PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 03-02-078.
Title of Rule and Other Identifying Information: Chapter 388-110 WAC, Contracted residential care services. As a result of this proposal, there are several requirements that may be repealed or deleted from chapter 388-110 WAC. However, many of these will remain as operating requirements for boarding homes because they will be found in chapter 388-78A WAC, Boarding home licensing rules as proposed in WSR 04-11-116 filed on May 19, 2004, with an effective date of September 1, 2004. Therefore, the amendments to chapter 388-110 WAC found in this proposal should be read and considered in concert with the proposed amendments to chapter 388-78A WAC filed on May 19, 2004.
Hearing Location(s): Blake Office Park (behind Goodyear Courtesy Tire), 4500 10th Avenue S.E., Rose Room, Lacey, WA 98503, by July 27, 2004, at 10:00 a.m.
Date of Intended Adoption: Not later than July 30, 2004.
Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, mail to P.O. Box 45850, Olympia, WA 98504-5850, deliver to 4500 10th Avenue S.E., Lacey, WA, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m., July 27, 2004.
Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by July 23, 2004, phone (360) 664-6097, TTY (360) 664-6178, e-mail swensFH@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of chapter 388-110 WAC being amended is to:
• Incorporate into administrative rules the dementia care pilot project standards for contracting with boarding homes to provide specialized dementia care to department clients;
• Make revisions necessary to be consistent with, and not duplicate, amendments to chapter 388-78A WAC, Boarding home licensing rules; and
• Review and update the rules under Executive Order 97-02.
Summary: Chapter 388-110 WAC, Contracted residential care services, describes the requirements for boarding homes to enter into contracts with the department to provide long-term care residential services to eligible department clients. These amendments address who is qualified to enter into a contract and the process for applying for a contract, the general service standards, requirements for the boarding home to hold a bed for a client who is hospitalized, and the program standards for assisted living services, enhanced adult residential care services including specialized dementia care, and adult residential care services. These amendments also delete a number of requirements that duplicate boarding home licensing requirements.
Proposal Changes the Following Existing Rules:
• WAC 388-110-005 is amended to cite the correct statutory authority for the rule;
• WAC 388-110-010 is amended to specify the rule also applies to the "enhanced adult residential care-specialized dementia care services" contract;
• WAC 388-110-020 is amended to delete definitions of terms no longer used in the chapter, to add a definition for "enhanced adult residential care-specialized dementia care services;" and to update other definitions;
• WAC 388-110-030 is amended to require contract applications to be submitted ninety days prior to the effective date of the contract, and to delete the requirements for the department to act within sixty days of receipt of a contract application and to conduct an on-site inspection prior to issuing a contract;
• WAC 388-110-040 is amended to list special qualifications for "enhanced adult residential care-specialized dementia care services" contractors and to eliminate disqualifying characteristics that are included in the boarding home licensing WAC;
• WAC 388-110-050 is amended to specify a change in contractor is required when a change in licensee occurs, requires licensees/contractors to give ninety days notice when a change in contractor occurs, and deletes conditions necessitating a change in contractors that are addressed in the boarding home licensing WAC as a change in licensees;
• WAC 388-110-060 is repealed because residents' rights are spelled out in the boarding home licensing WAC;
• WAC 388-110-070 is amended to eliminate duplication with the boarding home licensing WAC and clarify general service standards;
• WAC 388-110-080 is repealed because requirements for activities are spelled out in the boarding home licensing WAC;
• WAC 388-110-090 is amended to delete requirements that are duplicated in the boarding home licensing WAC, and to delete the limitations on contracted beds being located in units with restricted egress;
• WAC 388-110-100 is amended to clarify discharge and social leave requirements, and to make bed hold requirements consistent with SSB 6225 as passed by the 2004 legislature;
• WAC 388-110-120 is amended for clarity;
• WAC 388-110-140 is amended to clarify the construction requirements for individual assisted living apartments, to specify the dimensions of required roll-in showers in new construction, to allow the department to give exemptions to building requirements for certain limited modifications, to specify currently contracted assisted living providers meet contract construction requirements, and to specify married couples may share an assisted living apartment;
• WAC 388-110-150 deletes assisted living service requirements that are duplicated in the boarding home licensing WAC;
• WAC 388-110-170 is repealed because requirements for caregiver education and training are spelled out in chapter 388-112 WAC;
• WAC 388-110-180 is repealed because requirements for nurse delegation are spelled out in chapter 246-840 WAC;
• WAC 388-110-190 is repealed because requirements for nurse delegation are spelled out in chapter 246-840 WAC;
• WAC 388-110-200 is repealed because sanctions for non-compliance with nurse delegation standards are not necessary since WAC 388-110-170 through 388-110-190 are being repealed;
• WAC 388-110-220 is amended to add program requirements for "enhanced adult residential care-specialized dementia care services;"
• WAC 388-110-240 is amended to delete duplicate requirements found in the boarding home licensing WAC;
• WAC 388-110-260 is amended to include "enhanced adult residential care-specialized dementia care services" contractors as being subject to enforcement actions;
• WAC 388-110-270 is amended for clarity; and
• WAC 388-110-280 is amended for clarity.
Reasons Supporting Proposal: Chapter 388-110 WAC contains the requirements licensed boarding homes must meet in order to enter into a contract with the department to provide long-term residential care services to department clients. The department is amending this rule to include in these contract requirements, a program for providing specialized care to eligible persons with dementia, and to make the contracting requirements consistent with, and without duplicating the revised licensing requirements for boarding homes. The anticipated effects of this amendment are it will expand the resources available to department clients with dementia, and will make the contracting requirements simpler and easier to understand.
Statutory Authority for Adoption: RCW 74.39A.010, 74.39A.020, 74.39A.060, and 74.39A.070.
Statute Being Implemented: Chapter 74.39A RCW.
Rule is not necessitated by federal law, federal or state court decision.
Agency Comments or Recommendations, if any, as to Statutory Language, Implementation, Enforcement, and Fiscal Matters: DSHS intends to adopt proposed rules as permanent by July 30, 2004, and to make them effective as of September 1, 2004, to coincide with the effective date of amended chapter 388-78A WAC, Boarding home licensing rules.
Name of Proponent: Department of Social and Health Services, governmental.
