Staff - ALF Boss

WAC 388-78A-2450 Staff. (1) Each assisted living facility must provide sufficient, trained staff persons to:

Furnish the services and care needed by each resident consis-tent with his or her negotiated service agreement;
Maintain the assisted living facility free of safety hazards; and
Implement fire and disaster plans.

(2) The assisted living facility must:

Develop and maintain written job descriptions for the admin-istrator and each staff position and provide each staff person with a copy of his or her job description before or upon the start of employment;
Verify staff persons’ work references prior to hiring;
Verify prior to hiring that staff persons have the required licenses, certification, registrations, or other credentials for the position, and that such licenses, certifications, registrations, and credentials are current and in good standing;
Document and retain for twelve weeks, weekly staffing sched-ules, as planned and worked;
Ensure all resident care and services are provided only by staff persons who have the training, credentials, experience and other qualifications necessary to provide the care and services;
Ensure at least one caregiver, who is eighteen years of age or older and has current cardiopulmonary resuscitation and first-aid cards, is present and available to assist residents at all times:
When one or more residents are present on the assisted living facility premises; and
During assisted living facility activities off of the assis-ted living facility premises.
Ensure caregiver provides on-site supervision of any resident voluntarily providing services for the assisted living facility;
Provide staff orientation and appropriate training for expec-ted duties, including:
Organization of the assisted living facility;
Physical assisted living facility layout;
Specific duties and responsibilities;
How to report resident abuse and neglect consistent with chapter 74.34 RCW and assisted living facility policies and procedures;
Policies, procedures, and equipment necessary to perform du-ties;
Needs and service preferences identified in the negotiated service agreements of residents with whom the staff persons will be working; and
Resident rights, including without limitation, those speci-fied in chapter 70.129 RCW.

(i) Develop and implement a process to ensure caregivers:

Acquire the necessary information from the preadmission as-sessment, on-going assessment and negotiated service agreement relevant to providing services to each resident with whom the caregiver works;
Are informed of changes in the negotiated service agreement of each resident with whom the caregiver works; and
Are given an opportunity to provide information to respon-sible staff regarding the resident when assessments and negotiated service agreements are updated for each resident with whom the caregiver works.

(j) Ensure all caregivers have access to resident records relevant to effectively providing care and services to the resident.

(3) The assisted living facility must:

Protect all residents by ensuring any staff person suspected or accused of abuse, neglect, financial exploitation, or abandonment does not have access to any resident until the assisted living facility investigates and takes action to ensure resident safety;
Not interfere with the investigation of a complaint, coerce a resident or staff person regarding cooperating with a complaint investigation, or conceal or destroy evidence of alleged improprieties occurring within the assisted living facility;
Prohibit staff persons from being directly employed by a res-ident or a resident’s family during the hours the staff person is working for the assisted living facility;
Maintain the following documentation on the assisted living facility premises, during employment, and at least two years following termination of employment:

(i) Staff orientation and training or certification pertinent to duties, including, but not limited to:

Training required by chapter 388-112A WAC;
Home care aide certification as required by this chapter and chapter 246-980 WAC;
Cardiopulmonary resuscitation;
First aid; and(E) HIV/AIDS training.
Disclosure statements and background checks as required in

WAC 388-78A-2461 through 388-78A-2471; and

Documentation of contacting work references and professio-nal licensing and certification boards as required by subsection (2) of this section.

(4) The assisted living facility is not required to keep on the assisted living facility premises, staff records that are unrelated to staff performance of duties. Such records include, but are not limited to, pay records, and health and insurance benefits for staff.

[Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2450, filed 9/21/18, effective 10/22/18; WSR 13-13-063, § 388-78A-2450, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2450, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2450, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2460 Quality assurance committee. (1) To ensure the proper delivery of services and the maintenance and improvement in quality of care through self-review, any assisted living facility licensed under this chapter may maintain a quality assurance committee that, at a minimum, includes:

