reglab/statecodes huggingface dataset:
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.390 - Communication system.

RCW 74.42.390
Communication system.
The facility shall have a communication system, including telephone service, that insures prompt contact of on-duty personnel and prompt notification of responsible personnel in an emergency.
[ 1979 ex.s. c 211 § 39.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.400 - Engineering and maintenance personnel.

RCW 74.42.400
Engineering and maintenance personnel.
The facility shall have sufficient trained and experienced personnel for necessary engineering and maintenance functions.
[ 1979 ex.s. c 211 § 40.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.410 - Laundry services.

RCW 74.42.410
Laundry services.
The facility shall manage laundry services to meet the residents' daily clothing and linen needs. The facility shall have available at all times enough linen for the proper care and comfort of the residents.
[ 1979 ex.s. c 211 § 41.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.420 - Resident record system.

RCW 74.42.420
Resident record system.
The facility shall maintain an organized record system containing a record for each resident. The record shall contain:
(1) Identification information, including the information listed in RCW 18.51.095(1);
(2) Admission information, including the resident's medical and social history;
(3) A comprehensive plan of care and subsequent changes to the comprehensive plan of care;
(4) Copies of initial and subsequent periodic examinations, assessments, evaluations, and progress notes made by the facility and the department;
(5) Descriptions of all treatments, services, and medications provided for the resident since the resident's admission;
(6) Information about all illnesses and injuries including information about the date, time, and action taken; and
(7) A discharge summary.
Resident records shall be available to the staff members directly involved with the resident and to appropriate representatives of the department. The facility shall protect resident records against destruction, loss, and unauthorized use. The facility shall keep a resident's record after the resident is discharged as provided in RCW 18.51.300.
[ 2021 c 159 § 10; 1979 ex.s. c 211 § 42.]
NOTES:
Findings—2021 c 159: See note following RCW 18.20.520.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.430 - Written policy guidelines.

RCW 74.42.430
Written policy guidelines.
The facility shall develop written guidelines governing:
(1) All services provided by the facility;
(2) Admission, transfer or discharge;
(3) The use of chemical and physical restraints, the personnel authorized to administer restraints in an emergency, and procedures for monitoring and controlling the use of the restraints;
(4) Procedures for receiving and responding to residents' complaints and recommendations;
(5) Access to, duplication of, and dissemination of information from the resident's record;
(6) Residents' rights, privileges, and duties;
(7) Procedures if the resident is adjudicated incompetent or incapable of understanding his or her rights and responsibilities;
(8) When to recommend initiation of guardianship, conservatorship, or other protective arrangement proceedings under chapter 11.130 RCW;
(9) Emergencies;
(10) Procedures for isolation of residents with infectious diseases; and
(11) Procedures for residents to refuse treatment and for the facility to document informed refusal.
The written guidelines shall be made available to the staff, residents, members of residents' families, and the public.
[ 2020 c 312 § 739; 1980 c 184 § 12; 1979 ex.s. c 211 § 43.]
NOTES:
Effective dates—2020 c 312: See note following RCW 11.130.915.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.440 - Facility rated capacity not to be exceeded.

RCW 74.42.440
Facility rated capacity not to be exceeded.
The facility may only admit individuals when the facility's rated capacity will not be exceeded and when the facility has the capability to provide adequate treatment, therapy, and activities.
[ 1979 ex.s. c 211 § 44.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.455 - Transitional care management.

RCW 74.42.455
Transitional care management.
(1) Nursing facilities may provide telephone or web-based transitional care management services to persons discharged from the facility to home for up to thirty days postdischarge.
(2) When a nursing facility provides transitional care management services, the facility must coordinate postdischarge care and service needs with in-home agencies licensed under chapter 70.127 RCW, and other authorized care providers, to promote evidence-based transition care planning. In-home service agencies and other authorized care providers, including the department, shall, when appropriate, determine resident eligibility for postdischarge care and services and coordinate with nursing facilities to plan a safe transition of the client to the home setting. When a resident is discharged to home and is without in-home care or services due to the resident's refusal of care or their ineligibility for care, the nursing facility may provide telephone or web-based transitional care management services. These services may include care coordination services, review of the discharge plan, instructions to promote compliance with the discharge plan, reminders or assistance with scheduling follow-up appointments with other health care professionals consistent with the discharge plan, and promotion of self-management of the client's health condition. Web-based transition care services may include patient education and the provision of services described in this section. They are not intended to include telehealth monitoring.
(3) If the nursing facility identifies concerns in client care that result from telephone or web-based transitional care management services, the nursing facility will notify the client's primary care physician. The nursing facility will also discuss with the client options for care or other services which may include in-home services provided by agencies licensed under chapter 70.127 RCW.
[ 2011 c 366 § 7.]
NOTES:
Findings—Purpose—Conflict with federal requirements—2011 c 366: See notes following RCW 18.20.020.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.460 - Organization plan and procedures.

