WSR 25-11-012
PROPOSED RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
(Home and Community Living Administration)
[Filed May 8, 2025, 3:48 p.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 24-22-123.
Title of Rule and Other Identifying Information: This proposal would:
Add new sections to chapter 388-76 WAC and amend WAC 388-76-10320 Resident record;
Add new sections to chapter 388-78A WAC and amend WAC 388-78A-2410 Content of resident records; and
Add new sections to chapter 388-107 WAC and amend WAC 388-107-0560 Resident records—Clinical records.
Hearing Location(s): On June 24, 2025, at 10:00 a.m., virtually via Teams or call in. See the department of social and health services (DSHS) website at https://www.dshs.wa.gov/sesa/rpau/proposed-rules-and-public-hearings for the most current information.
Date of Intended Adoption: No earlier than June 25, 2025.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, email DSHSRPAURulesCoordinator@dshs.wa.gov, fax 360-664-6185, beginning noon on May 21, 2025, by 5:00 p.m. on June 24, 2025.
Assistance for Persons with Disabilities: Contact Shelley Tencza, rules consultant, phone 360-664-6036, fax 360-664-6185, TTY 711 relay service, email shelley.tencza@dshs.wa.gov, by 5:00 p.m. on June 10, 2025.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of the proposed rule making is to comply with Centers for Medicare and Medicaid [Services] (CMS) regulations related to home and community-based settings (HCBS) in adult family homes (AFH), assisted living facilities (ALF), and enhanced service facilities (ESF). Compliance with the regulations is necessary to administer the state's medicaid funded long-term services and supports programs, RCW 74.09.520(2) and 74.39A.007.
The proposed changes to the chapters create a requirement for the operators of AFH, ALF, and ESF to enter into a residency agreement with current and new residents with medicaid as a payor that addresses resident rights in relation to transfer and discharge.
The proposed changes require these operators to include, for residents with medicaid, information upon transfer or discharge that explains the resident's rights, which includes the right to an attorney to represent the resident's interests in response to the transfer or discharge notice. This right is subject to legislative appropriation.
The proposed changes require minor changes to existing rules to include a requirement that the residency agreement, if applicable, must be kept in the resident's record.
Reasons Supporting Proposal: Rule making is needed to comply with CMS regulations related to HCBS in AFH, ALF, and ESF. Compliance with regulations is necessary to administer the state's medicaid funded long-term services and supports programs.
Statutory Authority for Adoption: RCW 18.20.090, 70.97.230, 70.128.040, 74.09.520(2), and 74.39A.007.
Statute Being Implemented: RCW 74.09.520(2); 42 C.F.R. 441.530 (a)(1)(vi)(A) and 42 C.F.R. 441.301 (c)(4)(vi)(A).
Rule is necessary because of federal law, 42 C.F.R. 441.530 (a)(1)(vi)(A) and 42 C.F.R. 441.301 (c)(4)(vi)(A).
Name of Proponent: DSHS, governmental.
Name of Agency Personnel Responsible for Drafting, Implementation, and Enforcement: Colleen Jensen, 4500 10th Avenue S.E., Lacey, WA 98503, 564-999-3182.
A school district fiscal impact statement is not required under RCW 28A.305.135.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Colleen Jensen, P.O. Box 45600, Olympia, WA 98504, phone 564-999-3182, TTY 711 relay service, email RCSPolicy@DSHS.WA.GOV.
Scope of exemption for rule proposal:
Is not exempt.
The proposed rule does not impose more-than-minor costs on businesses. Following is a summary of the agency's analysis showing how costs were calculated. The purpose of these chapters, respectively, is to:
•Promote the safety and well-being of AFH residents, specify standards for AFH providers, and further establish requirements for operating an AFH;
•Provide for the development, establishment, and enforcement of standards for the maintenance and operation of ALF;
•Promote safe treatment and necessary care of individuals residing in the facility and provide for safe and clean conditions; and
•Establish licensee qualifications, licensing and enforcement, and license fees sufficient to cover the cost of licensing and enforcement (for ESF).
The purpose of the proposed rule making is to comply with CMS regulations related to HCBS in AFH, ALF, and ESF. Compliance with the regulations is necessary to administer the state's medicaid funded long-term services and supports programs, RCW 74.09.520(2) and 74.39A.007.
