WSR 98-20-097
PROPOSED RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Aging and Adult Services Administration)
[Filed October 7, 1998, 10:56 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 98-14-085.
Title of Rule: WAC 388-78A-990 Boarding home license fees and 388-78A-010 Definitions.
Purpose: 2SSB 6544, chapter 272, Laws of 1998, transferred the responsibility for licensing and inspection of boarding homes from the Department of Health to the Department of Social and Health Services.
WAC 388-78A-990, to increase the fee for obtaining or reissuing a boarding home license from $54 to $79 per licensed bed. At the direction of the legislature, the department is to increase quality assurance activities to ensure the health and safety of boarding home residents. The funding for the increased activity is to come from license fee revenue.
WAC 388-78A-010, to change the definition of "department" from Department of Health to Department of Social and Health Services.
Statutory Authority for Adoption: RCW 18.20.090 and 18.20.240.
Statute Being Implemented: RCW 18.20.090 and 18.20.240.
Summary: The department is increasing the boarding home license fee for new and reissued licenses from $54 to $79 per licensed bed. The legislature intends that boarding home licensing and quality assurance activities are funded 100% by license fee revenue by the end of the 1999-2001 biennium. To accomplish this, the department must incrementally raise the fees until the entire cost of licensing and quality assurance activity comes from license fee revenue.
Name of Agency Personnel Responsible for Drafting: Patricia Hague, Mailstop 45819, Olympia, Washington 98504-5819, (360) 753-0631; Implementation and Enforcement: Patricia Lashway, Mailstop 45600, Olympia, Washington 98504-5600, (360) 493-2560.
Name of Proponent: Department of Social and Health Services, governmental.
Rule is not necessitated by federal law, federal or state court decision.
Explanation of Rule, its Purpose, and Anticipated Effects: The department is increasing the boarding home license fee for new and reissued licenses from $54 to $79 per licensed bed. The legislature intends that boarding home licensing and quality assurance activities are funded 100% by license fee revenue by the end of the 1999-2001 biennium. To accomplish this, the department must incrementally raise the fees until the entire cost of licensing and quality assurance activity comes from license fee revenue.
Proposal Changes the Following Existing Rules: WAC 388-78A-990, to increase the fee for obtaining or reissuing a boarding home license from $54 to $79 per licensed bed. At the direction of the legislature, the department is to increase quality assurance activities to ensure the health and safety of boarding home residents. The funding for the increased activity is to come from license fee revenue.
WAC 388-78A-010, to change the definition of "department" from Department of Health to Department of Social and Health Services.
No small business economic impact statement has been prepared under chapter 19.85 RCW. RCW 19.85.025 exempts an agency from preparation of a small business economic impact statement when the rule is one as described in RCW 34.05.310(4). RCW 34.05.310 (4)(f) states "Rules that set or adjust fees or rates pursuant to legislative standards…" The legislative standard is RCW 43.20B.110(2) "Fees charged shall be based on, but shall not exceed, the cost to the department for the licensure of the activity or class of activities and may include costs of necessary inspection." The proposed change to WAC 388-78A-990 sets a fee for licensing and inspection of boarding homes.
RCW 34.05.328 does not apply to this rule adoption. RCW 34.05.328 (5)(b)(vi) exempts rules that set or adjust fees or rates pursuant to legislative standards. The legislative standard is RCW 43.20B.110(2) "Fees charged shall be based on, but shall not exceed, the cost to the department for the licensure of the activity or class of activities and may include costs of necessary inspection." The proposed change to WAC 388-78A-990 sets a fee for licensing and inspection of boarding homes.
Hearing Location: Lacey Government Center (behind Tokyo Bento Restaurant), 1009 College Street S.E., Room 104-B, Lacey, WA 98503, on November 10, 1998, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact Paige Wall by October 30, 1998, phone (360) 902-7540, TTY (360) 902-8324, e-mail pwall@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, Paige Wall, Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 902-8292, by November 10, 1998.
Date of Intended Adoption: November 15, 1998.
October 5, 1998
Marie Myerchin-Redifer, Manager
Rules and Policies Assistance Unit
SHS-2450.3
AMENDATORY SECTION (Amending WSR 98-20-021, filed 9/25/98, effective 9/25/98)
WAC 388-78A-990 Fees. For renewal of licenses that expire on December 31, 1998 or after and initial licenses issued effective January 1, 1999 or after, the licensee or applicant shall:
(1) Submit an annual license fee of ((fifty-four)) seventy-nine dollars per bed of the licensed resident bed capacity ((for
initial and renewed licenses));
(2) Submit an additional one hundred fifty dollars when billed by the department for:
(a) A third on-site visit resulting from failure of the licensee or applicant to adequately respond to a statement of deficiencies; and
(b) A complete on-site survey resulting from a substantiated complaint; and
(3) Submit an additional late fee in the amount of ten dollars per day from the license renewal date until the date of mailing the fee, as evidenced by the postmark.
