reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Admission And Assessment › Section 388-107-0040 - Preadmission assessment

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced
				  services facility must complete a face to face preadmission assessment at the
				  hospital with each potential resident prior to admission which includes the
				  following minimum information:
(a) Resident
				  identification information such as but not limited to the name, address and
				  telephone number of the resident's:
(i)
				  Representative;
(ii) Health Care
				  providers;
(iii) Significant family
				  members identified by the resident;
(iv) Other individuals the resident wants
				  involved or notified; and
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Admission And Assessment › Section 388-107-0050 - Timing of preadmission assessment

Current through Register Vol. 24-14, July 15, 2024
The assessor must complete the preadmission assessment of
					 the prospective resident before the resident moves into the enhanced services
					 facility.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Admission And Assessment › Section 388-107-0060 - Comprehensive assessment required

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The enhanced services facility must complete a comprehensive assessment for
				  each resident within fourteen (14) days of admission.
(2) The assessment will be repeated when
				  there is a significant change in the resident's condition or, at a minimum,
				  every one hundred eighty days if there is no significant change in
				  condition.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Admission And Assessment › Section 388-107-0070 - Comprehensive assessment

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must obtain sufficient
					 information to be able to assess the capabilities, needs, and preferences for
					 each resident, and must complete a comprehensive assessment. The assessment
					 addresses the following, within fourteen days of the resident's move-in
					 date:
(1) Individual's recent medical
				  history, including, but not limited to:
(a)
				  Diagnoses from a licensed medical or health professional, unless the resident
				  objects for religious reasons;
(b)
				  Chronic, current, and potential skin conditions; or
(c) Known allergies to foods or medications;
				  or
(d) Other considerations for
				  providing care or services.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Admission And Assessment › Section 388-107-0080 - Ongoing comprehensive assessments

Current through Register Vol. 24-14, July 15, 2024
(1) The department amended portions of this
				  rule from January 18, 2022, through June 8, 2023, in response to the state of
				  emergency related to the COVID-19 pandemic. For requirements in place during
				  that time, see WAC
				  388-107-0081.
(2) The enhanced services facility must:
(a) Complete a comprehensive assessment,
				  addressing the elements set forth in WAC
				  388-107-0070, upon a significant
				  change in the resident's condition or at least every 180 days if there is no
				  significant change in condition;
(b) Complete an assessment specifically
				  focused on a resident's identified strengths, preferences, limitations, and
				  related issues:
(i) Consistent with the
				  resident's change of condition as specified in WAC
				  388-107-0060;
(ii) When the resident's person-centered
				  service plan no longer addresses the resident's current needs and preferences;
				  and
(iii) When the resident has an
				  injury requiring the intervention of a practitioner;
(c) Review each resident's needs to evaluate
				  discharge or transfer options when the resident:
(i) No longer needs the level of behavioral
				  support provided by the facility; or
(ii) Expresses the desire to move to a
				  different type of community based setting;
(d) Ensure that the person-centered service
				  planning team discusses all available placement options; and
(e) Ensure the staff person performing the
				  ongoing assessments is a qualified assessor.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Admission And Assessment › Section 388-107-0081 - Ongoing comprehensive assessments-Requirements in effect from January 18, 2022, through June 8, 2023, in response to the state of emergency related to COVID-19

Current through Register Vol. 24-14, July 15, 2024
(1) In response
				  to the state of emergency related to the COVID-19 pandemic, the department
				  adopted emergency rules under
				  RCW
				  34.05.320 on January 18, 2022, to amend a
				  portion of WAC
				  388-107-0080. The emergency rules
				  remained in effect until June 8, 2023. The amended rules in place at that time
				  were:
(2) The enhanced services
				  facility must:
(a) Complete a comprehensive
				  assessment, addressing the elements set forth in WAC
				  388-107-0070 on the following
				  timelines:
(i) Upon a significant change in
				  the resident's condition; or
(ii) At
				  least every 180 days if there is no significant change in condition, except
				  beginning January 18, 2022, assessments for residents whose care is state
				  funded may be extended an additional 12 months during the COVID-19 public
				  health emergency.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Admission And Assessment › Section 388-107-0090 - Qualified assessor