The proposed changes to the chapters create a requirement for the operators of AFH, ALF, and ESF to enter into a residency agreement with current and new residents with medicaid as a payor that addresses resident rights in relation to transfer and discharge.
The proposed changes require these operators to include, for residents with medicaid, information upon transfer or discharge that explains the resident's rights, which includes the right to an attorney to represent the resident's interests in response to the transfer or discharge notice. This right is subject to legislative appropriation.
Residential care services (RCS) held six interested parties' meetings with about 30 to 40 participants attending each meeting. Representatives included the Adult Family Home Council (AFHC), the exclusive bargaining representative of AFHs, ALF associations LeadingAge Washington (LAW), Washington healthcare association (WHCA), and their legal counsel agency, and Ballard Spahr. An ESF provider attended regularly. Several resident advocacy agencies and their legal representatives were involved, including Northwest Justice Project and the long-term care ombudsman program (LTC Ombuds). The office of civil and legal aid played an active role, as they will administer the right to counsel program if appropriated in the state operating budget. DSHS requested and received additional input from the AFHC, LAW, and WHCA after completing the workgroup meetings. Representatives from the developmental disabilities ombuds were invited, but did not attend meetings or provide input. DSHS emailed a copy of the full analysis to the entire workgroup. There were no additional comments on the analysis.
Chapter 19.85 RCW, the Regulatory Fairness Act, requires that the economic impact of proposed regulations be analyzed in relation to small businesses. This statute outlines information that must be included in a small business economic impact statement (SBEIS). Preparation of an SBEIS is required when a proposed rule has the potential of placing more than a minor impact on a business.
RCS has analyzed these proposed rules and concludes that the proposed changes may impose a cost to AFH, ALF, and ESF operators. The cost would involve time spent drafting and implementing a residential agreement for residents with medicaid, including those already living in the facility. Costs also include time facility operators spend providing a copy of any transfer or discharge notice issued to residents with medicaid to the resident's case manager and to the LTC ombuds.
When proposed rule changes cause more-than-minor costs to small businesses, the Regulatory Fairness Act requires an analysis that compares these costs between small businesses and 10 percent of the largest businesses. Though the costs of the proposed rules do not meet the "more than minor" threshold, we still compared these cost impacts.
We analyzed the impact on 4,897 AFHs (presuming the majority of AFHs are operated as small businesses) vs 4.5 ALFs (10 percent of 45 ALFs licensed for 101-253 residents) and determined there will not be a disproportionate impact on these smallest businesses despite these factors: Larger ALFs have an advantage in that the tasks imposed by the rules would be absorbed by a dedicated administrative staff. In the smallest AFHs the operator of the AFH may act as both the administrator and the sole caregiver. AFHs would not be disproportionately impacted because there are fewer residents, and the required tasks could be completed in less time overall.
This rule making is required for compliance with federal regulations. RCS worked with an active group of interested parties to make the proposed rules user-friendly and to limit requirements to those that are federally mandated. Though not federally required, providing a copy of the transfer or discharge notice to a resident's department case manager and the LTC ombuds can help resolve issues between facility operators and residents. This could result in a facility receiving rent payments where previously withheld by the resident or resolution of issues that might have prompted a facility operator to seek legal or court action. Both would have a positive financial impact on the facility. Both would benefit the resident's housing stability and well-being.
Including model language in the rules will reduce the impact on all the regulated entities, giving them a template to use to comply with the rules. The optional residency agreement template the DSHS's home and community services division is developing can also help mitigate the impact on facilities, giving them a template that can take the place of multiple documents.
A copy of the detailed cost calculations may be obtained by contacting Colleen Jensen, P.O. Box 45600, Olympia, WA 98504, phone 564-999-3182, TTY 711 relay service, email RCSPolicy@dshs.wa.gov.
May 8, 2025
Katherine I. Vasquez
Rules Coordinator
SHS-5081.3
AMENDATORY SECTION(Amending WSR 07-21-080, filed 10/16/07, effective 1/1/08)
WAC 388-76-10320Resident record—Content.
The adult family home must ensure that each resident record contains, at a minimum, the following information:
(1) Identifying information about the resident;
(2) The name, address, and telephone number of the resident's:
(a) Representative;
(b) Health care providers;
(c) Significant family members identified by the resident; and
(d) Other individuals the resident wants involved or notified.
