New Guidance Issued on Washington Paid Sick Leave

Nov 1, 2017 — Many thanks to Krista Hardwick at Lane Powell for providing this article. The Washington Department of Labor and Industries this week published final regulations implementing Initiative 1433 — the new statewide paid sick leave law passed by the voters in November 2016. These regulations have been much-anticipated by Washington’s long-term care providers, and they provide […]

WHCA + Argentum | Together. Stronger.

Nov 1, 2017 —                 The Washington Health Care Association (WHCA) is excited to announce its partnership with Argentum. WHCA will be designated as an Argentum “State Partner.”  The “State Partner” designation is in recognition of the outstanding work that WHCA has done in promoting, assisting, and advocating for senior housing and […]

State Flu Resources for Long Term Care Communities

Oct 25, 2017 — Guidance for long term care facilities (PDF) (Washington State Department of Health) CDC guidance for long term care facilities (Centers for Disease Control and Prevention) ILI long term care quick guide for LHJ Modification (Word) (Washington State Department of Health) Hospital and long term care transfer and care of flu patients (Word) (Washington State Department […]

SNF Audits Announced by CMS

Apr 12, 2017 — This week, CMS posted information on two new CMS directed medical review audits of SNF PPS claims.  The first is a pre-pay audit limited to the CMS J5 Jurisdiction (IA, KS, MO, NE, and national), while the second is a national post-pay audit.  Please email Dan Ciolek, AHCA Associate VP, Therapy Advocacy with questions. Medicare […]

Medicare J5 MAC Announces Pre-Pay Audits for Rehab Ultra High RUGs in IA, KS, MO, NE, National

Apr 12, 2017 — On April 4, 2017, Wisconsin Physician Services Government Health Administrators (WPS GHA), a Medicare Administrative Contractor (MAC) for the Centers for Medicare and Medicaid Services (CMS), announced that they will be conducting prepayment service specific complex medical reviews of Inpatient SNF services for providers in the J5 Jurisdiction.  The J5 Jurisdiction encompasses SNFs that submit […]


Apr 12, 2017 — The Blacklisting Rule In late March, Congress passed, and President Trump signed, a resolution disapproving the federal blacklisting rule put into place during President Obama’s administration.  The blacklisting rule, formally entitled “Fair Pay and Safe Workplaces,” required companies attempting to procure large federal contracts (and their subcontractors) to report violations of numerous labor and employment […]


Apr 12, 2017 — The Volks Rule Last December, OSHA issued a rule entitled “Clarification of Employer’s Continuing Obligation to Make and Maintain Accurate Records of Each Recordable Injury and Illness,” informally known as the “Volks” rule.  The rule required employers to maintain records on injuries and illnesses for a five-year period and allowed OSHA to cite employers for […]

Bed Hold Policy

Apr 12, 2017 — According to the Centers for Medicare & Medicaid Services (CMS) Requirements of Participation (RoP) Admission, Transfer, and Discharge Rights, CFR 483.15, (Federal Register/Vol.81, No.192) before a resident is transferred to the hospital or goes on therapeutic leave, the facility must provide written information to the resident or representative regarding bed hold policy, duration, and reserve […]

Assisted Living Licensors and Kitchen Inspections

Apr 12, 2017 — Food sanitation is a major part of the assisted living inspection process.  The licensors will be focusing on your food workers sanitation practice.  According to the CDC, there are 48 million cases of foodborne illness (FBI) per year in the United States. Of those cases, 3,000 result in death and 128,000 in hospitalizations. FBI can […]

Changes to Background Check Notification Process

Apr 5, 2017 — The department issued a Dear Provider letter dated March 23, 2017, notifying providers that Background Check Central Unit (BCCU) has made some recent changes to the background check notification process. With the change, the applicant will no longer automatically receive the Federal Bureau of Investigation (FBI) Record of Arrest and Prosecutions (RAP) sheet following the […]

