Chapter 388-97 Nursing homes.

"Abandonment" means action or inaction by an individual or entity with a duty of care for a vulnerable adult that leaves the vulnerable individual without the means or ability to obtain necessary food, clothing, shelter, or health care."Abuse" means the willful action or inaction…

The nursing facility must provide items, care, and services in accordance with this chapter and with federal regulations under 42 C.F.R. § 483.1 through 483.206, or successor laws, and other applicable federal requirements.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42…

(1) A nursing facility must establish and maintain identical policies and practices regarding transfer, discharge, and the provision of services covered under the state medicaid plan for all individuals regardless of source of payment.(2) A nursing facility must not require or re…

Refer to WAC 388-106-0350 through 388-106-0360.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0060, filed 9/24/08, effective 11/1/08.]

(1) A resident has the right to attain or maintain the highest practicable physical, mental, and psychosocial well-being, and to reside in the most independent setting. Therefore, the nursing home must:(a) Utilize a formal resident discharge planning system with identical policie…

(1) To assure appropriate use of medicaid services, the nursing facility must determine whether each medicaid resident's health has improved sufficiently so the resident no longer needs nursing facility care.(a) The nursing facility must base its determination on:(i) An accurate,…

The department amended or repealed portions of this section to help facilitate care to align state nursing home rules with federal rules that were amended or suspended during the COVID-19 pandemic from April 13, 2020, through May 23, 2023, in response to the state of emergency. F…

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on April 13, 2020, to amend and repeal portions of WAC 388-97-0120. The emergency rules remained in effect until May 23, 2023. The following rule was…

The department amended or repealed portions of this section from November 30, 2021, through May 23, 2023, by waiving the requirement for nursing homes to suspend certain transfers and discharges pending the outcome of a resident appeal hearing, and improving resident safety by al…

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on November 30, 2021, to amend and repeal portions of WAC 388-97-0140. The emergency rules remained in effect until May 23, 2023. The following rule …

(1) A nursing facility must send immediate written notification of the date of discharge or death of a medicaid resident to the department's local home and community service office.(2) The nursing facility must:(a) Notify the department of nursing facility discharge and readmissi…

(1) The nursing home must meet the resident rights requirements of this section and those in the rest of the chapter.(2) The resident has a right to a dignified existence, self-determination, and timely communication with, and access to individuals and services inside and outside…

The resident has the right to:(1) Choose a personal attending physician.(2) Be fully informed in advance about care and treatment and of any changes in that care or treatment that may affect the resident's well-being.(3) Participate in planning care and treatment or changes in ca…

WAC 388-97-0240, 388-97-0260, and 388-97-0280 implement the federal Patient Self-Determination Act and clarify requirements under chapters 11.94, 7.70, 70.122, 11.88 and 11.92 RCW.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-022…

(1) At the time of admission, or not later than the completion of the initial comprehensive resident assessment, the nursing home must determine if the resident:(a) Has appointed another individual to make their health care, financial, or other decisions;(b) Has created any advan…

(1) The nursing home must ensure that the informed consent process is followed with:(a) The resident to the maximum extent possible, taking into consideration their ability to understand and respond; and(b) The surrogate decision maker when the resident is determined to be incapa…

(1) "Advance directive" as used in this chapter means any document indicating a resident's choice with regard to a specific service, treatment, medication, or medical procedure option that may be implemented in the future such as power of attorney, health care directive, limited …

The department amended or suspended portions of this section from May 15, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-03001.(1) The nursing home must provide the resi…

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on May 15, 2020, to amend and suspend portions of WAC 388-97-0300. The emergency rules remained in effect until May 7, 2022. The following rule was i…

(1) A nursing home must immediately inform the resident, consult with the resident's physician, and if known, notify the resident's surrogate decision maker, and when appropriate, with resident consent, interested family member(s) when there is:(a) An accident involving the resid…

(1) The resident has the right to manage their financial affairs and the nursing home may not require residents to deposit their personal funds with the nursing home. (2) Upon written authorization of a resident, the nursing home must hold, safeguard, manage, and account for the …

(1) The resident has the right to personal privacy and confidentiality of their personal and clinical records. Personal privacy includes:(a) Accommodations;(b) Medical treatment;(c) Written and telephone communications;(d) Personal care;(e) Visits; and(f) Meetings with family and…

(1) Except as provided in this section or in WAC 388-97-0400, the nursing home must not use the following in the facility or on the premises:(a) Audio monitoring equipment; or(b) Video monitoring equipment if it includes an audio component.(2) The nursing home may video monitor a…

(1) The nursing home must not use audio or video monitoring equipment to monitor any resident unless:(a) The resident has requested the monitoring; and(b) The monitoring is only used in the sleeping room of the resident who requested the monitoring.(2) If the resident requests au…

The resident has the right to:(1) Refuse to perform services for the nursing home; and(2) Perform services for the nursing home, if they choose, when:(a) The facility has documented the need or desire for work in the plan of care;(b) The plan specifies the nature of the services …

A resident may self-administer drugs if the interdisciplinary team has determined that this practice is safe.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0440, filed 9/24/08, effective 11/1/08.]

