title: RCW 70.405.050

text:
(1) The authority must adopt rules setting forth a methodology established by the board for setting upper payment limits for prescription drugs the board has determined have led or will lead to excess costs based on its affordability review. The rules adopted under this subsection may not go into effect until at least 90 days after the next regular legislative session. Each year, the board may set an upper payment limit for up to 12 prescription drugs.
(2) The methodology must take into consideration:
(a) The cost of administering the drug;
(b) The cost of delivering the drug to patients;
(c) The status of the drug on the drug shortage list published by the United States food and drug administration; and
(d) Other relevant administrative costs related to the production and delivery of the drug.
(3) The methodology determined by the board must not use quality-adjusted life years that take into account a patient's age or severity of illness or disability to identify subpopulations for which a prescription drug would be less cost-effective. For any prescription drug that extends life, the board's analysis of cost-effectiveness may not employ a measure or metric which assigns a reduced value to the life extension provided by a treatment based on a preexisting disability or chronic health condition of the individuals whom the treatment would benefit.
(4) Before setting an upper payment limit for a drug, the board must post notice of the proposed upper payment limit on the authority's website, including an explanation of the factors considered when setting the proposed limit and instructions to submit written comment. The board must provide 30 days to submit public comment.
(5) The board must monitor the supply of drugs for which it sets an upper payment limit and may suspend that limit if there is a shortage of the drug in the state.
(6) An upper payment limit for a prescription drug established by the board applies to all purchases of the drug by any entity and reimbursements for a claim for the drug by a health carrier, or a health plan offered under chapter 41.05 RCW, when the drug is dispensed or administered to an individual in the state in person, by mail, or by other means.
(7) An employer-sponsored self-funded plan may elect to be subject to the upper payment limits as established by the board.
(8) The board must establish an effective date for each upper payment limit, provided that the upper payment limit may not go into effect until at least 90 days after the next regular legislative session and that the date is at least six months after the adoption of the upper payment limit and applies only to purchases, contracts, and plans that are issued on or renewed after the effective date.
(9) Any entity affected by a decision of the board may request an appeal within 30 days of the board's decision, and the board must rule on the appeal within 60 days. Board rulings are subject to judicial review pursuant to chapter 34.05 RCW.
(10) For any upper payment limit set by the board, the board must notify the manufacturer of the drug and the manufacturer must inform the board if it is able to make the drug available for sale in the state and include a rationale for its decision. The board must annually report to the relevant committees of the legislature detailing the manufacturers' responses.
(11) The board may reassess the upper payment limit for any drug annually based on current economic factors.
(12) The board may not establish an upper payment limit for any prescription drug before January 1, 2027.
(13)(a) Any individual denied coverage by a health carrier for a prescription drug because the drug was unavailable due to an upper payment limit established by the board, may seek review of the denial pursuant to RCW 48.43.530 and 48.43.535.
(b) If it is determined that the prescription drug should be covered based on medical necessity, the carrier may disregard the upper payment limit and must provide coverage for the drug.
[ 2022 c 153 s 5.]

catchline: Upper payment limits.


doc_type: statute

jurisdiction: wa

title: RCW 70.405.060

text:
(1) Any savings generated for a health plan, as defined in RCW 48.43.005, or a health plan offered under chapter 41.05 RCW that are attributable to the establishment of an upper payment limit established by the board must be used to reduce costs to consumers, prioritizing the reduction of out-of-pocket costs for prescription drugs.
(2) By January 1, 2024, the board must establish a formula for calculating savings for the purpose of complying with this section.
(3) By March 1st of the year following the effective date of the first upper payment limit, and annually thereafter, each state agency and health carrier issuing a health plan in the state must submit a report to the board describing the savings in the previous calendar year that were attributable to upper payment limits set by the board and how the savings were used to satisfy the requirements of subsection (1) of this section.
[ 2022 c 153 s 6.]

license: public-domain-government-work

rule_set: Revised Code of Washington

catchline: Use of savings.