A Tournament for Everyday Superheroes

Apr 5, 2017 — SuperGolf! WHCA –PAC Spring Tournament sponsored by First Choice Medical Supply May 22, 2017 • 11:00 a.m. Registration & Lunch • Noon Shotgun Start Fircrest Golf and Country Club, Lakewood WA A Tournament for Everyday Superheroes This year, the WHCA Convention theme is a nod to the vibrant world of comics, comic art and the world of […]

More on Bed Rails

Mar 29, 2017 — According to the Centers for Medicare & Medicaid Services (CMS) Requirements of Participation (RoP), the skilled nursing facility must attempt to use appropriate alternatives prior to installing a side or bed rail. If a bed/side rail is used, the facility must ensure correct installation, use and maintenance of the rails including the following is done […]

Background Checks- Who Needs What?

Mar 29, 2017 — All employees in an Assisted Living Facility are required to have a completed background check.  However, there are differences between who needs just a name and date of birth background check and who needs a name and date of birth background check in addition to the national fingerprint background check.  The answer to who needs […]

Revisions Planned for Assisted Living Physical Plant Standards

Mar 29, 2017 — In 2016, DSHS announced a plan to work with the Department of Health Construction Review Services division to revise assisted living physical plant standards contained in Chapter 388-78A WAC. Click here for an overview of the DSHS plan. An internal WHCA work group was created to review current regulations and provide recommendations for revisions. The […]

Annual Convention Puts FUN in WHCA-PAC Fundraising Efforts

Mar 29, 2017 — The WHCA Annual Convention has a long-standing tradition of excellent professional development and networking opportunities – and provides the opportunity for our members and friends to help back the WHCA-PAC.  Our events and activities are designed to promote networking and fun, and we work to raise dollars to support our political action efforts. This work […]

House Budget Positive for Providers

Mar 29, 2017 — On Monday, the House Democrat budget was released in Olympia. The two-year state operating plan held positive news for assisted living and skilled nursing providers. The House proposal provides $7.1 million general fund state ($15.6 total funds) to address state minimum wage increases for assisted living and skilled nursing facility providers and includes a proviso […]

AHCA/NCAL: Repeal and Replace Legislation Withdrawn

Mar 24, 2017 — We reported to you yesterday that the House of Representatives planned to vote today on the “American Health Care Act,” the bill to repeal and replace the Affordable Care Act. This afternoon, House Leadership announced that the bill would be withdrawn. As late as yesterday evening, President Trump indicated that he will move on to […]

Can Gaming Technology Help Senior Living Operators Eliminate Resident Falls?

Mar 24, 2017 — Thank you to Michael Reph and Parker, Smith, Feek for the following article. Falling and mishandling residents is the number one insurance claim and litigation issue of senior living facilities, making this risk of particular concern to senior living operators.  Consider this innovative approach to reducing falls. In a recent three-month pilot study, Mission Health […]

Respiratory Therapy in Requirements of Participation

Mar 22, 2017 — The short answer, in my opinion, is that a nurse or respiratory therapist can perform respiratory therapy services that they are qualified to do (documented competencies) and that are within their state scope of practice/law in a skilled nursing facility.  The RoP did not address existing respiratory therapy coverage policy, it just added “registered respiratory […]

AHCA: HHS Issues Interim Final Rule Delaying New Mandatory Bundles

Mar 22, 2017 — The Department of Health and Human Services (HHS) this morning issued an interim final rule delaying the effective date of the final rule, “Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model.” The initial final rule, published on January 3, 2017, […]

AHCA/NCAL: Repeal and Replace Goes to House Rules Committee for Mark-Up

Mar 22, 2017 — Late yesterday evening, amendments were released for debate in the House Rules Committee hearing on the “American Health Care Act,” the bill to repeal and replace the Affordable Care Act. The proposed amendments are divided into two sets; one set is technical or clarifying in nature, and the other would make substantive policy changes to […]