(3) Current medical history;
(4) The resident assessment information;
(5) The preliminary service plan;
(6) The negotiated care plan;
(7) List of resident medications;
(8) The resident's Social Security number;
(9) When the resident was:
(a) Admitted to the home;
(b) Absent from the home; and
(c) Discharged from the home.
(10) A current inventory of the resident's personal belongings dated and signed by:
(a) The resident; and
(b) The adult family home.
(11) Financial records.
(12) If applicable, the residency agreement for residents with medicaid as a payor.
RESIDENCY AGREEMENT-RESIDENTS WITH MEDICAID
NEW SECTION
WAC 388-76-10506Written residency agreement-Residents with medicaid as a payor.
(1) For the purposes of this section "residency agreement" means a legally enforceable written document prepared by the adult family home that contains the rights and responsibilities of the facility and the resident specific to transfer and discharge and is signed by both parties.
(2) For residents with medicaid as a payor the facility must complete a signed written residency agreement with each resident that:
(a) Is signed by the resident or their legal representative and the facility upon admission of the resident to the facility;
(b) Requires the facility to agree to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129; and
(c) Requires the facility to provide notice to residents upon transfer and discharge that includes information about available legal resources and notice that, subject to legislative appropriation, residents have the right to legal counsel at public expense upon notice of transfer or discharge.
(3) For residents whose payor status changes from medicaid to private pay, a new residency agreement is required if the resident's payor status returns to medicaid.
(4) A copy of the residency agreement must be kept in the resident record.
(5) The residency agreement must be in substantially the following form:
Residency agreement-residents with medicaid as a payor.
(a) [facility name] agrees to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129.
(b) Subject to legislative appropriation [resident name] has a right to a free lawyer to help them in response to a notice of transfer or discharge. If they want a free lawyer to help them, they must call the long-term care discharge defense screening line at [phone number].
(c) [Signature of resident/legal representative].
(d) [Signature of facility].
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-76-10617Resident rights-Transfer and discharge notice-Residents with medicaid as a payor.
For residents with medicaid as a payor, in addition to the requirements in WAC 388-76-10616, the adult family home must do the following when issuing a written notice of transfer or discharge:
(1) Include in the notice contact information provided by the department for the legal services agencies assigned to provide legal counsel;
(2) Clearly state in the notice that, subject to legislative appropriation, legal counsel at public expense is available to represent the resident's interests in the transfer or discharge process. This language must be substantially in the following form: "Subject to legislative appropriation you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at [phone number].";
(3) Within three calendar days of issuing the notice, provide a copy of the notice to the resident's assigned department case manager;
(4) Within three calendar days of issuing the notice, provide a copy of the notice to the Washington state long-term care ombudsman program; and
(5) Issue the transfer and discharge notice in substantially the following form:
Notice of transfer or discharge-residents with medicaid as a payor:
(a) Resident information;
(i) Resident name;
(ii) Resident address;
(b) Facility information;
(i) Facility name;
(ii) Facility address;
(iii) Contact person's name;
(c) Date notice given;
(d) Effective date: Effective date must be at least 30 days from the date notice is given unless an exception applies according to RCW 70.129.110;
(e) Location to where resident is transferred or discharged:
(i) Name;
(ii) Address;
(iii) Phone;
(f) Reason for transfer or discharge: The specific reason for the transfer or discharge must be one or more of the reasons in (i)-(v) of this subsection:
(i) Transfer or discharge is necessary for the resident's welfare and the residents' needs cannot be met in the facility;
(ii) The safety of individuals in the facility is endangered;
(iii) The health of individuals in the facility would otherwise be endangered;
(iv) The resident has failed to make the required payment for their stay;
(v) The facility ceases to operate.
(g) Copy of notice given within three days to:
(i) Department case manager;
(ii) Washington state long-term care ombudsman program;
(h) Your rights and resources.
(i) Legal counsel: Subject to legislative appropriation, you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at [phone number].
(ii) Washington state ombuds: The Washington state long-term care ombudsman program is available to answer questions and provide assistance regarding this notice and other issues. If you wish to request assistance from the long-term care ombuds, call 1-800-562-6028. You may also make your request in writing, by fax at (253) 815-8173, email at ltcop@mschelp.org, or mail at PO Box 23699, Federal Way, WA 98093-0699.