code: rcw

unit: section

court: Washington State Legislature


title: RCW 70.405.070

text:
(1) Any manufacturer that intends to withdraw a prescription drug from sale or distribution within the state because the board has established an upper payment limit for that drug shall provide a notice of withdrawal in writing indicating the drug will be withdrawn because of the establishment of the upper payment limit at least 180 days before the withdrawal to the office of the insurance commissioner, the authority, and any entity in the state with which the manufacturer has a contract for the sale or distribution of the drug.
(2) If a manufacturer chooses to withdraw the prescription drug from the state, it shall be prohibited from selling that drug in the state for a period of three years.
(3) A manufacturer that has withdrawn a drug from the market may petition the authority, in a form and manner determined by the authority in rule, to reenter the market before the expiration of the three-year ban if it agrees to make the drug available for sale in compliance with the upper payment limit.
(4) The rules adopted under this section may not go into effect until at least 90 days after the next regular legislative session.
[ 2022 c 153 s 7.]

catchline: Manufacturer withdrawal from the market.


title: RCW 70.405.080

text:
By December 15, 2022, and annually thereafter, the board shall provide a comprehensive report to the legislature detailing all actions the board has taken in the past year, including any rules adopted by the authority pursuant to chapter 153, Laws of 2022, establishing any processes, such as the methodology for the upper payment limit, the list of drugs identified in RCW 70.405.030, the drugs the board completed an affordability review of and any determinations of whether the drug had led or will lead to excess costs, and the establishment of any upper payment limits.
[ 2022 c 153 s 8.]

catchline: Reporting.


title: RCW 70.405.090

text:
The authority may adopt any rules necessary to implement this chapter. The rules adopted under this section may not go into effect until at least 90 days after the next regular legislative session.
[ 2022 c 153 s 9.]

catchline: Rule making.


title: RCW 70.41.005

text:
The powers and duties of the department of social and health services under this chapter shall be performed by the department of health.
[ 1989 1st ex.s. c 9 s 249.]
Notes:
Effective date—Severability—1989 1st ex.s. c 9: See RCW 43.70.910 and 43.70.920.

catchline: Transfer of duties to the department of health.


title: RCW 70.41.010

text:
The primary purpose of this chapter is to promote safe and adequate care of individuals in hospitals through the development, establishment and enforcement of minimum hospital standards for maintenance and operation. To accomplish these purposes, this chapter provides for:
(1) The licensing and inspection of hospitals;
(2) The establishment of a Washington state hospital advisory council;
(3) The establishment by the department of standards, rules and regulations for the construction, maintenance and operation of hospitals;
(4) The enforcement by the department of the standards, rules, and regulations established under this chapter.
[ 1985 c 213 s 15; 1979 c 141 s 106; 1955 c 267 s 1.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Declaration of purpose.


