SOCIAL AND HEALTH SERVICES
(Aging and Long-Term Support Administration)
[Filed January 15, 2020, 8:53 p.m., effective February 15, 2020]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The purpose of this amendment is to remove references to chapter 388-526 WAC from this rule. WAC 388-97-0140(3) describes the appeal process for a nursing home resident or resident representative who wants to appeal a discharge or transfer decision made by the nursing home. Removing the references to chapter 388-526 WAC, which was repealed, will more clearly define the appeal process for the user.
Citation of Rules Affected by this Order: Amending WAC 388-97-0140.
Statutory Authority for Adoption: RCW 74.42.620
Other Authority: Not applicable.
Adopted under notice filed as WSR 19-22-068 on November 5, 2019.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at the Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.
Number of Sections Adopted using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.
Date Adopted: January 14, 2020.
Katherine I. Vasquez
AMENDATORY SECTION(Amending WSR 11-22-077, filed 11/1/11, effective 12/2/11)
WAC 388-97-0140Transfer and discharge appeals for resident in medicare or medicaid certified facilities.
(1) A skilled nursing facility and a nursing facility that initiates transfer or discharge of any resident, regardless of payor status, must:
(a) Provide the required written notice of transfer or discharge to the resident and, if known or appropriate, to a family member or the resident's representative;
(b) Attach a department-designated hearing request form to the transfer or discharge notice;
(c) Inform the resident in writing, in a language and manner the resident can understand, that:
(i) An appeal request may be made any time up to ninety days from the date the resident receives the notice of transfer or discharge; and
(ii) Transfer or discharge will be suspended when an appeal request is received by the office of administrative hearings on or before the date the resident actually transfers or discharges; and
(iii) The nursing home will assist the resident in requesting a hearing to appeal the transfer or discharge decision.
(2) A skilled nursing facility or nursing facility must suspend transfer or discharge pending the outcome of the hearing when the resident's appeal is received by the office of administrative hearings on or before the date of the transfer or discharge set forth in the written transfer or discharge notice, or before the resident is actually transferred or discharged.
(3) The resident is entitled to appeal the skilled nursing facility or nursing facility's transfer or discharge decision. The appeals process is set forth in ((chapter 388-526 WAC,)) chapter 182-526 WAC and this chapter. In such appeals, the following will apply:
(a) In the event of a conflict between a provision in this chapter and a provision in ((chapter 388-526 WAC or)) chapter 182-526 WAC, the provision in this chapter will prevail;
(b) The resident must be the appellant and the skilled nursing facility or the nursing facility will be the respondent;
(c) The department must be notified of the appeal and may choose whether to participate in the proceedings. If the department chooses to participate, its role is to represent the state's interest in assuring that skilled nursing facility and nursing facility transfer and discharge actions comply substantively and procedurally with the law and with federal requirements necessary for federal funds;
(d) If a medicare certified or medicaid certified facility's decision to transfer or discharge a resident is not upheld, and the resident has been relocated, the resident has the right to readmission immediately upon the first available bed in a semi-private room if the resident requires and is eligible for the services provided by a nursing facility or skilled nursing facility;
(e) Any review of the administrative law judge's initial decision shall be conducted under ((chapter 388-526 WAC or)) chapter 182-526 WAC.