(iii) Disability rights Washington: If you have a diagnosis of a mental illness or an intellectual disability, you may contact disability rights Washington 1-800-562-2702 or (206) 324-1521. You may also make your request in writing by fax at (206) 957-0729, email at info@dr-wa.org or mail at Disability rights Washington, 315 5th Ave S, Suite 850, Seattle WA, 98104.
(iv) Aging and long-term support administration (ALTSA) complaint resolution unit (CRU/complaint hotline) 1-800-562-6078.
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending WSR 13-13-063, filed 6/18/13, effective 7/19/13)
WAC 388-78A-2410Content of resident records.
The assisted living facility must organize and maintain resident records in a format that the assisted living facility determines to be useful and functional to enable the effective provision of care and services to each resident. Active resident records must include the following:
(1) Resident identifying information, including resident's:
(a) Name;
(b) Birth date;
(c) Move-in date; and
(d) Sleeping room identification.
(2) Current name, address, and telephone number of:
(a) Resident's primary health care provider;
(b) Resident's representative, if the resident has one;
(c) Individual(s) to contact in case of emergency, illness, or death; and
(d) Family members or others, if any, the resident requests to be involved in the development or delivery of services for the resident.
(3) Resident's written acknowledgment of receipt of:
(a) Required disclosure information prior to moving into the assisted living facility; and
(b) Information required by long-term care resident rights per RCW 70.129.030.
(4) The resident's assessment and reassessment information.
(5) Clinical information such as admission weight, height, blood pressure, temperature, blood sugar, and other laboratory tests required by the negotiated service agreement.
(6) The resident's negotiated service agreement consistent with WAC 388-78A-2140.
(7) Any orders for medications, treatments, and modified or therapeutic diets, including any directions for addressing a resident's refusal of medications, treatments, and prescribed diets.
(8) Medical and nursing services provided by the assisted living facility for a resident, including:
(a) A record of providing medication assistance and medication administration, which contains:
(i) The medication name, dose, and route of administration;
(ii) The time and date of any medication assistance or administration;
(iii) The signature or initials of the person providing any medication assistance or administration; and
(iv) Documentation of a resident choosing to not take ((his or her))their medications.
(b) A record of any nursing treatments, including the signature or initials of the person providing them.
(9) Documentation consistent with WAC 388-78A-2120 monitoring resident well-being.
(10) Staff interventions or responses to subsection (9) of this section, including any modifications made to the resident's negotiated service agreement.
(11) Notices of and reasons for relocation as specified in RCW 70.129.110.
(12) The individuals who were notified of a significant change in the resident's condition and the time and date of the notification.
(13) When available, a copy of any legal documents in which:
(a) The resident has appointed another individual to make ((his or her))their health care, financial, or other decisions;
(b) The resident has created an advance directive or other legal document that establishes a surrogate decision maker in the future ((and/)) or provides directions to health care providers or both; and
(c) A court has established guardianship on behalf of the resident.
(14) If applicable, the residency agreement for residents with medicaid as a payor.
Residency Agreement-Residents with Medicaid
NEW SECTION
WAC 388-78A-2651Written residency agreement-Residents with medicaid as a payor.
(1) For the purposes of this section "residency agreement" means a legally enforceable written document prepared by the assisted living facility that contains the rights and responsibilities of the facility and the resident specific to transfer and discharge and is signed by both parties.
(2) For residents with medicaid as a payor the facility must complete a signed written residency agreement with each resident that:
(a) Is signed by the resident or their legal representative and the facility upon admission of the resident to the facility;
(b) Requires the facility to agree to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129; and
(c) Requires the facility to provide notice to residents upon transfer and discharge that includes information about available legal resources, and notice that, subject to legislative appropriation, residents have the right to legal counsel at public expense upon notice of transfer or discharge.
(3) For residents whose payor status changes from medicaid to private pay, a new residency agreement is required if the resident's payor status returns to medicaid.
(4) A copy of the residency agreement must be kept in the resident record.
(5) The residency agreement must be in substantially the following form:
Residency agreement-residents with medicaid as a payor.
(a) [facility name] agrees to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129.
(b) Subject to legislative appropriation [resident name] has a right to a free lawyer to help them in response to a notice of transfer or discharge. If they want a free lawyer to help them, they must call the long-term care discharge defense screening line at [phone number].
(c) [Signature of resident/legal representative].
(d) [Signature of facility].
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-78A-2661Resident rights-Transfer and discharge notice-Residents with medicaid as a payor.