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced
				  services facility must ensure that an assessor performing an assessment for any
				  potential or admitted resident has experience working with residents who have
				  severe behavioral issues due to but not limited to functional or cognitive
				  disabilities, mental health or chemical dependency disorder, or both, or an
				  organic or traumatic brain injury and meets the following qualifications:
(a) A master's degree in social services,
				  human services, behavioral sciences or an allied field and two years social
				  service experience working with adults who have severe behavioral issues;
				  or
(b) A bachelor's degree in
				  social services, human services, behavioral sciences or an allied field and
				  five years social service experience working with adults who have severe
				  behavioral issues; or
(c) Has a
				  valid Washington state license to practice as a nurse under chapter 18.79 RCW
				  and three years of clinical nursing experience working with adults who have
				  severe behavioral issues; or
(d) Is
				  currently a licensed physician, including an osteopathic physician, in
				  Washington state with experience working with adults who have severe behavioral
				  issues; or
(e) Is a licensed
				  psychologist or psychiatrist; or
(f) Is a professional appropriately
				  credentialed or qualified to provide chemical dependency, mental health,
				  organic or traumatic brain injury and/or functional or cognitive services and
				  work experience with adults who have severe behavioral issues.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Individual Treatment Plan › Section 388-107-0100 - Person-centered service planning team

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must develop and maintain a
					 person-centered service planning team for each resident. The ESF must:
(1) Ensure the person-centered service
				  planning team includes the resident, the resident's representative when
				  applicable, individuals chosen by the resident, a mental health professional,
				  nursing staff, the medicaid client's department case manager, and other persons
				  as needed;
(2) Provide the
				  necessary information and support to ensure that the resident has an
				  opportunity to identify team members, make informed choices and decisions
				  regarding care and treatment, and direct the person-centered service planning
				  process as much as possible;
(3)
				  Ensure the person-centered service planning team has a coordinated approach to
				  the development, implementation, and evaluation of the comprehensive
				  person-centered service plan for the resident; and
(4) Ensure the person-centered service
				  planning team meets at least monthly and more often as needed, at times and
				  locations convenient to the resident, to review and modify the comprehensive
				  person-centered service plan as needed.
Reviser's note:
The typographical error in
						the above section occurred in the copy filed by the agency and appears in the
						Register pursuant to the requirements of
						RCW
						34.08.040.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Individual Treatment Plan › Section 388-107-0110 - Initial person-centered service plan

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must develop the initial
					 person-centered service plan prior to the resident's admission to the ESF,
					 using information from the resident, the resident's representative if the
					 resident has one, the comprehensive assessment reporting evaluation (CARE)
					 assessment for medicaid clients, and the preadmission assessment. The ESF must
					 ensure that each resident has an initial person-centered service plan that
					 describes:
(1) The resident's
				  immediate specific support needs (physical, mental, and behavioral) identified
				  in the pre-assessment;
(2)
				  Direction to staff and caregivers relating to the resident's immediate needs,
				  capabilities, and preferences;
(3)
				  The means by which the resident may choose not to accept care or
				  services;
(4) The resident's
				  informed consent to the person-centered service plan;
(5) What the facility will do to ensure the
				  resident's health and safety related to the refusal of any care or
				  service;
(6) Resident defined goals
				  and preferences;
(7) How the
				  facility will provide behavioral support to prevent a crisis and maintain
				  placement in the facility while respecting the resident's rights;
(8) What the facility will do to ensure
				  resident and community safety when the resident is in the community;
(9) Factors that prevent the resident from
				  accessing less restrictive community based services; and
(10) When and how the resident may transfer
				  or transition from the enhanced services facility to a more independent living
				  situation in the community.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Individual Treatment Plan › Section 388-107-0120 - Initial comprehensive person-centered service plan

