Chapter 388-97 Nursing homes.

In dementia care units the nursing home must:(1) Have proof that required approvals for any special egress control devices were obtained from the state fire marshal, department of social and health services, and the local official who enforces the International Building Code and …

(1) If nursing homes initially licensed after October 1, 1981 provide inpatient specialized rehabilitation, they must ensure that those services provide:(a) Easy access in general service areas;(b) Exercise, treatment, and supportive equipment as required by the narrative program…

The nursing home must ensure that facilities with outpatient programs provide:(1) A designated reception and waiting room or area and space for interviewing or counseling individual outpatients and their families;(2) Adequate space for the program so that disruption to designated…

The nursing home must ensure food service areas are in compliance with chapter 246-215 WAC, state board of health rules governing food service sanitation. The nursing home must:(1) Ensure food service areas are provided for the purpose of preparing, serving, and storing food and …

The nursing home must:(1) Provide adequate storage space for wheelchairs and other ambulation equipment;(2) Ensure stored equipment does not impinge upon the required corridor space; and(3) In new construction, provide adequate storage of four square feet or more of storage space…

The nursing home must provide separate storage for extra pillows and blankets for each bed. This may be in a location convenient to the resident room or combined with the wardrobe or closet if it does not impinge upon the required space for clothing.[Statutory Authority: Chapters…

A nursing home must have general storage space of not less than five square feet per bed in addition to the closets and storage required in WAC 388-97-2560.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3040, filed 9/24/08, effect…

The nursing home must ensure that lighting and lighting levels:(1) Are adequate and comfortable for the functions being conducted in each area of the nursing home;(2) Are suitable for any task the resident chooses or any task the staff must do;(3) Support the independent function…

(1) The nursing home must ensure that adequate natural or artificial light for inside illumination is provided in every useable room area, including but not limited to storerooms, attic and basement rooms, hallways, stairways, inclines, and ramps.(2) In new buildings and addition…

The nursing home must ensure:(1) Lighting levels in parking lots and approaches to buildings are appropriate for resident and visitor convenience and safety; and(2) All outside areas where nursing home equipment and machinery are stored have proper lighting.[Statutory Authority: …

The nursing home must ensure that light shields are provided in food preparation and serving areas, utility rooms, medication rooms, exam rooms, pool enclosures, laundry areas, and on ceiling mounted fluorescent lights in resident rooms.[Statutory Authority: Chapters 18.51 and 74…

The nursing home must ensure:(1) Lighting fixtures and circuitry provide at least the illumination levels appropriate to the task;(2) Design takes into consideration that lighting systems normally decrease in output with age and dirt accumulation; and(3) Light fixture locations a…

The nursing home must install in each resident room a night light that is:(1) Flush mounted on the wall;(2) Designed to prevent viewing the light source from thirty inches or more above the floor;(3) Located to provide safe pathway lighting for the staff and residents; and(4) Con…

The nursing home must install quiet operating switches for general illumination adjacent to doors in all areas and accessible to residents in resident rooms.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3180, filed 9/24/08, effec…

(1) The nursing home must provide enough electrical outlets to meet the care and personal appliance needs of each resident. An approved power tap may be used only for portable appliances with specific overcurrent protection needs, such as a computer. A "power tap" is a device for…

The nursing home must provide:(1) A safe, functional, sanitary, and comfortable environment for the residents, staff, and the public; and(2) Signs to designate areas of hazard.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3220, f…

The nursing home must ensure that poisons and nonmedicinal chemicals are stored in containers identified with warning labels. The containers must be stored:(1) In a separate locked storage when not in use by staff; and(2) Separate from drugs used for medicinal purposes.[Statutory…

The nursing home must ensure that the manner in which equipment and supplies are stored does not jeopardize the safety of residents, staff, or the public.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3260, filed 9/24/08, effectiv…

The nursing home must:(1) Provide handrails on each side of all corridors and stairwells accessible to residents; and(2) In new construction ensure that:(a) Ends of handrails are returned to the walls;(b) Handrails are mounted thirty to thirty-four inches above the floor and proj…

The nursing home must comply with the requirements of the group A, Public Water Systems, chapter 246-290 WAC or group B, Public Water Systems, chapter 246-291 WAC.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3300, filed 9/24/08,…

The nursing home must ensure:(1) The hot water system maintains water temperatures at one hundred ten degrees Fahrenheit, plus or minus ten degrees Fahrenheit, at fixtures used by residents and staff.(2) For laundry temperatures, refer to WAC 388-97-2780.(3) For dishwashing tempe…

The nursing home must:(1) Prohibit all cross connections between potable and nonpotable water;(2) Use backflow prevention devices on plumbing fixtures, equipment, facilities, buildings, premises or areas which are actual or potential cross-connections to prevent the backflow of w…

The nursing home must:(1) Maintain an effective pest control program so that the facility is free of pests such as rodents and insects;(2) Construct and maintain buildings to prevent the entrance of pests such as rodents and insects; and(3) Provide mesh screens or equivalent with…

The nursing home must ensure:(1) All sewage and liquid wastes are discharged into an approved public sewage system where such system is available; or(2) Sewage and liquid wastes are collected, treated, and disposed of in an on-site sewage system in accordance with chapter 246-272…