Washington State Crime Prevention Association Training in Eastern Washington

Mar 15, 2017 — The Spokane County Sheriff’s Office Crime Prevention unit is working collaboratively with the Washington State Crime Prevention Association (WSCPA) to host a conference on Community Engagement and crime prevention.  The conference will be hosted May 17-18, 2017, in Spokane.  The aim of the conference is to bring law enforcement agencies and professional crime prevention workers […]

Bed Hold Policy

Mar 15, 2017 — According to the Center for Medicare & Medicaid Services (CMS) requirements of participation, before a resident is transferred to the hospital or goes on therapeutic leave, the facility must provide written information to the resident or representative regarding bed hold policy, duration, and reserve bed payment policy. A facility in Washington must also comply with […]

Important Information Regarding Electronic Plan of Correction Enrollment

Mar 15, 2017 — Residential Care Services (RCS) is pleased to announce that Washington is one of the states participating in the CMS Electronic Plan of Correction (ePOC) project. The ePOC application will automate the distribution of the federal statements of deficiency 2567 (SOD) and State Licensure WAC citations via a secure website created by CMS. The CMS website will […]

Repeal and Replace Bill Advances in the House

Mar 15, 2017 — The “American Health Care Act,” Republican’s bill to repeal and replace Obamacare, passed out of two House committees this week on party-line votes. Both the Ways & Means and Energy & Commerce committees had significant deliberations and lengthy hearings, but the legislation remains unchanged from when we announced its introduction Monday. This puts the bill […]

Point of Care Devices and Infection Control

Mar 8, 2017 — It has come to WHCA staff attention that more than one skilled nursing facility has recently received citations at an Immediate Jeopardy-Level 4 related to the cleaning and use of point of care devices. Point of care devices include fingerstick devices, glucometers, and other similar devices including those that measure prothrombin time. It is imperative […]

Using a CPR eCard for Compliance

Mar 8, 2017 — According to training WAC 388-112- 0260, all caregivers must have a current CPR card within 30 days of hire and in order to be valid, the class completed must have a hands-on skills demonstration component. The American Heart Association just issued information that there are now two options to provide course completion cards—electronic and printed. […]

New Dear Administrator Letter References Disclosure of Services Form Changes

Mar 8, 2017 — A Dear Administrator Letter dated March 2, 2017, references changes made to the Disclosure of Services Form which can be found on the department’s website.  Some of the changes include language that states a 30-day notice is waived if the resident has an unanticipated, unplanned, and substantial condition change that requires an immediate increase in […]

CMS Update on the 2017 Special Focus Facility Program

Mar 8, 2017 — Article Provided by AHCA/NCAL In memorandum S&C: 17-20-NH (March 2, 2017), the Centers for Medicare and Medicaid Services (CMS) provides an update on the 2017 Special Focus Facility (SFF) Program. The memo describes the SFF program background, process for initial selection and notification of SFF, progressive enforcement, graduation from the SFF program, authority to terminate, […]


Mar 8, 2017 — Over the course of the last two weeks WHCA has received a number of complaints from SNF providers regarding unusually long lags in Medicaid payments. While we have not yet comprehensively identified the reasons for all these delays, initial research from the HCA has identified four common mistakes resulting in delayed payment. We understand that […]

Challenges with Specialty Training

Mar 1, 2017 — If your facility is approved to teach basic, specialty, and/or continuing education classes to your staff, there are certain circumstances when DSHS can prohibit you from continuing to doing so.  According to WAC 388-112-0345(6) if the department has imposed a civil fine exceeding $5,000 within the last 18 months, a stop placement order, or a […]

Washington Foundation for Long Term Care Gifts Car to Long Time Caregiver

Mar 1, 2017 — Late last year, the Washington Foundation for Long Term Care was thrilled to present a car to Suzanne Swanson of Fort Vancouver Post Acute, an Empres Healthcare Management community! Suzanne has worked at Fort Vancouver since 1991, and has been driving a car with over 320,000 miles to get to work. Suzanne’s 50 mile commute […]