For residents with medicaid as a payor, in addition to the requirements in WAC 388-78A-2660, the assisted living facility must do the following when issuing a written notice of transfer or discharge:
(1) Include in the notice contact information provided by the department for the legal services agencies assigned to provide legal counsel;
(2) Clearly state in the notice that, subject to legislative appropriation, legal counsel at public expense is available to represent the resident's interests in the transfer or discharge process. This language must be substantially in the following form: "Subject to legislative appropriation you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at [phone number].";
(3) Within three calendar days of issuing the notice, provide a copy of the notice to the resident's assigned department case manager;
(4) Within three calendar days of issuing the notice, provide a copy of the notice to the Washington state long-term care ombudsman program; and
(5) Issue the transfer and discharge notice in substantially the following form:
Notice of transfer or discharge-residents with medicaid as a payor:
(a) Resident information;
(i) Resident name;
(ii) Resident address;
(b) Facility information;
(i) Facility name;
(ii) Facility address;
(iii) Contact person's name;
(c) Date notice given;
(d) Effective date: Effective date must be at least 30 days from the date notice is given unless an exception applies according to RCW 70.129.110;
(e) Location to where resident is transferred or discharged:
(i) Name;
(ii) Address;
(iii) Phone;
(f) Reason for transfer or discharge: The specific reason for the transfer or discharge must be one or more of the reasons in (i)-(v) of this subsection:
(i) Transfer or discharge is necessary for the resident's welfare and the residents' needs cannot be met in the facility;
(ii) The safety of individuals in the facility is endangered;
(iii) The health of individuals in the facility would otherwise be endangered;
(iv) The resident has failed to make the required payment for their stay;
(v) The facility ceases to operate.
(g) Copy of notice given within three days to:
(i) Department case manager;
(ii) Washington state long-term care ombudsman program;
(h) Your rights and resources;
(i) Legal counsel: Subject to legislative appropriation, you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at [phone number].
(ii) Washington state ombuds: The Washington state long-term care ombudsman program is available to answer questions and provide assistance regarding this notice and other issues. If you wish to request assistance from the long-term care ombuds, call 1-800-562-6028. You may also make your request in writing, by fax at (253) 815-8173, email at ltcop@mschelp.org, or mail at PO Box 23699, Federal Way, WA 98093-0699.
(iii) Disability rights Washington: If you have a diagnosis of a mental illness or an intellectual disability, you may contact disability rights Washington 1-800-562-2702 or (206) 324-1521. You may also make your request in writing by fax at (206) 957-0729, email at info@dr-wa.org or mail at disability rights Washington, 315 5th Ave S, Suite 850, Seattle WA, 98104.
(iv) Aging and long-term support administration (ALTSA) complaint resolution unit (CRU/complaint hotline) 1-800-562-6078.
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.
RESIDENCY AGREEMENT-RESIDENTS WITH MEDICAID
NEW SECTION
WAC 388-107-0161Written residency agreement-Residents with medicaid as a payor.
(1) For the purposes of this section "residency agreement" means a legally enforceable written document prepared by the enhanced services facility that contains the rights and responsibilities of the facility and the resident specific to transfer and discharge and is signed by both parties.
(2) For residents with medicaid as a payor the facility must complete a signed written residency agreement with each resident that:
(a) Is signed by the resident or their legal representative and the facility upon admission of the resident to the facility;
(b) Requires the facility to agree to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129; and
(c) Requires the facility to provide notice to residents upon transfer and discharge that includes information about available legal resources, and notice that, subject to legislative appropriation, residents have the right to legal counsel at public expense upon notice of transfer or discharge.
(3) For residents whose payor status changes from medicaid to private pay, a new residency agreement is required if the resident's payor status returns to medicaid.
(4) A copy of the residency agreement must be kept in the resident record.
(5) The residency agreement must be in substantially the following form:
Residency agreement-residents with medicaid as a payor.
(a) [facility name] agrees to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129.
(b) Subject to legislative appropriation [resident name] has a right to a free lawyer to help them in response to a notice of transfer or discharge. If they want a free lawyer to help them, they must call the long-term care discharge defense screening line at [phone number].
(c) [Signature of resident/legal representative].
(d) [Signature of facility].
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.
NEW SECTION
WAC 388-107-0281Transfer and discharge notice-Residents with medicaid as a payor.