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced services facility must
				  ensure that when the person-centered service planning team develops the initial
				  comprehensive person-centered service plan, the team integrates the information
				  contained in the following documents:
(a) The
				  resident's preadmission assessment;
(b) Initial comprehensive
				  assessment;
(c) Initial
				  person-centered service plan; and
(d) The medicaid client's comprehensive
				  assessment reporting evaluation (CARE) assessment.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Individual Treatment Plan › Section 388-107-0130 - Ongoing comprehensive person-centered service plan

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced services facility must
				  ensure the person-centered service planning team reviews and updates each
				  resident's comprehensive person-centered service plan as follows:
(a) Within a reasonable time consistent with
				  the resident's needs following any significant change in the resident's
				  physical, mental, emotional, or behavioral functioning;
(b) Upon request by the resident;
(c) Whenever the comprehensive
				  person-centered service plan no longer adequately addresses the resident's
				  current assessed needs and preferences;
(d) Following every full comprehensive
				  assessment and medicaid client's full comprehensive assessment reporting
				  evaluation (CARE) assessment; and
(e) At least once every one hundred eighty
				  days.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Individual Treatment Plan › Section 388-107-0140 - Implementation of the person-centered service plan

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced services facility must
				  provide the care and services as agreed upon or outlined in the initial and
				  comprehensive person-centered service plan to each resident unless a deviation
				  from the plan is mutually agreed upon between the medicaid client's department
				  case manager, the resident or the resident's representative, or both, and the
				  person-centered service planning team at the time the care or services are
				  scheduled.
(2) The enhanced
				  services facility must document the details of any deviation from the initial
				  or comprehensive person-centered service plan in the resident's record and
				  ensure this deviation is supported with documentation by the medicaid client's
				  department case manager, the resident or the resident's representative, or
				  both, and the person-centered service planning team.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Individual Treatment Plan › Section 388-107-0150 - Comprehensive person-centered service plan sent to the state

Current through Register Vol. 24-14, July 15, 2024
When the department is paying for a resident's services,
					 the enhanced services facility must give the department case manager a copy of
					 the comprehensive person-centered service plan each time it is completed or
					 updated.
The ESF must keep a copy of the person-centered service
					 plan that has been signed and dated by the department case manager, in the
					 resident's file.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Individual Treatment Plan › Section 388-107-0160 - Behavioral support plan

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must ensure that each
					 resident's person-centered service plan has interventions for behavioral
					 support that are used immediately when a resident's behavior escalates in the
					 ESF or community. The behavioral support plan must include, at the minimum the
					 following:
(1) Resident strengths that
				  support strategies for prevention and intervention;
(2) Specific indicators that may signal a
				  potential crisis for the resident or led to a behavioral crisis in the past,
				  which may include the resident's typical challenging behavior he or she
				  displays during escalation, the resident's typical actions before a behavioral
				  outburst, and words or phrases that the resident has used in the past during
				  escalation;
(3) Specific
				  interventions and pre-crisis prevention strategies for each of the indicators
				  identified above;
(4) Steps to be
				  taken by each of the facility staff if the prevention or intervention
				  strategies are unsuccessful in diverting the resident from a behavior or action
				  that leads to crisis;
(5) A
				  description of holding techniques that are safe and effective for the
				  resident;
(6) A plan to ensure
				  coordination with community crisis responders in regard to each resident's
				  person-centered service plan as part of a regular, routine protocol for crisis
				  prevention and intervention; and
(7) A statement that the resident may not be
				  secluded or isolated as part of the behavior support plan.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Resident Rights › Section 388-107-0170 - Resident dignity and accommodation of needs

