Survey & Regulatory
WHCA Welcomes Members to Report on Their DSHS Survey/Inspection Experience
We encourage members who have experienced a recent survey or inspection who are interested in sharing their thoughts and ideas on the survey process to complete our quick informational Survey on Surveys. Read MoreMaking the Most Recent Inspection Results Available
WHCA and Residential Care Services (RCS) headquarters staff recently met to discuss issues regarding recent assisted living facility members’ inspections. Of concern during this meeting... Read MoreOverview of State & Federal CMPs: Including Federal Changes to CMS Civil Monetary Penalties (CMP) Policy
On July 31st the Centers for Medicare & Medicaid Services (CMS) issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS)... Read MoreFederal Arbitration Regulations-F847 & F848
Arbitration agreements have historically been a topic of confusion in our state that would garner the attention every few years with surveyors and facilities. With... Read MoreWhat is Required to Become an Assisted Living Administrator?
There are several different pathways to becoming a qualified assisted living administrator in Washington state. The regulations, though offered in a step-wise fashion based on... Read MoreBecome Familiar with and Prepared for a DOSH Inspection
Washington State Labor and Industries’ Division of Occupational Safety and Health (DOSH) has instituted a Local Emphasis Program (LEP) for enforcement that targets industrial hygiene... Read MoreBecome Familiar with and Prepared for a DOSH Inspection
Washington State Labor and Industries’ Division of Occupational Safety and Health (DOSH) has instituted a Local Emphasis Program (LEP) for enforcement that targets industrial hygiene... Read MoreOIG Report - Washington State Failed to Ensure that Nursing Homes Complied with Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control
In the fall of 2022, twenty Washington skilled nursing facilities had unexpected visits from auditors representing the Office of Inspector General (OIG). These surprise visits... Read MoreCoordination of Health Care Services
Assisted living residents will likely have outside health care service providers such as home health or hospice at some point during their stay in the... Read MoreWhat’s Needed for A Compliance and Ethics Program?
Not so long ago, in November of 2019, Phase 3 of the Requirements of Participation became effective. Part of those requirements expanded the expectations for... Read MoreCannabis in Assisted Living
Washington state was an early legalizer of both medical and recreational marijuana. The legalization of cannabis in the state prompted long term care providers to... Read MoreE-Tags and Emergency Preparedness
In September 2016, CMS published the Emergency Preparedness final rule which established consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid. These requirements then went into effect in November of 2017. Read MoreNonavailability of Medications in Assisted Living
There are times when assisted living wellness staff experiences difficulties in obtaining residents’ necessary medications; there are various reasons for these difficulties and methods to address them. Read MoreRoom and Roommate Changes - What You Need to Know
October 2023 | As many of you know, a major focus on the regulatory changes contained within the Requirements of Participation (ROP) involve Resident Rights and the facility’s need to ensure each resident remains the locus of control regarding decision-making, their care and services, and discharge planning. An area to highlight is room/roommate changes, this was a Phase 1 requirement. Read MoreWhat is an Oversight Nurse, and Do You Need One in Your Assisted Living?
October 2023 | While the term “oversight nurse” is not defined in statute or rule, many assisted livings employ or contract with a registered nurse (RN) to serve in this capacity. This article aims to clarify what the role of the “oversight RN” entails, to ensure intermittent nursing services are provided with the proper level of nursing care. Read MorePharmacy Services-F758- Free from Unnecessary Psychotropic Medications/PRN Use
In 2017, the Centers for Medicare and Medicaid Services (CMS) expanded the category of antipsychotic medications to the new category of psychotropic medications. In doing... Read MoreIntermittent Nursing Services
Nurses are a relatively new addition to assisted living in Washington. In the early 2000s, it was rare to see a nurse working full-time in an... Read MoreDining and Food Service-Phase 3 Requirements of Participation
The Centers for Medicare & Medicaid Services (CMS) made changes and clarifications to the food service and dining requirements in the Phase 3 implementation of the... Read MoreMedication Assistance Via Accurately Directing Others
Residents must be assessed for the level of staff assistance they need with medications. Some residents (and in many instances some medications) warrant different levels of... Read MoreTrauma Informed Care-Requirements Under F699 for Skilled Nursing Facilities
There is a continuing focus and pressure from regulatory agencies to ensure that facilities provide trauma informed and culturally competent care. The federal requirements outline... Read MoreCaregiver Training and Certification Timelines after the Pandemic’s End
The Department of Social and Health Services (DSHS) training unit and the Department of Health (DOH) worked diligently with stakeholders, including WHCA, throughout the pandemic... Read MoreF700 Guidance—Bedrails
The Phase 2 changes and Phase 3 Requirements of Participation (ROP) that took effect in October 2022 for all nursing homes included clarification and regulatory... Read MoreResident Dementia Screening in Assisted Living
While all assisted living residents receive preadmission and ongoing assessments, those with symptoms of dementia require the facility staff to do some additional data collection. This... Read MoreAdditions & Changes to Quality of Care FTags
Moving into 2023, it is important to note the changes the Centers for Medicare & Medicaid Services (CMS) made to the State Operations Manual (SOM)... Read MoreWho Can Conduct Resident Assessments in Assisted Living?