DSHS Nursing Assistant Training Program Workshop

Mar 1, 2017 — The upcoming Nursing Assistant Training Program Orientation presented by DSHS, to be held in the Puyallup area.  DSHS has changed the program and updated it with some of the suggestions from previous workshops. Admittance will be based on RSVP ONLY. There is a seating capacity for 100 guests and DSHS will only allow those into […]

New Cost Comparison Report Helps Skilled Nursing Providers Make Strategic Decisions

Mar 1, 2017 — The pace and complexity of change in the skilled nursing field is creating challenges and opportunities for providers throughout the state. As the field becomes more complex, the needs of providers change and access to financing and quality metrics is crucial to strategic planning. A recently released report from CliftonLarsonAllen, the Skilled Nursing Facility Cost […]

CMS to Hold Call on Value-Based Purchasing for Skilled Nursing Facilities

Mar 1, 2017 — On Wednesday, March 15 at 1:30 PM Eastern, the Centers for Medicare and Medicaid Services (CMS) will hold a call on the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program . The Program adjusts SNF Part A payments by up to 2 percent each year for 10 years starting in FY 2019 based on 2017 […]

RCS Issues Dear Administrator Letter Regarding Licensed Rooms

Feb 22, 2017 — On February 15, 2017, RCS issued a Dear Administrator letter providing clarification regarding the policy, procedure and/or information for licensed rooms. A summary of the letter states that a newly licensed facility will have six months to complete a DSHS 06-176 Change in Licensed Resident Bed Capacity/Use of Rooms form notifying the department of the […]

Completing a Plan of Correction

Feb 22, 2017 — According to WAC 388-78A-3152 a facility found to be out of compliance is required to complete a Plan of Correction.  Although you are not required to submit a plan of correction to the department, licensors may request to see it during a follow-up inspection. Give time and attention to your plan of correction to make […]

Assisted Living Civil Fines

Feb 15, 2017 — HB 1492 , legislation championed by the Washington State LTC Ombuds aims to align standards for civil penalties across all long term care settings. Under the legislation, the current $100 per day maximum limit on civil penalties against assisted living facilities for violations of licensing and inspection requirements is changed to a $100 minimum civil penalty […]

Infection Control Immediate Jeopardy Update from AHCA’s Dr. David Gifford

Feb 15, 2017 — After reviewing nearly 100 citations for F-tag 441 (infection control) that results in an immediate jeopardy (IJ) and/or a civil monetary penalty (CMP), it is clear that skilled nursing centers need to have a robust reminder system and staff culture of reminding each other to wash their hands.  In the cases reviewed, nearly every single […]

Nursing Assistant Training News

Feb 15, 2017 — DSHS has released the 2016 report regarding nursing assistant training programs and pass rates. Click here to review. The next DSHS/DOH Nursing Assistant training workshop for Instructors and Program Directors will be held on April 11, 2017.  Please hold that date; more details will follow in the next couple of weeks.  We do know the […]

AHCA/NCAL: HHS Adjusts CMPs for Inflation and March Fly-In

Feb 15, 2017 — The Department of Health and Human Services (HHS) recently issued a notice updating its regulations to reflect required annual inflation-related civil monetary penalty (CMP) increases pursuant to the Federal Civil Penalties Inflation Adjustment Act Improvement Act of 2015. The cost of living multiplier for 2017 is 1.01636, and this update is consistent with the requirements […]

NEW National Pressure Ulcer Advisory Panel (NPUAP) Pressure Injury Staging Position Statements

Feb 8, 2017 — The overall impact of the revised NPUAP Staging System is better patient care, improved health, and less patient pain and suffering. NPUAP recognizes that significant efforts are being made to implement these changes in databases, instructional materials, and electronic health records.  The NPUAP is very appreciative of the nation-wide efforts being undertaken to improve pressure […]

Does Your Facility Management Contract Put You at Risk?

