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PDFWAC 388-107-0945

Resident suicide and self-harm prevention.

When an enhanced services facility's functional program states that it plans to admit a resident, or the licensee or applicant identifies a current resident who is at risk of suicide or self-harm, or both the licensee or applicant must submit a risk assessment to the department of health construction review services, identifying the risks in the physical environment. The licensee or applicant must ensure that the facility meets all or part of the following standards as determined by the department of health's review of the risk assessment:
(1) Ceilings in resident bathrooms are secured to prevent resident access and ceiling systems of a non-secured (non-clipped down) lay-in ceiling tile design are not permitted;
(2) Ceilings in resident bedrooms and bathrooms are designed to eliminate tie-off point(s) or are at least nine feet in height;
(3) Door swings for private resident bathrooms or shower areas swing out to allow for staff emergency access;
(4) Door closers are not used unless required by the building code and if required on the resident room door, the closer must be mounted on the public side of the door rather than the private resident's side of the door;
(5) Door hinges are designed to minimize points for hanging, such as cut hinge type, and are consistent with the level of care for the resident;
(6) Door lever handles are specifically designed anti-ligature hardware and all hardware has tamper-resistant fasteners;
(7) Windows located in areas accessible to residents are designed to limit the opportunities for breakage;
(8) All glazing, both interior and exterior, and glass mirrors are fabricated with laminated safety glass or equivalent;
(9) Use of tempered glass for interior windows is permitted;
(10) Break-away window coverings are used for visual privacy;
(11) Special design considerations for injury and suicide prevention must be given to shower, bath, toilet, and sink hardware and accessories, including grab bars and toilet paper holders;
(12) Towel bars and shower curtain rods are not permitted;
(13) Where grab bars are provided in resident rooms, resident toilet rooms, resident bathing rooms or other nonpublic space, the space between the bar and the wall must be filled to prevent the grab bar from becoming a ligature point; and
(14) The facility must include an overall design for anti-ligature including, but not limited to, grab bars, towel hooks, levers, handles, sprinkler heads, and other protrusions that meet the following criteria:
(a) In unsupervised resident areas, sprinkler heads must be recessed or of a design to minimize resident access;
(b) In resident bathrooms, lighting fixtures, sprinkler heads, electrical outlets, and other fixtures must be the tamper-resistant type;
(c) Call system may not use cords; and
(d) All hardware fixtures that are fastened with exposed fasteners must use tamper resistant screws.
[Statutory Authority: RCW 70.97.230 and HCBS Final Rule 42 C.F.R. WSR 16-14-078, ยง 388-107-0945, filed 7/1/16, effective 8/1/16.]
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