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced services facility must
				  ensure that:
(a) Resident care is provided in
				  a manner to enhance each resident's dignity and quality of life including a
				  safe, clean, comfortable and homelike environment, and to respect and recognize
				  his or her individuality; and
(b)
				  Each resident's personal care needs and behavioral health treatment are
				  provided in a manner that protects resident's dignity and privacy.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Resident Rights › Section 388-107-0180 - Self-determination and participation rights

Current through Register Vol. 24-14, July 15, 2024
Except where the right conflicts with the resident's
					 person-centered service plan or when it endangers the health or safety of the
					 resident, other residents, or members of the community, each resident has the
					 right to:
(1) Choose activities,
				  schedules, and health care consistent with his or her interests, assessments,
				  and person-centered service plan;
(2) Interact with members of the community
				  both inside and outside the enhanced services facility;
(3) Make choices about aspects of his or her
				  life in the facility that are significant to the resident; and
(4) Participate in social, religious, and
				  community activities that do not interfere with the rights of other residents
				  in the enhanced services facility.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Quality of Care › Section 388-107-0200 - Quality of care

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced
				  services facility must provide each resident with the necessary care and
				  services to attain or maintain the highest practicable physical, mental, and
				  psychosocial well-being, self-care, and independence consistent with resident
				  rights and in accordance with his or her comprehensive assessment and
				  person-centered service plan.
(2)
				  Based on the resident's comprehensive assessment, the enhanced services
				  facility must ensure that:
(a) The resident's
				  abilities in activities of daily living do not decline unless circumstances of
				  the resident's clinical condition demonstrate that the decline was unavoidable,
				  including but not limited to the resident's ability to:
(i) Bathe, dress, and groom;
(ii) Transfer and ambulate;
(iii) Toilet;
(iv) Eat; and
(v) Use speech, language, or other functional
				  communication systems;
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Quality of Care › Section 388-107-0210 - Care and services

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must develop and implement
					 a program to meet the needs of each resident and to ensure each resident
					 receives:
(1) The care and services
				  identified in the resident's person-centered service plan;
(2) The necessary care and services to help
				  the resident reach the highest level of physical, mental, and psychosocial
				  well-being consistent with resident choice, current functional status, and
				  potential for improvement or decline;
(3) Services by the appropriate professionals
				  based upon the resident's assessment and person-centered service plan;
				  and
(4) The care and services in a
				  manner and in an environment that:
(a)
				  Actively supports, maintains or improves the resident's quality of
				  life;
(b) Actively supports the
				  resident's safety; and
(c)
				  Reasonably accommodates the resident's individual needs and preferences except
				  when the accommodation endangers the health or safety of the resident, another
				  resident, or a member of the community.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Quality Improvement › Section 388-107-0220 - Quality improvement

Current through Register Vol. 24-14, July 15, 2024
(1) To ensure
				  the proper delivery of services and the maintenance and improvement in quality
				  of care through self-review, any enhanced services facility licensed under this
				  chapter must maintain an active quality improvement committee.
(2) The quality improvement committee will
				  include a multi-disciplinary team.
(3) The quality improvement committee will
				  maintain an ongoing plan that includes areas the facility is working on
				  improving and one continuous quality improvement project annually, beginning in
				  the second contract year for completion by the end of the second calendar
				  year.
(4) To promote quality of
				  care through self-review without the fear of reprisal, and to enhance the
				  objectivity of the review process, the department shall not require disclosure
				  of any quality assurance committee records or reports, unless the disclosure is
				  related to the committee's compliance with this section, if:
(a) The records or reports are not maintained
				  pursuant to statutory or regulatory mandate; and
(b) The records or reports are created for
				  and collected and maintained by the committee.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › NURSING SERVICES AND STAFFING › Section 388-107-0230 - Sufficient staffing