Feb 8, 2017 — Thank you to ERNWest for providing this article. Management contracts are common in long term care. However, the wording in your contract may put you at financial risk for safety & health compliance liability. During the course of a Labor & Industries Safety & Health compliance inspection (also called DOSH inspection), the compliance officer may […]

ATLSA Requests Information Regarding Enhanced Service Facilities

Feb 8, 2017 — The Department of Social and Health Services’ Aging and Long-Term Support Administration is requesting information from parties with interest and capacity for developing resources to support people with personal care needs to move from state hospitals. The purpose of this Request for Information (RFI) is to solicit information regarding interest, availability, and geographic locations from […]

Notice of Transfer or Discharges

Feb 1, 2017 — According to the new Centers for Medicare and Medicaid Services (CMS) Requirements of Participation (RoP) (Federal Register/Vol.81, No.192, 483.15 Admission, Transfer and Discharge Rights), a facility must send a copy of all notices of transfer and discharge to the Office of the State Long-Term Care Ombudsman. The American Health Care Association (AHCA) is attempting to […]

March 1 Deadline for Mandatory Staffing Report Submission to DSHS

Feb 1, 2017 — In 2016, the Washington State Legislature adopted a 3.4 hour per resident day minimum staffing level for skilled nursing facilities. It is important to note that DSHS was forced to design a separate process in addition to the CMS PBJ process in order to collect staffing compliance data.  DSHS is monitoring compliance on a quarterly […]

Providing Respite Services

Feb 1, 2017 — Providing respite services is a great way to help the caregivers in the community get some much needed time away.  However, you must be familiar with the requirements to follow when providing respite services.  Respite services are meant to be short term, which is considered to be no longer than 30 days.  Prior to accepting […]

Specialized Dementia Care Program Contract with DSHS

Feb 1, 2017 — Many of you may not be aware of the Department of Social and Health Services Specialized Dementia Care Program (SDCP) Contract. Assisted living facilities interested in becoming a SDCP contractor must first apply for an Enhanced Adult Residential Care-Specialized Dementia Care (EARC-SDC) contract through the department. HCS is now accepting new contract applications.  Standards of Care […]

AHCA Provides Clarification on Executive Order Regarding Regulations

Feb 1, 2017 — Yesterday, President Trump issued an Executive Order  (EO) on Reducing and Controlling Regulatory Costs. As of yet, there is not a full and complete understanding as to how all aspects of this order will be implemented. An initial analysis and understanding is below. AHCA will continue to provide updates on the implementation of this EO […]

Revised Conditions of Participation for Home Health Agencies

Feb 1, 2017 — Post originally authored by the American Health Lawyers Association By Benjamin Lipschitz* The Centers for Medicare & Medicaid Services (CMS) issued a final rule on January 13, 2017, to implement significant revisions to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to participate in the Medicare and Medicaid programs,1 modifying 42 […]

CMS Approves Medicaid Expansion Waiver

Feb 1, 2017 — CMS has approved a five-year demonstration waiver that will allow up to $1.5 billion dollars in federal investments to help drive Medicaid Transformation in Washington State. This agreement will “waive” certain federal Medicaid requirements, allowing the state to use Medicaid funds for “innovative projects” that would not otherwise be available for funding. The demonstration is […]

Residential Care Services (RCS) Issues Two Dear Administrator Letters

Jan 18, 2017 — An RCS Dear Administrator Letter dated January 19, 2017, addresses Centers for Medicare & Medicaid Services (CMS) S&C Memo 16-21 regarding Federal requirements for providing services to individuals involved in the Justice System. Under Federal requirements, a nursing facility cannot incorporate into care plans restrictions that violate resident rights and cannot serve as an agent […]

CMS Rules of Participation-Abuse/Neglect/Exploitation Reporting-Clarification

Jan 18, 2017 — The American Health Care Association (AHCA) received a number of questions about changes in the new Requirements of Participation (RoPs) related to reporting abuse, neglect, exploitation or mistreatment, including injuries of unknown source and misappropriation of resident property. The specific regulatory language follows (emphasis added): 483.12 Freedom from abuse, neglect, and exploitation (c) In response to […]