RCW 74.42.460
Organization plan and procedures.
The facility shall have a written staff organization plan and detailed written procedures to meet potential emergencies and disasters. The facility shall clearly communicate and periodically review the plan and procedures with the staff and residents. The plan and procedures shall be posted at suitable locations throughout the facility. The planning requirement of this section shall complement the comprehensive disaster preparedness planning requirement of RCW 18.51.580.
[ 2021 c 159 § 12; 1979 ex.s. c 211 § 46.]
NOTES:
Findings—2021 c 159: See note following RCW 18.20.520.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.470 - Infected employees.

RCW 74.42.470
Infected employees.
No employee with symptoms of a communicable disease may work in a facility. The facility shall have written guidelines that will help enforce this section.
[ 1979 ex.s. c 211 § 47.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.480 - Living areas.

RCW 74.42.480
Living areas.
The facility shall design and equip the resident living areas for the comfort and privacy of each resident.
[ 1979 ex.s. c 211 § 48.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.490 - Room requirements—Waiver.

RCW 74.42.490
Room requirements—Waiver.
Each resident's room shall:
(1) Be equipped with or conveniently located near toilet and bathing facilities;
(2) Be at or above grade level;
(3) Contain a suitable bed for each resident and other appropriate furniture;
(4) Have closet space that provides security and privacy for clothing and personal belongings;
(5) Contain no more than four beds;
(6) Have adequate space for each resident; and
(7) Be equipped with a device for calling the staff member on duty.
The department may waive the space, occupancy, and certain equipment requirements of this section for an existing building constructed prior to January 1, 1980, or space and certain equipment for new intermediate care facilities for persons with intellectual disabilities for as long as the department considers appropriate if the department finds that the requirements would result in unreasonable hardship on the facility, the waiver serves the particular needs of the residents, and the waiver does not adversely affect the health and safety of the residents.
[ 2010 c 94 § 28; 1980 c 184 § 13; 1979 ex.s. c 211 § 49.]
NOTES:
Purpose—2010 c 94: See note following RCW 44.04.280.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.500 - Toilet and bathing facilities.

RCW 74.42.500
Toilet and bathing facilities.
Toilet and bathing facilities shall be located in or near residents' rooms and shall be appropriate in number, size, and design to meet the needs of the residents. The facility shall provide an adequate supply of hot water at all times for resident use. Plumbing shall be equipped with control valves that automatically regulate the temperature of the hot water used by residents.
[ 1979 ex.s. c 211 § 50.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.510 - Room for dining, recreation, social activities—Waiver.

RCW 74.42.510
Room for dining, recreation, social activities—Waiver.
The facility shall provide one or more areas not used for corridor traffic for dining, recreation, and social activities. A multipurpose room may be used if it is large enough to accommodate all of the activities without the activities interfering with each other: PROVIDED, That the department may waive the provisions of this section for facilities constructed prior to January 1, 1980.
[ 1979 ex.s. c 211 § 51.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.520 - Therapy area.

RCW 74.42.520
Therapy area.
The facility's therapy area shall be large enough and designed to accommodate the necessary equipment, conduct an examination, and provide treatment: PROVIDED, That developmentally disabled facilities shall not be subject to the provisions of this section if therapeutic services are obtained by contract with other facilities.
[ 1979 ex.s. c 211 § 52.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.530 - Isolation areas.

RCW 74.42.530
Isolation areas.
The facility shall have isolation areas for residents with infectious diseases or make other provisions for isolating these residents.
[ 1979 ex.s. c 211 § 53.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.540 - Building requirements.

RCW 74.42.540
Building requirements.
(1) The facility shall be accessible to and usable by all residents, personnel, and the public, including individuals with disabilities: PROVIDED, That no substantial structural changes shall be required in any facilities constructed prior to January 1, 1980.
(2) The facility shall meet the requirements of American national standards institute (ANSI) standard No. A117.1 (1961), or, if applicable, the requirements of chapter 70.92 RCW if the requirements are stricter than ANSI standard No. A117.1 (1961), unless the department waives the requirements of ANSI standard No. A117.1 (1961) under subsection (3) of this section.
(3) The department may waive, for as long as the department considers appropriate, provisions of ANSI standard No. A117.1 (1961) if:
(a) The construction plans for the facility or a part of the facility were approved by the department before March 18, 1974;
(b) The provisions would result in unreasonable hardship on the facility if strictly enforced; and
(c) The waiver does not adversely affect the health and safety of the residents.
[ 1979 ex.s. c 211 § 54.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.550 - Handrails.

