Archived Recording from AFH Council Webinars
- Understanding the CARE Tool and How it Affects Your Resident's Daily Rate and Services-Updated 2021
- RCS Complaint Investigations
- Best Practices for Hiring Staff in Your Adult Family
- Licensing Visit Walkthrough
- Update on the 2021-2023 AFH Collective Bargaining Agreement
- The Ins and Outs of Your AFH Inspection
- Financing Your Future
- Labor & Industry Webinar
AFHC 2021 Virtual Fall Conference
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- Preliminary Service Plans: Discussing WAC 388-76-10340
- Partnering with Hospice: Lessons Learned from Covid
- HR Best Practices: Developing and Retaining Long-Term Care Workers
- Moving Ahead Through Challenging Times
- Meeting the Behavioral Health Needs of Older Adults in Adult Family Homes
- Uniform Guardianship
- L&I Guidance for Adult Family Homes
- Cannabis Use in the Elderly
- Abuse & Neglect
- DSHS Leadership Panel
APS Investigations
Chapter 74.34 RCW authorizes the Department of Social and Health Services (DSHS) to receive and investigate reports of abandonment, abuse, financial exploitation, neglect and self-neglect of vulnerable adults, and to provide protective services and legal remedies to protect vulnerable adults. The APS Division within Aging and Long-Term Support Administration performs these functions. When an allegation is substantiated, APS must investigate whether other vulnerable adults may be at current risk of abandonment, abuse, financial exploitation, or neglect.
If you need to contact Adult Protective Services you can call in 1-877-734-6277, complete an online report Adult Protective Services (APS) Administrative Hearing Request Form or send an email to apscentralintake@dshs.wa.gov
ALTSA Long Term Care Manual Adult Protective Services Chapter 6 (APS Standard Operating Procedures) APS Interview Preparation 2022 LawIf you are substantiated against in an investigation with APS, you have a right to due process and the “opportunity to be heard” (challenge the finding) before a neutral body, which is the Office of Administrative Hearings (OAH). Legal Benefits Advisors (LBAs) represent the department in most administrative hearings at OAH. In some situations, the Attorney General’s Office will represent the department. An alleged perpetrator must request an administrative hearing timely for each initial substantiated finding. Here is the Adult Protective Services (APS) Administrative Hearing Request Form to request an Administrative Hearing.
RCS has primary investigative responsibility for alleged reports of provider practice violations related to abuse, neglect, exploitation, and abandonment of vulnerable adults in all licensed and/or certified settings regulated by RCS. This standard operating procedure provides consistent practices across all RCS programs; and to support staff that are cross-trained for various programs.
Each complaint is unique and the investigation must focus on the areas where RCS has jurisdiction in that particular setting. Regulations and the population served by each care setting vary so all these factors must be considered when developing the required investigative plan.
If you need to call in a complaint, you can call 1-800-562-6078 or complete an online report here.
This Standard Operating Procedure (SOP) outlines the expectations for staff conducting complaint investigations:
- How to process and review complaint assignments
- How to prepare for an investigation and develop a plan
- What to do after leaving a facility/home/provider and make a final determination
- How to write reports and submit/mail them within the required timelines
- When a complaint is considered closed
- How to report complaints from the field
Click here for Complaint Investigations Overview information.
RCS Investigation Timelines
Complaint Resolution Unit (CRU) staff will prioritize complaint intakes using the following guidelines:
- 2 working days (Immediate Jeopardy) – A situation in which the provider’s noncompliance with one or more requirements of participation has caused, or is likely to cause, serious injury, harm, impairment, or death to a resident. Immediate corrective action is necessary.
- 10 working days (Non Immediate Jeopardy-High) – The alleged noncompliance may have caused harm that negatively impacts the individual’s mental, physical and/or psychosocial status and are of such consequence to the person’s wellbeing, the SA conducts a rapid response. Usually, specific rather than general information (such as, descriptive identifiers, individual names, date/time/location of occurrence, description of harm, etc.) factors into the assignment of this level of priority.
- 20 working days (Non Immediate Jeopardy-Medium) – The alleged noncompliance caused or may cause harm that is of limited consequence and does not significantly impair the individual’s mental, physical and/or psychosocial status or function. Initiate complaint and incident investigations within 20 working days of linking the intake to the RCS Field Unit.
- 45 working days (Non Immediate Jeopardy-Low) – The alleged noncompliance may have caused physical, mental and/or psychosocial discomfort that does not constitute injury or damage. In most cases, an investigation of the allegation can wait until the next onsite survey. Initiate investigations within 45 working days of linking the intake to the RCS Field Unit.