Understanding the 45-Day Clock

Jan 18, 2017 — Have you ever submitted an attestation for a plan of correction to the department only to get a call from a licensor telling you that your date is beyond 45 days?  Do you wonder how the 45-day time frame is determined?  The clock actually begins with the last date of data gathering in your full […]

United Wound Healing Announced as Newest WHCA Affinity Partner

Jan 18, 2017 — WHCA is pleased to announce the United Wound Healing has been named as the association’s newest Affinity Partner. Since joining the association last year United Wound Healing has been dedicated to going above and beyond in supporting WHCA members and events. To view a list of current Affinity Partners, please click here. United Wound Healing […]

Bathing Without a Battle Launches Online Training Portal with Free Continuing Education Credit for Long-Term Care Staff

Jan 18, 2017 — The award-winning, evidence-based Bathing Without a Battle training on person-centered bathing for people with Alzheimer’s disease and other dementias is now accessible online free of charge.   The interactive training provides 2½ hours of free continuing education credit for nurses and 2 hours of free credit for nursing assistants.  Students who plan to enter long-term care […]

DSHS-ALTSA Publishes Request for Information

Jan 18, 2017 — The Department of Social and Health Services’ Aging and Long-Term Support Administration is requesting information from parties with interest and capacity for developing resources to support people with personal care needs to move from state hospitals. To read the full request, click here. The purpose of this Request for Information (RFI) is to solicit information […]

Senate Ways and Means Committee Work Session on LTC Budget

Jan 18, 2017 — Yesterday, the Senate Ways and Means Committee held a work session on long term care budget issues. Senator John Braun (R-20) chairs the committee. The Republicans hold the majority in the Senate, and are charged with developing the second of three budgets that will be drafted for the 2017-19 biennial budget period. The Senate plan […]

Governor’s Budget Subject to House and Senate Hearings This Week

Jan 11, 2017 — On Monday, the Washington State Legislature returned to Olympia to commence work on the state operating plan for the 2017-19 biennium. Legislative review of the Governor’s budget is the first order of business in Olympia. On Monday, the House Appropriations Committee received public testimony on the Governor’s budget; today the Senate Ways and Means Committee […]

Reviewing Infection Control Policies During Influenza Season

Jan 11, 2017 — As many of you have heard, this year is proving to be a challenging year with widespread influenza outbreaks.  Several counties in Washington are reportedly activating an emergency management system in response to the numbers of outbreaks.  An outbreak in your facility is defined as “A sudden increase in acute febrile respiratory illness over the […]

Skilled Nursing Facility Staffing Subject to Mandatory Reports to DSHS

Jan 11, 2017 — In 2016, the Washington State Legislature adopted a 3.4 hour per resident day minimum staffing level for skilled nursing facilities. It is important to note that DSHS was forced to design a separate process in addition to the CMS PBJ process in order to collect staffing compliance data.  DSHS is monitoring compliance on a quarterly […]

CMS, RTI, and Abt Announce Pilot Program for TOH Quality Measures

Jan 11, 2017 — CMS has contracted with RTI and Abt to develop and implement two Transfer of Health Information and Care Preferences (TOH) quality measures. The TOH measures meet requirements under the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act) of 2014.  Data for these cross-setting measures will be collected for the following post-acute care settings:  SNFs, IRFs, […]

Department of Health Updates Home Care Aide Application

Jan 11, 2017 — The Department of Health has updated the home care aide application as follows: There are three spaces for e-mail addresses.  The application asks for your employer and personal and e-mail addresses.  The personal e-mail address will be used to receive information from the department of health.  The employer e-mail address will be copied as a […]

Infection Control Information from Residential Care Services

Jan 4, 2017 — The director and policy staff of RCS recently met with leaders involved in many aspects of infection control in Washington, including some who are very involved with anti-microbial stewardship.  At that meeting, RCS learned that Washington received funding to bolster legionella prevention efforts.  The Department of Health (DOH) will be working with facilities who are […]