need for assistance in any activities listed in subsection (b) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose in determining your functional eligibility.
(c) You have an unmet or partially met need with at least two of the following activities of daily living, as defined in WAC 388-106-0010:
For each Activity of Daily Living, the minimum level of assistance required in
 
Self
Performance is:
Support
Provided is:
Eating
Supervision
One person physical assist
Toileting
Extensive Assistance
One person physical assist
Bathing
Limited Assistance
One person physical assist
Transfer
Extensive Assistance
One person physical assist
Bed Mobility
and
Turning and repositioning
Limited Assistance
and
Need
One person physical assist
Walk in Room
or
Locomotion in Room
or
Locomotion Outside Immediate Living Environment
Extensive Assistance
One person physical assist
Medication Management
Assistance Required Daily
N/A
Your need for assistance in any of the activities listed in subsection (c) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility.
or:
(d) You have a cognitive impairment and require supervision due to one or more of the following: Disorientation, memory impairment, impaired decision making, or wandering and have an unmet or partially met need with at least one or more of the following:
For each Activity of Daily Living, the minimum level of assistance required in
 
Self
Performance is:
Support
Provided is:
Eating
Supervision
One person physical assist
Toileting
Extensive Assistance
One person physical assist
Bathing
Limited Assistance
One person physical assist
Transfer
Extensive Assistance
One person physical assist
Bed Mobility
and
Turning and repositioning
Limited Assistance
and
Need
One person physical assist
Walk in Room
or
Locomotion in Room
or
Locomotion Outside Immediate Living Environment
Extensive Assistance
One person physical assist
Medication Management
Assistance Required Daily
N/A
Your need for assistance in any of the activities listed in subsection (d) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility.
(2) Determines that you meet the financial eligibility requirements set through WAC 182-513-1315.
[Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0355, filed 1/12/15, effective 2/12/15; WSR 05-11-082, § 388-106-0355, filed 5/17/05, effective 6/17/05.]