For residents with medicaid as a payor, in addition to the requirements in WAC 388-107-0280, the enhanced services facility must do the following when issuing a written notice of transfer or discharge:
(1) Include in the notice contact information provided by the department for the legal services agencies assigned to provide legal counsel;
(2) Clearly state in the notice that, subject to legislative appropriation, legal counsel at public expense is available to represent the resident's interests in the transfer or discharge process. This language must be substantially in the following form: "Subject to legislative appropriation you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at [phone number].";
(3) Within three calendar days of issuing the notice, provide a copy of the notice to the resident's assigned department case manager;
(4) Within three calendar days of issuing the notice, provide a copy of the notice to the Washington state long-term care ombudsman program; and
(5) Issue the transfer and discharge notice in substantially the following form:
Notice of transfer or discharge-residents with medicaid as a payor:
(a) Resident information;
(i) Resident name;
(ii) Resident address;
(b) Facility information;
(i) Facility name;
(ii) Facility address;
(iii) Contact person's name;
(c) Date notice given;
(d) Effective date: Effective date must be at least 30 days from the date notice is given unless an exception applies according to RCW 70.129.110;
(e) Location to where resident is transferred or discharged:
(i) Name;
(ii) Address;
(iii) Phone;
(f) Reason for transfer or discharge: The specific reason for the transfer or discharge must be one or more of the reasons in (i)-(v) of this subsection:
(i) Transfer or discharge is necessary for the resident's welfare and the residents' needs cannot be met in the facility;
(ii) The safety of individuals in the facility is endangered;
(iii) The health of individuals in the facility would otherwise be endangered;
(iv) The resident has failed to make the required payment for their stay;
(v) The facility ceases to operate.
(g) Copy of notice given within three days to:
(i) Department case manager;
(ii) Washington state long-term care ombudsman program;
(h) Your rights and resources:
(i) Legal counsel: Subject to legislative appropriation, you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at [phone number].
(ii) Washington state ombuds: The Washington state long-term care ombudsman program is available to answer questions and provide assistance regarding this notice and other issues. If you wish to request assistance from the long-term care ombuds, call 1-800-562-6028. You may also make your request in writing, by fax at (253) 815-8173, email at ltcop@mschelp.org, or mail at PO Box 23699, Federal Way, WA 98093-0699.
(iii) Disability rights Washington: If you have a diagnosis of a mental illness or an intellectual disability, you may contact disability rights Washington 1-800-562-2702 or (206) 324-1521. You may also make your request in writing by fax at (206) 957-0729, email at info@dr-wa.org or mail at disability rights Washington, 315 5th Ave S, Suite 850, Seattle WA, 98104.
(iv) Aging and long-term support administration (ALTSA) complaint resolution unit (CRU/complaint hotline) 1-800-562-6078.
Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency and appear in the Register pursuant to the requirements of RCW 34.08.040.
AMENDATORY SECTION(Amending WSR 16-14-078, filed 7/1/16, effective 8/1/16)
WAC 388-107-0560Resident records—Clinical records.
(1) The enhanced services facility must:
(a) Maintain clinical records on each resident in accordance with accepted professional standards and practices that are:
(i) Complete;
(ii) Accurately documented;
(iii) Readily accessible; and
(iv) Systematically organized;
(b) Safeguard clinical record information against alteration, loss, destruction, and unauthorized use; and
(c) Keep confidential all information contained in the resident's records, regardless of the form or storage method of the records, except when release is required by:
(i) Transfer to another health care institution;
(ii) Law; or
(iii) The resident.
(2) The enhanced services facility must ensure the clinical record of each resident includes a minimum of the following:
(a) Resident identification and sociological data, including the name and address of the individual or individuals the resident designates as significant;
(b) Medical information;
(c) Physician's orders;
(d) Assessments;
(e) Person-centered service plans;
(f) Services provided;
(g) Progress notes;
(h) Medications administered;
(i) Consents, authorizations, releases;
(j) Allergic responses;
(k) Laboratory, X-ray, and other findings;
(l) If applicable, the residency agreement for residents with medicaid as a payor; and
(((l)))(m) Other records as appropriate.
(3) The enhanced services facility must maintain resident records and preserve their confidentiality in accordance with applicable state and federal statutes and rules, including ((chapters))chapter 70.02 ((and 70.96A)) RCW.