Effective Date of Rule: Thirty-one days for WAC 388-78A-2202, 388-78A-2204, 388-78A-2206, 388-78A-2208, 388-78A-2600, and 388-78A-2730; and May 1, 2009, for WAC 388-78A-3150 and 388-78A-3152.

     Purpose: Respite: Adopt rules to implement E2SHB 2668 (chapter 146, Laws of 2008). Adopt new WAC 388-78A-2202 Respite -- General, 388-78A-2204 Respite -- Information, 388-78A-2206 Respite -- Assessment, and 388-78A-2208 Respite -- Negotiated service agreement, Adopt amendments to WAC 388-78A-2600 Policies and procedures.

     Plans of correction (POC): Clarify, streamline and improve usability of plan of correction requirements. Adopt amendments to WAC 388-78A-2730 Licensee's responsibilities and 388-78A-3150 Statements of deficiency. Adopt new WAC 388-78A-3152 Plan of correction -- Required.

     Citation of Existing Rules Affected by this Order: Amending WAC 388-78A-2600, 388-78A-2730, and 388-78A-3150.

     Statutory Authority for Adoption: RCW 18.20.090, E2SHB 2668 (chapter 146, Laws of 2008).

     Other Authority: Chapter 18.20 RCW.

      Adopted under notice filed as WSR 08-16-120 on August 5, 2008.

     Changes Other than Editing from Proposed to Adopted Version: WAC 388-78A-3150 Statements of deficiencies and plans of correction. (1) The department must will give the administrator or the administrator's designee a written statement of deficiencies report specifying any violations of chapters 18.20, or 70.129, or 74.34 RCW or, this chapter, or any other applicable laws or rules that the department found during on site any inspections and or complaint investigations.

     (2) The licensee must respond to a statement of deficiencies by submitting to the department within a time acceptable to the department, a signed written plan of correction for each deficiency stated in the report. The licensee must include in the plan of correction, for each cited deficiency:

     (a) A specific plan of what will be or was done to correct the problem;

     (b) A description of what will be done to prevent future problems of this type;

     (c) Who will be responsible for monitoring the corrections to ensure the problems do not recur; and

     (d) The date by which lasting correction will be achieved.

     WAC 388-78A-3152 Plan of correction -- Required. (1) The boarding home must comply with all applicable licensing laws and regulations at all times.

     (2) When the department finds the boarding home out of compliance with any licensing law or regulation the department will send the home an inspection report with an attestation of correction statement for each cited deficiency.

     (3) The boarding home must complete an attestation of correction for any inspection report as the department requires.

     (4) For purposes of this section an "attestation of correction statement" means a statement developed by the department and signed and dated by the home, that the home:

     (a) Has or will correct each cited deficiency; and

     (b) Will maintain correction of each cited deficiency.

     (5) The home must be able to show to the department, upon request, that, for each deficiency cited, the home has:

     (a) A plan of correction and maintaining correction;

     (b) Corrected or is correcting each deficiency; and

     (c) Maintained or is maintaining compliance.

     (6) On each attestation of correction statement, the home must:

     (a) Give a date, approved by the department, showing when the cited deficiency has been or will be corrected; and

     (b) By signature and date showing that the home has or will correct, and maintain correction, of each deficiency.

     (7) The home must return the inspection report, with completed attestation of correction statements, to the department within ten calendar days of receiving the report.

     The changes were made because:

