AGING AND DISABILITY SERVICES ADMINISTRATION

May 28, 2004

ADSA: AFH #2004-002
RESIDENT ACCESS TO MEDICAL CARE

Dear Adult Family Home Provider:

Recently, the Department became aware of incidents in which residents in a long-term care facility were not provided necessary medical care. In at least three of these cases, the residents died. The purpose of this letter is to remind you that an adult family home is responsible for providing necessary care and services, including medical care and access to emergency medical treatment, to every resident at all times.

In each of the incidents involving a resident death, the facility failed to adequately evaluate significant changes in the resident’s condition. The facility also failed to act on the resident’s and/or family’s repeated requests to see a physician and specific requests to be transported to the emergency room. Whether or not timely access to medical care would have changed the ultimate outcome cannot be determined. Nevertheless, these incidents demonstrate the potential for serious harm and even death if residents are not provided appropriate medical care and services.

The following rules and regulations address the adult family home requirements:

• RCW 70.128.007 requires an adult family home to assume general responsibility for its residents and to promote each resident’s health, safety, and well-being consistent with the resident’s negotiated care plan.
• RCW 70 .128.130(6) requires an adult family home to establish health care procedures for the care of residents, including medication administration and emergency medical care.
• RCW 70.129. 030 (6) requires immediate consultation with the resident’s physician if there is a significant change in the resident’s physical, mental, or psychosocial status.
• WAC 388-76-620 requires the adult family home provide for the appropriate care of each resident and promotes the most appropriate level of physical, mental, and psychosocial well-being consistent with the resident care plan and resident choice.
• WAC 388-76-675 (3a) requires when there is a significant change in a resident’s condition, or a serious injury, trauma or death of a resident, the adult family home must notify the resident’s family, surrogate decision maker, physician and other appropriate professionals, and other persons identified in the negotiated care plan.

Please bring this information to the attention of your staff to ensure compliance with the above noted requirements and to promote quality of life and quality of care for all residents.

If you have any questions please contact your local Residential Care Services Field Manager.

Sincerely,

Patricia K. Lashway, Director
Residential Care Services