WSR 02-07-116



(Aging and Adult Services Administration)

[ Filed March 20, 2002, 10:30 a.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 00-24-020.

Title of Rule: Chapter 388-98 WAC, Nursing home licensure program administration and chapter 388-97 WAC, Nursing homes.

Purpose: Repealing chapter 388-98 WAC and merging relevant provisions into chapter 388-97 WAC in order to bring all nursing homes' regulations into one chapter for easier reference. WAC sections are revised per clear rule-writing requirements of Executive Order 97-02.

Statutory Authority for Adoption: RCW 18.51.070, 74.42.620.

Statute Being Implemented: Chapters 18.51, 74.42, 74.39A, 74.34 RCW.

Summary: The amended and updated requirements of chapter 388-98 WAC will be merged with chapter 388-97 WAC as subchapter IV. Additional amendments are made to chapter 388-97 WAC to update to current statute and to clarify requirements. Chapter 388-98 WAC will be repealed. See Reasons Supporting Proposal below.

Reasons Supporting Proposal:

WAC 388-97-005 Definitions. Amended. Definitions were added as needed with addition of Subchapter IV, and other definitions were amended to conform to statutory changes or to clarify meaning.
WAC 388-97-043 Transfer and discharge appeals for residents in Medicare or Medicaid certified facilities. Technical update chapter 388-02 WAC reference.
WAC 388-97-07005 Notice of rights and services. Technical clarifying change.
WAC 388-97-07040 Examination of survey results. Amended. Added language to clarify that survey result must be posted when received from the department.
WAC 388-97-07050 Access and visitation rights. Amended. Clarifies that for Medicare and Medicaid residents, residents have access to any representative of the United States Department of Health and Human Services and Washington Protection and Advocacy System.
WAC 388-97-076 Prevention of abuse. Amended. Moved information about disqualification criteria from nursing home employment into new section. Added information about mandated reporter such as when to report and consequences for not reporting or making a false report.
WAC 388-97-160 General administration. Amended. Allows for an extension of time to find a qualified nursing home administrator when a nursing home is temporarily without an administrator. Clarifies what department will do related to complaints it receives. Conforms to chapter 74.34 RCW.
WAC 388-97-162 Required notification and reporting. Amended. Conforms to changes in chapter 74.34. RCW and clarifies provider responsibilities when a nursing home voluntarily closes or voluntarily terminates its Medicare or Medicaid contract. For clarification, moves written notification requirement from WAC 388-97-595 to this section.
WAC 388-97-180 Clinical records. Amended. Clarifies the provider's responsibilities for clinical records when a nursing home ceases operation.
WAC 388-97-202 Criminal history disclosure and background inquiries. Amended. Conforms to chapter 74.34 RCW. Updates name of Health Care Financing Administration.
WAC 388-97-205 Laundry services. Amended. Clarifies what chemical laundry disinfectant products are allowed.
WAC 388-97-260 Preadmission screening and resident review (PASRR) determination and appeal rights. Amended. Updates reference to chapter 388-02 WAC.
WAC 388-97-285 Intermediate care facilities for the mentally retarded. Editorial amendments.
WAC 388-97-35040 Ambulation route on a dementia care unit in a new building or addition. Editorial amendment.
WAC 388-97-565 Department review of nursing home license renewals. Amended. Clarifies "current licensee" instead of "proposed licensee."
WAC 388-97-570 Reasons for denial, suspension, modification, revocation of, or refusal to renew a nursing home license. Amended. Identifies reasons to deny, suspend, modify, revoke or refuse nursing home licenses.
WAC 388-97-575 Appeal of the department's licensing decision. Amended. Explains what to do if a licensee wants to appeal the department's licensing decision.
WAC 388-97-580 Management agreements. Amended. Recognizes existence of management agreements, identifies requirements for submission and required language to maintain licensee's responsibility.
WAC 388-97-585 Change of ownership. Amended. Identifies what events do and do not constitute a change of ownership.
WAC 388-97-595 Relocation of residents. Amended. For clarification, moves notification requirement to WAC 388-97-162.
WAC 388-98-001 Definitions. Repealed. Relevant definitions moved to WAC 388-97-005.
WAC 388-98-003 Remedies. Repealed. Replaced by WAC 388-97-630.
WAC 388-98-010 List of qualified receivers. Repealed. Replaced by WAC 388-97-680 and 388-97-685.
WAC 388-98-015 Duties and powers of receiver. Repealed. Replaced by WAC 388-97-690.
WAC 388-98-020 Termination of receivership. Repealed. Replaced by WAC 388-97-675 and 388-97-695.
WAC 388-98-300 Temporary management. Repealed. Replaced by WAC 388-97-670.
WAC 388-98-320 Temporary managers -- Application. Repealed. Replaced by WAC 388-97-680 and 388-97-685.
WAC 388-98-330 Duties and powers of temporary manager. Repealed. Replaced by WAC 388-97-690.
WAC 388-98-340 Termination of temporary management. Repealed. Replaced by WAC 388-97-695.
WAC 388-98-700 Stop placement -- Informal review. Repealed. Replaced by WAC 388-97-620 Informal department review and 388-97-650 Stop placement.
WAC 388-98-750 Notice and hearing rights. Repealed. Replaced by WAC 388-97-625.
WAC 388-98-810 Civil penalty fund. Repealed. Replaced by WAC 388-97-665.
WAC 388-98-830 Notification of response time. Repealed. Replaced by WAC 388-97-605.
WAC 388-98-870 Separate violations. Repealed. Replaced by WAC 388-97-645.
WAC 388-98-890 Reporting. Repealed.
WAC 388-97-203 Disqualification from nursing home employment. New section. Explains who must not be employed directly or by contract or as a volunteer or student.
WAC 388-97-204 Retaliation or discrimination prohibited. New section. Provides examples of retaliation or discrimination that is prohibited by licensee or licensee's agent.
WAC 388-97-605 Inspections and deficiency citation report. New section. Describes types of inspections, when it can be conducted, and responsibilities of licensee or licensee's agent in the inspection process.
WAC 388-97-610 Plan of correction. New section. Explains when plan of correction must be completed.

