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Inspection 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, the most commonly used sanctions include:
  • Suspending admissions (commonly called “stop placement”)
  • This could include stopping all admissions or stopping admissions in a specific part of the building, or stopping admissions of specific types of residents.
  • Civil penalties (found in WAC 388-78A-3181)
  • Typically, fines are limited to $100/day per violation, but can be upward of $3,000/day per violation. $3,000/day per violation are also imposed for interference, coercion, discrimination, and/or reprisal by the assisted living facility.
  • A civil fine grid is included in WAC 388-78A-3183 and highlights monetary penalties commensurate with level of harm involved.
  • Conditions
  • Temporary expectations targeted at specific citations that entice prompt and systematic correction. Common examples include hiring a RN to evaluate and update the medication system and retrain all medication staff, or hiring a RN to evaluate and update the mandatory reporting policies and retrain all staff.
WAC 388-78A-3180 states that RCS staff “must impose an appropriate remedy” in the event the assisted living facility has:
  • A serious, recurring, or uncorrected problem;
  • Created a hazard that causes or is likely to cause death or serious harm to one or more residents;
  • Discriminated or retaliated in any manner against a resident, employee, or any other person who made a complaint or provided information to DSHS; or
  • Willfully interfered with the performance of an ombuds’ duties.
Per WAC 388-78A-3200 enforcement remedies can occur even on initial citations. As risk to residents increases, remedies escalate and are focused to prompt, quick and lasting correction in order to ensure residents are safe. The most severe sanction includes license revocation via summary suspension; while this is a rare occurrence, egregious risk and negative resident outcomes allow RCS the ability to impose such efforts.
Should your facility receive an enforcement remedy and disagree, you can request an informal dispute resolution (IDR) and an administrative hearing following the directions on the cover page of the Statement of Deficiencies.
If you have questions related to assisted living regulations, processes, training, or nursing, contact Vicki McNealley via email, or call her at (800) 562-6170 extension 107.
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