Chapter 388-97 Nursing homes.

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 388-97-1915. The emergency rules remained in effect until May 10, 2023. The following rule was…

The department amended or repealed portions of this section to help facilitate care to align state nursing home rules with federal rules that were amended or suspended to facilitate care during the COVID-19 pandemic from April 13, 2020, through May 10, 2023, in response to the st…

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 388-97-1975. The emergency rules remained in effect until May 10, 2023. The following rule wa…

(1) The resident has the right to choose to remain in the nursing facility and receive specialized services if:(a) He or she has continuously resided in a nursing facility since October 1, 1987; and(b) The department determined, in 1990, that the resident required specialized ser…

(1) ICF/IID nursing facilities must meet the requirements of 42 C.F.R. § 483 Subpart I and the requirements of this subchapter except that in an ICF/IID nursing facility:(a) There must be at least one registered nurse or licensed practical nurse on duty eight hours per day, and a…

The design of a nursing home must facilitate resident-centered care and services in a safe, clean, comfortable and homelike environment that allows the resident to use his or her personal belongings to the greatest extent possible.[Statutory Authority: Chapters 18.51 and 74.42 RC…

The nursing home must ensure that:(1) New construction, as defined in WAC 388-97-2160, complies with all the requirements of subchapter II of this chapter;(2) New construction must maintain compliance with the regulations in effect at the time of initial submission to the departm…

The nursing home must:(1) Conform to at least the minimum standards for the prevention of fire, and for the protection of life and property against fire, according to the International Fire Code, RCW 19.27.031, the federal Life Safety Code, 42 C.F.R. 483.70(a), and additional sta…

All nursing homes must:(1) Maintain electrical, mechanical, and patient care equipment in safe and operating condition; and (2) Ensure floors, walls, ceilings, and equipment surfaces are maintained in clean condition and in good repair.[Statutory Authority: Chapters 18.51 and 74.…

(1) All nursing homes must maintain comfortable sound levels, to include minimizing the use of the public address system and taking reasonable precautions with noisy services so residents are not disturbed, particularly during their sleeping time; and(2) In new construction, the …

The nursing home must be readily accessible to a person with disability and comply with WAC 388-97-3520.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2140, filed 9/24/08, effective 11/1/08.]

New construction includes, but is not limited to:(1) New structures.(a) A new building to be licensed as a nursing home; or(b) An addition to a building currently licensed as a nursing home.(2) Existing buildings.(a) Conversion of another building to a nursing home;(b) Change in …

The following regulations do not apply to nursing homes certified exclusively under 42 C.F.R. § 483, Subpart I, or successor laws:(1) WAC 388-97-2440, regarding the required number of square feet per bed; and(2) WAC 388-97-2660, regarding cubicle curtains.[Statutory Authority: Ch…

(1) The nursing home must have an alternate source of power and automatic transfer equipment to connect the alternate source within ten seconds of the failure of the normal source.(2) The nursing home must ensure the alternate source is a generator:(a) With on-site fuel supply;(b…

The nursing home must ensure that:(1) Each resident care unit is located to minimize through traffic to any general service, diagnostic, treatment, or administrative area; and(2) In new construction, the resident care unit, and the services to support resident care and nursing ne…

(1) The nursing home must ensure each resident care unit has at least the following required service areas:(a) A staff work station;(b) A medicine storage and preparation area;(c) A utility room that maintains separated clean and soiled functions;(d) Storage space for linen, othe…

(1) On each unit, the nursing home must have a staff work station appropriate to the needs of staff using the space. At a minimum, the nursing home must equip the area with:(a) A charting surface;(b) A rack or other storage for current health records;(c) Storage for record and cl…

The nursing home must provide a system that meets the following standards:(1) A wired or wireless communication system which registers a call by distinctive light at the room door and by distinctive light and audible tone at the staff work station. The system must be equipped to …

The nursing home must provide 24-hour access to a telephone for resident use per RCW 18.51.575 which:(1) Provides auditory privacy;(2) Allows for communications with family, medical providers, and others;(3) Allows for emergency contact to and from facility staff;(4) Is accessibl…

(1) All nursing homes must:(a) Provide utility rooms designed, equipped, and maintained to ensure separation of clean and sterile supplies and equipment from those that are contaminated;(b) Ensure that each clean utility room has:(i) A work counter;(ii) A sink equipped with singl…

The nursing home must provide an area designed and equipped for drug preparation and locked storage convenient to each work station. The nursing home must ensure:(1) The drug facilities are well illuminated, ventilated, and equipped with a work counter, sink with hot and cold run…

The nursing home must provide:(1) A clean area for storage of clean linen and other bedding. This may be an area within the clean utility room;(2) A soiled linen area for the collection and temporary storage of soiled linen. This may be within the soiled utility room; and(3) In n…

(1) The nursing home must have a janitor's closet with a service sink and adequate storage space for housekeeping equipment and supplies convenient to each resident unit.(2) In new construction a janitor's closet must meet the ventilation requirements of Table 6, in WAC 388-97-40…

The department amended or suspended portions of this section from June 23, 2020, through June 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-24001.(1) The nursing home must ensure that ea…

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on June 23, 2020, to amend and suspend portions of WAC 388-97-2400. The emergency rules remained in effect until June 7, 2022. The following rule was…

(1) The nursing home must ensure that any resident bedroom has:(a) No more than two beds between any resident bed and exterior window wall; and(b) A maximum capacity of four beds.(2) In a new building, addition, or change of use to a resident bedroom the maximum capacity is two b…

The nursing home must ensure that minimum usable room space exclusive of toilet rooms, closets, lockers, wardrobes, must:(1) In existing facilities, be at least eighty square feet per bed in each multibed room and at least one hundred square feet for each single bed room;(2) In a…

The nursing home must ensure that each resident bedroom is designed or equipped to ensure full visual privacy for each resident.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2460, filed 9/24/08, effective 11/1/08.]

