reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › GENERAL › Section 388-78A-2010 - Purpose

Current through Register Vol. 24-14, July 15, 2024
This chapter is written to implement chapter 18.20 RCW, to
					 promote the safety and well-being of boarding home residents, to specify
					 standards for boarding home operators, and to further establish requirements
					 for the operation of boarding homes.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2010, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › GENERAL › Section 388-78A-2030 - Assisted living facility license required

Current through Register Vol. 24-14, July 15, 2024
(1) A boarding home license is required to
				  operate or maintain a boarding home as defined in chapter 18.20 RCW and this
				  chapter.
(2) A boarding home
				  license is required when any person other than a family member provides
				  housing, one or more basic services, and one or more of the following:
(a) Assumes general responsibility for the
				  safety and well-being of the residents except as provided in WAC
				  388-78A-2032;
(b) Provides domiciliary care which includes:
(i) Providing assistance with activities of
				  daily living, either directly or indirectly as defined in this chapter and
				  described in WAC
				  388-78A-2190;
(ii) Providing health support services,
				  either directly or indirectly as defined in this chapter and described in WAC
				  388-78A-2200; or
(iii) Providing intermittent nursing
				  services, either directly or indirectly as described in WAC
				  388-78A-2310.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › GENERAL › Section 388-78A-2032 - Assisted living facility license not required

Current through Register Vol. 24-14, July 15, 2024
(1) A boarding home license is not required
				  for the housing, or services, customarily provided under landlord tenant
				  agreements governed by the residential tenant act,
				  chapter
				  59.18 RCW, or when housing
				  nonresident individuals who chose to participate in the programs or services in
				  subsection (2) of this section when offered by the boarding home licensee or
				  the licensee's contractor.
(2) A
				  boarding home license is not required for one or more of the following items
				  and services that may, upon request of the nonresident individual, be provided
				  to a nonresident individual:
(a) Emergency
				  assistance provided on an intermittent or nonroutine basis;
(b) Systems including technology-based
				  monitoring devices employed by independent senior housing, or independent
				  living units in continuing care retirement communities, to respond to the
				  potential need for emergency services;
(c) Scheduled and nonscheduled blood pressure
				  checks;
(d) Nursing assessment
				  services to determine whether referral to an outside health care provider is
				  recommended;
(e) Making and
				  reminding of health care appointments;
(f) Preadmission assessment, for the purposes
				  of transitioning to a licensed care setting;
(g) Medication assistance which may include
				  reminding or coaching the nonresident individual, opening the nonresident
				  individual's medication container, using an enabler, and handing prefilled
				  insulin syringes to the nonresident individual;
(h) Prefilling insulin syringes which must be
				  performed by a nurse licensed under chapter 18.79 RCW;
(i) Assessment to determine cause of a
				  fall;
(j) Nutrition management and
				  education services;
(k) Dental
				  services;
(l) Wellness programs as
				  defined in WAC
				  388-78A-2020; or
(m) Services customarily provided under the
				  landlord tenant agreements governed by the Residential Landlord-Tenant Act,
				  chapter
				  59.18 RCW.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › GENERAL › Section 388-78A-2035 - Disclosure statement to nonresident individuals

Current through Register Vol. 24-14, July 15, 2024
(1) An assisted living facility must provide
				  each nonresident individual a disclosure statement upon admission and at the
				  time that additional services are requested by the nonresident
				  individual.
(2) The disclosure
				  statement must notify the nonresident individual that:
(a) The resident rights of chapter 70.129 RCW
				  do not apply to nonresident individuals;
(b) Licensing requirements for assisted
				  living facilities under this chapter do not apply to nonresident units;
				  and
(c) The jurisdiction of the
				  long-term care ombuds does not apply to nonresident individuals and nonresident
				  units.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › GENERAL › Section 388-78A-2040 - Other requirements

Current through Register Vol. 24-14, July 15, 2024
(1) The
				  boarding home must comply with all other applicable federal, state, county and
				  municipal statutes, rules, codes and ordinances, including without limitations
				  those that prohibit discrimination.
(2) The boarding home must have its building
				  approved by the Washington state fire marshal in order to be
				  licensed.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2040, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › GENERAL › Section 388-78A-2050 - Resident characteristics

