Chapter 388-97 Nursing homes.

The nursing home must ensure:(1) Wall finishes are easily cleanable;(2) A water-resistant finish extends above the splash line in all rooms or areas subject to splash or spray, such as bathing facilities with tubs only, toilet rooms, janitors' closets, and can-wash areas; and(3) …

The nursing home must provide the following accessories with the necessary backing, if required, for mounting:(1) Usable countertop area and mirror at each handwashing sink in toilet rooms and resident rooms;(2) Towel or robe hooks at each handwashing sink in resident rooms and a…

The nursing home must ensure:(1) Rooms and service areas are identified by visible and tactile signs, refer to WAC 388-97-2900(2) for possible exceptions; and(2) Equipment and casework is designed, manufactured and installed for ease of proper cleaning and maintenance, and suitab…

The nursing home must ensure:(1) The heating system is capable of maintaining a temperature of seventy-five degrees Fahrenheit for areas occupied by residents and seventy degrees Fahrenheit for nonresident areas;(2) Resident rooms have individual temperature control, except in a …

The nursing home must have:(1) A mechanical cooling system capable of maintaining a temperature of seventy-five degrees Fahrenheit for areas occupied by residents; and(2) A cooling system that has mechanical refrigeration equipment to provide summer air conditioning to resident a…

The nursing home must ensure:(1) Ventilation of all rooms is designed to prevent objectionable odors, condensation, and direct drafts on the residents;(2) All habitable space is mechanically ventilated including:(a) Air supply and air exhaust systems;(b) Installation of air-handl…

The nursing home must provide a handwashing sink in each toilet room and exam room.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4060, filed 9/24/08, effective 11/1/08.]

Where drinking fountains are installed, the nursing home must ensure the fountains are of the inclined jet, sanitary type.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4080, filed 9/24/08, effective 11/1/08.]

The nursing home must provide each fixture, except toilet fixtures and special use fixtures, with hot and cold water through a mixing valve or mixing faucet.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4100, filed 9/24/08, effec…

The nursing home must ensure all lavatories and sinks in resident rooms, resident toilet rooms, and utility and medication areas have gooseneck spouts, without aerators in areas requiring infection control.[Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. W…

The nursing home must provide wrist blade, single-lever controls or their equivalent at all sinks and lavatories. The nursing home must:(1) Provide at least four inch wrist blades and/or single-levers;(2) Provide sufficient space for full open and closed operation; and(3) Color-c…

(1) A complete nursing home license application must be:(a) Submitted at least sixty days prior to the proposed effective date of the license on forms designated by the department;(b) Signed by the proposed licensee or the proposed licensee's authorized representative;(c) Notariz…

The nursing home must:(1) Obtain liability insurance upon licensure and maintain the insurance as required in WAC 388-97-4167 and 388-97-4168; and(2) Have evidence of liability insurance coverage available if requested by the department.[Statutory Authority: Chapters 18.51 and 74…

The nursing home must have commercial general liability insurance or business liability insurance that includes:(1) Coverage for the acts and omissions of any employee and volunteer;(2) Coverage for bodily injury, property damage, and contractual liability;(3) Coverage for premis…

The nursing home must have professional liability insurance or errors and omissions insurance. The insurance must include:(1) Coverage for losses caused by errors and omissions of the nursing home, its employees, and volunteers; and(2) Minimum limits of:(a) Each occurrence at one…

(1) All nursing home licenses must be renewed annually.(2) License renewals must be:(a) Submitted at least thirty days prior to the license's expiration date on forms designated by the department;(b) Signed by the current licensee; and(c) Reviewed by the department in accordance …

(1) All initial nursing home license applications must be reviewed by the department under this chapter.(2) The department will not begin review of an incomplete license application.(3) The proposed licensee must respond to any department request for additional information within…

(1) The department may deny, suspend, modify, revoke, or refuse to renew a nursing home license when the department finds the proposed or current licensee, or any partner, officer, director, managing employee, owner of five percent or more of the proposed or current licensee of t…

A proposed or current licensee contesting a department licensing decision must file a written request for an administrative hearing within twenty days of receipt of the decision.The appeals process and requirements are set forth in WAC 388-97-4440.[Statutory Authority: Chapters 1…

(1) The licensee is responsible for the daily operations of the nursing home.(2) As used in this section:(a) "Management agreement," means a written, executed, agreement between the licensee and another individual or entity regarding the provision of certain services in a nursing…

(1) A change of ownership occurs when there is a substitution, elimination, or withdrawal of the licensee or a substitution of control of the licensee. "Control," as used in this section, means the possession, directly or indirectly, of the power to direct the management, operati…

A nursing home must not be licensed for a capacity that exceeds the number of beds permitted under:(1) This chapter;(2) Chapter 70.38 RCW and regulations thereunder; or(3) Applicable local zoning, building or other such regulations.[Statutory Authority: Chapters 18.51 and 74.42 R…

(1) In the event of license revocation or suspension, decertification, or other emergency closures the department will:(a) Notify residents and, when appropriate, residents' emergency contacts of the action;(b) Assist with residents' relocation and identify possible alternative l…