Current through Register Vol. 24-14, July 15, 2024
An enhanced services facility must have sufficient numbers
					 of staff with the appropriate credentials and training to provide residents
					 with the identified care and treatment needs. At a minimum the facility must
					 have staff to provide:
(1) Mental
				  health and/or chemical dependency treatment;
(2) Medication management services;
(3) Personal care, assistance with the
				  activities of daily living;
(4)
				  Medical treatment, including psychiatric;
(5) Activities;
(6) Social service support;
(7) Negotiated services;
(8) Dietary services; and
(9) Security.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › NURSING SERVICES AND STAFFING › Section 388-107-0240 - Staffing levels

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced
				  services facility must ensure that:
(a)
				  Sufficient numbers of appropriately qualified and trained staff are available
				  to safely provide necessary care and services consistent with residents'
				  person-centered service plans under routine conditions, as well as during fire,
				  emergency, and disaster situations; and
(b) At least two staff are awake and on duty
				  in the facility at all times if there are any residents in the
				  facility.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › NURSING SERVICES AND STAFFING › Section 388-107-0250 - Staffing credentials and qualifications

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced services facility must
				  ensure the staffing ratios are met with the following credentialed staff, who
				  are in good professional standing:
(a)
				  Registered nurse;
(b) Licensed
				  practical nurse;
(c) Nursing
				  assistant certified or certified home care aide; and
(d) Mental health
				  professional.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › NURSING SERVICES AND STAFFING › Section 388-107-0260 - Staffing for medically fragile residents

Current through Register Vol. 24-14, July 15, 2024
If an enhanced services facility serves one or more
					 medically fragile residents, the facility must ensure that a registered nurse
					 is on site for at least sixteen hours per day. A registered nurse or a doctor
					 must be on-call during the remaining eight hours.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › NURSING SERVICES AND STAFFING › Section 388-107-0270 - Providing care and services

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must ensure that all staff,
					 including management, provides care and services consistent with:
(1) Empowering each resident to attain or
				  maintain the highest practicable physical, mental, and psychosocial well-being,
				  self-care and independence;
(2)
				  Respecting resident rights; and
(3)
				  Enhancing each resident's quality of life.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Operations › Section 388-107-0280 - Transfer and discharge

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced
				  services facility, with input from the person-centered service planning team,
				  will meet with case management staff to identify residents who want to be
				  discharged from the facility or transfer to a less restrictive residential
				  setting. Once the facility identifies these residents, it will hold a discharge
				  planning meeting for each resident,
(2) The facility may not transfer or
				  discharge a resident from the facility unless:
(a) The transfer or discharge is necessary
				  for the resident's welfare and the resident's needs cannot be met in the
				  facility;
(b) The safety of
				  individuals in the facility is endangered;
(c) The health of individuals in the facility
				  would otherwise be endangered;
(d)
				  The resident has failed to make the required payment for his or her stay;
				  or
(e) The facility ceases to
				  operate.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0290 - Activities

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must:
(1) Provide space and staff support necessary
				  for:
(a) Each resident, at any time, to engage
				  in independent or self-directed activities that are appropriate to the setting,
				  consistent with the resident's assessed interests, choices, functional
				  abilities, preferences, and individualized treatment plan; and
(b) Group activities at least five times per
				  week that may be planned and facilitated by caregivers consistent with the
				  collective interests of a group of residents.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0300 - Admission and continuation of services

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must only admit or continue
					 to provide services to a resident when:
(1) The department has determined that the
				  individual is eligible for placement in an enhanced services
				  facility.
(2) The facility can
				  safely and appropriately meet the assessed needs and preferences of the
				  resident:
(a) With available staff;
				  and
(b) Through reasonable
				  accommodation.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0310 - Medical and/or adaptive equipment

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility is responsible to meet the
					 needs of residents through qualified and trained staff, services, medical
					 and/or adaptive equipment, security and building design.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0320 - Medication services