title: RCW 70.41.020

text:
Unless the context clearly indicates otherwise, the following terms, whenever used in this chapter, shall be deemed to have the following meanings:
(1) "Aftercare" means the assistance provided by a lay caregiver to a patient under this chapter after the patient's discharge from a hospital. The assistance may include, but is not limited to, assistance with activities of daily living, wound care, medication assistance, and the operation of medical equipment. "Aftercare" includes assistance only for conditions that were present at the time of the patient's discharge from the hospital. "Aftercare" does not include:
(a) Assistance related to conditions for which the patient did not receive medical care, treatment, or observation in the hospital; or
(b) Tasks the performance of which requires licensure as a health care provider.
(2)(a) "Audio-only telemedicine" means the delivery of health care services through the use of audio-only technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment.
(b) "Audio-only telemedicine" does not include:
(i) The use of facsimile or email; or
(ii) The delivery of health care services that are customarily delivered by audio-only technology and customarily not billed as separate services by the provider, such as the sharing of laboratory results.
(3) "Department" means the Washington state department of health.
(4) "Discharge" means a patient's release from a hospital following the patient's admission to the hospital.
(5) "Distant site" means the site at which a physician or other licensed provider, delivering a professional service, is physically located at the time the service is provided through telemedicine.
(6) "Emergency care to victims of sexual assault" means medical examinations, procedures, and services provided by a hospital emergency room to a victim of sexual assault following an alleged sexual assault.
(7) "Emergency contraception" means any health care treatment approved by the food and drug administration that prevents pregnancy, including but not limited to administering two increased doses of certain oral contraceptive pills within seventy-two hours of sexual contact.
(8) "Emergency medical condition" means:
(a) A condition of such severity that the absence of immediate medical attention could result in: (i) Placing the health of an individual or, with respect to a pregnant person, the health of the pregnant person or their embryo or fetus in serious jeopardy; (ii) serious impairment to bodily functions; or (iii) serious dysfunction of a bodily organ or part;
(b) With respect to a pregnant person who is having contractions: (i) That there is inadequate time to affect a safe transfer to another hospital before delivery; or (ii) that transfer may pose a threat to the health or safety of the pregnant person or their embryo or fetus; or
(c) Any of the following conditions: Ectopic pregnancy; emergent complications resulting from pregnancy or of pregnancy loss; previable preterm premature rupture of membranes; emergent placental abnormalities; or emergent hypertensive disorders, such as preeclampsia.
(9) "Hospital" means any institution, place, building, or agency which provides accommodations, facilities and services over a continuous period of twenty-four hours or more, for observation, diagnosis, or care, of two or more individuals not related to the operator who are suffering from illness, injury, deformity, or abnormality, or from any other condition for which obstetrical, medical, or surgical services would be appropriate for care or diagnosis. "Hospital" as used in this chapter does not include hotels, or similar places furnishing only food and lodging, or simply domiciliary care; nor does it include clinics, or physician's offices where patients are not regularly kept as bed patients for twenty-four hours or more; nor does it include nursing homes, as defined and which come within the scope of chapter 18.51 RCW; nor does it include birthing centers, which come within the scope of chapter 18.46 RCW; nor does it include behavioral health hospitals, which come within the scope of chapter 71.12 RCW; nor any other hospital, or institution specifically intended for use in the diagnosis and care of those suffering from mental illness, intellectual disability, convulsive disorders, or other abnormal mental condition. Furthermore, nothing in this chapter or the rules adopted pursuant thereto shall be construed as authorizing the supervision, regulation, or control of the remedial care or treatment of residents or patients in any hospital conducted for those who rely primarily upon treatment by prayer or spiritual means in accordance with the creed or tenets of any well recognized church or religious denominations.
(10) "Immediate jeopardy" means a situation in which the hospital's noncompliance with one or more statutory or regulatory requirements has placed the health and safety of patients in its care at risk for serious injury, serious harm, serious impairment, or death.
(11) "Lay caregiver" means any individual designated as such by a patient under this chapter who provides aftercare assistance to a patient in the patient's residence. "Lay caregiver" does not include a long-term care worker as defined in RCW 74.39A.009.
(12) "Originating site" means the physical location of a patient receiving health care services through telemedicine.
(13) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.
(14) "Secretary" means the secretary of health.
(15) "Sexual assault" has the same meaning as in RCW 70.125.030.
(16) "Telemedicine" means the delivery of health care services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment. "Telemedicine" includes audio-only telemedicine, but does not include facsimile or email.
(17) "Victim of sexual assault" means a person who alleges or is alleged to have been sexually assaulted and who presents as a patient.
[ 2025 c 182 s 4. Prior: 2021 c 157 s 3; 2021 c 61 s 1; 2016 c 226 s 1; prior: 2015 c 23 s 5; 2010 c 94 s 17; 2002 c 116 s 2; 1991 c 3 s 334; 1985 c 213 s 16; 1971 ex.s. c 189 s 8; 1955 c 267 s 2.]
Notes:
Findings—Effective date—2025 c 182: See notes following RCW 70.41.570.
Conflict with federal requirements—2021 c 157: See note following RCW 74.09.327.
Intent—2015 c 23: See note following RCW 41.05.700.
Purpose—2010 c 94: See note following RCW 44.04.280.
Findings—2002 c 116: See note following RCW 70.41.350.
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Definitions.


title: RCW 70.41.030

text:
The department shall establish and adopt such minimum standards and rules pertaining to the construction, maintenance, and operation of hospitals, and rescind, amend, or modify such rules from time to time, as are necessary in the public interest, and particularly for the establishment and maintenance of standards of hospitalization required for the safe and adequate care and treatment of patients. To the extent possible, the department shall endeavor to make such minimum standards and rules consistent in format and general content with the applicable hospital survey standards of the joint commission on the accreditation of health care organizations. The department shall adopt standards that are at least equal to recognized applicable national standards pertaining to medical gas piping systems.
[ 1995 c 282 s 1; 1989 c 175 s 127; 1985 c 213 s 17; 1971 ex.s. c 189 s 9; 1955 c 267 s 3.]
Notes:
Effective date—1989 c 175: See note following RCW 34.05.010.
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Standards and rules.


