To help ensure surveys are unpredictable, both state licensing statutes and federal nursing home regulations require some surveys be conducted in off-hour timeframes. Prior to June 11, 2020, the state nursing home statute (RCW 18.51.230) and federal regulations (42 CFR §488.307) differed on what constituted an off-hour survey. Because of that, off-hour surveys for nursing homes were conducted in accordance with state rules, federal rules, or both, depending on if the home was licensed by the state, certified with the Centers for Medicare and Medicaid Services (CMS), or both licensed and certified.

Effective June 11, 2020, Engrossed Second Substitute Senate Bill 6515 amended RCW 18.51.230 and changed the state standard for off-hour surveys. The state standard now aligns with the federal off-hour standard.

CMS describes the off-hour standard in the Chapter 7 (7207.2.2) of the State Operation Manual: “The time of day that surveyors begin should extend beyond the business hours of 8:00 a.m. to 6:00 p.m. In addition, the day of the week should vary to include weekend days, Saturday, and Sunday. At least 10 percent of standard health surveys must begin either on the weekend or in the evening/early morning hours before 8:00 a.m. or after 6:00 p.m. … In addition, standard health surveys that are conducted to satisfy the 10 percent requirement must be conducted on consecutive days. Consecutive days mean calendar days and are to include Saturdays, Sundays, and Holidays.”

See full letter here.

Questions?

Contact:

Laura Hofmann, MSN, RN – Director of Clinical and Nursing Facility Regulatory Services
c: 425-231-4804