Washington Administrative Code

The purpose of this section is to ensure the establishment and on-going maintenance of a coordinated quality improvement program. The intent is to improve the quality of health care services provided to patients and to identify and prevent medical malpractice. An ambulatory surgi…

The purpose of this section is to identify and reduce the risk of acquiring and transmitting infections and communicable diseases between patients, staff, medical staff, and visitors.An ambulatory surgical facility must:(1) Develop, implement and maintain a written infection cont…

This section establishes the initial and renewal license fees, change of ownership fee, late fee, and request for refund of an initial license fee for an ambulatory surgical facility (ASF).(1) Initial and renewal license fees. An initial license or a renewal license and fee are v…

This section assures patient pharmaceutical needs are met in a planned and organized manner. This section is consistent with the requirements for a health care entity license under RCW 18.64.450 and chapter 246-945 WAC.An ambulatory surgical facility must:(1) Only administer, dis…

This section guides the development of a plan for patient care. The ambulatory surgical facility accomplishes this by supervising staff, establishing, monitoring, and enforcing policies and procedures that define and outline the use of materials, resources, and promote the delive…

The purpose of this section is to guide the development and management of surgical services.An ambulatory surgical facility must:(1) Adopt and implement policies and procedures that:(a) Identify areas where surgery and invasive procedures may be performed;(b) Define staff access …

The purpose of this section is to guide the management and care of patients receiving anesthesia and sedation.An ambulatory surgical facility must:(1) Adopt and implement policies and procedures that:(a) Identify the types of anesthesia and sedation that may be used;(b) Identify …

The purpose of this section is to guide the management of patients recovering from anesthesia and sedation.An ambulatory surgical facility must:(1) Adopt and implement policies and procedures that define the qualifications and oversight of staff delivering recovery services;(2) A…

The purpose of this section is to guide the management and care of patients receiving emergency services.An ambulatory surgical facility must:(1) Develop, implement and maintain a facility safety and emergency training program that includes:(a) On-site equipment, medication and t…

The purpose of this section is to manage environmental hazards and risks, prevent accidents and injuries, and maintain safe conditions for patients, visitors, and staff. (1) An ambulatory surgical facility must create and follow an environment of care management plan that address…

The purpose of the new construction regulations is to provide minimum standards for the construction, maintenance and operation of ambulatory surgical facilities and the establishment of a safe and adequate care and treatment environment. These rules are consistent with other acc…

(1) This section identifies the actions and responsibilities of the department for reviewing and approving new construction of ambulatory surgical facilities.(2) Before issuing an approval of plans, the department will verify compliance with chapter 70.230 RCW and this chapter wh…

(1) Drawings and specifications for new construction, must be prepared by, or under the direction of, an architect registered under chapter 18.08 RCW. The services of a consulting engineer registered under chapter 18.43 RCW must be used for the various branches of the work where …

(1) These rules implement chapter 70.127 RCW which requires the department of health to set minimum health and safety standards for in-home services agencies licensed to provide home care, home health, hospice, or hospice care center services.(2) Applicants and licensees must mee…

The requirements in WAC 246-335-300 through 246-335-660 apply to in-home services agencies licensed to provide home care, home health, and/or hospice services unless otherwise noted in the specific sections. The requirements in WAC 246-335-705 through 246-335-768 apply to hospice…

The definitions in this section apply throughout this chapter unless the context clearly indicates otherwise:(1) "Activities of daily living" or "ADL" means routine activities performed around the home or in the community and includes:(a) "Ambulation" means how an individual move…

A person must possess a current license issued by the department before advertising, operating, managing, conducting, opening or maintaining an in-home services agency unless exempt under RCW 70.127.040 or 70.127.050. Any person who employs or contracts with two or more individua…

An applicant for initial licensure must:(1) Complete a department sponsored in-home services orientation class prior to submitting a state licensing application. The purpose of the orientation class is to provide prospective applicants an overview of the state licensing process, …

At least thirty days before the expiration date of the current license, the licensee must submit to the department:(1) A completed renewal licensing application on forms provided by the department;(2) Evidence of continuing insurance coverage according to WAC 246-335-320 (2)(b);(…

A change of ownership on an in-home services agency includes any of the following:(1) Transferring ownership, either whole or part, to a new owner;(2) Dissolving a partnership or corporation;(3) Merging with another entity taking on that entity's identity;(4) Consolidating with a…

An applicant or licensee must:(1) Comply with the provisions of chapter 70.127 RCW and this chapter;(2) Maintain at least one in-state office location where records are kept, secured, and accessible;(3) Display the license issued by the department in an area within the main offic…

To ensure compliance with chapters 246-335 WAC and 70.127 RCW, the department may:(1) Conduct unannounced surveys at any time and at least once during a licensure period, except for agencies approved through substantial equivalency according to WAC 246-335-350;(2) Survey a licens…

To ensure compliance with chapters 246-335 WAC and 70.127 RCW, the department may:(1) Issue a statement of deficiencies following a survey which identifies noncompliance with chapter 70.127 RCW and this chapter. The statement of deficiencies will include a brief statement of what…

To ensure compliance with chapters 246-335 WAC and 70.127 RCW, the following substantial equivalency options apply that satisfy the state survey requirement:(1) An in-home services licensee that is approved to provide home health or hospice services and is certified by the federa…

To request an exemption from specific requirements in this chapter, the applicant or licensee must submit a written request to the department including:(1) A description of the requested exemption and alternatives, if appropriate;(2) Rationale for the exemption;(3) Impact of the …

The requirements in WAC 246-335-405 through 246-335-455 apply to all in-home services agencies licensed to provide home care services.[Statutory Authority: RCW 70.127.120 and 43.70.250. WSR 18-06-093, § 246-335-405, filed 3/6/18, effective 4/6/18.]