Name of Agency Personnel Responsible for Drafting: Denny McKee, Residential Care Services, ADSA, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, (360) 725-2590; Implementation and Enforcement: Pat Lashway, Director, Residential Care Services, ADSA, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, (360) 725-2401.
No small business economic impact statement has been prepared under chapter 19.85 RCW. Residential care services, Aging and Disability Services Administration, has analyzed these proposed rule amendments and concluded a small business economic impact statement is not required because the rules do not impose more than minor costs on contracted boarding homes.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Denny McKee, Residential Care Services, ADSA, P.O. Box 45600, Olympia, WA 98504-5600, e-mail mckeedd@dshs.wa.gov, phone (360) 725-2590, fax (360) 438-7903.
June 4, 2004
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
3418.4CONTRACTED RESIDENTIAL CARE SERVICES((: ASSISTED LIVING
SERVICES, ENHANCED ADULT RESIDENTIAL CARE, AND ADULT
RESIDENTIAL CARE))
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-005, filed 5/8/96, effective 6/8/96.]
(2) Only services provided to or on behalf of the assisted living services, enhanced adult residential care, enhanced adult residential care-specialized dementia care services, or adult residential care resident, and paid for fully or partially by the department shall be subject to these rules.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-010, filed 5/8/96, effective 6/8/96.]
(("Aging in place" means being in a care environment that
can accommodate a resident's progressive disability or
changing needs without relocating. For aging in place to
occur, needed services are adjusted to meet the changing needs
of the resident.))
"Applicant" means the individual, partnership, corporation or other entity which has applied for a contract with the department to provide assisted living services, enhanced adult residential care, enhanced adult residential care-specialized dementia care services, or adult residential care to state funded residents in a licensed boarding home.
"Assisted living services" is a package of services((,
including)) provided by a boarding home that has a contract
with the department under RCW 74.39A.010 to provide personal
care ((and limited))services, intermittent nursing services,
and medication administration services ((that the department
contracts with a licensed boarding home to provide)) in
accordance with Parts I and II of this chapter. Assisted
living services include housing for the resident in a private
apartment-like unit.
"Boarding home" means the same as the definition found in
RCW 18.20.020(((2))), or a boarding home located within the
boundaries of a federally recognized Indian reservation and
licensed by the tribe.
(("Caregiver" means any person responsible for providing
direct personal care services to a resident and may include
but is not limited to the contractor, employee, volunteer, or
student.))
"Case manager" means the department staff person or designee assigned to negotiate, monitor, and facilitate a service plan for residents receiving services fully or partially paid for by the department.
"Contractor" means the individual, partnership, corporation, or other entity which is licensed by the department or tribe to operate the boarding home and contracts with the department to provide assisted living services, enhanced adult residential care, enhanced adult residential care-specialized dementia care services, or adult residential care to state funded residents in a licensed boarding home.
"Department" means the Washington state department of social and health services (DSHS).
"Dignity" means the quality or condition of being esteemed and respected in such a way as to validate the self-worth of the resident.
"Enhanced adult residential care" is a package of
services((, including)) provided by a boarding home that is
licensed under chapter 18.20 RCW and that has a contract with
the department to provide personal care ((and limited))
services, intermittent nursing services, and medication
administration services ((that the department contracts with a
licensed boarding home to provide)) in accordance with Parts I
and III of this chapter.
(("Frail elder or vulnerable adult" means the same as the
definition found in RCW 74.34.020 or 43.43.830.))
"Enhanced adult residential care-specialized dementia care services" is a package of service, including specialized dementia care assessment and care planning, personal care services, intermittent nursing services, medication administration services, specialized environmental features and accommodations, and activity programming. Enhanced adult residential care-specialized dementia care services are delivered only within:
(1) Contracted boarding homes that are dedicated solely to the care of individuals with dementia, including Alzheimer's disease, and that meet the requirements of parts I and III of this chapter; or
(2) Designated, separate units located within contracted boarding homes that are dedicated solely to the care of individuals with dementia, including Alzheimer's disease, and that meet the requirements of parts I and III of this chapter.
"Homelike" means an environment having the qualities of a
home, including privacy, comfortable surroundings, and the
opportunity to ((modify)) decorate one's living area and
arrange furnishings to suit one's individual preferences. A
homelike environment provides residents with an opportunity
for self-expression, and encourages interaction with the
community, family and friends.
"Independence" means free from the control of others and being able to assert one's own will, personality and preferences.
"Individuality" means the quality of being unique; the aggregate of qualities and characteristics that distinguishes one from others. Individuality is supported by modifying services to suit the needs or wishes of a specific individual.
(("Limited nursing services" means the same as the
definition found in WAC 246-316-265.))
"Medication administration" means the direct application of a prescribed medication, whether by injection, inhalation, ingestion, or any other means, to the body of a resident by a person legally authorized to do so.
"Personal care services" means ((both physical assistance
and/or prompting and supervising the performance of direct
personal care tasks as determined by the resident's needs as
defined in WAC 388-71-202.)) the same as "personal care
services" described in WAC 388-72A-0035. Personal care
services do not include assistance with tasks that must be
performed by a licensed health professional.
"Resident" means a person residing in a boarding home for whom services are paid for, in whole or in part, by the department under a contract for assisted living services, enhanced adult residential care, enhanced adult residential care-specialized dementia care services, or adult residential care. "Resident" includes former residents when examining complaints about admissions, re-admissions, transfers or discharges. For decision-making purposes, the term "resident" includes the resident's surrogate decision maker in accordance with state law or at the resident's request.
[Statutory Authority: RCW 74.08.090, 74.09.520, and 74.39A.090. 02-21-098, § 388-110-020, filed 10/21/02, effective 11/21/02. Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-020, filed 5/8/96, effective 6/8/96.]
(a) Have a valid boarding home license ((for the
facility)) issued by the department or tribe, or have applied
for a boarding home license for the boarding home at which the
contracted services will be provided;
(b) Complete and submit a contract application on
department provided forms at least ((sixty)) ninety days
before the requested effective date for the contract; and
(c) Provide information regarding any licensed care
facilities ((the applicant, and any partner, officer,
director, managerial employee, or owner of five percent or
more of the applicant has)) with which any of the following
have been affiliated ((with in)) within the last ten years((.
