August 27 2026 | Opioid Use Disorder-Discrimination Prohibited
While there are complex challenges to skilled nursing facilities in providing the necessary care and services to residents with a variety of medical conditions, treatment modalities, and comorbidities, it is important to ensure that all staff have a clear understanding that discrimination is prohibited not just based on resident payor source (Medicaid) but also diagnoses such as opioid use disorder (OUD).
According to the Washington Law Against Discrimination (“WLAD”), RCW 49.60.040(7), the definition of “disability” covers substance use disorder. Also, the Americans with Disabilities Act (ADA) prohibits discrimination against individuals with disabilities, including those with OUD, in many areas of life such as employment, public services, and healthcare. This applies to those individuals in recovery from OUD who are not engaging in illegal drug use, including those who are taking legally prescribed medication to treat their OUD.
According to Washington state nursing home rules, a facility must maintain only one list of names of individuals seeking admission to the facility, which is ordered by the date of request for admission, and must offer admission to individuals in the order they appear on the list as long as the facility can meet the needs of the individual with available staff or through the provision of reasonable accommodations required by state or federal laws.
As with any admission to the facility, qualified staff must assess the prospective resident’s condition and treatment plan along with the federal required facility assessment in order to determine if they are able to meet the needs of the person in conjunction with reasonable accommodation if necessary. This decision cannot be based on a diagnosis.
As a matter of best practice, when any individual’s admission to the facility is denied, the facility must maintain documentation as to the assessment of the prospective resident’s needs and legally defensible rationale as to why admission was denied. This documentation should also include why reasonable accommodation was not feasible. By state rule, the list of individuals seeking admission must be maintained by the facility for one year from the month that admission was requested.
Allegations of discrimination can and have been investigated in our state by the Attorney General’s office as well as the federal Department of Justice. These investigations remain a focus across the nation, and not just in healthcare. It is imperative that facility staff understand that discrimination is prohibited and that decisions for resident admissions are based on the care needs of the individual and the facility’s ability to meet those needs with available staff through reasonable accommodation.
If you have questions, please contact Elena Madrid, WHCA’s Executive VP for Education and Regulatory Affairs.
Resources:
Public Resources
The AG’s “Know Your Rights” hub and Washington State Human Rights Commission offer brochures and posters explaining SUD protections in employment, housing, and healthcare.
- KnowYourRights-Opioid-Tx_POSTER_english.pdf
- Employment Publications and Resources | WSHRC
- hhs.gov/opioids
- findtreatment.gov
- samhsa.gov/medication-assisted-treatment/practitioner-programdata/treatment-practitioner-locator
- dpt2.samhsa.gov/treatment