title: RCW 70.41.040

text:
The enforcement of the provisions of this chapter and the standards, rules and regulations established under this chapter, shall be the responsibility of the department which shall cooperate with the joint commission on the accreditation of health care organizations. The department shall advise on the employment of personnel and the personnel shall be under the merit system or its successor.
[ 1995 c 282 s 3; 1985 c 213 s 18; 1955 c 267 s 4.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Enforcement of chapter—Personnel—Merit system.


title: RCW 70.41.045

text:
(1) Unless the context clearly requires otherwise, the definitions in this subsection apply throughout this section.
(a) "Agency" means a department of state government created under RCW 43.17.010 and the office of the state auditor.
(b) "Audit" means an examination of records or financial accounts to evaluate accuracy and monitor compliance with statutory or regulatory requirements.
(c) "Hospital" means a hospital licensed under chapter 70.41 RCW.
(d) "Survey" means an inspection, examination, or site visit conducted by an agency to evaluate and monitor the compliance of a hospital or hospital services or facilities with statutory or regulatory requirements.
(2) By July 1, 2004, each state agency which conducts hospital surveys or audits shall post to its agency website a list of the most frequent problems identified in its hospital surveys or audits along with information on how to avoid or address the identified problems, and a person within the agency that a hospital may contact with questions or for further assistance.
(3) By July 1, 2004, the department of health, in cooperation with other state agencies which conduct hospital surveys or audits, shall develop an instrument, to be provided to every hospital upon completion of a state survey or audit, which allows the hospital to anonymously evaluate the survey or audit process in terms of quality, efficacy, and the extent to which it supported improved patient care and compliance with state law without placing an unnecessary administrative burden on the hospital. The evaluation may be returned to the department of health for distribution to the appropriate agency.
(4) Except when responding to complaints or immediate public health and safety concerns or when such prior notice would conflict with other state or federal law, any state agency that provides notice of a hospital survey or audit must provide such notice to the hospital no less than four weeks prior to the date of the survey or audit.
[ 2016 c 197 s 7; 2004 c 261 s 2.]

catchline: Hospital surveys or audits—Frequent problems to be posted on agency websites—Hospital evaluation of survey or audit, form—Notice.


title: RCW 70.41.080

text:
Standards for fire protection and the enforcement thereof, with respect to all hospitals to be licensed hereunder shall be the responsibility of the chief of the Washington state patrol, through the director of fire protection, who shall adopt, after approval by the department, the recognized standards applicable to hospitals for the protection of life against the cause and spread of fire and fire hazards adopted by the federal centers for medicare and medicaid services for hospitals that care for medicare or medicaid beneficiaries. The standards used for an inspection of an existing hospital, or existing portion thereof, shall be standards for existing buildings and not standards for new construction. The department upon receipt of an application for a license, shall submit to the director of fire protection in writing, a request for an inspection, giving the applicant's name and the location of the premises to be licensed. Upon receipt of such a request, the chief of the Washington state patrol, through the director of fire protection, or his or her deputy, shall make an inspection of the hospital to be licensed during the department's inspection. If it is found that the premises do not comply with the required safety standards and fire regulations as adopted pursuant to this chapter, the director of fire protection, or his or her deputy, shall promptly make a written report to the department listing the corrective actions required. The department shall incorporate the written report into the department's final inspection report. The applicant or licensee shall submit corrections to comply with the fire protection standards along with any other licensing inspection corrections to the department. The department shall submit the section of the statement of corrections from the applicant or licensee regarding fire protection standards to the director of fire protection. If the hospital's noncompliance constitutes immediate jeopardy, as defined in RCW 70.41.020, or a condition-level violation, the director of fire protection, or his or her deputy, may reinspect the premises. Whenever the hospital to be licensed meets with the approval of the chief of the Washington state patrol, through the director of fire protection, he or she shall submit to the department, in a timely manner so the license will not be delayed, a written report approving the hospital with respect to fire protection, and such report is required before a full license can be issued. The chief of the Washington state patrol, through the director of fire protection, shall make or cause to be made inspections of such hospitals at least once every 18 months. Inspections conducted consistent with the requirements in RCW 70.41.122 shall be deemed equivalent to an inspection by the chief of the Washington state patrol, through the director of fire protection, for purposes of meeting the requirements for the inspections specified in this section, and shall be conducted every 36 months, as described in RCW 70.41.122(3).
The director of fire protection shall designate one lead deputy state fire marshal on a regional basis to provide consistency with each of the department's survey teams for the purpose of conducting the fire protection inspection during the department's licensing inspection. The director of fire protection shall ensure deputy state fire marshals are provided orientation with the department on the unique environment of hospitals before they conduct fire protection inspections in hospitals. The orientation shall include, but not be limited to: Clinical environment of hospitals; operating room environment; fire protection practices in hospitals; full participation in a complete licensing inspection of at least one urban hospital; and full participation in a complete licensing inspection of at least one rural hospital.
In cities which have in force a comprehensive building code, the provisions of which are determined by the chief of the Washington state patrol, through the director of fire protection, to be equal to the minimum standards of the code for hospitals adopted by the chief of the Washington state patrol, through the director of fire protection, the chief of the fire department, provided the latter is a paid chief of a paid fire department, shall make the inspection with the chief of the Washington state patrol, through the director of fire protection, or his or her deputy and they shall jointly approve the premises before a full license can be issued.
For the purposes of this section, "condition-level violation" means noncompliance that does not present an immediate jeopardy or threat to patient health or safety, but the deficient practice does limit the hospital's capacity to furnish safe and effective care that meets the needs of the patient and otherwise does not substantially meet the applicable licensing requirements.
[ 2026 c 35 s 3; 2008 c 155 s 1; 2004 c 261 s 3; 1995 c 369 s 40; 1986 c 266 s 94; 1985 c 213 s 19; 1955 c 267 s 8.]
Notes:
Effective date—1995 c 369: See note following RCW 43.43.930.
Severability—1986 c 266: See note following RCW 38.52.005.
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.
State fire protection: Chapter 43.44 RCW.

