ASSESSMENT AND MONITORING

WAC 388-78A-2060  Preadmission assessment.  The assisted living facility must conduct a preadmission assessment for each prospective resident that includes the following information, unless unavailable despite the best efforts of the assisted living facility:

  • Medical history;
  • Necessary and contraindicated medications;
  • A licensed medical or health professional’s diagnosis, unless the prospective resident objects for religious reasons;
  • Significant known behaviors or symptoms that may cause con-cern or require special care;
  • Mental illness diagnosis, except where protected by confiden-tiality laws;
  • Level of personal care needs;
  • Activities and service preferences; and
  • Preferences regarding other issues important to the prospec-tive resident, such as food and daily routine.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2060, filed 6/18/13, effective 7/19/13; WSR 10-03-066, § 388-78A-2060, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2060, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2070  Timing of preadmission assessment.  (1) Unless there is an emergency, the assisted living facility must complete the preadmission assessment of the prospective resident before each prospective resident moves into the assisted living facility.

  • The assisted living facility must ensure the preadmission as-sessment is completed within five calendar days of the resident moving into the assisted living facility when the resident moves in under emergency conditions.
  • For the purposes of this section, “emergency” means any cir-cumstances when the prospective resident would otherwise need to remain in an unsafe setting or be without adequate and safe housing.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2070, 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-2070, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2080  Qualified assessor.  The assisted living facility must ensure the person responsible for completing a preadmission assessment of a prospective resident:

  • Has a master’s degree in social services, human services, be-havioral sciences or an allied field and two years social service experience working with adults who have functional or cognitive disabilities; or
  • Has a bachelor’s degree in social services, human services, behavioral sciences, or an allied field and three years social service experience working with adults who have functional or cognitive disabilities; or
  • Has a valid Washington state license to practice nursing, in accordance with chapters 18.79 RCW and 246-840 WAC; or
  • Is a physician with a valid state license to practice medi-cine; or
  • Has three years of successful experience acquired prior to September 1, 2004, assessing prospective and current assisted living facility residents in a setting licensed by a state agency for the care of vulnerable adults, such as a nursing home, assisted living facility, or adult family home, or a setting having a contract with a recognized social service agency for the provision of care to vulnerable adults, such as supported living.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2080, 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-2080, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2090  Full assessment topics.    The assisted living facility must obtain sufficient information to be able to assess the capabilities, needs, and preferences for each resident, and must complete a full assessment addressing the following, within fourteen days of the resident’s move-in date, unless extended by the department for good cause:

  • Individual’s recent medical history, including, but not limi-ted to:
  • A licensed medical or health professional’s diagnosis, unless the resident objects for religious reasons;
  • Chronic, current, and potential skin conditions; or
  • Known allergies to foods or medications, or other considera-tions for providing care or services.
  • Currently necessary and contraindicated medications and treatments for the individual, including:
  • Any prescribed medications, and over-the-counter medications commonly taken by the individual, that the individual is able to independently self-administer, or safely and accurately direct others to administer to him/her;
  • Any prescribed medications, and over-the-counter medications commonly taken by the individual, that the individual is able to selfadminister when he/she has the assistance of a caregiver; and
  • Any prescribed medications, and over-the-counter medications commonly taken by the individual, that the individual is not able to self-administer, and needs to have administered to him or her.
  • The individual’s nursing needs when the individual requires the services of a nurse on the assisted living facility premises.
  • Individual’s sensory abilities, including:(a) Vision; and

(b) Hearing.

  • Individual’s communication abilities, including:
  • Modes of expression;
  • Ability to make self understood; and(c) Ability to understand others.
  • Significant known behaviors or symptoms of the individual causing concern or requiring special care, including:
  • History of substance abuse;
  • History of harming self, others, or property; or
  • Other conditions that may require behavioral intervention strategies;
  • Individual’s ability to leave the assisted living facility unsupervised; and
  • Other safety considerations that may pose a danger to the in-dividual or others, such as use of medical devices or the individual’s ability to smoke unsupervised, if smoking is permitted in the assisted living facility.
  • Individual’s special needs, by evaluating available informa-tion, or if available information does not indicate the presence of special needs, selecting and using an appropriate tool, to determine the presence of symptoms consistent with, and implications for care and services of:
  • Mental illness, or needs for psychological or mental health services, except where protected by confidentiality laws;
  • Developmental disability;
  • While screening a resident for dementia, the assis-ted living facility must:
  • Base any determination that the resident has short-term memo-ry loss upon objective evidence; and
  • Document the evidence in the resident’s record.

(d) Other conditions affecting cognition, such as traumatic brain injury.

  • Individual’s level of personal care needs, including:(a) Ability to perform activities of daily living; (b) Medication management ability, including:
  • The individual’s ability to obtain and appropriately use over-the-counter medications; and
  • How the individual will obtain prescribed medications for use in the assisted living facility.
  • Individual’s activities, typical daily routines, habits and service preferences.
  • Individual’s personal identity and lifestyle, to the extent the individual is willing to share the information, and the manner in which they are expressed, including preferences regarding food, community contacts, hobbies, spiritual preferences, or other sources of pleasure and comfort.
  • Who has decision-making authority for the individual, in-cluding:
  • The presence of any advance directive, or other legal docu-ment that will establish a substitute decision maker in the future;
  • The presence of any legal document that establishes a current substitute decision maker; and
  • The scope of decision-making authority of any substitute de-cision maker.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2090, 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-2090, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2100  On-going assessments.  The assisted living facility must:

  • Complete a full assessment addressing the elements set forth in WAC 388-78A-2090 for each resident at least annually;
  • Complete an assessment specifically focused on a resident’s identified problems and related issues:
  • Consistent with the resident’s change of condition as speci-fied in WAC 388-78A-2120;
  • When the resident’s negotiated service agreement no longer addresses the resident’s current needs and preferences;
  • When the resident has an injury requiring the intervention of a practitioner.
  • Ensure the staff person performing the on-going assessments is qualified to perform them.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2100, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2100, 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-2100, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2110  Resident participation in assessments.  The assisted living facility must directly involve each resident or prospective resident, to the extent possible, along with any appropriate resident representative to the extent he or she is willing and capable, in the preadmission assessment and on-going assessment process.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2110, 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-2110, filed 7/30/04, effective 9/1/04.]

WAC 388-78A-2120  Monitoring residents’ well-being.  The assisted living facility must:

  • Observe each resident consistent with his or her assessed needs and negotiated service agreement;
  • Identify any changes in the resident’s physical, emotional, and mental functioning that are a:
  • Departure from the resident’s customary range of functioning; or
  • Recurring condition in a resident’s physical, emotional, or mental functioning that has previously required intervention by others.

(3) Evaluate, in order to determine if there is a need for further action:

  • The changes identified in the resident per subsection (2) of this section; and
  • Each resident when an accident or incident that is likely to adversely affect the resident’s well-being, is observed by or reported to staff persons.

(4) Take appropriate action in response to each resident’s changing needs.

[Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2120, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2120, 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-2120, filed 7/30/04, effective 9/1/04.]

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