(2) Within sixty days of the receipt of the application
the department shall approve a contract, refuse to enter into
a contract, or request additional information the department
deems relevant from the applicant. The department may extend
the sixty days to allow the applicant to supply or clarify
information requested by the department. The department shall
conduct an on-site review of the contracting facility before
issuing a contract)):
(i) The applicant;
(ii) Any partner, or owner of five percent or more of the applicant; and
(iii) Any officer, director, or managerial employee of the applicant.
(2) The department must confirm that the applicant has a valid boarding home license issued by the department or tribe and meets the requirements of this chapter before issuing a contract.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-030, filed 5/8/96, effective 6/8/96.]
(2) In making a determination whether to grant a
contract, the department ((shall)) must review and consider:
(a) The information in the application; ((and))
(b) Other documents and information the department deems
relevant, including inspection and complaint investigation
findings for each licensed care facility with which ((the
applicant or any partner, officer, director, managerial
employee, or owner of five percent or more of the entity
applicant has been affiliated)) any of the following have been
affiliated within the last ten years:
(i) The applicant;
(ii) Any partner, or owner of five percent or more of the applicant; or
(iii) Any officer, director, or managerial employee of the applicant.
(c) The history and quality of services provided by the applicant; and
(d) Funding from the legislature available to the department to purchase residential care.
(3) The applicant and the ((facility)) boarding home for
which a contract is sought ((shall)) must comply with all
requirements established by chapter 74.39A RCW, chapter 388-78A WAC and this chapter. (( The department may deny a
contract for noncompliance with any such requirements.))
(4) The department shall review the qualifications of applicants for enhanced adult residential care-specialized dementia care services contracts and may select a limited number with which to enter into contracts, based on:
(a) Which applicants are best qualified to provide specialized dementia care services, as determined by the department;
(b) The need for services in the area of the state in which the applicant is located; and
(c) Other qualifications specified in this section.
(5) The department ((shall)) must deny, suspend, revoke
or refuse to renew a contract if an applicant or contractor or
any partner, officer, director, managerial employee, or owner
of five percent or more of the ((entity)) contractor or
applicant ((applying for a contract)) has a history of
significant noncompliance with federal or state regulations,
rules or laws in providing care or services to frail elders,
vulnerable adults or children. The department ((shall)) must
consider((, at a minimum, the following as a history of
significant noncompliance requiring denial of a contract:
(a) Revocation or suspension of a license for the care of
children, frail elders or vulnerable adults;
(b) Enjoined from operating a facility for the care of
children, frail elders or vulnerable adults; or
(c) Termination, cancellation, suspension, or nonrenewal
of a Medicaid or Medicare provider agreement, or any other
agreement with a public agency for the care or treatment of
children, frail elders or vulnerable adults.
(5) The department shall deny, terminate, or refuse to
renew a contract if an applicant or any partner, officer,
director, managerial employee, an owner of fifty percent or
more of the entity applicant, or an owner who exercises
control over daily operations has been:
(a) Convicted of a crime against a person as defined
under RCW 43.43.830 or 43.43.842;
(b) Convicted of a crime related to financial
exploitation as defined under RCW 43.43.830 or 43.43.842;
(c) Found by a court in a protection proceeding or in a
civil damages lawsuit under chapter 74.34 RCW to have abused,
neglected, abandoned or exploited a vulnerable adult;
(d) Found in any final decision issued by a disciplinary
board to have sexually or physically abused, neglected, or
exploited any minor or vulnerable adult;
(e) Found in any dependency action under chapter 13.34 RCW to have sexually assaulted, neglected, exploited, or
physically abused any minor; or
(f) Found by a court in a domestic relations proceeding
under Title 26 RCW to have sexually abused, exploited, or
physically abused any minor.
(6) The department may deny, terminate, or refuse to
renew a contract if an applicant or any partner, officer,
director, managerial employee, an owner of fifty percent or
more of the entity applicant, or an owner who exercises
control over daily operations has:
(a) Obtained or attempted to obtain a license or contract
by fraudulent means or misrepresentation;
(b) Been convicted of a felony or a crime against a
person if the conviction reasonably relates to the competency
of the person to contract with the department;
(c) Had sanction, corrective or remedial action taken by
federal, state, county, or municipal health or safety
officials related to the care or treatment of children, frail
elders or vulnerable adults;
(d) A poor credit history;
(e) Engaged in the illegal use of drugs or the excessive
use of alcohol;
(f) Operated a facility for the care of children or
adults without a license;
(g) Failed to meet financial obligations as the
obligations fell due in the normal course of business;
(h) Misappropriated property of residents;
(i) Filed for bankruptcy, reorganization, or
receivership;
(j) Been denied a license or license renewal to operate a
facility that was licensed for the care of children, frail
elders or vulnerable adults;
(k) Relinquished or returned a license in connection with
the operation of any facility for the care of children, frail
elders or vulnerable adults, or did not seek the renewal of
such license, following written notification of the licensing
agency's initiation of denial, suspension, cancellation or
revocation of the license; or
(l) Had resident trust funds or assets of an entity
providing care to children, frail elders or vulnerable adults
seized by the IRS or a state entity for failure to pay income
or payroll taxes)) evidence of noncompliance on a case-by-case
basis.
[Statutory Authority: RCW 74.39A.010, 74.39A.020 and 74.39A.080. 96-21-050, § 388-110-040, filed 10/11/96, effective 11/11/96. Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-040, filed 5/8/96, effective 6/8/96.]
(a) Events which constitute a change of contractor include but are not limited to the following:
(i) The form of legal organization of the contractor is changed (e.g., a sole proprietor forms a partnership or corporation);
(ii) Assisted living services, enhanced adult residential care, or adult residential care contract rights and responsibilities are transferred by the initial contractor to another party regardless of whether ownership of some or all of the real property and/or personal property assets of the facility are also transferred;
(iii) If the contractor is a partnership, any event occurs which dissolves the partnership;
(iv) If the contractor is a corporation, and the corporation is dissolved, merges with another corporation which is the survivor, or consolidates with one or more other corporations to form a new corporation;
(v) If the contractor is a corporation and, whether by a single transaction or multiple transactions within any continuous twenty-four-month period, fifty percent or more of the stock is transferred to one or more:
(A) New or former stockholders; or
(B) Present stockholders each having held less than five percent of the stock before the initial transaction; or
(vi) Any other event or combination of events which results in a substitution or substitution of control of the individual contractor or the contracting entity.