Current through Register Vol. 24-14, July 15, 2024
The boarding home may admit and retain an individual as a
					 resident in a boarding home only if:
(1) The boarding home can safely and
				  appropriately serve the individual with appropriate available staff providing:
(a) The scope of care and services described
				  in the boarding home's disclosure information, except if the boarding home
				  chooses to provide additional services consistent with
				  RCW
				  18.20.300(4); and
(b) The reasonable accommodations required by
				  state or federal law, including providing any specialized training to
				  caregivers that may be required according to WAC
				  388-78A-2490 through
				  388-78A-2510;
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2060 - Preadmission assessment

Current through Register Vol. 24-14, July 15, 2024
The boarding home must conduct a preadmission assessment
					 for each prospective resident that includes the following information, unless
					 unavailable despite the best efforts of the boarding home:
(1) Medical history;
(2) Necessary and contraindicated
				  medications;
(3) A licensed medical
				  or health professional's diagnosis, unless the prospective resident objects for
				  religious reasons;
(4) Significant
				  known behaviors or symptoms that may cause concern or require special
				  care;
(5) Mental illness diagnosis,
				  except where protected by confidentiality laws;
(6) Level of personal care needs;
(7) Activities and service preferences;
				  and
(8) Preferences regarding other
				  issues important to the prospective resident, such as food and daily
				  routine.
Statutory Authority: Chapter 18.20 RCW. WSR 10-03-066,
						§ 388-78A-2060, filed 1/15/10, effective 2/15/10. Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2060, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2070 - Timing of preadmission assessment

Current through Register Vol. 24-14, July 15, 2024
(1)
				  Unless there is an emergency, the boarding home must complete the preadmission
				  assessment of the prospective resident before each prospective resident moves
				  into the boarding home.
(2) The
				  boarding home must ensure the preadmission assessment is completed within five
				  calendar days of the resident moving into the boarding home when the resident
				  moves in under emergency conditions.
(3) For the purposes of this section,
				  "emergency" means any circumstances when the prospective resident would
				  otherwise need to remain in an unsafe setting or be without adequate and safe
				  housing.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2070, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2080 - Qualified assessor

Current through Register Vol. 24-14, July 15, 2024
The boarding home must ensure the person responsible for
					 completing a preadmission assessment of a prospective resident:
(1) Has 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 functional or cognitive
				  disabilities; or
(2) Has a
				  bachelor's degree in social services, human services, behavioral sciences, or
				  an allied field and three years social service experience working with adults
				  who have functional or cognitive disabilities; or
(3) Has a valid Washington state license to
				  practice nursing, in accordance with chapters 18.79 RCW and 246-840 WAC;
				  or
(4) Is a physician with a valid
				  state license to practice medicine; or
(5) Has three years of successful experience
				  acquired prior to September 1, 2004, assessing prospective and current boarding
				  home residents in a setting licensed by a state agency for the care of
				  vulnerable adults, such as a nursing home, boarding home, or adult family home,
				  or a setting having a contract with a recognized social service agency for the
				  provision of care to vulnerable adults, such as supported living.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2080, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2090 - Full assessment topics

Current through Register Vol. 24-14, July 15, 2024
The boarding home must obtain sufficient information to be
					 able to assess the capabilities, needs, and preferences for each resident, and
					 must complete a full assessment addressing the following, within fourteen days
					 of the resident's move-in date, unless extended by the department for good
					 cause:
(1) Individual's recent medical
				  history, including, but not limited to:
(a) A
				  licensed medical or health professional's diagnosis, unless the resident
				  objects for religious reasons;
(b)
				  Chronic, current, and potential skin conditions; or
(c) Known allergies to foods or medications,
				  or other considerations for providing care or services.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2100 - Ongoing 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
				  388-78A-2101.
(2) The assisted living facility must:
(a) Complete a full assessment addressing the
				  elements set forth in WAC
				  388-78A-2090 for each resident at
				  least annually;
(b) Complete an
				  assessment specifically focused on a resident's identified problems and related
				  issues:
(i) Consistent with the resident's
				  change of condition as specified in WAC
				  388-78A-2120;
(ii) When the resident's negotiated service
				  agreement no longer addresses the resident's current needs and
				  preferences;
(iii) When the
				  resident has an injury requiring the intervention of a practitioner.
(c) Ensure the staff person
				  performing the ongoing assessments is qualified to perform them.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2101 - Ongoing 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
				  388-78A-2100. The emergency rules
				  remained in effect until June 8, 2023. The amended rules in place at that time
				  were:
(2) The assisted living
				  facility must:
(a) Complete a full assessment
				  addressing the elements set forth in WAC
				  388-78A-2090 for each resident at
				  least annually, 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;
(b) Complete an assessment specifically
				  focused on a resident's identified problems and related issues:
(i) Consistent with the resident's change of
				  condition as specified in WAC
				  388-78A-2120;
(ii) When the resident's negotiated service
				  agreement no longer addresses the resident's current needs and
				  preferences;
(iii) When the
				  resident has an injury requiring the intervention of a practitioner.
(c) Ensure the staff person
				  performing the ongoing assessments is qualified to perform them.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2110 - Resident participation in assessments