(1) A nursing home licensee must voluntarily relinquish its license when:(a) The nursing home ceases to do business as a nursing home; and(b) Within twenty-four hours after the last resident is discharged from the facility.(2) The nursing home may not be required to relinquish it…

(1) The department may inspect nursing homes at any time in order to determine compliance with the requirements of chapters 18.51 or 74.42 RCW and this chapter. Types of state inspections in nursing homes include preoccupancy, licensing, revisit, and complaint investigation. In t…

(1) In response to the COVID-19 pandemic, the governor suspended the requirement for the department to conduct general periodic inspections of nursing homes under RCW 18.51.091 and 18.51.230.(2) During the suspension of the general periodic inspection requirements, the department…

(1) The licensee or nursing home must, within ten calendar days of notification of the cited deficiencies prepare, sign, date and provide to the department a detailed written plan of correction. Such plan of correction will provide notification to the department of the date by wh…

(1) A plan of correction must:(a) Address how corrective action will be accomplished for those residents found to have been affected by the deficient practice;(b) Address how the nursing home will identify other residents having the potential to be affected by the same deficient …

(1) For medicare or medicaid certified nursing homes, the informal department review process described in this section is the only opportunity for the nursing home to dispute the federal deficiency citation report, unless a federal sanction is imposed.(2) The nursing home license…

Service of the department notices is complete when:(1) Personal service is made;(2) The notice is addressed to the facility or to the individual at his or her last known address, and deposited in the United States mail;(3) The notice is faxed and the department receives evidence …

The department may establish proof of service by any of the following:(1) A declaration of personal service;(2) An affidavit or certificate of mailing to the nursing home or to the individual to whom the notice is directed;(3) A signed receipt from the person who accepted the cer…

(1) The appeal rights in this section apply to any appealable action taken by the department under chapters 18.51, 74.42 and 74.39A RCW. Notice and appeal requirements for resident protection program findings are described in WAC 388-97-0720 and 388-97-0740.(2) The following acti…

Mandatory Remedies(1) In accordance with RCW 18.51.060 (5)(a), the department must impose a stop placement order when the department determines that the nursing home is not in substantial compliance with applicable laws or regulations and the cited deficiency(ies):(a) Jeopardize …

(1) The criteria set forth in this section implement the requirements under RCW 18.51.060(8). The criteria do not replace the standards for imposition of mandatory remedies under RCW 18.51.060 (3) and (5), or for the imposition of mandatory remedies in accordance with WAC 388-97-…

(1) "Severity of a deficiency" means the seriousness of the deficiency. Factors the department will consider when determining the severity of a deficiency may include, but are not limited to:(a) Whether harm to the resident has occurred, or could occur, including but not limited …

(1) Each deficiency cited by the department for noncompliance with a statute or regulation is a separate deficiency subject to the assessment of a separate remedy.(2) Each day upon which the same deficiency occurs is a separate deficiency subject to the assessment of a separate r…

(1) The department must impose a stop placement order when required by RCW 18.51.060 (5)(a) and WAC 388-97-4460(1) and may impose a stop placement order as an optional remedy in accordance with WAC 388-97-4480. The department's stop placement order becomes effective upon verbal o…

(1) Except as otherwise provided in statute, the range for a:(a) Per day civil fine is fifty dollars to three thousand dollars; and(b) Per instance civil fine is one thousand to three thousand dollars.(2) In the event of continued noncompliance, nothing in this section must preve…

(1) Accrual of a per day civil fine begins on the first date the department verifies that the nursing home has or had a specific deficiency. Accrual of the per day civil fine will end on the date the department determines the nursing home corrected the deficiency.(2) A per instan…

(1) The department must deposit civil penalties collected under chapter 18.51 or 74.42 RCW into a special fund administered by the department to be applied to the protection of the health or property of residents of nursing homes found to be deficient.(2) The funds must be admini…

(1) When the department appoints a temporary manager, the department must order the licensee to:(a) Cease operating the nursing home; and(b) Immediately turn over to the temporary manager possession and control of the nursing home including, but not limited to, all patient care r…

(1) Receivership is authorized under RCW 18.51.400 through 18.51.520 and the following regulations.(2) After receivership is established, the department may recommend to the court that all residents be relocated and the nursing home closed when:(a) Problems exist in the physical …

(1) The department may recruit individuals, partnerships, corporations and other entities interested in serving as a temporary manager or receiver of a nursing home.(2) Individuals, partnerships, corporations, or other entities interested in being appointed as a temporary manager…

(1) The department's authority to appoint a temporary manager or to recommend appointment of a specific individual or entity to act as receiver is discretionary in all cases.(2) The department, in appointing a temporary manager or recommending appointment of a receiver, may consi…

(1) The temporary manager or receiver must protect the health, security and welfare of the residents for the duration of the temporary management or receivership. The temporary manager or receiver must perform all acts reasonably necessary to ensure residents' needs are met. Such…

(1) The department will terminate temporary management:(a) After three months unless good cause is shown to continue the temporary management. Good cause for continuing the temporary management exists when returning the nursing home to its former licensee would subject residents …