SUMMARY	ACTION TAKEN BY DEPARTMENT
WAC 388-78A-3150 Statements of deficiencies. Replace the term "must" with "will" in the following phrase in WAC 388-78A-3150: "The department will give the administrator...a written statement of deficiencies report..." Keep the phrase "statement of deficiencies" in the phrase just mentioned. Replace the word "and" with "or" in the following phrase in WAC 388-78A-3150: "any inspections or complaint investigation(s)."	WAC 388-78A-3150 Statements of deficiencies. Clarifying change made. Clarifying change made.
WAC 388-78A-3152 Plan of correction -- Required. Insert the term "applicable" in the phrase "must comply with all applicable licensing laws and regulations" in new WAC 388-78A-3152. Revise text to use the phrase "attestation of correction" in WAC 388-78A-3152 rather than simply use the term "attestation statement." Add language in WAC 388-78A-3152 that clarifies that the boarding home must complete an attestation of correction for any inspection report the department requires. Change the term "certifying" to "showing" WAC 388-78A-3152. Insert the term "calendar" in WAC 388-78A-3152 to read "within ten calendar days." Divide WAC 388-78A-3152 into additional subsections.	WAC 388-78A-3152 Plan of correction -- Required. Clarifying change made. Clarifying change made. Clarifying change made. Clarifying change made. Clarifying change made. Clarifying change made.

     A final cost-benefit analysis is available by contacting Todd Henry, RCS, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2580, fax (360) 438-7903, e-mail henryte@dshs.wa.gov.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 4, Amended 1, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 2, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 5, Amended 3, Repealed 0.

     Date Adopted: December 15, 2008.

Robin Arnold-Williams

Secretary

     (1) May provide short term respite care;

     (2) Must limit the length of stay for an individual on respite to thirty calendar days or less; and

     (3) Must not use respite as a placement pending the resident's admission to the boarding home.

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     (1) The resident's legal name;

     (2) The name, phone number and address of the resident's representative, if applicable;

     (3) The name and address of the adult family home, boarding home, or other location where the resident normally lives, with the name of a contact person and the contact person's phone number;

     (4) The name, address, and telephone number of the resident's attending physician, and alternate physician if any;

     (5) Medical and social history, which may be obtained from a respite care assessment and respite service plan performed by a case manager designated by an area agency on aging under contract with the department, and mental and physical assessment data; and

     (6) Physician's orders for diet, medication, and routine care consistent with the resident's status on admission.

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     (1) Tuberculosis, follow required tuberculosis testing requirements; and

     (2) Other infectious conditions or diseases, follow the appropriate infection control processes.

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     (a) Maintain or enhance the quality of life for residents including resident decision-making rights;

     (b) Provide the necessary care and services for residents, including those with special needs;

     (c) Safely operate the boarding home; and

     (d) Operate in compliance with state and federal law, including, but not limited to, chapters 7.70, 11.88, 11.92, 11.94, 69.41, 70.122, 70.129, and 74.34 RCW, and any rules promulgated under these statutes.

     (2) The boarding home must develop, implement and train staff persons on policies and procedures to address what staff persons must do:

     (a) Related to suspected abandonment, abuse, neglect, exploitation, or financial exploitation of any resident;

     (b) When there is reason to believe a resident is not capable of making necessary decisions and no substitute decision maker is available;

     (c) When a substitute decision maker is no longer appropriate;

     (d) When a resident stops breathing or a resident's heart appears to stop beating, including, but not limited to, any action staff persons must take related to advance directives and emergency care;

     (e) When a resident does not have a personal physician or health care provider;

     (f) In response to medical emergencies;

     (g) When there are urgent situations in the boarding home requiring additional staff support;

     (h) In the event of an internal or external disaster, consistent with WAC 388-78A-2700;

     (i) To supervise and monitor residents, including accounting for residents who leave the premises;

     (j) To appropriately respond to aggressive or assaultive residents, including, but not limited to:

     (i) Actions to take if a resident becomes violent;

     (ii) Actions to take to protect other residents; and

     (iii) When and how to seek outside intervention.