(b) The contractor does not change when the following, without more, occur:
(i) A party contracts with the contractor to manage the assisted living, enhanced adult residential care, or adult residential care facility as the contractor's agent, i.e., subject to the contractor's general approval of daily operating and management decisions; or
(ii) The real property or personal property assets of the
facility contractor change ownership or are leased, or a lease
of the real property or personal property assets is
terminated, without a substitution of individual operator or
operating entity and without a substitution of control of the
operating entity)) change in the boarding home licensee per
WAC 388-78A-2770.
(2) When a change of licensee and contractor is
contemplated, the current contractor ((shall)) must notify the
department and all residents at least ((sixty)) ninety days
prior to the proposed date of ((transfer)) change. The notice
((shall)) must be in writing and ((shall)) must contain the
following information:
(a) Name of the present contractor and prospective contractor;
(b) Name and address of the ((facility being
transferred)) boarding home being changed; and
(c) Date of proposed ((transfer)) change.
(3) The operation ((or ownership)) of an assisted living
services, enhanced adult residential care, enhanced adult
residential care-specialized dementia care services, or adult
residential care contract ((shall)) must not be
((transferred)) changed until the new operator has entered
into a contract with the department. The new contractor
((shall)) must comply with contract application requirements
in WAC 388-110-030.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-050, filed 5/8/96, effective 6/8/96.]
(1) ((Ensure residents have control over their time,
space and lifestyle to the extent that the health, safety and
well-being of other residents is not disturbed;
(2) Promote the resident's right to exercise decision
making and self-determination to the fullest extent possible;
(3) Follow the informed consent process as required in
chapter 7.70 RCW, when applicable, in the development of the
negotiated service agreement;
(4) Provide services for residents in a manner and in an
environment that encourages maintenance or enhancement of each
resident's quality of life, and promotes the resident's
privacy, dignity, choice, independence, individuality, and
decision-making ability; and
(5) Provide a safe, clean and comfortable homelike
environment, allowing residents to use their personal
belongings to the extent possible)) Provide the services
agreed upon in the resident's negotiated service agreement and
approved by the department case manager consistent with WAC 388-78A-2150, including any reasonable accommodations required
by chapter 70.129 RCW, Long-term care residents rights; and
(2) Provide the resident and case manager with a copy of the negotiated service agreement developed according to chapter 388-78A WAC.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-070, filed 5/8/96, effective 6/8/96.]
(1) Maintain substantial compliance with all requirements
of ((chapter)) chapters 18.20 RCW, ((Law for)) Boarding homes,
and 70.129 RCW, Long-term care resident rights, and chapters
((246-316)) 388-78A WAC, Boarding ((homes)) home licensing
rules, and 388-105 WAC Medicaid rates for contracted home and
community residential care services;
(2) ((Ensure all facility staff are knowledgeable about
chapter 70.129 RCW, Long-term care resident rights;
(3) Provide residents, prior to move-in, a copy of the
facility's admission agreement which clearly specifies the
range of services the facility is able to provide to
residents;
(4) Not require a resident to sign any admission contract
or agreement that purports to waive any rights of the
resident;
(5) Develop and implement a grievance procedure and
process which is responsive to resident's complaints;
(6) Post in a place and manner clearly visible to
residents and visitors the department's toll-free complaint
telephone number;
(7) Comply with all federal and state statutory and
regulatory requirements regarding nondiscrimination in all
aspects of the facility's operation;
(8) Ensure resident rooms or resident units are not
located in a separate unit within a facility that has exiting
doors that restrict egress from the unit, such as, but not
limited to automatic locking and unlocking exiting doors,
unless the contractor is already providing services to
residents in such a unit under a contract with the department
for assisted living services, adult residential care, or
enhanced adult residential care on the effective date of this
chapter;
(9) Encourage residents and the resident council, if
there is one, to provide input to the facility about
residents' preferences for food choices, taking into account
the cultural and religious needs of residents;
(10) Ensure all instances of suspected abuse, neglect,
exploitation, or abandonment are reported to the department,
as required in chapter 74.34 RCW, and to the local law
enforcement agency;
(11) Not have any sexual contact with any resident and
shall ensure that facility staff and students not have sexual
contact with any resident;
(12) Notify the department within five business days when
there is a change in the facility administrator; and
(13))) Permit department representatives to enter the
((facility)) boarding home without prior notification ((in
order to)) and cooperate with department representatives as
they monitor the contract requirements under this chapter and
((to)) conduct complaint investigations, including but not
limited to observing and privately interviewing residents, and
accessing resident records.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-090, filed 5/8/96, effective 6/8/96.]
(1) ((Comply with chapter 70.129 RCW and chapter 246-316 WAC pertaining to transfer and discharge (move-out);
(2) Include the department's case manager in the
development of a relocation or discharge (move-out) plan, and
have the case manager approve the plan before any notice
required under subsection (1) of this section is issued to the
resident, except in an emergency;
(3))) Note an absence in a resident's record when a
resident ((will be)) is absent from the ((facility)) boarding
home for more than seventy-two consecutive hours;
(((4) Not be required to discharge (move-out) and readmit
a resident for absences less than thirty-one consecutive days;
(5))) (2) Obtain department approval for payment for
social leave in excess of fifteen consecutive days; ((and))
(3) Notify the department within one working day whenever the resident:
(a) Is hospitalized;
(b) Is discharged to another boarding home, nursing home or other health care facility;
(c) Dies; or
(d) Is missing from the boarding home and his or her whereabouts are unknown.
(4) Include the department's case manager in the development of a discharge (move out) plan, and have the case manager approve the plan before any required notice of discharge is issued to the resident, except in an emergency;
(5) Notify the resident of the boarding home's policies regarding bed-holds, consistent with subsection (7) of this section as soon as possible before, or as soon as practicable following hospitalization or discharge to a nursing home. The notification must include information concerning:
(a) Options for bed-hold payments, and
(b) Rights to return to the boarding home.