If a nursing home provides an isolation room, the nursing home must ensure the room is uncarpeted and contains:(1) A handwashing sink with water supplied through a mixing valve;(2) Its own adjoining toilet room containing a bathing facility; and(3) In new construction, the handwa…

The director of residential care services, aging and disability services administration, or their designee, may permit exceptions to WAC 388-97-2420 (1)(a) and 388-97-2440(1) when the nursing home demonstrates in writing that the exception:(1) Is in accordance with the special ne…

The nursing home must determine a resident's furniture and equipment needs at the time of admission and routinely thereafter to ensure resident comfort. Except as specified in WAC 388-97-0560, the nursing home must provide each resident with the following items required in WAC 38…

The nursing home must provide:(1) A comfortable bed of size and height to maximize a resident's independent functioning. Beds may be arranged to satisfy the needs and desires of the individual resident provided the arrangement does not negatively impact the health or safety of ot…

The nursing home must provide:(1) A lockable storage space accessible to each resident for storage of small personal items, upon request; and(2) In a new building or addition, a lockable cabinet space or drawer for storage of personal belongings for each resident bed, in addition…

The nursing home must provide:(1) A separated, enclosed wardrobe or closet for each resident's clothing and belongings accessible to the resident; and(2) In a new building or addition, each bed in each room must have a separate, enclosed wardrobe or closet accessible to the resid…

The nursing home must provide comfortable seating for residents and visitors, not including resident care equipment, that provides proper body alignment and support.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2600, filed 9/24/0…

The nursing home must provide a permanently mounted or equivalent light suitable for any task the resident chooses to do or any task the staff must do.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2620, filed 9/24/08, effective 1…

The nursing home must provide a resident call signal device that complies with WAC 388-97-2280.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2640, filed 9/24/08, effective 11/1/08.]

The nursing home must provide:(1) Flame-retardant cubicle curtains in multibed rooms that ensures full visual privacy for each resident;(2) In a new building or addition, the cubicle curtain or enclosed space ensures full visual privacy for each bed in a multibed room with enclos…

The nursing home must provide:(1) A phone jack for each bed in each room;(2) A handwashing sink in each multibed room and a handwashing sink in each single room that does not have an adjoining toilet room containing a handwashing sink. A handwashing sink located in a resident bed…

The nursing home must ensure that:(1) Each resident room is equipped with or located convenient to toilet facilities.(2) For new construction, a toilet room must:(a) Be directly accessible from each resident room and from each bathing facility without going through or entering a …

The nursing home must ensure:(1) Each resident room is equipped with or located near bathing facilities;(2) At least one bathing unit for no more than thirty residents that is not located in a room served by an adjoining bathroom;(3) At least one bathing device for immersion per …

The nursing home must ensure:(1) All lockable toilet facilities and bathrooms have a readily available means of unlocking from the outside; and(2) Locks are operable from the inside with a single motion.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR …

(1) The nursing home must provide one or more rooms designated for resident dining and activities that are:(a) Well lighted;(b) Well ventilated;(c) Adequately furnished; and(d) Large enough to accommodate all activities.(2) In a new building or addition, the nursing home must des…

The nursing home must comply with WAC 388-97-1860 and ensure:(1) Sufficient laundry washing and drying facilities to meet the residents' care and comfort needs without delay.(2) That the nursing home linen is disinfected in accordance with:(a) The temperature and time of the cycl…

A nursing home that began operating a dementia care unit at any time after November 13, 1989, must meet all requirements of this section, WAC 388-97-2820 through 388-97-2920, and the resident care unit requirements of WAC 388-97-2220 through 388-97-2380. Refer to WAC 388-97-1040,…

(1) The nursing home must provide dining areas in the dementia care unit which may also serve as day areas for the unit.(2) In a new building or addition, the dining, dayroom, and activity area or areas on the unit must provide a minimum of thirty square feet per resident.[Statut…

The nursing home must provide the dementia care unit with:(1) Secured outdoor space and walkways;(2) An ambulation area with accessible walking surfaces that:(a) Are firm, stable, and free from cracks and abrupt changes with a maximum of one inch between sidewalk and adjoining la…

The nursing home must provide the dementia care unit with:(1) Indoor ambulation areas that meet the needs of the residents and are maintained free of equipment; and(2) Nontoxic indoor plants in areas accessible to residents.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 4…

The nursing home must ensure that the dementia care unit has a continuous ambulation route which may include outdoor ambulation areas and allows the resident to return to the resident's starting point without reversing direction.[Statutory Authority: Chapters 18.51 and 74.42 RCW …

The nursing home must:(1) Provide a staff toilet room with a handwashing sink;(2) Ensure that floors, walls, and ceiling surfaces display contrasting color for identification:(a) Surfaces may have a disguise design to obscure or conceal areas that residents should not enter, exce…