RCW 74.42.550
Handrails.
The facility shall have handrails that are firmly attached to the walls in all corridors used by residents: PROVIDED, That the department may waive the provisions of this section in developmentally disabled facilities.
[ 1979 ex.s. c 211 § 55.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.560 - Emergency lighting for facilities housing persons with developmental disabilities.

RCW 74.42.560
Emergency lighting for facilities housing persons with developmental disabilities.
If a living unit of a facility for the developmentally disabled houses more than fifteen residents, the living unit shall have emergency lighting with automatic switches for stairs and exits.
[ 1979 ex.s. c 211 § 56.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.570 - Health and safety requirements.

RCW 74.42.570
Health and safety requirements.
The facility shall meet state and local laws, rules, regulations, and codes pertaining to health and safety.
[ 1980 c 184 § 14; 1979 ex.s. c 211 § 57.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.580 - Penalties for violation of standards.

RCW 74.42.580
Penalties for violation of standards.
The department may deny, suspend, revoke, or refuse to renew a license or provisional license, assess monetary penalties of a civil nature, deny payment, seek receivership, order stop placement, appoint temporary management, order emergency closure, or order emergency transfer as provided in RCW 18.51.054 and 18.51.060 for violations of requirements of this chapter or, in the case of medicaid contractors, the requirements of Title XIX of the social security act, as amended, or rules adopted thereunder. Chapter 34.05 RCW shall apply to any such actions, except for receivership, and except that stop placement, appointment of temporary management, emergency closure, emergency transfer, and summary license suspension shall be effective pending any hearing, and except that denial of payment shall be effective pending any hearing when the department determines deficiencies jeopardize the health and safety of the residents or seriously limit the nursing home's capacity to provide adequate care.
[ 1989 c 372 § 13; 1987 c 476 § 27; 1980 c 184 § 15; 1979 ex.s. c 211 § 58.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.600 - Department inspections—Notice of noncompliance—Penalties—Coordination with department of health.

RCW 74.42.600
Department inspections—Notice of noncompliance—Penalties—Coordination with department of health.
(1) In addition to the inspection required by chapter 18.51 RCW, the department shall inspect the facility for compliance with resident rights and direct care standards of this chapter. The department may inspect any and all other provisions randomly, by exception profiles, or during complaint investigations.
(2) If the facility has not complied with all the requirements of this chapter, the department shall notify the facility in writing that the facility is in noncompliance and describe the reasons for the facility's noncompliance and the department may impose penalties in accordance with RCW 18.51.060.
(3) To avoid unnecessary duplication in inspections, the department shall coordinate with the department of health when inspecting medicaid-certified or medicare-certified, or both, long-term care beds in hospitals for compliance with Title XVIII or XIX of the social security act.
[ 1995 c 282 § 5; 1987 c 476 § 28; 1982 c 120 § 3; 1980 c 184 § 17; 1979 ex.s. c 211 § 60.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.620 - Departmental rules.

RCW 74.42.620
Departmental rules.
The department shall adopt rules pursuant to chapter 34.05 RCW necessary to carry out the policies and provisions of RCW 74.42.010 through 74.42.570. The department shall amend or repeal any rules that are in conflict with RCW 74.42.010 through 74.42.570.
[ 1979 ex.s. c 211 § 62.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.630 - Conflict with federal requirements.

RCW 74.42.630
Conflict with federal requirements.
If any part of chapter 184, Laws of 1980 shall be found to be in conflict with federal requirements which are a prescribed condition to the allocation of federal funds to the state, such conflicting part of this act is hereby declared to be inoperative solely to the extent of such conflict, and such finding or determination shall not affect the operation of the remainder of this act; the rules and regulations under this act shall meet federal requirements which are a necessary condition to the receipt of federal funds by the state.
[ 1980 c 184 § 21.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.910 - Construction—Conflict with federal requirements.