(6) Retain a bed or unit for a resident who is
hospitalized or temporarily placed in a nursing home for up to
((thirty)) twenty days when the resident is likely to
return((, but if as part of the negotiated service agreement
it is determined)) to the boarding home and the department
makes payment to the boarding home for holding the bed or unit
consistent with WAC 388-105-0045. If, prior to the end of the
((thirty days that the resident will not return to the
facility, the facility may discharge (move-out) the resident
in accordance with subsections (1) and (2) above and release
the bed or unit)) twenty days, the department determines, or
the contractor determines and the department concurs, that the
resident will likely not return to the boarding home:
(a) The department must terminate the bed-hold payment; and (b) The contractor may rent that bed or unit to another resident.
(7) Not seek third-party payment for the first twenty days of retaining the bed for a resident who is hospitalized or discharged to a nursing home.
(a) The contractor may seek third-party payment consistent with RCW 18.20.290 and chapter 388-105 WAC to hold a bed or unit for the time following the first twenty days of a resident's absence for hospitalization or nursing home care.
(b) If third-party payment is not available, the contractor must readmit the resident to the first available and appropriate bed or unit if the resident:
(i) Continues to meet the boarding home's admission criteria; and
(ii) Chooses to return to the boarding home.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-100, filed 5/8/96, effective 6/8/96.]
(a) When the personal funds of the deceased resident
((shall)) must be paid to the state of Washington, those funds
and the final accounting shall be made payable to the
secretary, department of social and health services, and sent
to the Office of Financial Recovery, Estate Recovery Unit,
P.O. Box 9501, Olympia, Washington 98507-9501, or such address
as may be directed by the department in the future;
(b) The check and final accounting accompanying the
payment ((shall)) must contain the name and Social Security
number of the deceased individual from whose personal funds
account the monies are being paid; and
(c) The department of social and health services shall establish a release procedure for use of funds necessary for burial expenses.
(2) In situations where the resident is absent from the
((facility)) boarding home for an extended time without
notifying the ((facility)) boarding home, and the resident's
whereabouts is unknown:
(a) The ((facility shall)) contractor must make a
reasonable effort to find the missing resident; and
(b) If the resident cannot be located after ninety days,
the ((facility shall)) contractor must notify the department
of revenue of the existence of "abandoned property," outlined
in chapter 63.29 RCW. The ((facility shall)) contractor must
deliver to the department of revenue the balance of the
resident's personal funds within twenty days following such
notification.
(3) Prior to the change of contractor of the ((facility))
boarding home business, the contractor ((shall)) must:
(a) Provide each resident with a written accounting of
any personal funds held by the ((facility)) boarding home;
(b) Provide the new contractor with a written accounting of all resident funds being transferred; and
(c) Obtain a written receipt for those funds from the new operator.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-120, filed 5/8/96, effective 6/8/96.]
(a) ((In an existing facility, an individual unit with))
A minimum area of one hundred eighty square feet ((including
counters, closets and built-ins, and excluding the bathroom. In a new facility, an individual unit with a minimum of)) in
an existing boarding home, and two hundred twenty square feet
((including)) in a new boarding home. The minimum area may
include counters, closets and built-ins, ((and excluding)) but
must exclude the bathroom;
(b) A separate private bathroom, which includes a sink,
toilet, and a shower or bathtub. In a new ((facility, a
minimum of fifty percent of resident bathrooms shall be
wheelchair accessible and have a roll-in shower)) boarding
home, the contractor must provide a minimum of one wheelchair
accessible bathroom with a roll-in shower that is at least
forty-eight inches by thirty inches for every two residents
whose care is partially or fully funded by the department
through the assisted living contract;
(c) A lockable entry door;
(d) A kitchen area equipped((, at a minimum,)) with a
refrigerator, a microwave oven or stovetop, and a counter or
table for food preparation. In a new ((facility, a)) boarding
home, the kitchen area must also be equipped with a ((sink and
counter area, and)) storage space for utensils and supplies,
and a counter surface, a minimum of thirty inches wide by
twenty-four inches in depth, a maximum height of thirty-four
inches, and a knee space beneath at least twenty-seven inches
in height; and
(e) A living area wired for telephone and, where available in the geographic location, wired for television service.
(2)(a) For purposes of this section, a new boarding home is:
(i) A new building to be used as a boarding home or part of a boarding home, for which plans are submitted to the department of health for construction review on or after June 8, 1996; or
(ii) An addition, modification, or alteration to an existing licensed boarding home, for which plans are submitted to the department of health for construction review on or after June 8, 1996.
(A) The department may, in consultation with the office of construction review services in the department of health, exempt from selected new boarding home contract construction requirements, a limited addition, modification, or alteration to an existing licensed boarding home that will improve the quality of life for residents, if compliance with all new boarding home contract construction requirements would otherwise make the limited addition, modification, or alteration cost prohibitive. A limited addition, modification, or alteration means any physical change to an existing licensed boarding home that does not affect the structural integrity of the building, does not affect fire and life safety, and does not increase the boarding home's maximum facility capacity as defined in WAC 388-78A-2020.
(B) A major addition, modification, or alteration to an existing licensed boarding home must meet new boarding home contract construction requirements for applicable portions of the building. A major addition, modification, or alteration means any physical change within a room or area in an existing licensed boarding home that results in reconstruction to structural or other building systems.
(b) All boarding homes that are not new boarding homes under subsection (2)(a) of this section, are existing boarding homes. An existing building, or portion thereof, that is converted to boarding home use must be considered an existing boarding home unless there is an addition, modification or alteration to the existing building.
(3) If a boarding home submitted plans to the department of health for construction review on or after June 8, 1996, and the boarding home had an assisted living contract as of September 1, 2004, then the boarding home is "grandfathered" under the contracting rules for structural requirements that were in effect at the time of contracting and is considered to meet the assisted living structural requirements of subsection (1) of this section. However, if the same boarding home submits plans to the department of health for construction review for an addition, modification or alteration of the boarding home after September 1, 2004, then the boarding home must meet the current new boarding home requirements of subsection (1) for the applicable portions of the building.
(4) Married couples may share an apartment-like unit under an assisted living contract if:
(a) Both residents understand they are each entitled to live in a separate private unit; and
(b) Both residents mutually request to share a single apartment-like unit.