Current through Register Vol. 24-14, July 15, 2024
(1) An enhanced
				  services facility providing medication service, either directly or indirectly,
				  must:
(a) Meet the requirements of
				  chapter
				  69.41 RCW regarding legend
				  and prescription medications, and other applicable statutes and administrative
				  rules;
(b) Develop and implement
				  systems that support and promote safe medication service for each resident;
				  and
(c) Ensure that each resident
				  is monitored for desired responses and undesirable side effects of prescribed
				  medications.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0330 - Pharmacy services

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced
				  services facility must:
(a) Obtain routine and
				  emergency medications for its residents under an agreement with a licensed
				  pharmacy;
(b) Ensure that
				  pharmaceutical services:
(i) Meet the needs
				  of each resident; and
(ii)
				  Establish and monitor systems for the accurate acquiring, receiving,
				  dispensing, control and administering of all medications; and
(c) Employ or obtain the services
				  of a license pharmacist who must:
(i) Provide
				  consultation on all aspects of the provision of pharmacy services in the
				  enhanced services facility;
(ii)
				  Determine that enhanced services facility medication records are in
				  order;
(iii) Perform regular
				  reviews at least once each month of each resident's medication therapy;
				  and
(iv) Document and report
				  medication irregularities to the attending physician.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0332 - Storing, securing, and accounting for medications

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced services facility must
				  secure medications for residents who are not capable of safely storing their
				  own medications.
(2) The enhanced
				  services facility must ensure all medications under the enhanced services
				  facility's control are properly stored and accounted for:
(a) In containers with pharmacist-prepared
				  label or original manufacturer's label;
(b) Together for each resident and physically
				  separated from other residents' medications;
(c) Separate from food or toxic
				  chemicals;
(d) In a locked
				  compartment that is accessible only to designated responsible staff persons; or
				  as otherwise directed by a physician; and
(e) In environments recommended on the
				  medication label.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0334 - Resident controlled medications

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The enhanced services facility must ensure all medications are stored in a
				  manner that prevents each resident from gaining access to another resident's
				  medications.
(2) The enhanced
				  services facility must allow a resident to control and secure the medications
				  that he or she self-administers or self-administers with assistance if the
				  enhanced services facility assesses the resident to be capable of safely and
				  appropriately storing his or her own medications and the resident desires to do
				  so.
(3) The enhanced services
				  facility must ensure no staff person other than a nurse or licensed pharmacist
				  fills medication organizers for residents.
(4) The enhanced services facility must
				  ensure that any nurse who fills a medication organizer for a resident labels
				  the medication organizer with:
(a) The name of
				  the resident;
(b) The name of the
				  medications in the organizer; and
(c) The frequency of the dosage.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0340 - Prescribed medication authorizations

Current through Register Vol. 24-14, July 15, 2024
(1) Before the enhanced services facility may
				  provide medication administration to a resident for prescribed medications, the
				  enhanced services facility must have one of the following:
(a) A prescription label completed by a
				  licensed pharmacy;
(b) A written
				  order from the prescriber;
(c) A
				  facsimile or other electronic transmission of the order from the prescriber;
				  or
(d) Written documentation by a
				  nurse of a telephone order from the prescriber.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0350 - Medication refusal

Current through Register Vol. 24-14, July 15, 2024
(1) When a resident
				  who is receiving medication administration services from the enhanced services
				  facility chooses to not take his or her medications, the enhanced services
				  facility must:
(a) Respect the resident's
				  right to choose not to take medication;
(b) Document the time, date and medication
				  the resident did not take in the resident's medical record;
(c) Notify the physician of the refusal and
				  follow any instructions provided, unless there is a staff person available who,
				  acting within his or her scope of practice, is able to evaluate the
				  significance of the resident not getting his or her medication, and such staff
				  person;
(i) Conducts an evaluation;
				  and
(ii) Takes the appropriate
				  action, including notifying the prescriber or primary care practitioner when
				  there is a consistent pattern of the resident choosing to not take his or her
				  medications.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0360 - Medication refusal-Antipsychotics