WAC 388-97-615 Acceptable and unacceptable plans of correction. New section. Describes what information must be included in a plan of correction.
WAC 388-97-620 Informal department review. New section. Explains how licensee or licensee's agent may request an informal department review.
WAC 388-97-625 Notice and appeal rights. New section. Describes what actions may be appealed and the purpose of a hearing.
WAC 388-97-630 Remedies. New section. Explains mandatory remedies and optional remedies.
WAC 388-97-635 Criteria for imposing optional remedies. New section. Provides criteria for when the department can consider optional remedies.
WAC 388-97-640 Severity and scope of deficiencies. New section. Defines severity of a deficiency, the severity levels and scope of the deficiency.
WAC 388-97-645 Separate deficiencies. New section. Defines separate deficiency.
WAC 388-97-650 Stop placement. New section. Explains when a stop placement becomes effective and remains in effect.
WAC 388-97-655 Amount of civil fine. New section. Provides range of civil fine.
WAC 388-97-660 Civil fine accrual, due dates and interest. New section. Describes when civil fine begins, when it is due, and how interest is calculated.
WAC 388-97-665 Civil penalty fund. New section. Describes the uses of the funds.
WAC 388-97-670 Temporary management. New section. Explains what happens when the department appoints a temporary manager and when the temporary manager has the authority to relocate residents.
WAC 388-97-675 Receivership. New section. Explains the situations when the department may recommend that all residents be relocated and nursing home closed after receivership is established.
WAC 388-97-680 Temporary managers and receivers -- Application. New section. Describes who can be temporary manager or receiver and that they must complete application forms.
WAC 388-97-685 Temporary managers and receivers -- Considerations before appointment. New section. Describes factors to consider in appointing a temporary manager or receiver.
WAC 388-97-690 Duties and powers of temporary manager and receiver. New section. Explains the responsibilities of temporary manager or receiver.
WAC 388-97-695 Termination of temporary management and receivership. New section. Explains when the department may terminate temporary management or receivership and when the department may appoint an alternate temporary manager or receiver.

Name of Agency Personnel Responsible for Drafting: Lisa Yanagida, Aging and Adult Services Administration, (360) 725-2589; Implementation and Enforcement: Joyce Stockwell, NHQA, Aging and Adult Services Administration, (360) 725-2404.

Name of Proponent: Department of Social and Health Services, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: See Reasons Supporting Proposal above.

Proposal Changes the Following Existing Rules: See Reasons Supporting Proposal above for amendments to chapter 388-97 WAC. Chapter 388-98 WAC will be repealed.

No small business economic impact statement has been prepared under chapter 19.85 RCW. It is unlikely that any licensed nursing homes regulated under chapters 18.51 and 74.42 RCW have fewer than fifty employees. In the event that there is such a nursing home, RCS has analyzed its proposed rules and has concluded that they do not impose an increase in existing costs, an imposition of a new cost, or a decrease in benefit. The primary purposes of the proposed amendments are to clarify preexisting requirements and to update existing rules to conform to changes in procedures or in state or federal law. In addition, the department has rewritten its criteria for determining the scope and severity of regulatory violations for clarity. The criteria provide guidance to the department when making decisions about imposition of mandatory and/or optional remedies. After careful review, the department has determined that there should be no additional costs associated with the changes in criteria.

As a result, the preparation of a small business economic impact statement is not required.

RCW 34.05.328 applies to this rule adoption. A copy of the cost-benefit analysis can be obtained from Lisa Yanagida, Aging and Adult Services Administration, P.O. Box 45600, Olympia, WA 98504-5600, phone (360) 725-2589, fax (360) 438-7903, e-mail

Hearing Location: Office Building 2 Auditorium (DSHS Headquarters) (public parking off 12th and Jefferson), 1115 Washington, Olympia, WA 98504, on May 21, 2002, at 10:00 a.m.

Assistance for Persons with Disabilities: Contact Andy Fernando, DSHS Rules Coordinator, by May 17, 2002, phone (360) 664-6094, TTY (360) 664-6178, e-mail

Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail, by 5:00 p.m. May 21, 2002.

Date of Intended Adoption: No sooner than May 22, 2002.

March 7, 2002

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

Reviser's note: The material contained in this filing exceeded the page-count limitations of WAC 1-21-040 for appearance in this issue of the Register. It will appear in the 02-09 issue of the Register.

Washington State Code Reviser's Office