[Statutory Authority: RCW 18.20.240. 98-20-021, recodified as § 388-78A-990, filed 9/25/98, effective 9/25/98. Statutory Authority: RCW 18.20.050, 43.70.110 and 43.70.250. 98-01-165, § 246-316-990, filed 12/22/97, effective 1/22/98; 96-12-027, § 246-316-990, filed 5/30/96, effective 6/30/96. Statutory Authority: RCW 43.70.250, 43.70.110 and 43.20B.020. 95-12-097, § 246-316-990, filed 6/7/95, effective 7/8/95. Statutory Authority: RCW 43.70.110 and 43.70.250. 94-13-180, § 246-316-990, filed 6/21/94, effective 7/22/94. Statutory Authority: RCW 43.70.250. 92-12-086 (Order 276), § 246-316-990, filed 6/2/92, effective 7/1/92. Statutory Authority: RCW 43.70.040. 91-02-050 (Order 122), § 246-316-990, filed 12/27/90, effective 1/31/91.]
SHS-2487.1
AMENDATORY SECTION (Amending WSR 98-20-021, filed 9/25/98, effective 9/25/98)
WAC 388-78A-010 Definitions. For the purpose of this chapter, the following words and phrases shall have the following meanings unless the context clearly indicates otherwise.
(((1))) "Abuse" means an act by any individual which
injures, exploits or in any way jeopardizes a resident's health,
welfare, or safety, including but not limited to:
(((a))) (1) Physically damaging or potentially damaging
nonaccidental acts;
(((b))) (2) Emotionally damaging verbal behavior and
harassment; and
(((c))) (3) Sexual use, exploitation and mistreatment
through inappropriate touching, inappropriate remarks or
encouraging participation in pornography or prostitution.
(((2))) "Activities of daily living" means those tasks
related to basic personal care such as bathing, toileting,
dressing, grooming, hygiene, ambulation, and eating.
(((3))) "Aged person" means, according to RCW 18.20.020, a
person of the age of sixty-five years or more, or a person of
less than sixty-five years who by reason of infirmity requires
domiciliary care.
(((4))) "Ambulatory" means capable of walking or traversing
a normal path to safety without the physical assistance of
another individual;
(((a))) (1) "Semi-ambulatory" means physically and mentally
capable of traversing a normal path to safety with the use of
mobility aids, but unable to ascend or descend stairs without the
physical assistance of another individual;
(((b))) (2) "Nonambulatory" means unable to walk or traverse
a normal path to safety without the physical assistance of
another individual.
(((5))) "Bathing fixture" means a bathtub, shower or
sit-down shower.
(((6))) "Bathroom" means a room containing at least one
bathing fixture.
(((7))) "Board" means, in the definition of boarding home,
the provision of meal service and lodging.
(((8))) "Boarding home" means any home or other institution,
however named, which is advertised, announced or maintained for
the express or implied purpose of providing board and domiciliary
care to three or more aged persons not related by blood or
marriage to the operator. It shall not include facilities
certified as group training homes pursuant to RCW 71A.22.040, nor
any home, institution or section thereof which is otherwise
licensed and regulated under the provisions of state law
providing specifically for the licensing and regulation of such
home, institution or section thereof. Nor shall it include any
independent senior housing, independent living units in
continuing care retirement communities, or other similar living
situations including those subsidized by the department of
housing and urban development.
(((9))) "Colostomy care, uncomplicated routine" means an act
of changing a colostomy bag and dressing according to boarding
home procedures approved by a RN or physician, when the resident
does not:
(((a))) (1) Have colostomy complications, including but not
limited to obvious infection, constipation, diarrhea, painful,
cracked or bleeding skin; or
(((b))) (2) Need colostomy irrigations.
(((10))) "Construction" means:
(((a))) (1) A new building to be used as a boarding home or
part of a boarding home;
(((b))) (2) An addition, modification or alteration to the
facility which changes the department-approved use of an existing
boarding home or portion of a boarding home; and
(((c))) (3) An existing building or portion thereof to be
converted for use as a boarding home.
(((11))) "Continuing care contract" means, as stated in RCW
70.38.025, a contract providing a person, for the duration of
that person's life or for a term in excess of one year, shelter
along with nursing, medical, health-related, or personal care
services, which is conditioned upon the transfer of property, the
payment of an entrance fee to the provider of such services, or
the payment of periodic charges for the care and services
involved. A continuing care contract is not excluded from this
definition because the contract is mutually terminable or because
shelter and services are not provided at the same location.
