(1) After January 1, 1958, no person shall operate or maintain an assisted living facility as defined in this chapter within this state without a license under this chapter.
(2) An assisted living facility license is not required for the housing, or services, that are customarily provided under landlord-tenant agreements governed by the residential landlord-tenant act, chapter
59.18 RCW, or when housing nonresident individuals who chose to participate in programs or services under subsection (5) of this section, when offered by the assisted living facility licensee or the licensee's contractor. This subsection does not prohibit the licensee from furnishing written information concerning available community resources to the nonresident individual or the individual's family members or legal representatives. The licensee may not require the use of any particular service provider.
(3) Residents receiving domiciliary care, directly or indirectly by the assisted living facility, are not considered nonresident individuals for the purposes of this section.
(4) An assisted living facility license is required when any person other than an outside service provider, under RCW
18.20.380, or family member:
(a) Assumes general responsibility for the safety and well-being of a resident;
(b) Provides assistance with activities of daily living, either directly or indirectly;
(c) Provides health support services, either directly or indirectly; or
(d) Provides intermittent nursing services, either directly or indirectly.
(5) An assisted living facility license is not required for one or more of the following services that may, upon the request of the nonresident, be provided to a nonresident individual: (a) Emergency assistance provided on an intermittent or nonroutine basis; (b) systems, including technology-based monitoring devices, employed by independent senior housing, or independent living units in continuing care retirement communities, to respond to the potential need for emergency services; (c) scheduled and nonscheduled blood pressure checks; (d) nursing assessment services to determine whether referral to an outside health care provider is recommended; (e) making and reminding the nonresident of health care appointments; (f) preadmission assessment for the purposes of transitioning to a licensed care setting; (g) medication assistance which may include reminding or coaching the nonresident, opening the nonresident's medication container, using an enabler, and handing prefilled insulin syringes to the nonresident; (h) falls risk assessment; (i) nutrition management and education services; (j) dental services; (k) wellness programs; (l) prefilling insulin syringes when performed by a nurse licensed under chapter
18.79 RCW; or (m) services customarily provided under landlord-tenant agreements governed by the residential landlord-tenant act, chapter
59.18 RCW.