catchline: Fire protection.


title: RCW 70.41.090

text:
(1) No person or governmental unit of the state of Washington, acting separately or jointly with any other person or governmental unit, shall establish, maintain, or conduct a hospital in this state, or use the word "hospital" to describe or identify an institution, without a license under this chapter: PROVIDED, That the provisions of this section shall not apply to state mental institutions and *psychiatric hospitals which come within the scope of chapter 71.12 RCW.
(2) After June 30, 1989, no hospital shall initiate a tertiary health service as defined in **RCW 70.38.025(14) unless it has received a certificate of need as provided in RCW 70.38.105 and 70.38.115.
(3) A rural health care facility licensed under RCW 70.175.100 formerly licensed as a hospital under this chapter may, within three years of the effective date of the rural health care facility license, apply to the department for a hospital license and not be required to meet certificate of need requirements under chapter 70.38 RCW as a new health care facility and not be required to meet new construction requirements as a new hospital under this chapter. These exceptions are subject to the following: The facility at the time of initial conversion was considered by the department to be in compliance with the hospital licensing rules and the condition of the physical plant and equipment is equal to or exceeds the level of compliance that existed at the time of conversion to a rural health care facility. The department shall inspect and determine compliance with the hospital rules prior to reissuing a hospital license.
(4) A rural hospital, as defined by the department, reducing the number of licensed beds to become a rural primary care hospital under the provisions of Part A Title XVIII of the Social Security Act Section 1820, 42 U.S.C., 1395c et seq. may, within three years of the reduction of licensed beds, increase the number of beds licensed under this chapter to no more than the previously licensed number of beds without being subject to the provisions of chapter 70.38 RCW and without being required to meet new construction requirements under this chapter. These exceptions are subject to the following: The facility at the time of the reduction in licensed beds was considered by the department to be in compliance with the hospital licensing rules and the condition of the physical plant and equipment is equal to or exceeds the level of compliance that existed at the time of the reduction in licensed beds. The department may inspect and determine compliance with the hospital rules prior to increasing the hospital license.
(5) If a rural hospital is determined to no longer meet critical access hospital status for state law purposes as a result of participation in the Washington rural health access preservation pilot identified by the state office of rural health, the rural hospital may renew its license by applying to the department for a hospital license and the previously licensed number of beds without being subject to the provisions of chapter 70.38 RCW and without being required to meet new construction review requirements under this chapter. These exceptions are subject to the following: The hospital, at the time it began participation in the pilot, was considered by the department to be in compliance with the hospital licensing rules, and the condition of the physical plant and equipment is equal to or exceeds the level of compliance that existed at the time of the reduction in licensed beds. The department may inspect and determine compliance with the hospital licensing rules. If all or part of a formerly licensed rural hospital is sold, purchased, or leased during the period the rural hospital does not meet critical access hospital status as a result of participation in the Washington rural health access preservation pilot and the new owner or lessor applies to renew the rural hospital's license, then the sale, purchase, or lease of part or all of the rural hospital is subject to the provisions of chapter 70.38 RCW.
[ 2016 sp.s. c 31 s 3; 1992 c 27 s 3; 1989 1st ex.s. c 9 s 611; 1955 c 267 s 9.]
Notes:
Reviser's note: *(1) The term "psychiatric hospital" was changed to "behavioral health hospital" by 2024 c 121 s 19.
**(2) RCW 70.38.025 was alphabetized pursuant to RCW 1.08.015(2)(k), changing subsection (14) to subsection (15).
Finding—Intent—2016 sp.s. c 31: See note following RCW 74.09.5225.
Effective date—Severability—1989 1st ex.s. c 9: See RCW 43.70.910 and 43.70.920.