RCW 74.42.910
Construction—Conflict with federal requirements.
If any part of this act is found to be in conflict with federal requirements which are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is hereby declared to be inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and such finding or determination shall not affect the operation of the remainder of this act in its application to the agencies concerned. The rules under this act shall meet federal requirements which are a necessary condition to the receipt of federal funds by the state.
[ 1979 ex.s. c 211 § 70.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.42 - Nursing Homes—Resident Care, Operating Standards. › 74.42.920 - Chapter 74.42 RCW suspended—Effective date delayed until January 1, 1981.

RCW 74.42.920
Chapter 74.42 RCW suspended—Effective date delayed until January 1, 1981.
Chapter 74.42 RCW shall be suspended immediately, and its effective date delayed so that it shall take effect on January 1, 1981.
[ 1980 c 184 § 19; 1979 ex.s. c 211 § 72.]
NOTES:
Effective date—1980 c 184 § 19: "Section 19 of this 1980 act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect immediately [April 4, 1980]." [ 1980 c 184 § 22.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.010 - Short title—Purpose—Finding.

RCW 74.46.010
Short title—Purpose—Finding.
(1) This chapter may be known and cited as the "nursing facility medicaid payment system."
(2) The purposes of this chapter are to set forth principles to guide the nursing facility medicaid payment system and specify the manner by which legislative appropriations for medicaid nursing facility services are to be allocated as payment rates among nursing facilities.
(3) The legislature finds that the medicaid nursing facility rates calculated under this chapter provide sufficient reimbursement to efficient and economically operating facilities and bear a reasonable relationship to costs.
[ 2010 1st sp.s. c 34 § 1; 1998 c 322 § 1; 1980 c 177 § 1.]
NOTES:
Effective date—2010 1st sp.s. c 34: "This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 1, 2010." [ 2010 1st sp.s. c 34 § 23.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.024 - Pay-for-performance supplemental payment structure—Establishing procedures, principles, and conditions.

RCW 74.46.024
Pay-for-performance supplemental payment structure—Establishing procedures, principles, and conditions.
The department shall establish, by rule, the procedures, principles, and conditions for a pay-for-performance supplemental payment structure that provides payment add-ons for high performing facilities. To the extent that funds are appropriated for this purpose, the pay-for-performance structure will include a one percent reduction in payments to facilities with exceptionally high direct care staff turnover, and a method by which the funding that is not paid to these facilities is then used to provide a supplemental payment to facilities with lower direct care staff turnover.
[ 2010 1st sp.s. c 34 § 20.]
NOTES:
Effective date—2010 1st sp.s. c 34: See note following RCW 74.46.010.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.441 - Public disclosure of rate-setting information.

RCW 74.46.441
Public disclosure of rate-setting information.
The department shall disclose to any member of the public all rate-setting information consistent with requirements of state and federal laws.
[ 1998 c 322 § 20.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.475 - Submitted cost report—Analysis and adjustment by department.

RCW 74.46.475
Submitted cost report—Analysis and adjustment by department.
The department shall analyze the submitted cost report or a portion thereof of each contractor for each report period to determine if the information is correct, complete, reported in conformance with department instructions and generally accepted accounting principles, the requirements of this chapter, and such rules as the department may adopt. If the analysis finds that the cost report is incorrect or incomplete, the department may make adjustments to the reported information for purposes of establishing payment rate allocations. A schedule of such adjustments shall be provided to contractors and shall include an explanation for the adjustment and the dollar amount of the adjustment. Adjustments shall be subject to review and appeal as provided in this chapter.
[ 2010 1st sp.s. c 34 § 8; 1998 c 322 § 21; 1985 c 361 § 13; 1983 1st ex.s. c 67 § 23.]
NOTES:
Effective date—2010 1st sp.s. c 34: See note following RCW 74.46.010.
Savings—1985 c 361: See note following RCW 74.46.020.
Effective dates—1983 1st ex.s. c 67: "This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions and shall take effect on July 1, 1983, with the exception of section 28 of this act, which shall take effect on January 1, 1985." [ 1983 1st ex.s. c 67 § 51.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.531 - Department may adjust component rates—Contractor may request—Errors or omissions.