Current through Register Vol. 24-14, July 15, 2024
(1)
				  When a resident who is being administered anti-psychotic medication, chooses to
				  not take his or her medications after two or three attempts, the enhanced
				  services facility must:
(a) Respect the
				  resident's right to choose not to take medication;
(b) Document the time, date and medication
				  the resident did not take in the medical record; and
(c) Notify the physician within eight hours
				  of the refusal.
(d) Notify the DSHS
				  case manager within twenty four hours of the refusal.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0370 - Treatment services

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must:
(1) Provide for diagnostic and therapeutic
				  services prescribed by the attending clinical staff that meet all of the
				  resident needs identified in the person-centered service plan, to include
				  mental health and chemical dependency treatment;
(2) Ensure that each resident's
				  person-centered service plan has interventions for behavioral support in
				  accordance with WAC
				  388-107-0160;
(3) Ensure that all services are provided by
				  specific program professionals, such as mental health professionals and
				  chemical dependency professionals.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0380 - Use of psychopharmacologic medications

Current through Register Vol. 24-14, July 15, 2024
(1) The enhanced services facility must
				  ensure that each resident is free from psychopharmacologic medications used for
				  discipline, to restrain, or for convenience of the staff.
(2) The facility must ensure that when a
				  psychopharmacologic medication is used the resident assessment indicates that
				  the use is necessary to treat the resident's medical symptoms and documented in
				  the medical record.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0390 - Use of routine psychopharmacologic medications

Current through Register Vol. 24-14, July 15, 2024
When the resident is using a psychopharmacologic
					 medication on a routine basis, the facility must ensure that :
(1) The medication is prescribed by a
				  physician or health care professional with prescriptive authority;
(2) The resident's person-centered service
				  plan includes strategies and modifications of the environment and staff
				  behavior to address the symptoms for which the medication is
				  prescribed;
(3) Changes in
				  medication only occur when the prescriber decides it is medically
				  necessary;
(4) The resident's
				  record includes documentation about the specific symptom or behavior that
				  caused the physician to order the medication and what is required of the
				  resident before the medication may be discontinued;
(5) The resident's record includes
				  documentation that the resident, guardian, or legal representative, if any, was
				  informed of the need for the psychopharmacologic medication; and
(6) Antipsychotic medications are
				  administered in a manner consistent with
				  RCW
				  70.97.040 and
				  70.97.050.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0400 - Use of as needed psychopharmacologic medications

Current through Register Vol. 24-14, July 15, 2024
If the physician has ordered an as-needed
					 psychopharmacologic medication for a resident, the facility must ensure
					 that:
(1) The order details the
				  circumstances under which the medication may be used and the medication is
				  given only as specifically ordered;
(2) The resident's person-centered service
				  plan includes behavioral intervention strategies and modifications of the
				  environment and staff behavior to address the symptoms for which the medication
				  is prescribed;
(3) There is
				  documentation in the resident record about the specific symptom or behavior
				  that caused the need for the medication and the results of its use;
(4) There is documentation in the resident
				  record that the resident, guardian or legal representative, if any, was
				  informed of the need for the medication;
(5) The resident, guardian, or legal
				  representative has given informed consent for the medication; and
(6) Antipsychotic medications are
				  administered in a manner consistent with
				  RCW
				  70.97.040 and
				  70.97.050.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Service Provided › Section 388-107-0410 - Management of escalating behaviors

Current through Register Vol. 24-14, July 15, 2024
(1)
				  An enhanced services facility must have a specific procedure for deescalating,
				  preventing, and redirecting aggressive and challenging behavior. This protocol
				  must always be the first approach and strategy in resolving behavioral issues
				  and must include:
(a) Training on prevention
				  of escalation of behavior before it reaches the stage of physical
				  assault;
(b) Techniques for staff
				  to use in response to challenging client behaviors;
(c) Evaluation of the safety of the physical
				  environment;
(d) Issues of respect
				  and dignity of the resident; and
(e) Use of the least restrictive physical and
				  behavioral interventions depending upon the situation.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Restraints › Section 388-107-0420 - Physical restraints for medical purposes only