This article was originally sent via an emailed Survey and Regulatory newsletter in March 2022. While still accurate, new updates have come from DSHS because... Read MorePsychosocial Outcome Severity Guide and Citations at F600-Abuse
The Centers for Medicare & Medicaid Services (CMS) released the psychosocial outcome and severity guide (POSG) in conjunction with the Phase 2 ROP (Requirements of... Read MoreMedication Errors in Assisted Living
With the high average number of daily medications taken by residents in assisted living, medication error rates can be relatively high. Combine the high number of... Read MoreCMS Requirements of Participation (ROP) Overview of Abuse and Neglect Changes
It is very important to keep in mind our specific Washington State requirements related to mandatory reporting (RCW 74.34), the WACs in Chapter 388-97, and the... Read MoreMedication Administration and Nurse Delegation in Assisted Living
WHAT IS MEDICATION ADMINISTRATION? Legally, medication administration, accomplished by either a licensed nurse or a qualified credentialed caregiver, is the only medication service level that... Read MoreROP Phase 3-§483.15 Admission, Transfer, and Discharge
Like many other portions of the requirements of participation (ROP), CMS published changes to the requirements regarding resident admissions, transfers, and discharges, implementation of which... Read MorePets in Assisted Living
Pets can be a benefit to residents in assisted living; dogs and cats (and other animals) offer companionship and attention and can enhance the homelike... Read MoreCMS Requirements of Participation (ROP) Changes - Residents Rights
As you are aware, on October 24, the changes to Phase 2 and the Phase 3 ROP became effective. Residential Care Services (RCS) will be... Read MoreContinuing Education Requirement
Washington State’s continuing education (CE) requirements vary, depending on the person’s job title as well as which (if any) credential they hold. This article is written... Read MoreTransferring Residents to Other Settings
There seems to be ongoing confusion surrounding the intricacies of involuntarily discharging a resident. Clarity was attempted through this article, with cited rules and step-by-step instructions provided.... Read MoreTransferring Residents to Other Settings
There seems to be ongoing confusion surrounding the intricacies of involuntarily discharging a resident. Clarity was attempted through this article, with cited rules and step-by-step instructions provided.... Read MoreResident Rights - Visitation
Over the last two years, no topic has been more controversial and frequently altered than the guidance surrounding resident visitation. With the retirement of the... Read MoreInspection Process: Family Assistance with Medications and Treatment
The list of top citations over the past quarter shows family assistance with medications or treatments peaking at #2, the highest this WAC section has... Read MoreInspection Process: Writing a Plan of Correction
A plan of correction (POC) is required for every WAC violation noted in a Statement of Deficiencies (SOD) report. WAC 388-78A-3152 states that, by signing the attestation... Read MoreResident Smoking
Smoking is still a topic that is fraught with personal opinions, safety hazards, resident rights, and multiple regulations. Every facility needs to remain hypervigilant related... Read MoreInspection Process: Enforcement Remedies
Residential Care Services (RCS) holds the authority to impose enforcement remedies on an assisted living licensee. While the entire list of remedies is listed in WAC 388-78A-3160,... Read MoreGrievance System
Outlined in section CFR 483.10 Resident Rights in the Federal Register/Vol.81, No.192 are the requirements for all skilled nursing facilities related to management of grievances/complaints. While F585... Read MoreInspection Process: Resident Record Review
As part of the full inspection process, licensors will complete a full resident record review for each resident in the sample. While the record review is an important... Read MoreState Enforcement Remedies for SNFs
Civil fines or Civil Monetary Penalties (CMP) are the most common state enforcement. Except as otherwise provided in statute, the range for a per-day civil fine is... Read MoreSurvey Process: Facilitating the Resident Group Meeting
Facility inspections include resident group meetings, conducted by your licensor. These meetings are ideally held relatively early in the full inspection process. This allows the licensors... Read MoreDischarge Notice Guidance for Assisted Living and Skilled Nursing
Issuing a discharge notice to a resident and his/her surrogate decision maker is never an easy task. Not only is it emotionally difficult for all involved... Read MoreDischarge Notice Guidance for Assisted Living and Skilled Nursing
Issuing a discharge notice to a resident and his/her surrogate decision maker is never an easy task. Not only is it emotionally difficult for all involved... Read More
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Upcoming Events
DSHS Licensing-Agency Provider Meeting
November 20 Rescheduled: December 18 | Zoom
Top 10 Citations in Assisted Living
January 9, 2025 | Zoom
Top 10 Citations in Skilled Nursing
January 16, 2025 | Zoom
Virtual Winter Symposium
February 18, 20, 26 | Zoom