A resident has the right to:(1) Voice grievances without discrimination or reprisal. Grievances include those with respect to treatment which has been furnished as well as that which has not been furnished.(2) Prompt efforts by the nursing home to resolve voiced grievances, inclu…

(1) The resident has the right to examine the results of:(a) The most recent survey of the nursing home conducted by federal and state surveyors;(b) Surveys related to any current or subsequent complaint investigation; and(c) Any required accompanying plan of correction, complete…

The resident has the right and the nursing home must provide immediate access to any resident by the following:(1) Send and promptly receive mail that is unopened; and(2) Have access to stationary, postage and writing implements at the resident's own expense.[Statutory Authority:…

(1) The resident has the right and the nursing home must provide immediate access to any resident by the following:(a) For medicare and medicaid residents any representative of the U.S. department of health and human services (DHHS);(b) Any representative of the state;(c) The res…

The resident has the right to have twenty-four hour access to a telephone which:(1) Provides auditory privacy;(2) Is accessible to an individual with a disability and accommodates an individual with sensory impairment; and(3) Does not include the use of telephones in staff office…

(1) The resident has the right, unless to do so would infringe upon the rights or health and safety of other residents, to:(a) Retain and use personal possessions, including some furnishings, and appropriate clothing, as space permits;(b) Provide his or her own bed and other furn…

(1) A resident has the right to:(a) Share a room with their spouse or state registered domestic partners when both residents live in the same facility and both consent to the arrangement and the room complies with the requirements for two occupants; and(b) Receive three days noti…

(1) Each resident has the right to refuse a transfer to another room within the facility, if the purpose of the transfer is to make the resident eligible for coverage by the medicare or medicaid program.(2) Refer to WAC 388-97-0580 for requirements related to a resident's right t…

(1) The resident has the right to be free from any physical or chemical restraint imposed for purposes of:(a) Discipline or convenience, and not required to treat the resident's medical symptoms; or(b) Preventing or limiting independent mobility or activity.(2) The nursing home m…

(1) Each resident has the right to be free from verbal, sexual, physical and mental abuse, corporal punishment, and involuntary seclusion.(2) The nursing home must develop and implement written policies and procedures that:(a) Prohibit abandonment, abuse, and neglect of residents…

(1) Dignity. The nursing home must ensure that:(a) Resident care is provided in a manner to enhance each resident's dignity, and to respect and recognize their individuality; and(b) Each resident's personal care needs are provided in a private area free from exposure to individua…

The nursing home must provide and maintain:(1) A safe, clean, comfortable, and homelike environment, allowing the resident to use their personal belongings to the extent possible;(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable …

The resident has the right to:(1) Choose activities, schedules, and health care consistent with their interests, assessments, and plan of care;(2) Interact with members of the community both inside and outside the nursing home;(3) Make choices about aspects of their life in the f…

The department repealed this section from April 13, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. The requirements of this section were not in effect during that time.(1) A resident has the right to organize and participate in …

The nursing home must:(1) Provide for an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interests and the physical, mental, and psychosocial well-being of each resident;(2) Provide activities meaningful to the residents at var…

The nursing home must:(1) Provide medically related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident; and(2) Employ a qualified social worker on a full-time basis if the nursing home has more than one hun…

(1) Each resident must have a reasonable opportunity to have regular contact with animals, if desired.(2) The nursing home must:(a) Consider the recommendations of nursing home residents, resident councils, and staff;(b) Determine how to provide residents access to animals;(c) De…

The department amended or suspended portions of this section from April 13, 2020, through May 10, 2021, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-10001.(1) The nursing home must:(a) Provide r…

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on April 13, 2020, to amend and suspend portions of WAC 388-97-0300. The emergency rules remained in effect until May 10, 2021. The following rule wa…

The department amended or suspended portions of this section from April 13, 2020, through May 10, 2021, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-10201.(1) The nursing home must develop a com…

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on April 13, 2020, to amend and suspend portions of WAC 388-97-0300. The emergency rules remained in effect until May 10, 2021. The following rule wa…

(1) A nursing home must ensure that it provides residents with dementia with an environment designed to attain or maintain the highest level of functioning and well-being possible, taking into consideration the resident's medical condition and functional status. Therefore, the nu…

(1) Consistent with resident rights, the nursing home 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 in accordance with his or her comprehensive…

(1) The nursing home must ensure that a sufficient number of qualified nursing personnel are available on a twenty-four hour basis seven days per week to provide nursing and related services to attain or maintain the highest practicable physical, mental and psychosocial well-bein…