What is HB 1859?
Washington House Bill 1859 concerns the rights of residents in long-term care facilities. The bill was introduced in the 2023 legislative session by Representatives Simmons and Harris.
HB 1859 would extend federal skilled nursing facility residents’ rights to community-based long-term care settings in Washington, including assisted living and adult family homes. Notably, HB 1859 creates a 90-day period to file an appeal for a resident discharge, which extends 60 days beyond current practice. The bill disregards the fact that nursing homes are designed and staffed for 24/7 post-acute medical care and higher acuity personal care, whereas home and community settings are designed for wraparound personal care and are not a medical model.
While Washington Health Care Association strongly supports the goal of allowing residents to appeal discharges, we cannot support the bill as currently written.
Why does WHCA oppose HB 1859?
Long-term care residents absolutely deserve rights and protections, including the right to appeal a discharge. However, the prolonged appeal process that would become law if HB 1859 passes puts residents and long-term care staff at unnecessary risk. A 90-day period to file an appeal means that appropriate discharges cannot move forward.
HB 1859 creates law that stalls appropriate discharges by 60 days for individuals who:
- Need medical or wound care beyond what is provided in an assisted living or adult family home, stretching staff capacity to care for other residents;
- Have behaviors that are a danger to themselves or others putting the general resident population and staff at risk; and/or
- Are no longer paying for services, creating an unfunded mandate for care and services.
Long-term care facilities need to be able to complete appropriate discharges safely and expeditiously when a resident has medical needs that cannot be met by their staff, or behavioral issues that could lead them to harm themselves or others – especially when the facility is not equipped to handle the situation. Most community-based long-term care facilities do not have enough staff to adequately monitor these appropriate discharges pending appeal, which stretches staff capacity to provide care to other residents.
It is misguided and potentially dangerous to apply nursing home standards to assisted living and adult family homes. Nursing homes have mandatory staffing requirements that ensure there are trained medical personnel on site, including 24/7 RNs, at least 3.4 hours of daily direct nursing care for each resident, and nursing assistance who are certified. Assisted living has intermittent nursing services and providers can schedule RNs and LPNs as needed. In this setting RNs/LPNs may work weekday day shifts, may only come in a few days a week, or may only come in as needed.
While the backers of HB 1859 express intention to “protect residents,” this bill applies harmful, time-intensive, and bureaucratic requirements that increase the risk of harm to the resident or others when a community setting is not equipped to handle the situation. These requirements will apply whether a provider is contracted for Medicaid services or not. Any laws or regulations relating to discharge rights in long-term care should carefully and thoughtfully consider the specific needs of residents and staff in different types of settings.
How can I help?
WHCA invites administrators and staff from assisted living facilities to join us as we urge the legislature not to pass HB 1859.
Our goal is for 100 assisted living professionals to sign in to oppose HB 1859. You can help by attending the Healthcare and Wellness Committee meeting on Friday, January 19 – either virtually or in-person – to voice opposition to HB 1859. If you do not wish to testify, you can also select to have your position noted on the legislative record.
Register to Testify
Click the button above for guidance on how to submit in-person, virtual, or written testimony to the Committee. If you do not wish to testify, you can also click the button below to register your opposition.
Oppose HB 1859
What do I say in my testimony?
We need your stories about how a prolonged appeal period for appropriate discharges negatively impacts the residents and staff at your assisted living facility. Your voice will make a tremendous difference on whether this bill passes.
WHCA stands by to support you in creating your testimony. Please email Eric Negomir for assistance. To learn more about how you can support the fight against the passage of HB 1859, please register to attend our prep session on Tuesday, January 16 at 3pm.
RSVP for HB 1859 Prep Session
The more people attend the bill hearing on January 19, the louder our message becomes. Encourage your colleagues to sign up or submit their opposition, and help us meet our goal of 100 assisted living representatives in united opposition to HB 1859.