(5) In a new ((facility)) boarding home, the contractor
((shall)) must provide a private accessible mailbox in which
the resident may receive mail.
(((3))) (6) The contractor ((shall)) must provide
homelike smoke-free common areas with sufficient space for
socialization designed to meet resident needs. Common areas
((shall)) must be available for resident use at any time
provided such use does not disturb the health or safety of
other residents. ((When possible,)) The contractor must make
access to outdoor areas ((shall be made)) available to all
residents.
(((4))) (7) The contractor ((shall)) must provide a space
for residents to meet with family and friends outside the
resident's living unit.
(((5)(a) For purposes of this section, a new facility is:
(i) A new building to be used as a boarding home or part
of a boarding home, for which plans are submitted to the
department of health for construction review, as required by
WAC 246-316-070, on or after the effective date of this
chapter; or
(ii) An addition, modification, or alteration to an
existing building, for which plans are submitted to the
department of health for construction review, as required by
WAC 246-316-070, on or after the effective date of this
chapter.
(b) All facilities that are not new facilities under
subsection (5)(a) of this section, are existing facilities. An existing building, or portion thereof, that is converted to
boarding home use shall be considered an existing facility
unless there is an addition, modification or alteration to the
existing building))
(8) The department may grant an exemption to the requirements of this section as they apply to a specified resident when it is in the best interest of the specific resident.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-140, filed 5/8/96, effective 6/8/96.]
(1) ((The contractor shall)) Ensure that both the
physical environment and the delivery of assisted living
services are designed to enhance autonomy in ways which
reflect personal and social values of dignity, privacy,
independence, individuality, choice and decision-making of
residents. The contractor ((shall)) must provide ((the))
resident services ((in a manner which:
(a) Makes the services available)) in a homelike
environment for residents ((with)) who may have a range of
needs and preferences((;
(b) Facilitates aging in place by providing flexible
services in an environment that accommodates and supports the
resident's individuality;
(c) Supports managed risk which includes the resident's
right to take responsibility for the risks associated with
decision-making; and
(d) Develops a formal written, negotiated plan to
decrease the probability of a poor outcome when a resident's
decision or preference places the resident or others at risk,
leads to adverse consequences, or conflicts with other
residents' rights or preferences.
(2) Building on the department's assessment and service
plan completed before admission, the contractor shall complete
a negotiated service agreement within thirty days of move-in. The contractor shall involve the following persons in the
negotiation and renegotiation of the agreement:
(a) The resident to the greatest extent practicable;
(b) Appropriate facility staff;
(c) The department's case manager; and
(d) If the resident chooses, the resident's family or any
other person the resident wants included.
(3) The contractor shall ensure the negotiated service
agreement:
(a) Includes recognition of the resident's capabilities
and choices, and defines the division of responsibility in the
implementation of services;
(b) Addresses, at a minimum, the following elements:
assessed health care needs; social needs and preferences;
personal care tasks; and if applicable, limited nursing and
medication services, including frequency of service and level
of assistance;
(c) Is signed and approved by the resident, the
contractor, and the department case manager; and
(d) Includes the date the agreement was approved.
(4) The contractor shall provide the resident and case
manager with a copy of the agreement, and place a copy in the
resident's record.
(5) The contractor shall update the agreement when there
are changes in the services the resident needs and wants to
receive. At a minimum, the contractor shall review and update
the negotiated service agreement semiannually.
(6) The contractor shall provide personal care services
based on the resident's negotiated service agreement.
(7) The contractor shall provide the range of services
required to meet the increasing or changing needs of residents
as they age in place to the maximum extent permitted by the
boarding home regulations.
(8) The contractor shall provide or arrange for limited
nursing services to meet the needs of residents who require
nursing services, at no additional cost to the resident.
(9) The contractor shall provide written policies and
procedures that ensure the facility will provide limited
nursing services and will allow additional on-site health care
services to the maximum extent allowed under chapter 246-316 WAC, and if requested, shall assist the resident to obtain the
additional on-site health care services.
(10) If requested or needed by the resident, the
contractor shall assist the resident to obtain, arrange, and
coordinate services such as: transportation to medical
services and recreational activities; ancillary services for
medically related care (e.g., physician, pharmacist, mental
health services, physical or occupational therapy, hospice,
home health care, podiatry); barber/beauty services; and other
services necessary to support and assist the resident in
maintaining as much independence as possible.
(11) The contractor shall)).
(2) Must provide or arrange for, at no additional cost to the resident and consistent with chapter 388-78A WAC:
(a) Intermittent nursing services;
(b) Medication administration;
(c) Personal care services; and
(d) Supportive services that promote independence and self-sufficiency.
(3) Make available and offer at no additional cost to the resident generic personal care items needed by the resident such as soap, shampoo, toilet paper, toothbrush, toothpaste, deodorant, sanitary napkins, and disposable razors. This does not include items covered by medical coupons or preclude residents from choosing to purchase their own personal care items.
(((12) The contractor shall))
(4) Provide all residents with access to an on-site washing machine and dryer for resident use.
(((13) The contractor shall))
(5) Make beverages and snacks available to residents.
(((14) The contractor shall develop written policies and
procedures to be followed by staff and shared with residents
which illustrate how employees shall deliver services to
residents while ensuring resident's privacy, dignity, choice,
independence, individuality and decision-making ability.))
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-150, filed 5/8/96, effective 6/8/96.]
(2) The agreement shall include what services shall be provided, who will provide the services, and when and how the services will be provided.
(3) The service agreement shall support the principles of dignity, privacy, choice in decision making, individuality, and independence.
(4) At a minimum, the contractor shall review and update the negotiated service agreement semi-annually, give a copy of the agreement to the resident and case manager, and keep a copy in the resident's record.
(5) The contractor shall provide personal care services based on the resident's negotiated service agreement.
(6) The contractor shall provide or arrange for limited nursing services to meet the needs of residents who require nursing services, at no additional cost to the resident.
(7) The contractor shall allow a maximum of two residents
per room)) In a boarding home with an enhanced adult
residential care contract, the contractor must meet the
requirements of parts I and III of this chapter, and for
residents served under the enhanced adult residential care
contract:
(a) Develop for each resident a negotiated service agreement that supports the principles of dignity, privacy, choice in decision making, individuality, and independence.
