AGING AND DISABILITY SERVICES ADMINISTRATION
December 23, 2004
ADSA: BH #2004-025
USE OF EMERGENCY MEDICAL SERVICES
Dear Boarding Home Provider:
The Department has become aware of situations in which boarding homes have inappropriately used the local fire department/emergency medical services (911) to pick up residents who have fallen when there are no injuries. If a boarding home (BH) chooses to admit or retain a resident with a significant history of falling, or is assessed to be a high risk for falling, the BH must have systems and staff in place to be able to respond to non-emergent falls without calling 911.
The following laws and rules apply :
- RCW 70.129.030(3) and WAC 388-78A-2050 require a BH to admit or retain only those residents whose needs it can safely and appropriately serve in the facility with appropriate available staff.
- WAC 388-78A-2090 requires a BH to complete a full assessment of the resident’s needs.
- WAC 388-78A-2120 requires a BH to observe each resident consistent with his/her needs, identify any changes in the resident’s functioning, evaluate those changes to determine if there is a need for further action, including an assessment, and take appropriate actions in response.
- WAC 388-78A-2140 requires a BH to develop a plan to meet the needs of resident, including appropriate interventions for identified risks.
- WAC 388-78A-2450 requires each BH to provide sufficient, trained staff persons to furnish the services and care needed by each resident consistent with his/ her negotiated services agreement.
- WAC 388-78A-2600 requires a BH to develop and implement policies and procedures to address urgent situations.
Boarding homes that choose to admit a resident with a risk of falling must have available staff who are capable of 1) evaluating the resident’s condition after a fall, and 2) assisting the resident back to the pre-fall position, if there is no indication of injuries. The same requirement applies if the BH chooses to retain a resident who is identified as being at risk for falling after admission.
This letter should not be construed to mean that it is never appropriate to call 911. Clearly, there are occasions when an evaluation reveals the resident may have a medical emergency and calling 911 is appropriate and required. It is not appropriate, however, for boarding homes to routinely call 911 as a primary plan for responding to all resident falls.
Please contact your local Residential Care Services Field Manager if you have further questions regarding this matter.
Sincerely,
Patricia K. Lashway, Director
Residential Care Services
