Licensees providing care for medically fragile children and youth must meet the following documentation requirements in addition to the requirements in WAC 110-145-2900:

1. (1) Obtain documentation when children or youth have been in care for more than 30 calendar days of:

   1. (a) A physical examination and diagnosis by a licensed health care provider;

   2. (b) Information about the child's or youth's daily care, if applicable including, but not limited to:

      1. (i) Treatment plans;
      2. (ii) Medications;
      3. (iii) Observations;
      4. (iv) Medical examinations;
      5. (v) Physicians' orders;
      6. (vi) Proper treatment for allergic reactions;
      7. (vii) Consent authorizations;
      8. (viii) Releases;
      9. (ix) Diagnostic reports; and
      10. (x) Revised assessments;

   3. (c) Upon discharge, a summary including:

      1. (i) Diagnoses, treatments, and prognosis by the individual responsible for providing care; and
      2. (ii) Any instructions and referrals for continuity of care; and
   4. (d) Evidence of meeting criteria for eligibility for services from DDCS, if applicable.

2. (2) If a medication order is given over the phone from a licensed health care provider, licensees must:

   1. (a) Have an RN or LPN receive the order; and
   2. (b) Obtain a signed copy of the order from a licensed health care provider within 72 hours of the order.

[Statutory Authority: RCW 74.15.030. WSR 25-23-103, s 110-145-3490, filed 11/18/25, effective 5/1/26.]