The definitions in this section apply throughout WAC 246-335-405 through 246-335-455 unless the context clearly indicates otherwise:(1) "Certified home care aide" or "home care aide" means an individual credentialed under chapters 18.88B RCW and 246-980 WAC.(2) "Client" means an …

The applicant or licensee must develop and implement a plan of operation which includes:(1) A description of the organizational structure;(2) Personnel job descriptions according to WAC 246-335-425(2);(3) Responsibilities of contractors and volunteers;(4) Services to be provided;…

The applicant or licensee must develop and operationalize delivery of services policies and procedures that describe:(1) Admission, transfer, discharge, and referral processes:(a) In order to minimize the possibility of client abandonment, clients must be given at least a forty-e…

The applicant or licensee must develop and operationalize personnel, contractor, and volunteer policies and procedures that describe:(1) Employment criteria regarding discrimination consistent with chapter 49.60 RCW;(2) Job descriptions that contain responsibilities and are consi…

The licensee must maintain records on all personnel and volunteers and have access to records on all contractors to include:(1) Current practice certification, credential, licensure, or documentation that noncredentialed long-term care workers meet the exemption criteria in chapt…

A home care agency at the time of admission must provide each client, designated family member, or legal representative with a written bill of rights affirming each client's right to:(1) Receive quality services from the home care agency for services identified in the plan of car…

Except as provided in subsections (5) and (6) of this section, the licensee must:(1) Develop and implement a written home care plan of care for each client with input and written approval by the client, designated family member, or legal representative;(2) Ensure each plan of car…

(1) The licensee must employ a supervisor of direct care services;(2) The supervisor of direct care services must designate in writing a similarly qualified alternate to act in the supervisor's absence;(3) The licensee shall ensure the supervisor of direct care services and the d…

The licensee must:(1) Maintain a current record for each client consistent with chapter 70.02 RCW;(2) Ensure that client records are:(a) Accessible in the licensee's office location for review by appropriate direct care personnel, volunteers, contractors, and the department;(b) W…

Every home care licensee must develop and operationalize a quality improvement program to ensure the quality of care and services provided throughout all approved service areas including, at a minimum:(1) A complaint process that includes a procedure for the receipt, investigatio…

The requirements in WAC 246-335-505 through 246-335-560 apply to all in-home services agencies licensed to provide home health services.[Statutory Authority: RCW 70.127.120 and 43.70.250. WSR 18-06-093, § 246-335-505, filed 3/6/18, effective 4/6/18.]

The definitions in the section apply throughout WAC 246-335-505 through 246-335-560 unless the context clearly indicates otherwise:(1) "Acute care" means care provided by an in-home services agency licensed to provide home health services for patients who are not medically stable…

The applicant or licensee must develop and implement a plan of operation which includes:(1) A description of the organizational structure;(2) Personnel job descriptions according to WAC 246-335-525(2);(3) Responsibilities of contractors and volunteers;(4) Services to be provided;…

The applicant or licensee must develop and operationalize delivery of services policies and procedures that describe:(1) Admission, transfer, discharge, and referral processes:(a) In order to minimize the possibility of patient abandonment, patients must be given at least a forty…

The applicant or licensee must develop and operationalize personnel, contractor, and volunteer policies and procedures that describe:(1) Employment criteria regarding discrimination consistent with chapter 49.60 RCW;(2) Job descriptions that contain responsibilities and are consi…

The licensee must maintain records on all personnel and volunteers and have access to records on all contractors, to include:(1) Current practice certification, credential or licensure, as applicable;(2) Documentation of references;(3) Contracts when using contractors;(4) Evidenc…

A home health agency at the time of admission must provide each patient, designated family member, or legal representative with a written bill of rights affirming each patient's right to:(1) Receive effective treatment and quality services from the home health agency for services…

Except as provided in subsections (5) and (6) of this section, the licensee must:(1) Develop and implement a written home health plan of care for each patient with input from the patient, designated family member, or legal representative and authorizing practitioner;(2) Ensure ea…

(1) A licensee must employ a director of clinical services.(2) The director of clinical services must designate in writing a similarly qualified alternate to act in the director's absence.(3) The licensee shall ensure the director of clinical services and the designated alternate…

The licensee must:(1) Maintain a current record for each patient consistent with chapter 70.02 RCW;(2) Ensure that patient records are:(a) Accessible in the licensee's office location for review by appropriate direct care personnel, volunteers, contractors, and the department;(b)…

Every home health licensee must develop and operationalize a quality improvement program to ensure the quality of care and services provided throughout all approved service areas including, at a minimum:(1) A complaint process that includes a procedure for the receipt, investigat…

This section applies to home health agencies providing or contracting for medical supplies or equipment services.(1) The applicant or licensee must develop and implement policies and procedures to:(a) Maintain medical supplies and equipment;(b) Clean, inspect, repair and calibrat…

The requirements in WAC 246-335-605 through 246-335-660 apply to all in-home services agencies licensed to provide hospice services.[Statutory Authority: RCW 70.127.120 and 43.70.250. WSR 18-06-093, § 246-335-605, filed 3/6/18, effective 4/6/18.]

The definitions in this section apply throughout WAC 246-335-605 through 246-335-660 unless the context clearly indicates otherwise:(1) "Assessment" means an evaluation performed by an appropriate health care professional of a patient's physical, psychosocial, emotional and spiri…