catchline: Hospital license required—Certificate of need required—Participation in Washington rural health access preservation pilot.


title: RCW 70.41.100

text:
An application for license shall be made to the department upon forms provided by it and shall contain such information as the department reasonably requires which may include affirmative evidence of ability to comply with the standards, rules, and regulations as are lawfully prescribed hereunder. An application for renewal of license shall be made to the department upon forms provided by it and submitted thirty days prior to the date of expiration of the license. Each application for a license or renewal thereof by a hospital as defined by this chapter shall be accompanied by a fee as established by the department under RCW 43.20B.110.
[ 1987 c 75 s 8; 1982 c 201 s 9; 1955 c 267 s 10.]
Notes:
Savings—1987 c 75: See RCW 43.20B.900.

catchline: Applications for licenses and renewals—Fees.


title: RCW 70.41.110

text:
Upon receipt of an application for license and the license fee, the department shall issue a license or a provisional license if the applicant and the hospital facilities meet the requirements of this chapter and the standards, rules and regulations established by the department. All licenses issued under the provisions of this chapter shall expire on a date to be set by the department: PROVIDED, That no license issued pursuant to this chapter shall exceed thirty-six months in duration. Each license shall be issued only for the premises and persons named in the application, and no license shall be transferable or assignable except with the written approval of the department. Licenses shall be posted in a conspicuous place on the licensed premises.
If there be a failure to comply with the provisions of this chapter or the standards, rules and regulations promulgated pursuant thereto, the department may in its discretion issue to an applicant for a license, or for the renewal of a license, a provisional license which will permit the operation of the hospital for a period to be determined by the department.
[ 1985 c 213 s 20; 1982 c 201 s 12; 1971 ex.s. c 247 s 3; 1955 c 267 s 11.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Licenses, provisional licenses—Issuance, duration, assignment, posting.