- 90 working days Complaint investigation delay may occur if the allegation is general in nature, anonymous, and a scheduled survey is within 90 working days. In general, this is a priority assignment made by the field manager, not the CRU.
- Quality Review Assign intakes this priority if an onsite investigation is not necessary. The field conducts an offsite administrative review (e.g., written/verbal communication or documentation) to determine if further action is necessary. The field may review the information at the next onsite survey. Allegations may also receive a “Quality Review” designation if any other report of a more urgent nature has already prompted an investigation of the situation by the Department.
The purpose of conducting AFH licensing visits is to ensure homes are in compliance or continuing to remain in compliance with minimum licensing standards as defined in RCW Chapter 70.128 and WAC Chapter 388-76. RCS inspections will focus on resident’s rights and their safety and well-being. RCS conducts unannounced inspections in AFHs regularly. An inspection must occur by the end of the eighteenth month after the end of the previous inspection. The first inspection for a newly licensed home must occur no later than the end of the ninth month after licensure. Here is a link to the working papers Annual Inspection Working Papers
Statement of Deficiencies and Enforcement letters will be delivered via E-fax to provide the AFH with timely delivery of the documents.
FAQ's and Best Practices for Licensing Visits
- Residential Care Services Long Term Care Manual Chapter 12- Adult Family Homes (RCS Standard Operating Procedure)
Informal Dispute Resolution
If you do not agree with the Statement of Deficiency the home received, you have the right to an Informal Dispute Resolution. There are two types of IDR’s. The IDR panel which includes one provider, one Residential Care Services (RCS) staff, one consumer advocate, and a panel chair or the traditional IDR which is a 1:1 meeting. To request an IDR, please use this IDR Form and submit all IDR documents to RCSIDR@dshs.wa.gov or via fax (360) 725-3225. We would be happy to assist you with this process.
To learn more about the IDR process we have included IDR guidelines and CHAPTER 22: Informal Dispute Resolution (IDR) of the Residential Care Services Long Term Care Manual.
Administrative Hearing
If you disagree with a Statement of Deficiency with enforcement action you have a right to an Administrative Hearing. Read your Statement of Deficiency thoroughly as it has instructions on how to appeal. It is your responsibility to follow those instructions. If you do not, you may lose your right to appeal. You can contact the Office of Administrative Hearings at 360-407-2700 or 800-583-8271. We would happy to assist you with this process.
Inspections
Adult family homes, also known as AFHs, are residential homes that are licensed through Residential Care Services (RCS) to provide personal care for up to eight residents. Adult family homes are unique in that their fundamental characteristic is that they are home-like and they are always located in a residential home. The population served by AFHs vary widely and may include people who require very little care who will live in the home for years or the home may offer services to people who require a great deal of care and are near the end of their life. The type of services that an AFH offers depends greatly on the skill level of the provider and the caregivers they employ. Residential Care Services regulates these homes and conducts licensing visits every 9 to 18 months. Homes are required to meet the minimum licensing standards as stipulated in WAC Chapter 388-76 and RCW Chapter 70.128. Adult family homes must also comply with the following WAC and RCW chapters: RCW 70.129 RESIDENT RIGHTS, WAC 51.51 STATE BUILDING CODE, TITLE 42 §441.530 HOME AND COMMUNITY-BASED SETTING, RCW 74.34 ABUSE OF VULNERABLE ADULTS, WAC 388-113 DISQUALIFYING CRIMES AND NEGATIVE ACTIONS, WAC 388-112A RESIDENTIAL LONG-TERM CARE SERVICES.
Investigations
RCS has primary investigative responsibility for alleged reports of provider practice violations related to abuse, neglect, exploitation, and abandonment of vulnerable adults in all licensed and/or certified settings regulated by RCS. Each complaint is unique and the investigation must focus on the areas where RCS has jurisdiction in that particular setting.
RCW Chapter 74.34 authorizes the Department of Social and Health Services (DSHS) to receive and investigate reports of abandonment, abuse, financial exploitation, neglect and self-neglect of vulnerable adults, and to provide protective services and legal remedies to protect vulnerable adults. The APS Division within Aging and Long-Term Support Administration performs these functions. APS receives reports of allegations of abandonment, abuse, financial exploitation, neglect, or self-neglect of vulnerable adults living in the community, facilities, and certified community residential services and supported living settings.
Providers and caregivers deliver most of the direct care and spend the most time with residents in the Adult Family Home. The Long Term Care Foundation of Washington can assist with training. Their AFH Training Network is available to assist eligible adult family homes recruit, train and retain new, qualified long-term care workers.