RCW 74.46.531
Department may adjust component rates—Contractor may request—Errors or omissions.
(1) The department may adjust component rates for errors or omissions made in establishing component rates and determine amounts either overpaid to the contractor or underpaid by the department.
(2) A contractor may request the department to adjust its component rates because of:
(a) An error or omission the contractor made in completing a cost report; or
(b) An alleged error or omission made by the department in determining one or more of the contractor's component rates.
(3) A request for a rate adjustment made on incorrect cost reporting must be accompanied by the amended cost report pages prepared in accordance with the department's written instructions and by a written explanation of the error or omission and the necessity for the amended cost report pages and the rate adjustment.
(4) The department shall review a contractor's request for a rate adjustment because of an alleged error or omission, even if the time period has expired in which the contractor must appeal the rate when initially issued, pursuant to rules adopted by the department under *RCW 74.46.780. If the request is received after this time period, the department has the authority to correct the rate if it agrees an error or omission was committed. However, if the request is denied, the contractor shall not be entitled to any appeals or exception review procedure that the department may adopt under *RCW 74.46.780.
(5) The department shall notify the contractor of the amount of the overpayment to be recovered or additional payment to be made to the contractor reflecting a rate adjustment to correct an error or omission. The recovery from the contractor of the overpayment or the additional payment to the contractor shall be governed by the reconciliation, settlement, security, and recovery processes set forth in this chapter and by rules adopted by the department in accordance with this chapter.
(6) Component rate adjustments approved in accordance with this section are subject to the provisions of RCW 74.46.421.
[ 1998 c 322 § 31.]
NOTES:
*Reviser's note: RCW 74.46.780 was repealed by 2010 1st sp.s. c 34 § 21.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.541 - Skilled nursing facility safety net assessment—Reimbursement of medicaid share.

RCW 74.46.541
Skilled nursing facility safety net assessment—Reimbursement of medicaid share.
(1) The department shall establish a skilled nursing facility safety net assessment medicaid share pass-through or rate add-on to reimburse the medicaid share of the skilled nursing facility safety net assessment as a medicaid allowable cost consistent with RCW 74.48.030. This add-on shall not be considered an allowable cost for future year cost rebasing.
(2) As of July 1, 2011, supplemental payments to reimburse medicaid expenditures, including an amount to reimburse the medicaid share of the skilled nursing facility safety net assessment, not to exceed the annual medicare upper payment limit, must be provided for all years when the skilled nursing facility safety net assessment is levied, consistent with RCW 74.48.030. These supplemental payments, at a minimum, must be sufficient to reimburse the medicaid share of the assessment for those paying the assessment. The part of these supplemental payments that reimburses the medicaid share of the assessment are not subject to the reconciliation and settlement process provided in RCW 74.46.022(6).
[ 2011 1st sp.s. c 7 § 10.]
NOTES:
Purpose—Findings—Intent—Severability—Effective date—2011 1st sp.s. c 7: See RCW 74.48.005, 74.48.900, and 74.48.901.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.551 - Facility-based payment rates—Comparative analysis—Rate add-ons.

RCW 74.46.551
Facility-based payment rates—Comparative analysis—Rate add-ons.
(1) For fiscal year 2016 and subject to appropriation, the department shall do a comparative analysis of the facility-based payment rates calculated on July 1, 2015, using the payment methodology defined in this chapter, to the facility-based rates in effect June 30, 2010. If the facility-based payment rate calculated on July 1, 2015, is smaller than the facility-based payment rate on June 30, 2010, the difference must be provided to the individual nursing facilities as an add-on per medicaid resident day.
(2) During the comparative analysis performed in subsection (1) of this section, for fiscal year 2016, if it is found that the direct care rate for any facility calculated under this chapter is greater than the direct care rate in effect on June 30, 2010, then the facility must receive a ten percent direct care rate add-on to compensate that facility for taking on more acute clients than it has in the past.
(3) The rate add-ons provided in subsection (2) of this section are subject to the reconciliation and settlement process provided in RCW 74.46.022(6).
[ 2015 2nd sp.s. c 2 § 3.]
NOTES:
Effective date—2015 2nd sp.s. c 2: See note following RCW 74.46.501.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.562 - Indian health service or tribal facilities—Payment rates.

RCW 74.46.562
Indian health service or tribal facilities—Payment rates.
Services provided by or through facilities of the Indian health service or facilities operated by a tribe or tribal organization pursuant to 42 C.F.R. Part 136 may be paid at the applicable rates published in the federal register or at a cost-based rate applicable to such types of facilities as approved by the centers for medicare and medicaid services and may be exempted from the rate determination set forth in this chapter. The department may enact emergency rules to implement this section.
[ 2019 c 301 § 2.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.571 - Nursing home payment rates—Rules.

RCW 74.46.571
Nursing home payment rates—Rules.
The department shall adopt rules as are necessary and reasonable to effectuate and maintain the new system for establishing nursing home payment rates described in RCW 74.46.561 and the minimum staffing standards described in RCW 74.42.360. The rules must be consistent with the principles described in RCW 74.46.561 and 74.42.360. In adopting such rules, the department shall solicit the opinions of nursing facility providers, nursing facility provider associations, nursing facility employees, and nursing facility consumer groups.
[ 2015 2nd sp.s. c 2 § 5.]
NOTES:
Effective date—2015 2nd sp.s. c 2: See note following RCW 74.46.501.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.581 - Separate nursing facility quality enhancement account.

