The Associated Press
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“Some of them didn’t get some services they would have benefited from, and none of them got the kind of record keeping [the federal government] says they were entitled to,” said Kevin Quigley, who became secretary of the Department of Social and Health Services early this year.
Federal law requires that federally funded long term-care facilities provide any services residents need, including behavioral therapy, personal-care training and skill-building exercises.
The state will spend the next six months evaluating all residents of longterm care facilities to determine what services they need, Quigley said.
Gov. Jay Inslee put $4.2 million in his supplemental budget proposal for evaluations.
It is unclear how much it will ultimately cost to fix the problem and how much of a penalty the federal government may impose for years of violations.
In a letter to state officials last month, the federal Centers for Medicare & Medicaid Services initially estimated a $16 million penalty just for the two years of denied services to 27 residents at Spokane-area Lakeland Village.
Quigley, who noted regulators have not before mentioned this issue to Washington, said he is not focused on the potential penalty.
“All that matters right now is, let’s fix it,” he said. “Fix it as fast as we can.”
Nursing-facility services make up a small part of Washington’s $900 million system to help residents with developmental disabilities.
About 850 of the more than 20,000 people receiving services live at one of four state residential rehabilitative centers: Lakeland Village, Fircrest School in Shoreline, Rainier School in Buckley and Yakima Valley School in Selah.
Most of those residents live in the centers’ intermediate-care facilities, which provide specialized services meant to help participants function better in society.
But Lakeland, Fircrest and Yakima Valley also have nursing facilities for residents who need more medical care and help with basic living.
Washington started the nursing-facility program in 1992, said Sue Elliott, who at that time served as director of DSHS services for the developmentally disabled. She said lawmakers faced a budget deficit and thought nursing facilities would be less expensive to run than the traditional intermediate-care facilities.
They were cheaper because they didn’t provide specialized services, Elliott said.
“There were concerns,” she said, “but when the Legislature takes your money away and directs you to do something, the executive branch has to do it.”
About 250 people now live in the nursing facilities, with roughly 80 each at Lakeland, Fircrest and Yakima Valley, according to DSHS. An additional 300 or so with developmental disabilities live in private nursing homes, which are also subject to federal requirements for specialized services.
David Carlson of Disability Rights Washington, an advocacy group, said the state has gotten away with not providing specialized services because staffers didn’t know any better.
“If it’s never happened, nobody notices that it’s not happening,” Carlson said.