Current through Register Vol. 24-14, July 15, 2024
The boarding home must directly involve each resident or
					 prospective resident, to the extent possible, along with any appropriate
					 resident representative to the extent he or she is willing and capable, in the
					 preadmission assessment and on-going assessment process.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2110, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSESSMENT AND MONITORING › Section 388-78A-2120 - Monitoring residents' well-being

Current through Register Vol. 24-14, July 15, 2024
The boarding home must:
(1) Observe each resident consistent with his
				  or her assessed needs and negotiated service agreement;
(2) Identify any changes in the resident's
				  physical, emotional, and mental functioning that are a:
(a) Departure from the resident's customary
				  range of functioning; or
(b)
				  Recurring condition in a resident's physical, emotional, or mental functioning
				  that has previously required intervention by others.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › NEGOTIATED SERVICE AGREEMENT › Section 388-78A-2130 - Service agreement planning

Current through Register Vol. 24-14, July 15, 2024
The boarding home must:
(1) Develop an initial resident service plan,
				  based upon discussions with the resident and the resident's representative if
				  the resident has one, and the preadmission assessment of a qualified assessor,
				  upon admitting a resident into a boarding home. The boarding home must ensure
				  the initial resident service plan:
(a)
				  Integrates the assessment information provided by the department's case manager
				  for each resident whose care is partially or wholly funded by the department or
				  the health care authority;
(b)
				  Identifies the resident's immediate needs; and
(c) Provides direction to staff and
				  caregivers relating to the resident's immediate needs, capabilities, and
				  preferences.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › NEGOTIATED SERVICE AGREEMENT › Section 388-78A-2140 - Negotiated service agreement contents

Current through Register Vol. 24-14, July 15, 2024
The boarding home must develop, and document in the
					 resident's record, the agreed upon plan to address and support each resident's
					 assessed capabilities, needs and preferences, including the following:
(1) The care and services necessary to meet
				  the resident's needs, including:
(a) The plan
				  to monitor the resident and address interventions for current risks to the
				  resident's health and safety that were identified in one or more of the
				  following:
(i) The resident's preadmission
				  assessment;
(ii) The resident's
				  full assessments;
(iii) On-going
				  assessments of the resident;
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › NEGOTIATED SERVICE AGREEMENT › Section 388-78A-2150 - Signing negotiated service agreement

Current through Register Vol. 24-14, July 15, 2024
The boarding home must ensure that the negotiated service
					 agreement is agreed to and signed at least annually by:
(1) The resident, or the resident's
				  representative if the resident has one and is unable to sign or chooses not to
				  sign;
(2) A representative of the
				  boarding home duly authorized by the boarding home to sign on its behalf;
				  and
(3) Any public or private case
				  manager for the resident, if available.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2150, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › NEGOTIATED SERVICE AGREEMENT › Section 388-78A-2160 - Implementation of negotiated service agreement

Current through Register Vol. 24-14, July 15, 2024
The boarding home must provide the care and services as
					 agreed upon in the negotiated service agreement to each resident unless a
					 deviation from the negotiated service agreement is mutually agreed upon between
					 the boarding home and the resident or the resident's representative at the time
					 the care or services are scheduled.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2160, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Section 388-78A-2170 - Required assisted living facility services