RCW 74.46.581
Separate nursing facility quality enhancement account.
A separate nursing facility quality enhancement account is created in the custody of the state treasurer. Beginning July 1, 2015, all net receipts from the reconciliation and settlement process provided in RCW 74.46.022(6), as described within RCW 74.46.561, must be deposited into the account. Beginning July 1, 2016, all receipts from the system of financial penalties for facilities out of compliance with minimum staffing standards, as described within RCW 74.42.360, must be deposited into the account. Only the secretary, or the secretary's designee, may authorize expenditures from the account. The account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures. The department shall use the special account only for technical assistance for nursing facilities, specialized training for nursing facilities, or an increase to the quality enhancement established in RCW 74.46.561, or as necessary for the reconciliation and settlement process, which requires deposits and withdrawals to complete both the preliminary and final settlement net receipt amounts for this account.
[ 2016 c 131 § 7; 2015 2nd sp.s. c 2 § 8.]
NOTES:
Effective date—2015 2nd sp.s. c 2: See note following RCW 74.46.501.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.800 - Rule-making authority.

RCW 74.46.800
Rule-making authority.
(1) The department shall have authority to adopt, amend, and rescind such administrative rules and definitions as it deems necessary to carry out the policies and purposes of this chapter and to resolve issues and develop procedures to implement, update, and improve the nursing facility medicaid payment system.
(2) Nothing in this chapter shall be construed to require the department to adopt or employ any calculations, steps, tests, methodologies, alternate methodologies, indexes, formulas, mathematical or statistical models, concepts, or procedures for medicaid rate setting or payment that are not expressly called for in this chapter.
[ 2010 1st sp.s. c 34 § 18; 1998 c 322 § 42; 1980 c 177 § 80.]
NOTES:
Effective date—2010 1st sp.s. c 34: See note following RCW 74.46.010.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.835 - AIDS pilot nursing facility—Payment for direct care.

RCW 74.46.835
AIDS pilot nursing facility—Payment for direct care.
(1) Payment for direct care at the pilot nursing facility in King county designed to meet the service needs of residents living with AIDS, as defined in *RCW 70.24.017, and as specifically authorized for this purpose under chapter 9, Laws of 1989 1st ex. sess., shall be exempt from case mix methods of rate determination set forth in this chapter and shall be exempt from the direct care wage index adjustment set forth in this chapter.
(2) Direct care component rates at the AIDS pilot facility shall be based on direct care reported costs at the pilot facility, utilizing the same rate-setting cycle prescribed for other nursing facilities, and as supported by a staffing benchmark based upon a department-approved acuity measurement system.
(3) The provisions of RCW 74.46.421 and all other rate-setting principles, cost lids, and limits, including settlement as provided in rule shall apply to the AIDS pilot facility.
(4) This section applies only to the AIDS pilot nursing facility.
[ 2016 c 131 § 6; 2010 1st sp.s. c 34 § 17; 1998 c 322 § 46.]
NOTES:
*Reviser's note: RCW 70.24.017 was amended by 2020 c 76 § 2, deleting the definition of "AIDS."
Effective date—2010 1st sp.s. c 34: See note following RCW 74.46.010.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.840 - Conflict with federal requirements.

RCW 74.46.840
Conflict with federal requirements.
If any part of this chapter or RCW 18.51.145 or 74.09.120 is found by an agency of the federal government to be in conflict with federal requirements that are a prescribed condition to the receipts of federal funds to the state, the conflicting part of this chapter or RCW 18.51.145 or 74.09.120 is declared inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and such finding or determination shall not affect the operation of the remainder of this chapter or RCW 18.51.145 or 74.09.120 in its application to the agencies concerned. In the event that any portion of this chapter or RCW 18.51.145 or 74.09.120 is found to be in conflict with federal requirements that are a prescribed condition to the receipt of federal funds, the secretary, to the extent that the secretary finds it to be consistent with the general policies and intent of chapters 18.51, 74.09, and 74.46 RCW, may adopt such rules as to resolve a specific conflict and that do meet minimum federal requirements. In addition, the secretary shall submit to the next regular session of the legislature a summary of the specific rule changes made and recommendations for statutory resolution of the conflict.
[ 1998 c 322 § 44; 1983 1st ex.s. c 67 § 42; 1980 c 177 § 92.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.46 - Nursing Facility Medicaid Payment System. › 74.46.909 - Retrospective application—Clarification of chapter 8, Laws of 2001 1st sp. sess.—2008 c 263.