(((12))) "Continuing care retirement community" means, as
stated in RCW 70.38.025, an entity which provides shelter and
services under continuing care contracts with its members and
which sponsors or includes a health care facility or a health
service.
(((13))) "Contractor" means an agency or person who
contracts with a licensee to provide resident-care services or
equipment.
(((14))) "Dementia care" means a form of care unique to the
needs of residents with dementia of the alzheimer type exhibiting
symptoms such as impaired cognition, confusion, memory loss,
personality change, disorientation, chronic wandering, loss of
inhibitions, and other intellectual losses diminishing the
ability to perform basic personal care functions, which:
(((a))) (1) May or may not be provided in a dementia care
unit; and
(((b))) (2) Is not normally applied to developmentally
disabled individuals as defined in chapter 71A.10 RCW.
(((15))) "Dementia care unit" means an area of a boarding
home staffed by individuals trained in dementia care and designed
to facilitate the provision of such care to residents with
dementia of the alzheimer type.
(((16))) "Department" means the Washington state department
of social and health services.
(((17))) "Dietitian" means an individual certified under
chapter 18.138 RCW.
(((18))) "Document" means to record, with signature, title,
date and time:
(((a))) (1) Information about medication administration or
disposal, a nursing care procedure, accident, occurrence or
change in resident condition that may impact the care or needs of
a resident; and
(((b))) (2) Processes, events or activities that are
required by law, rule or policy.
(((19))) "Domiciliary care" means:
(((a))) (1) Assistance with activities of daily living
provided by the licensee either directly or by contract;
(((b))) (2) Assuming general responsibility for the safety
and well-being of the resident; and
(((c))) (3) Limited nursing services, if provided by the
licensee.
(((20))) "Exploitation" means the illegal or improper use of
a resident's resources, labor, or services for another person's
profit or advantage.
(((21))) "Functional abilities" means the physical, mental,
emotional and social abilities of a resident to cope with the
affairs and activities of daily living.
(((22))) "Health care practitioner" means any individual
authorized by Washington state law to provide health care,
including but not limited to a physician, dentist, chiropractor,
naturopath, advanced registered nurse practitioner or physician's
assistant.
(((23))) "Incident report" means a written record of an
event involving a resident including but not limited to injury,
abuse, neglect, or exploitation.
(((24))) "Infectious" means capable of causing infection or
disease by entrance of organisms into the body which grow and
multiply there, including but not limited to bacteria, viruses,
protozoans, and fungi.
(((25))) "Independent living unit" means an apartment,
condominium or other self-sufficient dwelling unit occupied by an
individual or individuals not receiving domiciliary care.
(((26))) "Independent senior housing" means an independent
living unit occupied by an individual or individuals sixty or
more years of age.
(((27))) "Individual's resident plan" means a statement,
written by the licensee and approved by the resident or
resident's representative, of services to be provided based on an
evaluation of the resident's needs.
(((28))) "Infirmity" means a disability which materially
limits normal activity without requiring inpatient medical or
nursing care. An infirmity may be based on conditions, including
but not limited to physical handicap, mental illness,
developmental disability, mental confusion, disability or
disturbance.
(((29))) "Licensee" means the person to whom the department
issues the boarding home license.
(((30))) "Licensed resident bed capacity" means the resident
occupancy level requested by the licensee and approved by the
department.
(((31))) "Licensed room list" means a department-approved
list identifying resident rooms, the dimensions and calculated
square footage of each room, the number of approved bed spaces,
and other information relative to the licensed resident bed
capacity of a boarding home.
(((32))) "Limited nursing services" means nursing care,
consistent with chapters 18.78 and 18.88 RCW, provided by the
licensee which does not include continuous skilled nursing care
and supervision of the type provided in nursing homes licensed
pursuant to chapter 18.51 RCW.
(((33))) "Medication" means "drugs" as defined in RCW
18.64.011.
(((34))) "Medication administration" means the act of an
authorized individual giving medication to a resident in
accordance with the laws and regulations governing such acts and
entails:
(((a))) (1) Comparing the label on the container with the
prescriber's order or with a direct copy of a verified
transcription of the order;
(((b))) (2) Removing an individual dose from a previously
dispensed, properly labeled container;
(((c))) (3) Giving an individual dose to the proper
resident; and
(((d))) (4) Properly recording the medication, dose, and
time given in the resident record.
