WAC 388-106-0355   Am I eligible for nursing facility care services?  You are eligible for nursing facility care if the department:

     (1) Assesses you in CARE and determines that you meet the functional criteria for nursing facility level of care which means one of the following applies:

     (a) You require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis;

     (b) You have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010:

    
For each Activity of Daily Living, the minimum level of assistance required in
Self Performance is: Support Provided is:
Eating N/A Setup
Toileting Supervision N/A
Bathing Supervision N/A
Transfer Supervision Setup
Bed Mobility Supervision Setup
Walk in Room

OR

Locomotion in Room

OR

Locomotion Outside Immediate Living Environment		 Supervision Setup
Medication Management Assistance Required N/A
Your need for assistance in any activities listed in subsection (b) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose in determining your functional eligibility.

     (c) You have an unmet or partially met need with at least two of the following activities of daily living, as defined in WAC 388-106-0010:

    
For each Activity of Daily Living, the minimum level of assistance required in
Self Performance is: Support Provided is:
Eating Supervision One person physical assist
Toileting Extensive Assistance One person physical assist
Bathing Limited Assistance One person physical assist
Transfer Extensive Assistance One person physical assist
Bed Mobility

and

Turning and repositioning		 Limited Assistance

and

Need		 One person physical assist
Walk in Room

OR

Locomotion in Room

OR

Locomotion Outside Immediate Living Environment		 Extensive Assistance One person physical assist
Medication Management Assistance Required Daily N/A
Your need for assistance in any of the activities listed in subsection (c) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility.

     or:

     (d) You have a cognitive impairment and require supervision due to one or more of the following: Disorientation, memory impairment, impaired decision making, or wandering and have an unmet or partially met need with at least one or more of the following:

    
For each Activity of Daily Living, the minimum level of assistance required in
Self Performance is: Support Provided is:
Eating Supervision One person physical assist
Toileting Extensive Assistance One person physical assist
Bathing Limited Assistance One person physical assist
Transfer Extensive Assistance One person physical assist
Bed Mobility

and

Turning and repositioning		 Limited Assistance

and

Need		 One person physical assist
Walk in Room

OR

Locomotion in Room

OR

Locomotion Outside Immediate Living Environment		 Extensive Assistance One person physical assist
Medication Management Assistance Required Daily N/A
Your need for assistance in any of the activities listed in subsection (d) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility.

     (2) Determines that you meet the financial eligibility requirements set through WAC 388-513-1315.



[Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, § 388-106-0355, filed 5/17/05, effective 6/17/05.]