A licensed registered nurse under chapter 18.79 RCW;
The administrator; and
Three other members from the staff of the assisted living fa-cility.
When established, the quality assurance committee shall meet at least quarterly to identify issues that may adversely affect quality of care and services to residents and to develop and implement plans of action to correct identified quality concerns or deficiencies in the quality of care provided to residents.
To promote quality of care through self-review without the fear of reprisal, and to enhance the objectivity of the review process, the department shall not require, and the long-term care ombuds program shall not request, disclosure of any quality assurance committee records or reports, unless the disclosure is related to the committee’s compliance with this section, if:
The records or reports are not maintained pursuant to statu-tory or regulatory mandate; and
The records or reports are created for and collected and maintained by the committee.
If the assisted living facility refuses to release records or reports that would otherwise be protected under this section, the department may then request only that information that is necessary to determine whether the assisted living facility has a quality assurance committee and to determine that it is operating in compliance with this section. However, if the assisted living facility offers the department documents generated by, or for, the quality assurance committee as evidence of compliance with assisted living facility requirements, the documents are protected as quality assurance committee documents when in the possession of the department.
Good faith attempts by the committee to identify and correct quality deficiencies shall not be used as a basis for sanctions.
Any records that are created for and collected and maintained by the quality assurance committee shall not be discoverable or admitted into evidence in a civil action brought against an assisted living facility.
Notwithstanding any records created for the quality assurance committee, the facility shall fully set forth in the resident’s records, available to the resident, the department, and others as permitted by law, the facts concerning any incident of injury or loss to the resident, the steps taken by the facility to address the resident’s needs, and the resident outcome.

[Statutory Authority: Chapter 18.20 RCW, RCW 18.20.090. WSR 19-14-031, § 388-78A-2460, filed 6/25/19, effective 7/26/19. Statutory Authority: Chapter 18.20 RCW. WSR 14-05-035, § 388-78A-2460, filed 2/12/14, effective 3/15/14; WSR 13-13-063, § 388-78A-2460, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2460, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2461 Background checks—General. (1) Background checks conducted by the department and required in this chapter include:

Washington state name and date of birth background checks; and
After January 7, 2012, a national fingerprint background check in accordance with RCW 74.39A.056.
Nothing in this chapter should be interpreted as requiring the employment of a person against the better judgment of the assisted living facility.
In addition to chapter 18.20 RCW, these rules are authorized by RCW 43.20A.710, RCW 43.43.830 through 43.43.842 and RCW 74.39A.051.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2461, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2461, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2461, filed 7/30/10, effective 1/1/11.]

WAC 388-78A-2462 Background checks—Who is required to have. (1) Applicants for an assisted living facility license, as defined in WAC 388-78A-2740, must have the following background checks before licensure:

A Washington state name and date of birth background check; and
A national fingerprint background check.

(2) The assisted living facility must ensure that the administrator and all caregivers employed directly or by contract after January 7, 2012 have the following background checks:

A Washington state name and date of birth background check; and
A national fingerprint background check.

(3) The assisted living facility must ensure that the following individuals have a Washington state name and date of birth background check:

Volunteers who are not residents, and students who may have unsupervised access to residents;
Staff persons who are not caregivers or administrators;
Managers who do not provide direct care to residents; and
Contractors other than the administrator and caregivers who may have unsupervised access to residents.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2462, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2462, filed 10/18/12, effective 11/18/12. Statutory Authority:

Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2462, filed

7/30/10, effective 1/1/11.]

WAC 388-78A-2464 Background checks—Process—Background authorization form. Before the assisted living facility employs, directly or by contract, an administrator, staff person or caregiver, or accepts any volunteer, or student, the home must:

Require the person to complete a DSHS background authoriza-tion form; and
Submit to the department’s background check central unit, in-cluding any additional documentation and information requested by the department.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2464, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2464, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2464, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2464, filed 7/30/10, effective 1/1/11.]

WAC 388-78A-24641 Background checks—Washington state name and date of birth background check. Unless the individual is eligible for an exception under WAC 388-113-0040, if the results of the Washington state name and date of birth background check indicate the person has a disqualifying criminal conviction or a pending charge for a disqualifying crime under chapter 388-113 WAC, or a disqualifying negative action under WAC 388-78A-2470, then the assisted living facility must:

Not employ, directly or by contract, a caregiver, administra-tor, or staff person; and
Not allow a volunteer or student to have unsupervised access to residents.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-24641, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24641, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-24641, filed

10/18/12, effective 11/18/12.]

WAC 388-78A-24642 Background checks—National fingerprint background check. (1) Administrators and all caregivers who are hired after January 7, 2012 and are not disqualified by the Washington state name and date of birth background check, must complete a national fingerprint background check and follow department procedures.

After receiving the results of the national fingerprint back-ground check the assisted living facility must not employ, directly or by contract, an administrator or caregiver who has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or that is disqualifying under WAC 388-78A-2470.
The assisted living facility may accept a copy of the nation-al fingerprint background check results letter and any additional information from the department’s background check central unit from an individual who previously completed a national fingerprint check through the department’s background check central unit, provided the national fingerprint background check was completed after January 7, 2012.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-24642, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24642, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-24642, filed 10/18/12, effective 11/18/12.]