Current through Register Vol. 24-14, July 15, 2024
(1) The boarding home must provide housing
				  and assume general responsibility for the safety and well-being of each
				  resident, as defined in this chapter, consistent with the resident's assessed
				  needs and negotiated service agreement.
(2) The boarding homes must provide each
				  resident with the following basic services, consistent with the resident's
				  assessed needs and negotiated service agreement:
(a)
Activities -
Arranging for
				  activities in accordance with WAC
				  388-78A-2180;
(b)
Housekeeping -
Providing a
				  safe, clean and comfortable environment for each resident, including personal
				  living quarters and all other resident accessible areas of the
				  building;
(c)
Laundry -
Keeping the resident's clothing clean and in good repair, and laundering
				  towels, washcloths, bed linens on a weekly basis or more often as necessary to
				  maintain cleanliness;
(d)
Meals -
Providing meals in accordance with WAC
				  388-78A-2300; and
(e)
Nutritious snacks -
Providing nutritious snack items on a scheduled and nonscheduled basis,
				  and providing nutritious snacks in accordance with WAC
				  388-78A-2300.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Section 388-78A-2180 - Activities

Current through Register Vol. 24-14, July 15, 2024
The boarding home must:
(1) Provide space and staff support necessary
				  for:
(a) Each resident to engage in
				  independent or self-directed activities that are appropriate to the setting,
				  consistent with the resident's assessed interests, functional abilities,
				  preferences, and negotiated service agreement; and
(b) Group activities at least three 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 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Section 388-78A-2190 - Activities of daily living

Current through Register Vol. 24-14, July 15, 2024
Assistance with activities of daily living is a service
					 that the assisted living facility may provide.
(1) If an assisted living facility chooses
				  not to provide assistance with activities of daily living:
(a) The assisted living facility must admit
				  or retain only those residents who are independent in activities of daily
				  living; except that
(b) A resident,
				  or the resident's representative, may independently arrange for outside
				  services to assist with activities of daily living.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Section 388-78A-2200 - Health support services

Current through Register Vol. 24-14, July 15, 2024
Health support services are an optional service that the
					 boarding home may provide. The boarding home may choose to provide any of the
					 following health support services; however, a boarding home may or may not need
					 to provide additional health support services to comply with the reasonable
					 accommodation requirements in federal and state law. The boarding home may
					 provide:
(1) Blood glucose
				  testing;
(2) Puree diets;
(3) Calorie controlled diabetic
				  diets;
(4) Dementia care;
(5) Mental health care; and
(6) Developmental disabilities
				  care.
Statutory Authority:
						RCW
						18.20.090 (2004 c 142 § 19) and chapter
						18.20 RCW. WSR 04-16-065, § 388-78A-2200, filed 7/30/04, effective
						9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Respite › Section 388-78A-2202 - Respite - General

Current through Register Vol. 24-14, July 15, 2024
A boarding home:
(1) May provide short term respite
					 care;
(2) Must limit the length of
					 stay for an individual on respite to thirty calendar days or less;
					 and
(3) Must not use respite as a
					 placement pending the resident's admission to the boarding home.
Statutory Authority:
						  RCW
						  18.20.090, 2008 c 146, and chapter 18.20 RCW.
						  WSR 09-01-079, § 388-78A-2202, filed 12/15/08, effective
						  1/15/09.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Respite › Section 388-78A-2204 - Respite - Information

Current through Register Vol. 24-14, July 15, 2024
When a boarding home provides respite care, before or at
						the time of admission, the boarding home must obtain sufficient information
						about the individual to meet the individual's anticipated needs. That
						information must include at a minimum:
(1) The resident's legal name;
(2) The name, phone number and address of the
					 resident's representative, if applicable;
(3) The name and address of the adult family
					 home, boarding home, or other location where the resident normally lives, with
					 the name of a contact person and the contact person's phone number;
(4) The name, address, and telephone number
					 of the resident's attending physician, and alternate physician if
					 any;
(5) Medical and social
					 history, which may be obtained from a respite care assessment and respite
					 service plan performed by a case manager designated by an area agency on aging
					 under contract with the department, and mental and physical assessment data;
					 and
(6) Physician's orders for
					 diet, medication, and routine care consistent with the resident's status on
					 admission.
Statutory Authority:
						  RCW
						  18.20.090, 2008 c 146, and chapter 18.20 RCW.
						  WSR 09-01-079, § 388-78A-2204, filed 12/15/08, effective
						  1/15/09.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Respite › Section 388-78A-2206 - Respite - Assessment

