May 15, 2013_ALF "Dear Administrator" Letters

May 15, 2013

ALTSA: ALF 2013-007

Dear Assisted Living Facility Administrator:

Recently, we have become aware of situations where a resident was asked to sign a waiver of liability or waiver of rights.  In one situation, the waiver was requested before a provider refunded the resident's money and in another situation, a resident was asked to sign a waiver indicating the resident did not want to receive a specific service.  We have also heard of providers requiring prospective Medicaid residents to pay a private rate for a minimum period of time as a condition of admission or continued stay in the home.  This letter is a reminder of the relevant laws and rules.

  • Resident rights statute Revised Code of Washington (RCW) 70.129.105 states that no long-term care facility shall require or request residents to sign waivers of potential liability for losses of personal property or injury, or to sign waivers of resident's rights set forth in this chapter or in the applicable licensing laws.
  • If Medicaid residents are admitted, the provider must accept Medicaid payment as payment in full of services, items, activities, room and board required by each resident's negotiated service agreement and department contract.  The provider may only request or receive payment of supplementation to Medicaid if the supplementation is for things over and above those already covered by the Medicaid rate.  (Washington  Administrative Code (WAC) 388-105-0050 and WAC 388-105-0055)
  • RCW 18.20.440 allows assisted living facilities to voluntarily withdraw from participation in the Medicaid program but the withdrawal is not an acceptable basis for the transfer or discharge of residents who were receiving Medicaid on the day before the effective date of the withdrawal or who have been paying the ALF privately for two years and who become eligible for Medicaid within one hundred eighty days of the date of withdrawal.

Licensors will continue to monitor to ensure these regulations are met and will cite if noncompliance is found. Please contact your local Field Manager if you have any questions.  Thank you for your continued commitment to residents living in assisted living facilities.


Joyce Pashley Stockwell, Director 
Residential Care Services