(1) The project sponsor must submit plans for all new construction to the department of health, construction review, for review and approval. Documents must be approved before the work begins. The project sponsor must also submit documents to department of health, certificate of …

If preliminary documents and specifications are submitted, they must:(1) Include a narrative program with drawings. Copies of these documents must be sent to the department of health, certificate of need and construction review, and to aging and disability services administration…

(1) Construction must not start until at least two sets of final construction documents drawn to scale with complete specifications have been submitted to and approved by the department of health, construction review, in coordination with aging and disability services administrat…

The department of health, construction review, must receive and approve preinstallation submissions prior to installation. Preinstallation submissions may include any or all of the following:(1) Stamped shop drawings, hydraulic calculations, and equipment information sheets for f…

(1) Construction documents must be resubmitted for review as a new project according to current requirements if construction:(a) Has not started within one year from the date of approval; or(b) Is not completed within two years from the date of approval.(2) To obtain an extension…

(1) The director of residential care services, aging and disability services administration, may grant exemptions to new construction requirements for:(a) Alterations when the applicant demonstrates the proposed alterations will serve to correct deficiencies or will upgrade the n…

The nursing home must through its design, construction and necessary permits demonstrate compliance with the following codes and local jurisdiction standards. The nursing home that submitted plans for construction review after July 1, 2007 must also comply with the following Inte…

The nursing home must ensure that all electrical wiring complies with state and local electrical codes including chapter 296-46B WAC and the National Electric Code of the National Fire Protection Association (NFPA-70) as adopted by the Washington state department of labor and ind…

The nursing home must ensure that elevators are installed in accordance with chapter 296-96 WAC.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3560, filed 9/24/08, effective 11/1/08.]

The nursing home must:(1) Follow all local ordinances relating to zoning, building, and environmental standards; and(2) Obtain all local permits before construction and keep permits on file at the nursing home.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.5…

The nursing home must have the main entrances and exits sheltered from the weather and barrier free accessible in accordance with chapter 51-50 WAC.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3600, filed 9/24/08, effective 11/1…

The nursing home must have a lobby or area in close proximity to the main entrance that is barrier free accessible and includes:(1) Waiting space with seating accommodations;(2) A reception and information area;(3) Space to accommodate persons in wheelchairs;(4) A public restroom…

The nursing home must have interview spaces for private interviews relating to social service and admission.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3640, filed 9/24/08, effective 11/1/08.]

The nursing home must provide:(1) Office space convenient to the work area for the administrator, the director of nursing services, medical records staff, social services staff, activities director, and other personnel as appropriate;(2) Work space for physicians and outside cons…

The nursing home must provide space for employee inservice education that will not infringe upon resident space.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3680, filed 9/24/08, effective 11/1/08.]

The nursing home must ensure a lounge, lockers, and toilets are provided convenient to the work areas for employees and volunteers.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3700, filed 9/24/08, effective 11/1/08.]

The nursing home must design a separate room or areas for residents to have family and friends visit and for residents to spend time alone. The nursing home must ensure these areas provide:(1) Space which facilitates conversation and privacy; and(2) Access to a common-use toilet …

A nursing home must provide a safe, protected outdoor area for resident use. The nursing home must ensure the outdoor area has:(1) Shaded and sheltered areas to meet residents needs;(2) Accessible walking surfaces which are firm, stable, and free from cracks and abrupt changes wi…

The nursing home must ensure swimming pools, spas, and tubs which remain filled between uses meet the requirements in chapter 246-260 WAC.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3760, filed 9/24/08, effective 11/1/08.]

The nursing home must ensure that an on-site pharmacy meets the requirements of the Washington state board of pharmacy per chapters 18.64 RCW and 246-865 WAC.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3780, filed 9/24/08, effe…

The nursing home must:(1) Ensure that all buildings having residential use areas or service areas that are not located on the main entrance floor, have an elevator; and(2) Have at least one elevator sized to accommodate a resident bed and attendant for each sixty beds on floors o…

The nursing must ensure that:(1) An abrupt change in the walking surface level including at door thresholds which are greater than one quarter inch are beveled to a one vertical in two horizontal; and(2) Changes in the walking surface level greater than one half inch are accompli…

The nursing home must ensure doors to:(1) Resident rooms provide a minimum of forty-four inches clear width;(2) Resident bathrooms and toilet rooms are a minimum of thirty-two inches clear width for wheelchair access;(3) All resident toilet rooms and bathing facilities open outwa…

The nursing home must ensure:(1) Floors at all outside entrances have slip-resistant finishes both inside and outside the entrance even when wet; and(2) All uncarpeted floors are smooth, nonabsorbent and easily cleanable.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C…

The nursing home must ensure that department of health, construction review approves of all carpet installation.(1) Carpets may be used in all areas except: Toilet rooms, bathrooms, kitchen, laundry, utility rooms, medication rooms, maintenance, isolation rooms if provided, and a…

The nursing home must ensure:(1) Kitchens, restrooms, laundry, utility rooms, and bathing areas have integral coves of continuous commercial grade sheet vinyl, bullnose ceramic tile or sealed bullnose quarry tile at least six inches in height; and(2) All other wall junctions have…