     (k) To prevent and limit the spread of infections consistent with WAC 388-78A-2610;

     (l) To manage residents' medications, consistent with WAC 388-78A-2210 through 388-78A-2290; sending medications with a resident when the resident leaves the premises;

     (m) When services related to medications and treatments are provided under the delegation of a registered nurse consistent with chapter 246-840 WAC;

     (n) Related to food services consistent with chapter 246-215 WAC and WAC 388-78A-2300;

     (o) Regarding the safe operation of any boarding home vehicles used to transport residents, and the qualifications of the drivers;

     (p) To coordinate services and share resident information with outside resources, consistent with WAC 388-78A-2350;

     (q) Regarding the management of pets in the boarding home, if permitted, consistent with WAC 388-78A-2620; ((and))

     (r) When receiving and responding to resident grievances consistent with RCW 70.129.060; and

     (s) Related to providing respite care services consistent with RCW 18.20.350, if respite care is offered.

     (3) The boarding home must make the policies and procedures specified in subsection (2) of this section available to staff persons at all times and must inform residents and residents' representatives of their availability and make them available upon request.

[Statutory Authority: RCW 18.20.090 and chapters 18.20 and 74.34 RCW. 08-05-099, § 388-78A-2600, filed 2/15/08, effective 3/17/08. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. 04-16-065, § 388-78A-2600, filed 7/30/04, effective 9/1/04.]

     (a) The operation of the boarding home;

     (b) Complying at all times with the requirements of this chapter, chapter 18.20 RCW, and other applicable laws and rules; and

     (c) The care and services provided to the boarding home residents.

     (2) The licensee must:

     (a) Maintain the occupancy level at or below the licensed resident bed capacity of the boarding home;

     (b) Maintain and post in a size and format that is easily read, in a conspicuous place on the boarding home premises:

     (i) A current boarding home license, including any related conditions on the license;

     (ii) The name, address and telephone number of:

     (A) The department;

     (B) Appropriate resident advocacy groups; and

     (C) The state and local long-term care ombudsman with a brief description of ombudsman services.

     (iii) A copy of the report, including the cover letter, and plan of correction of the most recent full inspection conducted by the department.

     (c) Ensure any party responsible for holding or managing residents' personal funds is bonded or obtains insurance in sufficient amounts to specifically cover losses of resident funds; and provides proof of bond or insurance to the department.

     (3) The licensee must not delegate to any person responsibilities that are so extensive that the licensee is relieved of responsibility for the daily operations and provisions of services in the boarding home.

     (4) The licensee must act in accord with any department-approved management agreement, if the licensee has entered into a management agreement.

     (5) The licensee must appoint the boarding home administrator consistent with WAC 388-78A-2520.

[Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. 04-16-065, § 388-78A-2730, filed 7/30/04, effective 9/1/04.]

     (((2) The licensee must respond to a statement of deficiencies by submitting to the department within a time acceptable to the department, a signed written plan of correction for each deficiency stated in the report. The licensee must include in the plan of correction, for each cited deficiency:

     (a) A specific plan of what will be or was done to correct the problem;

     (b) A description of what will be done to prevent future problems of this type;

     (c) Who will be responsible for monitoring the corrections to ensure the problems do not recur; and

     (d) The date by which lasting correction will be achieved.))

[Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. 04-16-065, § 388-78A-3150, filed 7/30/04, effective 9/1/04.]

     (2) When the department finds the boarding home out of compliance with any licensing law or regulation the department will send the home an inspection report with an attestation of correction statement for each cited deficiency.

     (3) The boarding home must complete an attestation of correction for any inspection report as the department requires.

     (4) For purposes of this section an "attestation of correction statement" means a statement developed by the department and signed and dated by the home, that the home:

     (a) Has or will correct each cited deficiency; and

     (b) Will maintain correction of each cited deficiency.

     (5) The home must be able to show to the department, upon request, that, for each deficiency cited, the home has:

     (a) A plan of correction and maintaining correction;

     (b) Corrected or is correcting each deficiency; and

     (c) Maintained or is maintaining compliance.

     (6) On each attestation of correction statement, the home must:

     (a) Give a date, approved by the department, showing when the cited deficiency has been or will be corrected; and

     (b) By signature and date showing that the home has or will correct, and maintain correction, of each deficiency.

     (7) The home must return the inspection report, with completed attestation of correction statements, to the department within ten calendar days of receiving the report.

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