title: RCW 70.41.115

text:
(1) The definitions in this subsection apply throughout this section unless the context clearly requires otherwise.
(a) "Emergency services" means health care services medically necessary to evaluate and treat a medical condition that manifests itself by the acute onset of a symptom or symptoms, including severe pain, that would lead a prudent layperson acting reasonably to believe that a health condition exists that requires immediate medical attention, and that the absence of immediate medical attention could reasonably be expected to result in serious impairment to bodily functions or serious dysfunction of an organ or part of the body, or would place the person's health, or in the case of a pregnant woman, the health of the woman or her unborn child, in serious jeopardy.
(b) "General hospital" means a hospital that provides general acute care services, including emergency services.
(c) "Specialty hospital" means a subclass of hospital that is primarily or exclusively engaged in the care and treatment of one of the following categories: (i) Patients with a cardiac condition; (ii) patients with an orthopedic condition; (iii) patients receiving a surgical procedure; and (iv) any other specialized category of services that the secretary of health and human services designates as a specialty hospital.
(d) "Transfer agreement" means a written agreement providing an effective process for the transfer of a patient requiring emergency services to a general hospital providing emergency services and for continuity of care for that patient.
(e) "Health service area" has the same meaning as in RCW 70.38.025.
(2) To be licensed under this chapter, a specialty hospital shall:
(a) Be significantly engaged in providing inpatient care;
(b) Comply with all standards and rules adopted by the department for hospitals;
(c) Provide appropriate discharge planning;
(d) Provide staff proficient in resuscitation and respiration maintenance twenty-four hours per day, seven days per week;
(e) Participate in the medicare and medicaid programs and provide at least the same percentage of services to medicare and medicaid beneficiaries, as a percent of gross revenues, as the lowest percentage of services provided to medicare and medicaid beneficiaries by a general hospital in the same health service area. The lowest percentage of services provided to medicare and medicaid beneficiaries shall be determined by the department in consultation with the general hospitals in the health service area but shall not be the percentage of medicare and medicaid services of a hospital that serves primarily members of a particular health plan or government sponsor;
(f) Provide at least the same percentage of charity care, as a percent of gross revenues, as the lowest percentage of charity care provided by a general hospital in the same health service area. The lowest percentage of charity care shall be determined by the department in consultation with the general hospitals in the health service area but shall not be the percentage of charity care of a hospital that serves primarily members of a particular health plan or government sponsor;
(g) Require any physician owner to: (i) In accordance with chapter 19.68 RCW, disclose a financial interest in the specialty hospital and provide a list of alternative hospitals before referring a patient to the specialty hospital; and (ii) if the specialty hospital does not have an intensive care unit, notify the patient that if intensive care services are required, the patient will be transferred to another hospital;
(h) Provide emergency services twenty-four hours per day, seven days per week in a designated area of the hospital, and comply with requirements for emergency facilities that are established by the department;
(i) Establish procedures to stabilize a patient with an emergency medical condition until the patient is transported or transferred to another hospital if emergency services cannot be provided at the specialty hospital to meet the needs of the patient in an emergency, and maintain a transfer agreement with a general hospital in the same health service area that establishes a process for patient transfers in a situation in which the specialty hospital cannot provide continuing care for a patient because of the specialty hospital's scope of services and for the transfer of patients; and
(j) Accept the transfer of patients from general hospitals when the patients require the category of care or treatment provided by the specialty hospital.
(3) This section does not apply to:
(a) A specialty hospital that provides only psychiatric, pediatric, long-term acute care, cancer, or rehabilitative services; or
(b) A hospital that was licensed under this chapter before January 1, 2007.
[ 2007 c 102 s 2.]
Notes:
Finding—2007 c 102: "The legislature finds that specialty hospitals jeopardize the financial balance of community hospitals by selectively providing care to less ill patients, treating fewer medicare, medicaid, and uninsured patients, providing primarily care that is profitable to investors, and reducing community hospital staffing. To assure that private and public hospitals in Washington remain financially viable institutions able to provide general acute care in their communities and maintain the capacity to respond to local, state, and national emergencies, the legislature has concluded that specialty hospitals must meet certain conditions in order to be licensed. These conditions will ensure that specialty hospitals and community hospitals compete on a level playing field and, therefore, will minimize the adverse impacts of specialty hospitals on community general hospitals while assuring quality patient care." [ 2007 c 102 s 1.]


title: RCW 70.41.120

text:
(1) The department shall make or cause to be made an unannounced inspection of all hospitals at least every 18 months. Every inspection of a hospital may include an inspection of every part of the premises. The department may make an examination of all phases of the hospital operation necessary to determine compliance with the law and the standards, rules, and regulations adopted thereunder.
(2) The department shall not issue its final report regarding an unannounced inspection by the department until: (a) The hospital is given at least two weeks following the inspection to provide any information or documentation requested by the department during the unannounced inspection that was not available at the time of the request; and (b) at least one person from the department conducting the inspection meets personally with the chief administrator or executive officer of the hospital following the inspection or the chief administrator or executive officer declines such a meeting.
(3) Any licensee or applicant desiring to make alterations or additions to its facilities or to construct new facilities shall, before commencing such alteration, addition or new construction, comply with the regulations prescribed by the department.
(4) No hospital licensed pursuant to the provisions of this chapter shall be required to be inspected or licensed under other state laws or rules and regulations promulgated thereunder, or local ordinances, relative to hotels, restaurants, lodging houses, boarding houses, places of refreshment, nursing homes, maternity homes, or psychiatric hospitals.
(5) To avoid unnecessary duplication in inspections, the department shall coordinate with the department of social and health services, the office of the state fire marshal, and local agencies when inspecting facilities over which each agency has jurisdiction, the facilities including but not necessarily being limited to hospitals with both acute care and skilled nursing or psychiatric nursing functions. The department shall notify the office of the state fire marshal and the relevant local agency at least four weeks prior to any inspection conducted under this section and invite their attendance at the inspection, and shall provide a copy of its inspection report to each agency upon completion.
(6)(a) In the event of a federal, state, or local emergency, if the department determines that conducting an unannounced inspection is not in the best interest of public health, the department may temporarily pause inspections of an individual hospital or all hospitals until it determines it is appropriate to resume.
(b) The provisions of (a) of this subsection do not prohibit or limit the department's responsibility to investigate concerns related to patient well-being described in RCW 70.41.155.
[ 2026 c 35 s 1; 2009 c 242 s 1; 2005 c 447 s 1; 2004 c 261 s 4; 1995 c 282 s 4; 1985 c 213 s 21; 1955 c 267 s 12.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Inspection of hospitals—Final report—Alterations or additions, new facilities—Coordination with state and local agencies—Notice of inspection.