Current through Register Vol. 24-14, July 15, 2024
The boarding home must ensure that any individual on
						respite has assessments performed, where needed, and if the assessment of the
						individual shows symptoms of:
(1)
					 Tuberculosis, follow required tuberculosis testing requirements; and
(2) Other infectious conditions or diseases,
					 follow the appropriate infection control processes.
Statutory Authority:
						  RCW
						  18.20.090, 2008 c 146, and chapter 18.20 RCW.
						  WSR 09-01-079, § 388-78A-2206, filed 12/15/08, effective
						  1/15/09.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Respite › Section 388-78A-2208 - Respite - Negotiated service agreement

Current through Register Vol. 24-14, July 15, 2024
With the participation of the individual, and where
						appropriate their representative, the boarding home must develop a negotiated
						service agreement, to maintain or improve the individual's health and
						functional status during their stay in the boarding home.
Statutory Authority:
						  RCW
						  18.20.090, 2008 c 146, and chapter 18.20 RCW.
						  WSR 09-01-079, § 388-78A-2208, filed 12/15/08, effective
						  1/15/09.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2210 - Medication services

Current through Register Vol. 24-14, July 15, 2024
(1) A boarding home
					 providing medication service, either directly or indirectly, must:
(a) Meet the requirements of
					 chapter
					 69.41 RCW Legend
					 drugs-Prescription drugs, and other applicable statutes and administrative
					 rules; and
(b) Develop and
					 implement systems that support and promote safe medication service for each
					 resident.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2220 - Prescribed medication authorizations

Current through Register Vol. 24-14, July 15, 2024
(1) Before the boarding home may provide
					 medication assistance or medication administration to a resident for prescribed
					 medications, the boarding home 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 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2230 - Medication refusal

Current through Register Vol. 24-14, July 15, 2024
(1) When a resident
					 who is receiving medication assistance or medication administration services
					 from the boarding home chooses to not take his or her medications, the boarding
					 home 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;
(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 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2240 - Nonavailability of medications

Current through Register Vol. 24-14, July 15, 2024
When the boarding home has assumed responsibility for
						obtaining a resident's prescribed medications, the boarding home must obtain
						them in a correct and timely manner.
Statutory Authority:
						  RCW
						  18.20.090 (2004 c 142 § 19) and chapter
						  18.20 RCW. WSR 04-16-065, § 388-78A-2240, filed 7/30/04, effective
						  9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2250 - Alteration of medications

Current through Register Vol. 24-14, July 15, 2024
The boarding home must generally provide medications in
						the form they are prescribed when administering medications or providing
						medication assistance to a resident. The boarding home may provide medications
						in an altered form consistent with the following:
(1) Alteration includes, but is not limited
					 to, crushing tablets, cutting tablets in half, opening capsules, mixing
					 powdered medications with foods or liquids, or mixing tablets or capsules with
					 foods or liquids.
(2) Residents
					 must be aware that the medication is being altered or added to their
					 food.
(3) A pharmacist or other
					 practitioner practicing within their scope of practice must determine that it
					 is safe to alter a medication.
(4)
					 If the medication is altered, documentation of the appropriateness of the
					 alteration must be on the prescription container, or in the resident's
					 record.
(5) Alteration of
					 medications for self-administration with assistance is provided in accordance
					 with chapter 246-888 WAC.
Statutory Authority:
						  RCW
						  18.20.090 (2004 c 142 § 19) and chapter
						  18.20 RCW. WSR 04-16-065, § 388-78A-2250, filed 7/30/04, effective
						  9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2260 - Storing, securing, and accounting for medications

Current through Register Vol. 24-14, July 15, 2024
(1) The boarding home must secure medications
					 for residents who are not capable of safely storing their own
					 medications.
(2) The boarding home
					 must ensure all medications under the boarding home's control are properly
					 stored:
(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;
					 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 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2270 - Resident controlled medications

Current through Register Vol. 24-14, July 15, 2024
(1)
					 The boarding home must ensure all medications are stored in a manner that
					 prevents each resident from gaining access to another resident's
					 medications.
(2) The boarding home
					 must allow a resident to control and secure the medications that he or she
					 self-administers or self-administers with assistance if the boarding home
					 assesses the resident to be capable of safely and appropriately storing his or
					 her own medications and the resident desires to do so.
Statutory Authority:
						  RCW
						  18.20.090. WSR 06-01-047, §
						  388-78A-2270, filed 12/15/05, effective 1/15/06. Statutory Authority:
						  RCW
						  18.20.090 (2004 c 142 § 19) and chapter
						  18.20 RCW. WSR 04-16-065, § 388-78A-2270, filed 7/30/04, effective
						  9/1/04.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2280 - Medication organizers