(((35))) "Neglect" means conduct resulting in the
deprivation of care necessary to maintain the resident's minimum
physical and mental health including:
(((a))) (1) Physical and material deprivation;
(((b))) (2) Lack of medical care;
(((c))) (3) Inadequate food, clothing or cleanliness;
(((d))) (4) Rejection;
(((e))) (5) Lack of social interaction and physical
activity;
(((f))) (6) Lack of personal care; and
(((g))) (7) Lack of supervision appropriate for the
resident's level of functioning.
(((36))) "Nurse" means an individual licensed either as a:
(((a))) (1) "Licensed practical nurse" or "LPN" under
chapter 18.78 RCW; or
(((b))) (2) "Registered nurse" or "RN" under chapter 18.88
RCW.
(((37))) "Person" means any individual, firm, partnership,
corporation, company, association, joint stock association, and
the legal successor thereof.
(((38))) "Physician" means an individual licensed under
chapter 18.57 or 18.71 RCW.
(((39))) "Prescriber" means a health care practitioner
authorized by Washington state law to prescribe drugs.
(((40))) "Resident-care staff person" means any employee,
temporary employee, volunteer, or contractor who provides direct
care services to a resident.
(((41))) "Resident" means an individual living in a boarding
home who is not related by blood or marriage to the operator of
the boarding home and, by reason of age or infirmity, requires
domiciliary care.
(((42))) "Resident's representative" means an individual
legally appointed, or designated by the resident in writing, to
act in the resident's behalf.
(((43))) "Respite care" means short term care of an aged
person to temporarily relieve the family or other care-giver of
providing that care.
(((44))) "Restraint" means any methods used to prevent or
limit free body movement, including but not limited to:
(((a))) (1) Confinement, unless agreed to as provided in WAC
246-316-335(3);
(((b))) (2) An apparatus; and
(((c))) (3) A drug given without, or contrary to, a legally
prescribed order.
(((45))) "Room" means a space set apart by floor to ceiling
partitions on all sides with all openings provided with doors or
windows.
(((46))) "Staff person" means any employee, temporary
employee, volunteer, or contractor.
(((47))) "State Building Code" means chapter 51-20 WAC,
State Building Code adoption and amendment of the Uniform
Building Code; chapter 51-22 WAC, State Building Code adoption
and amendment of the Uniform Mechanical Code; chapter 51-24 WAC,
State Building Code adoption and amendment of the Uniform Fire
Code; and chapter 51-25 WAC, State Building Code adoption and
amendment of the Uniform Fire Code.
(((48))) "Toilet" means a disposal apparatus fitted with a
seat and flushing device used for urination and defecation.
(((49))) "Urethral catheter care, uncomplicated routine"
means an act of performing perineal care, emptying the drainage
bag, measuring the contents as required, and replacing and
repositioning the drainage bag; but does not mean the act of
inserting, irrigating, or removing the catheter.
(((50))) "Usable floor space" means:
(((a))) (1) For boarding homes licensed prior to January 1,
1989, and continuously thereafter, floor area in resident
bedrooms excluding walk-in closets; or
(((b))) (2) For boarding homes licensed after December 31,
1988, floor area in living and sleeping rooms excluding
bathrooms, toilets, toilet compartments, closets, halls, storage,
and utility spaces.
(((51))) "Volunteer" means an individual who regularly
provides planned and organized services within the boarding home
without reimbursement, but does not mean an individual who visits
residents or provides occasional entertainment.
(((52))) "Vulnerable adult" means an individual sixty years
of age or older who has the functional, mental, or physical
inability to care for himself or herself.
(((53))) "WISHA" means the Washington Industrial Safety and
Health Act, chapter 49.17 RCW administered by the Washington
state department of labor and industries.
[Statutory Authority: RCW 18.20.240. 98-20-021, recodified as § 388-78A-010, filed 9/25/98, effective 9/25/98. Statutory Authority: RCW 18.20.090. 94-13-180, § 246-316-010, filed 6/21/94, effective 7/22/94; 92-02-018 (Order 224), § 246-316-010, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.70.040. 91-02-049 (Order 121), recodified as § 246-316-010, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 18.20.090. 89-09-034 (Order 2786), § 248-16-001, filed 4/14/89; 83-13-068 (Order 264), § 248-16-001, filed 6/16/83; Order 147, § 248-16-001, filed 6/29/77; Order 97, § 248-16-001, filed 4/5/74; § 248-16-001, filed 10/3/67; Emergency Regulation filed 8/4/67; Regulation .16.001, effective 3/11/60; Subsec. 6, Rule 1 and Subsec. 7, Rule 2, filed 5/31/61.]