Current through Register Vol. 24-14, July 15, 2024
(1) For the purposes of this section,
				  "physical restraint" means a manual method, obstacle, or physical or mechanical
				  device, material, or equipment attached or adjacent to the resident's body that
				  restricts freedom of movement or access to his or her body, required to treat
				  the resident's medical symptoms. The enhanced services facility must
				  ensure:
(2) Each resident has the
				  right to be free from physical and chemical restraints used for discipline,
				  behavioral intervention, or staff convenience;
(3) That physical restraints are used only
				  during infrequent and episodic occurrences for the protection of the resident
				  during delivery of medical care or treatment;
(4) That before using the physical restraint,
				  the least restrictive alternatives have been tried and documented, and such
				  restraint is deemed required to temporarily protect the resident from harming
				  himself or herself or others during the medical care or treatment;
(5) That before physical restraints are used,
				  the resident has been assessed as needing the restraint to treat the emergent
				  medical symptoms or provide the medical care, and to prevent the resident from
				  self-harm and all of the following has been met:
(a) The resident or resident representative
				  has given informed consent for the use of physical restraints for medical
				  purposes;
(b) The person-centered
				  service team has been consulted and evaluated the resistance to medical care;
				  and
(c) The use of positive
				  interventions and supports has been documented;
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-107 - Licensing requirements for enhanced services facilities › Food Services › Section 388-107-0430 - Food services

Current through Register Vol. 24-14, July 15, 2024
The enhanced services facility must provide or contract
					 out food services for residents. If the facility chooses to contract out the
					 food service, the contracted services must meet all of the applicable food
					 codes and requirements.
(1) The
				  enhanced services facility must:
(a) Provide a
				  minimum of three meals a day;
(b)
				  Provide snacks between meals and in the evening at regular intervals with no
				  more than fourteen hours between the evening meal and breakfast unless the
				  facility provides a nutritious snack after the evening meal and before
				  breakfast;
(c) Provide access to
				  fluids and snacks at all times;
(d)
				  Provide sufficient time and staff support for residents to consume
				  meals;
(e) Ensure all menus:
(i) Are written at least one week in advance
				  and delivered to residents' rooms or posted where residents can see them,
				  except as specified in subsection (1)(h) of this subsection;
(ii) Indicate the date, day of week, month,
				  and year;
(iii) Include all food
				  and snacks served that contribute to nutritional requirements;
(iv) Are kept at least six months;
(v) Provide a variety of foods;
(vi) Provide foods at safe and appropriate
				  temperatures; and
(vii) Are not
				  repeated for at least three weeks, except breakfast menus that provide a
				  variety of daily choices of hot and cold foods are not required to have a
				  minimum three-week cycle;
(f) Prepare food on-site, or provide food
				  through a contract with a food service establishment located in the vicinity
				  that meets the requirements of chapter 246-215 WAC regarding food
				  service;
(g) Serve nourishing,
				  palatable, and attractively presented meals adjusted for age, gender and
				  activities, unless medically contraindicated, and individual preferences to the
				  extent reasonably possible;
(h)
				  Substitute foods of equal nutrient value when changes in the current day's menu
				  are necessary and record changes on the original menu;
(i) Make available and give residents
				  alternate choices in entrees for midday and evening meals that are of
				  comparable quality and nutritional value; however the enhanced services
				  facility is not required to post alternate choices in entrees on the menu one
				  week in advance, but must record on the menus the alternate choices in entrees
				  that are served;
(j) Develop, make
				  known to residents, and implement a process for residents to express their
				  views and comment on the food services; and
(k) Maintain a dining area or areas approved
				  by the department with a seating capacity for seventy-five percent or more of
				  the residents per meal setting, or ten square feet times the licensed resident
				  bed capacity, whichever is greater.