WAC 388-78A-2465 Background check—Results—Inform. (1) After receiving the results of the Washington state name and date of birth background check, the assisted living facility must:

Inform the person of the results of the background check;
Inform the person that they may request a copy of the results of the background check. If requested, a copy of the background check results must be provided within ten days of the request; and
Notify the department and other appropriate licensing or cer-tification agency of any person resigning or terminated as a result of having a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is disqualifying under WAC 388-78A-2470.

(2) After receiving the result letter for the national fingerprint background check, the assisted living facility must inform the person:

Of the national fingerprint background check result letter;
That they may request a copy of the national fingerprint check result letter; and
That any additional information requested can only be ob-tained from the department’s background check central unit.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2465, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2465, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2465, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2465, filed 7/30/10, effective 1/1/11.]

WAC 388-78A-2466 Background checks—Washington state name and date of birth background check—Valid for two years—National fingerprint background check—Valid indefinitely. (1) A Washington state name and date of birth background check is valid for two years from the initial date it is conducted. The assisted living facility must ensure:

A new DSHS background authorization form is submitted to the department’s background check central unit every two years for all administrators, caregivers, staff persons, volunteers and students; and
There is a valid Washington state name and date of birth background check for all administrators, caregivers, staff persons, volunteers and students.

(2) A national fingerprint background check is valid for an indefinite period of time. The assisted living facility must ensure there is a valid national fingerprint background check completed for all administrators and caregivers hired after January 7, 2012. To be considered valid, the national fingerprint background check must be initiated and completed through the department’s background check central unit after January 7, 2012.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2466, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2466, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2466, filed

7/30/10, effective 1/1/11.]

WAC 388-78A-2467 Background check—Sharing by health care facilities. In accordance with RCW 43.43.832 a health care facility may share Washington state background check results with other health care facilities under certain circumstances. Results of the national fingerprint checks may not be shared. For the purposes of this section health care facility means a nursing home licensed under chapter 18.51 RCW, an assisted living facility licensed under chapter 18.20 RCW, or an adult family home licensed under chapter 70.128 RCW.

(1) The health care facility may, upon request from another health care facility, share completed Washington state background check results only if:

The health care facility sharing the background check infor-mation is reasonably known to be the person’s most recent employer;
No more than twelve months has elapsed between the date the individual was last employed at a licensed health care facility and the date of the individual’s current employment application;
The background check is no more than two years old; and
The assisted living facility has no reason to believe the in-dividual has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, a negative action that is disqualifying under WAC 388-78A-2470.

(2) The assisted living facility may also establish, maintain and follow a written agreement with home health, hospice, or home care agencies licensed under chapter 70.127 RCW or nursing pools registered under chapter 18.52C RCW in order to ensure that the agency or pool staff meet the requirements of WAC 388-78A-2470.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2467, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2467, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2467, filed 7/30/10, effective

1/1/11.]

WAC 388-78A-2468 Background checks—Employment—Conditional hire —Pending results of Washington state name and date of birth background check. The assisted living facility may conditionally hire an administrator, caregiver, or staff person directly or by contract, pending the result of the Washington state name and date of birth background check, provided that the assisted living facility:

Submits the background authorization form for the person to the department no later than one business day after he or she starts working;
Requires the person to sign a disclosure statement indicating if he or she has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is disqualifying under WAC 388-78A-2470;
Has received three positive references for the person;
Does not allow the person to have unsupervised access to any resident;
Ensures direct supervision of the administrator, all caregiv-ers, and staff persons; and
Ensures that the person is competent, and receives the neces-sary training to perform assigned tasks and meets the training requirements under chapter 388-112 WAC.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2468, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2468, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2468, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2468, filed 7/30/10, effective

1/1/11.]

WAC 388-78A-24681 Background checks—Employment—Provisional hire —Pending results of national fingerprint background check. The assisted living facility may provisionally employ a caregiver and an administrator hired after January 7, 2012 for one hundred and twentydays and allow the caregiver or administrator to have unsupervised access to residents when:

The caregiver or administrator is not disqualified based on the results of the Washington state name and date of birth background check; and
The results of the national fingerprint background check are pending.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24681, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-24681, filed 10/18/12, effective 11/18/12.]

WAC 388-78A-2469 Background check—Disclosure statement. (1) The assisted living facility must require each administrator, caregiver, staff person, volunteer and student, prior to starting his or her duties, to make disclosures of any crimes or findings consistent with RCW 43.43.834(2). The disclosures must be in writing and signed by the person under penalty of perjury.

