Assisted Living Disaster Preparedness Regulations Get an Overhaul

As the result of Substitute House Bill 1218, which passed the legislature in 2021, DSHS has finalized updates to the emergency preparedness section of WAC 388-78A. For details on the concise explanatory statement, please review the Dear Provider Letter issued January 14, 2026. WHCA and member representatives participated in routine meetings with DSHS and other stakeholders over months to finalize the language in the updated regulations.

These updated rules go into effect on February 2, 2026.

The underlined areas of WAC 388-78A-2700 below are new and reflective of the language in the bill as passed. It is imperative that administrators, owners, and operators review and update the facility’s disaster preparedness plan to reflect the new standards and implement systems to revisit/update the plan at least annually. Staff must also be trained upon hire and retrained on the plan annually.

If additional resources are needed to round out your facility’s disaster preparedness and response plan, consider accessing the National Center for Assisted Living’s resource here. The American Assisted Living Nurses Association also has resources on disaster planning efforts: Assisted Living Incident Command System (ALICS) – AALNA – American Assisted Living Nurses Association.

For questions about disaster planning efforts or updated regulations in assisted living, email WHCA’s Vicki McNealley.

WAC 388-78A-2700Emergency and disaster preparedness.

(1) The assisted living facility must:

(a) Maintain the premises free of hazards;

(b) Maintain any vehicles used for transporting residents in a safe condition;

(c) Provide, and tell staff persons of a means of emergency access to resident-occupied bedrooms, toilet rooms, bathing rooms, and other rooms;

(d) Provide emergency lighting or flashlights in all areas accessible to residents of the assisted living facility((.));

(e) Make sure first-aid supplies are:

(i) Readily available and not locked;

(ii) Clearly marked;

(iii) Able to be moved to the location where needed; and

(iv) Stored in containers that protect them from damage, deterioration, or contamination.

(f) Make sure first-aid supplies are appropriate for:

(i) The size of the assisted living facility;

(ii) The services provided;

(iii) The residents served; and

(iv) The response time of emergency medical services.

(((g) Develop))(2) The assisted living facility must develop and maintain a ((current disaster plan describing))written emergency preparedness plan that describes measures to take in the event of ((internal or external))emergencies or disasters, including, but not limited to:

(((i) On-duty staff persons’ responsibilities;

(ii) Provisions for summoning emergency assistance;

(iii) Coordination with first responders regarding plans for evacuating residents from area or building;

(iv) Alternative resident accommodations;

(v) Provisions for essential resident needs, supplies and equipment including water, food, and medications; and

(vi) Emergency communication plan.))

(a) Fires;

(b) Earthquakes;

(c) Floods;

(d) Infectious disease outbreaks;

(e) Loss of power or water; and

(f) Other events that may require sheltering in place, evacuations, or other emergency measures to protect the health and safety of residents.

(3) The assisted living facility’s emergency preparedness plan must include procedures for:

(a) Staff roles and responsibilities;

(b) Identifying and locating residents;

(c) Summoning emergency assistance and coordinating with first responders;

(d) Communicating emergency information to staff and residents as well as external partners, including emergency contacts for residents, state and local agencies, developmental disability ombuds, and long-term care ombuds;

(e) How resident care and treatment needs will be maintained;

(f) Provision of essential resident needs and supplies, including water, food, medications, and personal care items; and

(g) Alternative resident accommodations.

(4) The assisted living facility must incorporate infection prevention and control capability into its emergency preparedness plan. At minimum, the plan must:

(a) Include procedures for the procurement, inventory, tracking, safe storage, and rotation of personal protective equipment to ensure supplies remain within manufacturer recommended shelf life and are available for use; and

(b) Describe how the facility will ensure adequate staffing and implement isolation or cohorting procedures during an infectious disease emergency.

(5) In addition to the plan requirements, the assisted living facility must:

(a) Maintain an adequate supply of personal protective equipment appropriate to the facility size and resident population, including, but not limited to: gloves, gowns, surgical masks, eye protection, and NIOSH–approved respirators;

(b) Train all employees in the comprehensive emergency preparedness plan and staff procedures upon hire and reviewed annually thereafter;

(c) Review the comprehensive emergency preparedness plan and procedures and update at least annually;

(d) Communicate the location of the emergency preparedness plan to residents and staff to ensure access as needed during emergencies; and

(e) Comply with WAC 388-78A-3140.