(b) Provide or arrange for, at no additional cost to the resident and consistent with the resident's negotiated service agreement and chapter 388-78A WAC:
(i) Intermittent nursing services;
(ii) Medication administration;
(iii) Personal care services; and
(iv) Supportive services that promote independence and self-sufficiency; and
(c) Not allow more than two residents per room.
(2) An enhanced adult residential care-specialized dementia care services contract is a distinct contract, separate from an enhanced adult residential care contract. In a boarding home with an enhanced adult residential care-specialized dementia care services contract, the contractor must:
(a) Meet the requirements of parts I and III of this chapter,
(b) Meet the requirements of subsection (1) of this section, and
(c) Maintain an enhanced adult residential care services contract or an assisted living services contract in addition to the enhanced adult residential care-specialized dementia care services contract.
(3) In a boarding home with an enhanced adult residential care-specialized dementia care services contract, for residents served under that contract, the contractor must:
(a) Complete a full re-assessment of residents as specified in chapter 388-78A WAC, at a minimum, on a semi-annual basis;
(b) Maintain awake staff twenty-four hours per day. The contractor must provide staffing that is adequate to respond to the assessed sleeping and waking patterns and needs of residents;
(c) Develop and implement policies and procedures:
(i) To manage residents who may wander;
(ii) To outline actions to be taken in case a resident elopes; and
(iii) To obtain consultative resources to address behavioral issues for residents. The contractor must include a plan that identifies the professional (i.e., clinical psychologist, psychiatrist, psychiatric nurse practitioner, or other behavioral specialist familiar with care of persons with dementia with complex or severe problems) who will provide the consultation, and when and how the consultation will be utilized.
(d) Ensure that each staff who works directly with residents has at least six hours of continuing education per year related to dementia, including Alzheimer's disease. This six hours of continuing education may be part of the ten hours of continuing education required by WAC 388-112-0205. Appropriate topics include, but are not limited to:
(i) Aggressive behaviors and catastrophic reactions;
(ii) Agitation: Caregiving strategies;
(iii) Delusions and hallucinations;
(iv) Dementia problem-solving strategies;
(v) Depression and dementia;
(vi) Fall prevention for dementia;
(vii) Personal care as meaningful activity;
(viii) Promoting pleasant and purposeful activity; and
(ix) Resistance to care: Caregiving strategies.
(e) Provide all necessary physical assistance with bathing and toilet use for residents who require caregivers to perform these activities and subtasks of these activities, and required oversight and supervision, encouragement and cuing. For the purposes of this subsection:
(i) "Bathing" has the same meaning as described in WAC 388-72A-0035; and
(ii) "Toilet use" has the same meaning as described in WAC 388-72A-0035.
(f) Provide extensive assistance with eating as necessary, including required oversight and supervision, encouragement and cuing. The contractor must also provide all necessary physical assistance with eating on an occasional basis for residents who require total feeding assistance. However, the contractor is not required to provide tube feedings or intravenous nutrition nor provide total feeding assistance for an extended or indefinite period.
(i) "Eating" has the same meaning as described in WAC 388-72A-0035, except that the contractor is not required to provide tube feedings or intravenous nutrition;
(ii) "Extensive assistance" has the same meaning as described in WAC 388-72A-0040.
(g) Provide daily activities consistent with the functional abilities, interests, habits and preferences of the individual residents. The contractor must support the participation of residents and the resident council, if there is one, in the development of recreational and activity programs that reflect the needs and choices of residents. On a daily basis, the contractor must provide residents access to:
(i) Opportunities for independent, self-directed, activities.
(ii) Individual activities, in which a staff person or volunteer engages the resident in a planned and/or spontaneous activity of interest. Activities may include personal care activities that provide opportunities for purposeful and positive interactions; and
(iii) Group activities.
(h) Offer opportunities for activities that accommodate variations in a resident's mood, energy and preferences. The contractor must make appropriate activities available based upon the resident's individual schedule and interests. For example, individuals up at night must have access to staff support, food and appropriate activities;
(i) Make available multiple common areas, at least one of which is outdoors, that vary by size and arrangement such as: various size furniture groupings that encourage social interaction; areas with environmental cues that may stimulate activity, such as a resident kitchen or workshop; areas with activity supplies and props to stimulate conversation; a garden area; and paths and walkways that encourage exploration and walking. These areas must accommodate and offer opportunities for individual or group activity;
(j) Ensure that the outdoor area for residents:
(i) Is accessible to residents without staff assistance;
(ii) Is surrounded by walls or fences at least seventy-two inches high;
(iii) Has areas protected from direct sunshine and rain throughout the day;
(iv) Has walking surfaces that are firm, stable, slip-resistant and free from abrupt changes, and are suitable for individuals using wheelchairs and walkers;
(v) Has suitable outdoor furniture;
(vi) Has plants that are not poisonous or toxic to humans; and
(vii) Has areas for appropriate outdoor activities of interest to residents, such as walking paths, raised garden or flower beds, bird feeders, etc.
(k) Ensure that areas used by residents have a residential atmosphere, and residents have opportunities for privacy, socialization, and wandering behaviors;
(l) Ensure any public address system in the area of specialized dementia care services is used only for emergencies;
(m) Encourage residents' individualized spaces to be furnished and or decorated with personal items based on resident needs and preferences;
(n) Ensure residents have access to their own rooms at all times without staff assistance; and
(o) Make available and offer at no additional cost to the resident generic personal care items needed by the resident such as soap, shampoo, toilet paper, toothbrush, toothpaste, deodorant, sanitary napkins, and disposable razors. This does not include items covered by medical coupons or preclude residents from choosing to purchase their own personal care items..
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-220, filed 5/8/96, effective 6/8/96.]
Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending Order 3979, filed 5/8/96,
effective 6/8/96)
WAC 388-110-240
Adult residential care service
standards.
(((1) The contractor shall complete a negotiated
service agreement within thirty days of move-in with
participation from the resident and the department's case
manager, consistent with the general service standards set
forth in WAC 388-110-070.
(2) The agreement shall include what services shall be
provided, who will provide the services, and when and how the
services will be provided.