Current through Register Vol. 24-14, July 15, 2024
(1) The boarding
					 home must ensure no staff person other than a nurse or licensed pharmacist
					 fills medication organizers for residents.
(2) The boarding home 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 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Medications › Section 388-78A-2290 - Family assistance with medications and treatments

Current through Register Vol. 24-14, July 15, 2024
(1) A boarding home may permit a resident's
					 family member to administer medications or treatments or to provide medication
					 or treatment assistance, including obtaining medications or treatment supplies,
					 to the resident.
(2) The boarding
					 home must disclose to the department, residents, the residents' legal
					 representatives, if any, and if not the residents' representative if any, and
					 to interested consumers upon request, information describing whether the
					 boarding home permits such family administration or assistance and, if so, the
					 extent of any limitations or conditions.
(3) If the boarding home allows family
					 assistance with or administration of medications and treatments, and the
					 resident and a family member(s) agree a family member will provide medication
					 or treatment assistance, or medication or treatment administration to the
					 resident, the boarding home must request that the family member submit to the
					 boarding home a written plan for such assistance or administration that
					 includes at a minimum:
(a) By name, the family
					 member who will provide the medication or treatment assistance or
					 administration;
(b) A description
					 of the medication or treatment assistance or administration that the family
					 member will provide, to be referred to as the primary plan;
(c) An alternate plan if the family member is
					 unable to fulfill his or her duties as specified in the primary plan;
(d) An emergency contact person and telephone
					 number if the boarding home observes changes in the resident's overall
					 functioning or condition that may relate to the medication or treatment plan;
					 and
(e) Other information
					 determined necessary by the boarding home.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Food › Section 388-78A-2300 - Food and nutrition services

Current through Register Vol. 24-14, July 15, 2024
(1)
					 The boarding home must:
(a) Provide a minimum
					 of three meals a day:
(i) At regular
					 intervals;
(ii) With no more than
					 fourteen hours between the evening meal and breakfast, unless the boarding home
					 provides a nutritious snack after the evening meal and before
					 breakfast.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Food › Section 388-78A-2305 - Food sanitation

Current through Register Vol. 24-14, July 15, 2024
The boarding home must:
(1) Manage food, and maintain any on-site
					 food service facilities in compliance with chapter 246-215 WAC, Food
					 service;
(2) Ensure employees
					 working as food service workers obtain a food worker card according to chapter
					 246-217 WAC; and
(3) Ensure a
					 resident obtains a food worker card according to chapter 246-217 WAC whenever:
(a) The resident is routinely or regularly
					 involved in the preparation of food to be served to other residents;
(b) The resident is paid for helping to
					 prepare food; or
(c) The resident
					 is preparing food to be served to other residents as part of an
					 employment-training program.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Intermittent Nursing Services and Resident-Arranged Services › Section 388-78A-2310 - Intermittent nursing services

Current through Register Vol. 24-14, July 15, 2024
(1)
					 Intermittent nursing services are an optional service that the boarding home
					 may provide.
(2) The boarding home
					 may choose to provide any of the following intermittent nursing services
					 through appropriately licensed and credentialed staff; however, the facility
					 may or may not need to provide additional intermittent nursing services to
					 comply with the reasonable accommodation requirements in federal or state law:
(a) Medication administration;
(b) Administration of health
					 treatments;
(c) Diabetic
					 management;
(d) Nonroutine ostomy
					 care;
(e) Tube feeding;
					 and
(f) Nurse delegation consistent
					 with chapter 18.79 RCW.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Intermittent Nursing Services and Resident-Arranged Services › Section 388-78A-2320 - Intermittent nursing services systems

Current through Register Vol. 24-14, July 15, 2024
(1)
					 When a boarding home provides intermittent nursing services to any resident,
					 either directly or indirectly, the boarding home must:
(a) Develop and implement systems that
					 support and promote the safe practice of nursing for each resident;
					 and
(b) Ensure the requirements of
					 chapters 18.79 RCW and 246-840 WAC are met.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Intermittent Nursing Services and Resident-Arranged Services › Section 388-78A-2330 - Tube feeding