(2) The department may require the assisted living facility or any administrator, caregiver, staff person, volunteer or student to complete additional disclosure statements or background authorization forms if the department has reason to believe that a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is disqualifying under WAC 388-78A-2470 have occurred since completion of the previous disclosure statement or background check.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2469, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2469, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2469, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2469, filed 7/30/10, effective

1/1/11.]

WAC 388-78A-2470 Background check—Employment-disqualifying information—Disqualifying negative actions. (1) The assisted living facility must not employ an administrator, caregiver, or staff person, to have unsupervised access to residents, as defined in RCW 43.43.830, if the individual has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, unless the individual is eligible for an exception under WAC 388-113-0040.

(2) The assisted living facility must not employ an administrator, caregiver, or staff person, or allow an administrator, caregiver, or staff person to have unsupervised access to residents, as defined in RCW 43.43.830, if the individual has one or more of the following disqualifying negative actions:

A court has issued a permanent restraining order or order of protection, either active or expired, against the person that was based upon abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult;
The individual is a registered sex offender;
The individual is on a registry based upon a final finding of abuse, neglect or financial exploitation of a vulnerable adult, unless the finding was made by adult protective services prior to October 2003;
A founded finding of abuse or neglect of a child was made against the person, unless the finding was made by child protective services prior to October 1, 1998;
The individual was found in any dependency action to have sexually assaulted or exploited any child or to have physically abused any child;
The individual was found by a court in a domestic relations proceeding under Title 26 RCW, or under any comparable state or federal law, to have sexually abused or exploited any child or to have physically abused any child;
The person has had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or
The person has relinquished a license or terminated a con-tract because an agency was taking an action against the individual related to alleged abuse, neglect, financial exploitation or mistreatment of a child or vulnerable adult.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2470, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2470, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2470, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2470, filed 7/30/10, effective 1/1/11. Statutory Authority: Chapter 18.20 RCW. WSR 10-03-066, § 388-78A-2470, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapters 18.20 and 74.34 RCW. WSR 09-01-052, § 388-78A-2470, filed 12/10/08, effective 1/10/09. Statutory Authority: RCW 18.20.090 and chapters 18.20 and 74.34 RCW. WSR 08-05-099, § 388-78A-2470, filed 2/15/08, effective 3/17/08. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2470, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2470, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-24701 Background checks—Employment—Nondisqualifying information. (1) If the background check results show that an employee or prospective employee has a criminal conviction or pending charge for a crime that is not a disqualifying crime under chapter 388-113 WAC, then the assisted living facility must determine whether the person has the character, competence and suitability to work with vulnerable adults in long-term care.

(2) Nothing in this section should be interpreted as requiring the employment of any person against the better judgment of the assisted living facility.

[Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-24701, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24701, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-24701, filed

10/18/12, effective 11/18/12.]

WAC 388-78A-2471 Background check—Confidentiality—Use restricted—Retention. The assisted living facility must ensure that all disclosure statements, background authorization forms, background check results and related information are:

Maintained on-site in a confidential and secure manner;
Used for employment purposes only;
Not disclosed to anyone except to the individual, authorized state and federal employees, the Washington state patrol auditor, persons or health care facilities authorized by chapter 43.43 RCW; and
Retained and available for department review during the indi-vidual’s employment or association with a facility and for at least two years after termination of the employment or association.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2471, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2471, filed

7/30/10, effective 1/1/11.]

WAC 388-78A-2474 Training and home care aide certification requirements. (1) The assisted living facility must ensure staff persons hired before January 7, 2012 meet training requirements in effect on the date hired, including requirements in chapter 388-112A WAC.

(2) The assisted living facility must ensure all assisted living facility administrators, or their designees, and caregivers hired on or after January 7, 2012 meet the long-term care worker training requirements of chapter 388-112A WAC, including but not limited to:

Orientation and safety;
Basic;
Specialty for dementia, mental illness and/or developmental disabilities when serving residents with any of those primary special needs;
Cardiopulmonary resuscitation and first aid; and(e) Continuing education.
The assisted living facility must ensure that all staff re-ceive appropriate training and orientation to perform their specific job duties and responsibilities.
The assisted living facility must ensure all persons listed in subsection (2) of this section, obtain the home-care aide certification.
Under RCW 18.88B.041 and chapter 246-980 WAC, certain indi-viduals including registered nurses, licensed practical nurses, certified nursing assistants, or persons who are in an approved certified nursing assistant training program are exempt from long-term care worker basic training requirements. Continuing education requirements under chapter 388-112A WAC still apply to these individuals, except for registered nurses and licensed practical nurses.
For the purpose of this section, the term “caregiver” has the same meaning as the term “long-term care worker” as defined in RCW 74.39A.009.

[Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2474, filed 9/21/18, effective 10/22/18; WSR 14-05-035, § 388-78A-2474, filed 2/12/14, effective 3/15/14; WSR 13-13-063, §

388-78A-2474, filed 6/18/13, effective 7/19/13; WSR 12-21-070, § 388-78A-2474, filed 10/18/12, effective 11/18/12; WSR 12-01-003, § 388-78A-2474, filed 12/7/11, effective 1/7/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2474, filed

7/30/10, effective 1/1/11.]

WAC 388-78A-2480 Tuberculosis—Testing—Required. (1) The assisted living facility must develop and implement a system to ensure each staff person is screened for tuberculosis within three days of employment.

(2) For purposes of WAC 388-78A-2481 through 388-78A-2489, “staff person” means any assisted living facility employee or temporary employee of the assisted living facility, excluding volunteers and contractors.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2480, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2480, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090. WSR 06-24-073, § 388-78A-2480, filed 12/4/06, effective 1/4/07; WSR 06-01-047, § 388-78A-2480, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2480, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2481 Tuberculosis—Testing method—Required. The assisted living facility must ensure that all tuberculosis testing is done through either:

(1) Intradermal (Mantoux) administration with test results read:

Within forty-eight to seventy-two hours of the test; and
By a trained professional; or

(2) A blood test for tuberculosis called interferon-gamma release assay (IGRA).

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2481, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2481, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2482 Tuberculosis—No testing. The assisted living facility is not required to have a staff person tested for tuberculosis if the staff person has:

A documented history of a previous positive skin test, with ten or more millimeters induration;
A documented history of a previous positive blood test; or(3) Documented evidence of:
Adequate therapy for active disease; or
Completion of treatment for latent tuberculosis infection preventive therapy.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2482, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2482, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2483 Tuberculosis—One test. The assisted living facility is only required to have a staff person take one test if the staff person has any of the following:

A documented history of a negative result from a previous two step skin test done no more than one to three weeks apart; or
A documented negative result from one skin or blood test in the previous twelve months.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2483, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2483, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2484 Tuberculosis—Two step skin testing. Unless the staff person meets the requirement for having no skin testing or only one test, the assisted living facility choosing to do skin testing, must ensure that each staff person has the following two-step skin testing:

An initial skin test within three days of employment; and
A second test done one to three weeks after the first test.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2484, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2484, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2485 Tuberculosis—Positive test result. When there is a positive result to tuberculosis skin or blood testing the assisted living facility must:

Ensure that the staff person has a chest X-ray within seven days;
Ensure each resident or staff person with a positive test re-sult is evaluated for signs and symptoms of tuberculosis; and
Follow the recommendation of the resident or staff person’s health care provider.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2485, filed 6/18/13, effective 7/19/13; WSR 10-03-066, §

388-78A-2485, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2486 Tuberculosis—Negative test result. The assisted living facility may be required by the public health provider or licensing authority to ensure that staff persons with negative test results have follow-up testing in certain circumstances, such as:

After exposure to active tuberculosis;
When tuberculosis symptoms are present; or
For periodic testing as determined by the public health pro-vider.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2486, filed 6/18/13, effective 7/19/13; WSR 10-03-066, §

388-78A-2486, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2487 Tuberculosis—Declining a skin test. The assisted living facility must ensure that a staff person take the blood test for tuberculosis if they decline the skin test.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2487, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2487, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2488 Tuberculosis—Reporting—Required. The assisted living facility must:

Report any staff person or resident with tuberculosis symp-toms or a positive chest X-ray to the appropriate health care provider, or public health provider;
Follow the infection control and safety measures ordered by the staff person’s health care provider including a public health provider;
Institute appropriate infection control measures;
Apply living or work restrictions where residents or staff persons are, or may be, infectious and pose a risk to other residents and staff persons; and
Ensure that staff person’s caring for a resident with suspec-ted tuberculosis comply with the WISHA standard for respiratory protection found in chapter 296-842 WAC.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2488, filed 6/18/13, effective 7/19/13; WSR 10-03-066, §

388-78A-2488, filed 1/15/10, effective 2/15/10.]

WAC 388-78A-2489 Tuberculosis—Test records. The assisted living facility must:

Keep the records of tuberculin test results, reports of X-ray findings, and any physician or public health provider orders in the assisted living facility;
Make the records readily available to the appropriate health provider and licensing agency,
Retain the records for at least two years after the date the staff person either quits or is terminated; and
Provide the staff person a copy of his/her test results.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2489, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2489, filed 1/15/10, effective 2/15/10.]