Arc of King County

This is an administrative scheduling letter confirming an Informal Dispute Resolution (IDR) meeting for September 9, 2024 Statement of Deficiencies related to WAC 388-101D-0220. The facility (The Arc of King County) is formally disputing the citation through proper regulatory channels. The facility's response demonstrates good engagement with the regulatory process by promptly requesting IDR review and organizing appropriate leadership participation, though the actual nature of the violation and corrective actions cannot be assessed from this scheduling document alone.

The inspection identified a regulatory non-compliance issue that was disputed through the Informal Dispute Resolution process. The facility's response was substantive, resulting in modifications to the Statement of Deficiencies including a change from WAC 388-101D-0220(2) to WAC 388-101D-0025(1)(d), removal of staff interviews and client skin check language, and correction of a staff title. The facility engaged appropriately in the dispute resolution process and successfully demonstrated that portions of the original findings required amendment, indicating a proactive compliance approach, though the underlying violation remains requiring a corrective action plan.

A resident sustained a fractured clavicle of unknown origin that went undetected for days despite 24-hour supervision, indicating a serious failure in resident monitoring and observation. Medical documentation confirmed the injury occurred days before discovery, suggesting inadequate staff vigilance. The provider failed to determine how the fracture occurred and could not account for the injury despite continuous supervision requirements, demonstrating systemic failures in care oversight. A failed provider practice citation was issued under WAC 388-101D-0220(2), but the investigation summary provides no evidence of meaningful corrective actions or systemic improvements implemented by the facility.

The inspection identified a pattern of non-compliance across multiple regulatory areas including failure to immediately report alleged exploitation to authorities, lapsed staff training (bloodborne pathogens, continuing education, mandatory reporter training), missing medical device safety instructions and physician orders, absent nurse delegation documentation, facility safety hazards (exposed electrical wires, mold-like substance), incomplete client refusal plans, and medication administration without required blood pressure checks. The facility's response included acknowledging deficiencies and attributing many gaps to leadership turnover and an office relocation in 2022, with corrective actions initiated during the inspection process. A follow-up inspection on 06/06/2024 confirmed all deficiencies were corrected, though the systematic nature of documentation and training failures indicated significant operational breakdowns requiring comprehensive remediation.