Washington State has an “interesting” concept in place with regards to the campus based communities for people with intellectual and developmental disabilities. The term used in Washington State is Residential Habilitation Center (RHC).
What makes this term very confusing is that the RHC could be a Specialized Skilled Nursing Facility (SNF), an Intermediate Care Facility for People with Intellectual and Developmental Disabilities (ICF/IDD) or both.
What makes the term RHC even more difficult is the fact that there are different rules and regulations for the SNF and the ICF/IDD so when one talks about the RHC which type of facility is one referring to? Most people do not realize that when referring to the RHC they are actually referring to two different types of institutions.
Nursing care is an area of concern for those who live in the ICF/IDD. Even though the ICF/IDD is defined as a healthcare facility under the Social Security Act, Washington State does not define it that way. The ICF/IDD also does not fit under the definition of “Long Term Care Facility” by Washington State Law but many consider it a long term care facility. This ambiguity about what the ICF/IDD leaves the residents floundering in limbo without appropriate oversight for the care that is to be provided to the residents.
This issue is clearly seen when looking at who does the surveys and investigations in each type of facility. The SNF has all registered nurses on these teams while the ICF/IDD rarely has a healthcare professional on the team. Even if allegations are written concerning medical, nursing or other healthcare related problems, there is no healthcare professional on the investigation team to assess the situation. This is a problem.
There are several solutions that can be examined for this error. The first solution would be to transfer oversight of the healthcare from the Department of Social and Health Services to the Department of Health. Another solution would be to include registered nurses or other healthcare professionals to do the investigations and surveys. At the minimum the healthcare professionals should be consulted for any allegation that pertains to healthcare.