(1) The enhanced services facility must develop and implement written policies and procedures for all treatment, care and services provided in the facility.

(2) The enhanced services facility must train staff persons on implementation of all the policies and procedures.

(3) The facility must ensure that the policies and procedures include, at a minimum the following:

(a) Transitioning new residents;

(b) Security precautions to meet the safety needs of the residents and the surrounding community;

(c) Delayed egress, when used by the facility;

(d) Crisis prevention and response protocol;

(e) Discharge planning;

(f) Compliance with resident rights, consistent with WAC 388-107-0190;

(g) Suspected abandonment, abuse, neglect, exploitation, or financial exploitation of any resident;

(h) Situations in which there is reason to believe a resident is not capable of making necessary decisions and no substitute decision maker is available;

(i) Situations in which a substitute decision maker is no longer appropriate;

(j) Situations in which 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;

(k) Response to medical emergencies;

(l) Urgent situations in the enhanced services facility requiring additional staff support;

(m) Appropriate responses to residents engaging in aggressive or assaultive behavior, including, but not limited to:

(i) Preventive actions for a behavioral crisis or violent behavior to ensure the safety of residents and the community;

(ii) Actions to take to protect other residents;

(iii) When and how to seek outside intervention;

(iv) Training on deescalation techniques for managing resident's challenging behavior before it reaches the stage of physical aggression or assault;

(v) Techniques for staff to use in response to aggressive behaviors when deescalation techniques have not succeeded;

(vi) Evaluation of the safety of the physical environment;

(vii) Issues of respect and dignity of the client; and

(viii) Use of the least restrictive physical and behavioral interventions depending upon the situation, including use of holding techniques to physically restrain residents.

(n) Preventing and limiting the spread of infections, including tuberculosis, consistent with WAC 388-107-0440;

(o) Providing subacute detoxification services approved by an authorized health care provider and ensuring resident health and safety;

(p) Prohibition of restraints, except when medically necessary;

(q) Use of medications, including marijuana, for staff or residents;

(r) Presence of firearms in the facility, including provisions for keeping firearms locked and accessible only to authorized persons;

(s) Safe transportation of residents and the qualifications of the drivers;

(t) Management of pets in the enhanced services facility;

(u) Medication process for resident outings; and

(v) Medications to include:

(i) Medication services;

(ii) Pharmacy services;

(iii) Storing, securing and accounting for medications;

(iv) Resident controlled medications; and

(v) Medication refusals, including refusals of court ordered medication.

(w) Are reviewed and updated annually.

(4) The enhanced services facility must make the policies and procedures specified in subsection (3) 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.