RCW 74.46.909
Retrospective application—Clarification of chapter 8, Laws of 2001 1st sp. sess.—2008 c 263.
The legislature clarifies the enactment of *chapter 8, Laws of 2001 1st sp. sess. and intends this act be curative, remedial, and retrospectively applicable to July 1, 1998.
[ 2008 c 263 § 5.]
NOTES:
*Reviser's note: For codification of chapter 8, Laws of 2001 1st sp. sess., see Codification Tables.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.005 - Purpose—Findings—Intent.

RCW 74.48.005
Purpose—Findings—Intent.
(1) It is the intent of the legislature to encourage maximization of financial resources eligible and available for medicaid services by establishing the skilled nursing facility safety net trust fund to receive skilled nursing facility safety net assessments to use in securing federal matching funds under federally prescribed programs available through the state medicaid plan.
(2) The purpose of this chapter is to provide for a safety net assessment on certain Washington skilled nursing facilities, which will be used solely to support payments to skilled nursing facilities for medicaid services.
(3) The legislature finds that:
(a) Washington skilled nursing facilities have proposed a skilled nursing facility safety net assessment to generate additional state and federal funding for the medicaid program, which will be used in part to restore recent reductions in skilled nursing facility reimbursement rates and provide for an increase in medicaid reimbursement rates; and
(b) The skilled nursing facility safety net assessment and skilled nursing facility safety net trust fund created in this chapter allows the state to generate additional federal financial participation for the medicaid program and provides for increased reimbursement to skilled nursing facilities.
(4) In adopting this chapter, it is the intent of the legislature:
(a) To impose a skilled nursing facility safety net assessment to be used solely for the purposes specified in this chapter;
(b) That funds generated by the assessment, including matching federal financial participation, shall not be used for purposes other than as specified in this chapter;
(c) That the total amount assessed not exceed the amount needed, in combination with all other available funds, to support the reimbursement rates and other payments authorized by this chapter, including payments under RCW 74.48.030; and
(d) To condition the assessment and use of the resulting funds on receiving federal approval for receipt of additional federal financial participation.
[ 2011 1st sp.s. c 7 § 12.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.030 - Assessments.

RCW 74.48.030
Assessments.
(1) In accordance with the redistribution method set forth in 42 C.F.R. Sec. 433.68(e)(1) and (2), the department shall seek a waiver of the broad-based and uniform provider assessment requirements of federal law to exclude certain nursing facilities from the skilled nursing facility safety net assessment and to permit certain high volume medicaid nursing facilities or facilities with a high number of total annual resident days to pay the skilled nursing facility safety net assessment at a lesser amount per nonmedicare patient day.
(2) The skilled nursing facility safety net assessment shall, at no time, be greater than the maximum percentage of the nursing facility industry reported net patient service revenues allowed under federal law or regulation.
(3) All skilled nursing facility safety net assessments collected pursuant to this section by the department shall be transmitted to the state treasurer who shall credit all such amounts to the skilled nursing facility safety net trust fund.
[ 2011 1st sp.s. c 7 § 15.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.050 - Exceptions.

RCW 74.48.050
Exceptions.
(1) Subject to subsection (4) of this section the department shall exempt the following nursing facility providers from the skilled nursing facility safety net assessment subject to federal approval under 42 C.F.R. Sec. 433.68(e)(2):
(a) Continuing care retirement communities;
(b) Nursing facilities with thirty-five or fewer licensed beds;
(c) State, tribal, and county operated nursing facilities; and
(d) Any nursing facility operated by a public hospital district and nursing facilities that are hospital-based.
(2) The department shall lower the skilled nursing facility safety net assessment for either certain high volume medicaid nursing facilities or certain facilities with high resident volumes to meet the redistributive tests of 42 C.F.R. Sec. 433.68(e)(2).
(3) The department shall lower the skilled nursing facility safety net assessment for any skilled nursing facility with a licensed bed capacity in excess of two hundred three beds to the same level described in subsection (2) of this section.
(4) To the extent necessary to obtain federal approval under 42 C.F.R. Sec. 433.68(e)(2), the exemptions prescribed in subsections (1), (2), and (3) of this section may be amended by the department.
(5) The per resident day assessment rate shall be the same amount for each affected facility except as prescribed in subsections (1), (2), and (3) of this section.
(6) The department shall notify the nursing facility operators of any skilled nursing facilities that would be exempted from the skilled nursing facility safety net assessment pursuant to the waiver request submitted to the United States department of health and human services under this section.
[ 2011 1st sp.s. c 7 § 17.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.060 - Conditions.

