AGING AND DISABILITY SERVICES ADMINISTRATION
Directory of Nursing Homes
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DEFINITIONS:
A Nursing Facility (NF)
As of October 1, 1990, all nursing facilities must meet the requirements for a skilled nursing facility. Under these provisions, nursing services are available 24-hours a day to residents whose conditions are complex and/or medically unstable and who require frequent medical or nursing intervention. In addition, they provide at least daily nursing supervision to residents needing health services and restorative or maintenance assistance with medications, eating, dressing, walking, and other personal care needs.
An Intermediate Care Facility for the Mentally Retarded (IMR)
Provides nursing supervision of health care, habilitation, and active treatment services for mentally retarded residents or those with related conditions.
The Medicare Program (Title 18 of the Social Security Act)
Established by Congress in 1965 as a health insurance program for the aged, the blind, and the disabled. Eligibility for this program is not dependent on financial need.
The Medicaid Program (Title 19 of the Social Security Act)
Established by Congress as a joint federal-state program of medical assistance to help fund the health care costs of those who cannot afford to pay for necessary care from their own resources. Eligibility to participate is dependent on financial need, which is determined on the basis of personal assets and income.
AGING AND DISABILITY SERVICES ADMINISTRATION
Aging and Disability Services Administration is a component of the Washington State Department of Social and Health Services. One of its responsibilities is the regulation and oversight of nursing home care provided in Washington State. It also manages the state's Medicaid nursing home program.
The Aging and Disability Services Administration also performs Medicare certification surveys and advises the federal government as to whether facilities meet federal requirements to participate in that program.
For the Medicaid Program, the Aging and Disability Services Administration not only performs licensure and certification functions, but also establishes reimbursement rates for all Medicaid nursing home providers and reviews the care given to Medicaid patients.
Program responsibilities of the Aging and Disability Services Administration related to nursing homes include:
- Assuring compliance with state and federal laws and regulations governing the operation of nursing homes.
- Performing on-site facility surveys to ensure that all nursing home residents receive safe and adequate care, consistent with licensing and certification requirements and professional standards of practice.
- Conducting complaint investigations pertaining to nursing home residents. The toll-free number for reporting abuse or neglect is 1-800-562-6078. Reports may be made 24-hours a day, seven days a week.
- Applying regulatory sanctions to ensure correction of identified problems, consistent with state and federal laws and regulations.
- Evaluating the quality of services provided to nursing facility residents. Computerized resident assessments are transmitted to a Nursing Home Services data base by certified nursing facilities. Using certain quality indicators derived from this data base, quality assurance nurses monitor care, services, and accuracy of assessment in the facilities. Technical assistance is provided to facility staff to assist them in identifying care problems.
- Safeguarding against inappropriate use of Medicaid services to ensure residents are cared for in the least restrictive and least costly setting, consistent with their care needs. This includes evaluation of facility discharge planning activity and initiating relocation in certain instances.
- Establishing a facility-specific cost related reimbursement rate for each Medicaid provider, consistent with state laws and regulations.
- Mentally ill and developmentally disabled residents are reviewed annually by quality assurance nurses to determine need for nursing facility care.
- Promoting the most effective and appropriate use of available resources, including budget and program planning, as well as coordination with other components of the long term care system.