Current through Register Vol. 24-14, July 15, 2024
(1) Tube feeding
					 services are an optional service that a boarding home may provide.
(2) The boarding home must provide
					 intermittent nursing services to develop and implement the nursing component of
					 the negotiated service agreement, administer feedings and necessary
					 medications, and provide routine care of the tube insertion site whenever any
					 resident requiring tube feeding is not able to:
(a) Independently and safely manage:
(i) Maintenance of the tube insertion
					 site;
(ii) Necessary medication
					 administration through the tube; and
(iii) Feeding administration through the
					 tube.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Intermittent Nursing Services and Resident-Arranged Services › Section 388-78A-2340 - Resident-arranged services

Current through Register Vol. 24-14, July 15, 2024
(1) The boarding
					 home must allow a resident to arrange to receive on-site care and services
					 from:
(a) A practitioner, licensed under
					 Title
					 18 RCW regulating health care
					 professions; and
(b) A home health,
					 hospice, or home care agency licensed under chapter 70.127 RCW.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Intermittent Nursing Services and Resident-Arranged Services › Section 388-78A-2350 - Coordination of health care services

Current through Register Vol. 24-14, July 15, 2024
(1)
					 The boarding home must coordinate services with external health care providers
					 to meet the residents' needs, consistent with the resident's negotiated service
					 agreement.
(2) The boarding home
					 must develop, implement and inform residents of the boarding home's policies
					 regarding how the boarding home interacts with external health care providers,
					 including:
(a) The conditions under which
					 health care information regarding a resident will be shared with external
					 health care providers, consistent with
					 chapter
					 70.02 RCW; and
(b) How residents' rights to privacy will be
					 protected, including provisions for residents to authorize the release of
					 health care information.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Service Delivery and Monitoring › Adult Day Services › Section 388-78A-2360 - Adult day services

Current through Register Vol. 24-14, July 15, 2024
(1) The assisted
						living facility may, but is not required to, provide an adult day services
						program for nonresidents.
(2) If
						adult day services are provided, the assisted living facility must:
(a) Ensure each adult day services client
						receives appropriate supervision and agreed upon care and services during the
						time spent in the day services program;
(b) Ensure the care and services provided to
						adult day services clients do not compromise the care and services provided to
						assisted living facility residents;
(c) Ensure the total number of residents plus
						adult day services clients does not exceed the assisted living facility's
						maximum facility capacity;
(d) Only
						accept adult day services clients who are appropriate for assisted living
						facility care and services, consistent with WAC
						388-78A-2050;
(e) Provide sufficient furniture for the
						comfort of day services clients, in addition to furniture provided for
						residents;
(f) Notify appropriate
						individuals specified in the client's record and consistent with WAC
						388-78A-2640
						when there is a significant change in the condition of an adult day services
						client;
(g) Investigate and
						document incidents and accidents involving adult day services clients
						consistent with WAC
						388-78A-2371;
(h) Maintain a separate register of adult day
						services clients; and
(i) Maintain
						a record for each adult day services client.
Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-78A - Assisted living facility licensing rules › ASSISTED LIVING FACILITY SERVICES › Service Delivery and Monitoring › Adult Day Services › Section 388-78A-2361 - Project and operations functional program

Current through Register Vol. 24-14, July 15, 2024
(1) The facility must develop and document
						their functional programing, under WAC 388-78A-2852, during the project
						development and planning process. This document must inform the design process
						and be provided to the department of health construction review services
						consistent with WAC 388-78A-2852 for use in review of the construction project
						documents and preoccupancy survey. This document must identify and describe, as
						applicable:
(a) Services offered, whether
						intermittent nursing services or contract care services under chapter 388-110
						WAC;
(b) Number of residents served
						under contract care services, as applicable;
(c) The care needs of the population served,
						to include but not limited to dementia, cognitive and developmental disability,
						mental health, bariatric needs, safety risks, security, resident rights, and
						dignity of memory care residents;
(d) Circulation patterns;
(e) Special locking or other security
						measures;
(f) Room use, required
						resources, and systems to include intermittent nursing services that will take
						place in the resident unit;
(g)
						Consideration of and mitigation for risks associated with:
(i) Operational infection control;
(ii) Resident mobility and falls;
(iii) Elopement and security;
(iv) Medication services; and
(v) Staff injury.