(1) Licensees providing care and services for medically fragile children and youth must:

(a) Use licensed health care providers to provide care that meets the child's or youth's unique needs;

(b) Have sufficient nursing personnel to meet the nursing care needs of the children and youth in care, including at least one RN as required by WAC 110-145-3450;

(c) Offer to develop individualized treatment plans using information from the children's or youth's licensed health care providers that addresses their unique needs and includes:

(i) The care and services to be provided, with details on the child's or youth's preferences and choices; and

(ii) How the services will be delivered to accommodate those preferences and choices; and

(d) Have an infection control program supervised by an RN or a certified infection preventionist.

(2) RNs caring for medically fragile children or youth must:

(a) Complete and document an initial assessment of each child and youth admitted to the facility;

(b) Update assessments as needed; and

(c) Advise and assist nonmedical personnel providing care at the facility with:

(i) Maintaining health records;

(ii) Meeting children's and youth's daily health needs; and

(iii) Caring for their minor illnesses and injuries.

(3) Licensees may provide specialized care to medically fragile children and youth in care who need intensive personal care including:

(a) Skilled health care;

(b) Physical therapy; or

(c) Other forms of therapy.