RCW 74.48.060
Conditions.
(1) If the centers for medicare and medicaid services fail to approve any state plan amendments or waiver requests that are necessary in order to implement the applicable sections of this chapter then the assessment authorized in RCW 74.48.040 shall cease to be imposed.
(2) Nothing in subsection (1) of this section prohibits the department from working cooperatively with the centers for medicare and medicaid services to secure approval of any needed state plan amendments or waiver requests. As provided in RCW 74.48.030 and 74.48.050, the department shall adjust any submitted state plan amendments or waiver requests as necessary to achieve approval.
(3) If this chapter does not take effect or ceases to be imposed, any moneys remaining in the fund shall be refunded to skilled nursing facilities in proportion to the amounts paid by such facilities.
[ 2011 1st sp.s. c 7 § 18.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.070 - Assessment part of operating overhead.

RCW 74.48.070
Assessment part of operating overhead.
The incidence and burden of assessments imposed under this chapter shall be on skilled nursing facilities and the expense associated with the assessments shall constitute a part of the operating overhead of the facilities. Skilled nursing facilities shall not itemize the safety net assessment on billings to residents or third-party payers.
[ 2011 1st sp.s. c 7 § 19.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.080 - Enforcement.

RCW 74.48.080
Enforcement.
If a nursing facility fails to make timely payment of the safety net assessment, the department may seek a remedy provided by law, including, but not limited to:
(1) Withholding any medical assistance reimbursement payments until such time as the assessment amount is recovered;
(2) Suspension or revocation of the nursing facility license; or
(3) Imposition of a civil fine up to one thousand dollars per day for each delinquent payment, not to exceed the amount of the assessment.
[ 2011 1st sp.s. c 7 § 20.]
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.090 - Quality incentive payments.

RCW 74.48.090
Quality incentive payments.
(1) The department and the department of health, in consultation with the Washington state health care association, and aging services of Washington, shall design a system of skilled nursing facility quality incentive payments. The design of the system shall be submitted to the relevant policy and fiscal committees of the legislature by January 1, 2013. For the 2011-2013 fiscal biennial budget period, the department shall not implement a system of skilled nursing facility quality incentive payments designed pursuant to this section. The system shall be based upon the following principles:
(a) Evidence-based treatment and processes shall be used to improve health care outcomes for skilled nursing facility residents;
(b) Effective purchasing strategies to improve the quality of health care services should involve the use of common quality improvement measures, while recognizing that some measures may not be appropriate for application to facilities with high bariatric, behaviorally challenged, or rehabilitation populations;
(c) Quality measures chosen for the system should be consistent with the standards that have been developed by national quality improvement organizations, such as the national quality forum, the federal centers for medicare and medicaid services, or the federal agency for healthcare research and quality. New reporting burdens to skilled nursing facilities should be minimized by giving priority to measures skilled nursing facilities that are currently required to report to governmental agencies, such as the nursing home compare measures collected by the federal centers for medicare and medicaid services;
(d) Benchmarks for each quality improvement measure should be set at levels that are feasible for skilled nursing facilities to achieve, yet represent real improvements in quality and performance for a majority of skilled nursing facilities in Washington state; and
(e) Skilled nursing facilities performance and incentive payments should be designed in a manner such that all facilities in Washington are able to receive the incentive payments if performance is at or above the benchmark score set in the system established under this section.
(2) Pursuant to an appropriation by the legislature, for state fiscal year 2014 and each fiscal year thereafter, assessments may be increased to support an additional one percent increase in skilled nursing facility reimbursement rates for facilities that meet the quality incentive benchmarks established under this section.
[ 2012 2nd sp.s. c 7 § 921; 2011 1st sp.s. c 7 § 21.]
NOTES:
Effective date—2012 2nd sp.s. c 7: See note following RCW 2.68.020.
2023 Revised Code of Washington › Title 74 - Public Assistance › Chapter 74.48 - Skilled Nursing Facility Safety Net Assessments. › 74.48.900 - Severability—2011 1st sp.s. c 7.

RCW 74.48.900
Severability—2011 1st sp.s. c 7.
Except as provided in RCW 74.48.060, if any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.
[ 2011 1st sp.s. c 7 § 24.]