(3) The)) In a boarding home with an adult residential
care contract, the contractor must meet the requirements of
parts I and IV of this chapter, and for residents served under
the adult residential care contract:
(1) Develop for each resident a negotiated service
agreement ((shall support)) that supports the principles of
dignity, privacy, choice in decision making, individuality,
and independence((.
(4) At a minimum, the contractor shall review and update
the negotiated service agreement semi-annually, give a copy of
the agreement to the resident and case manager, and keep a
copy in the resident's record.
(5) The contractor shall)); and
(2) Provide personal care services based on the resident's negotiated service agreement.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-240, filed 5/8/96, effective 6/8/96.]
PART VREMEDIES FOR ASSISTED LIVING, ENHANCED ADULT RESIDENTIAL CARE,
((AND)) ENHANCED ADULT RESIDENTIAL CARE -- SPECIALIZED DEMENTIA
CARE, AND ADULT RESIDENTIAL CARE
AMENDATORY SECTION(Amending WSR 96-21-050, filed 10/11/96,
effective 11/11/96)
WAC 388-110-260
Remedies.
(1) The department may take
one or more of the actions listed in subsection (3)(a) of this
section in any case in which the department finds that a
contractor of assisted living services, enhanced adult
residential care services, enhanced residential
care-specialized dementia care services, or adult residential
care services has:
(a) Failed or refused to comply with the applicable requirements of chapter 74.39A RCW, of chapter 70.129 RCW, chapter 388-78A WAC or of this chapter;
(b) Operated without a license or under a revoked license;
(c) Knowingly, or with reason to know, made a false statement of material fact on his or her application for a contract or any data attached thereto, or in any matter under investigation by the department; or
(d) Willfully prevented or interfered with any inspection or investigation by the department.
(2)(a) For failure or refusal to comply with any
applicable requirements of chapter 74.39A RCW, of chapter 70.129 RCW, chapter 388-78A WAC or of this chapter, the
department may provide consultation ((and shall allow the
contractor a reasonable opportunity to correct)) before
imposing remedies under subsection (3)(a) unless the
violations pose a serious risk to residents, are recurring or
have been uncorrected.
(b) When violations of this chapter pose a serious risk
to a resident, are recurring or have been uncorrected, the
department ((shall)) must impose a remedy or remedies listed
under subsection (3)(a). In determining which remedy or
remedies to impose, the department ((shall)) must take into
account the severity of the impact of the violations on
residents and which remedy or remedies are likely to improve
resident outcomes and satisfaction in a timely manner.
(3)(a) Actions and remedies the department ((may)) is
authorized to impose include:
(i) Refusal to enter into a contract;
(ii) Imposition of reasonable conditions on a contract, such as correction within a specified time, training, and limits on the type of clients the provider may admit or serve;
(iii) Imposition of civil penalties of not more than one hundred dollars per day per violation;
(iv) Suspension, termination, or refusal to renew a contract; or
(v) Order stop placement of persons under the contract.
(b) When the department orders stop placement, the
((facility shall)) boarding home must not admit any person
under the contract until the stop placement order is
terminated. The department may approve readmission of a
resident to the ((facility)) boarding home from a hospital or
nursing home during the stop placement. The department
((shall)) must terminate the stop placement when the
department determines that:
(i) The violations necessitating the stop placement have been corrected; and
(ii) The provider exhibits the capacity to maintain adequate care and service.
(c) Conditions the department may impose on a contract include, but are not limited to the following:
(i) Correction within a specified time;
(ii) Training related to the violations; and
(iii) Discharge of any resident when the department determines discharge is needed to meet that resident's needs or for the protection of other residents.
(d) When a contractor fails to pay a fine when due under this chapter, the department may, in addition to other remedies, withhold an amount equal to the fine plus interest, if any, from the contract payment.
[Statutory Authority: RCW 74.39A.010, 74.39A.020 and 74.39A.080. 96-21-050, § 388-110-260, filed 10/11/96, effective 11/11/96. Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-260, filed 5/8/96, effective 6/8/96.]
(2) Civil monetary penalties shall become due twenty eight days after the contractor is served with a notice of the penalty unless the contractor requests a hearing in compliance with chapter 34.05 RCW and RCW 43.20A.215. If a hearing is requested, the penalty becomes due ten days after a final decision in the department's favor is issued. Interest shall accrue beginning thirty days after the department serves the contractor with notice of the penalty at a rate of one percent per month in accordance with RCW 43.20B.695.
(3) A person contesting any decision by the department to
impose a remedy ((shall)) must within twenty-eight days of
receipt of the decision:
(a) File a written application for an adjudicative
proceeding by a method showing proof of receipt with the
((Office)) Board of Appeals, PO Box ((2465)) 45803, Olympia,
WA 98504; and
(b) Include in or with the application:
(i) The grounds for contesting the department decision; and
(ii) A copy of the contested department decision.
(4) Administrative proceedings shall be governed by
chapter 34.05 RCW, RCW 43.20A.215, where applicable, this
section, and chapter ((388-08)) 388-02 WAC. If any provision
in this section conflicts with chapter ((388-08)) 388-02 WAC,
the provision in this section governs.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-270, filed 5/8/96, effective 6/8/96.]
(2) When requested by a contractor, the department
((shall)) must expedite the dispute resolution process to
review violations upon which a department order imposing
contract suspension, stop placement, or a contract condition
is based.
(3) Orders of the department imposing contracts suspension, stop placement, or conditions for continuation of a contract are effective immediately upon notice and shall continue pending dispute resolution.
[Statutory Authority: RCW 74.39A.010, 74.39A.020, 74.39A.060, 74.39A.080, 74.39A.170, 18.88A.210-[18.88A.]240 and 70.129.040. 96-11-045 (Order 3979), § 388-110-280, filed 5/8/96, effective 6/8/96.]
The following sections of the Washington Administrative Code are repealed:
WAC 388-110-060 | Resident rights. |
WAC 388-110-080 | Social and recreational activities. |
WAC 388-110-170 | Education and training requirements. |
WAC 388-110-180 | Nurse delegation training and registration. |
WAC 388-110-190 | Performance of delegated nursing care tasks. |
WAC 388-110-200 | Nurse delegation--Penalties. |