title: RCW 70.41.122

text:
Surveys conducted on hospitals by the department for the purpose of certification by the federal centers for medicare and medicaid services or a department recognized and approved accrediting body for the purpose of accreditation or certification by the federal centers for medicare and medicaid services may be deemed equivalent to a department survey if the department determines that the applicable survey standards are substantially equivalent to its own.
(1) Hospitals so surveyed shall provide to the department within 30 days of learning the result of a survey documentary evidence that the hospital has been certified as a result of a survey and the date of the survey.
(2) Hospitals shall make available to department surveyors the written reports of such surveys during department surveys, upon request.
(3) Hospitals that provide the department with documentary evidence as described in subsection (1) of this section may be exempt from the inspection frequency described in RCW 70.41.120(1), and instead will be inspected at least every 36 months.
(4)(a) In the event of a federal, state, or local emergency, if the department determines that conducting an unannounced inspection is not in the best interest of public health, the department may temporarily pause inspections of an individual hospital or all hospitals until it determines it is appropriate to resume.
(b) The provisions of (a) of this subsection do not prohibit or limit the department's responsibility to investigate concerns related to patient well-being described in RCW 70.41.155.
[ 2026 c 35 s 2; 2009 c 242 s 2; 2005 c 447 s 2; 1999 c 41 s 1; 1995 c 282 s 6.]

catchline: Exemption from RCW 70.41.120 for hospitals accredited by other entities.


title: RCW 70.41.125

text:
(1) The department shall coordinate its hospital construction review process with other state and local agencies having similar review responsibilities, including the department of labor and industries, the office of the state fire marshal, and local building and fire officials. Inconsistencies or conflicts among the agencies shall be identified and eliminated. The department shall provide local agencies with relevant information derived from its construction review process.
(2) By September 1, 2004, the department shall report to the legislature regarding its implementation of subsection (1) of this section.
[ 2004 c 261 s 5.]

catchline: Hospital construction review process—Coordination with state and local agencies.


title: RCW 70.41.130

text:
(1) The department is authorized to take any of the actions identified in this section against a hospital's license or provisional license in any case in which it finds that there has been a failure or refusal to comply with the requirements of this chapter or the standards or rules adopted under this chapter or the requirements of RCW 71.34.375 on the basis of findings by the department of labor and industries under RCW 70.41.425(6)(b).
(a) When the department determines the hospital has previously been subject to an enforcement action for the same or similar type of violation of the same statute or rule, or has been given any previous statement of deficiency that included the same or similar type of violation of the same or similar statute or rule, or when the hospital failed to correct noncompliance with a statute or rule by a date established or agreed to by the department, the department may impose reasonable conditions on a license. Conditions may include correction within a specified amount of time, training, or hiring a department-approved consultant if the hospital cannot demonstrate to the department that it has access to sufficient internal expertise. If the department determines that the violations constitute immediate jeopardy, the conditions may be imposed immediately in accordance with subsection (3) of this section.
(b)(i) In accordance with the authority the department has under RCW 43.70.095, the department may assess a civil fine of up to $10,000 per violation, not to exceed a total fine of $1,000,000, on a hospital licensed under this chapter when the department determines the hospital has previously been subject to an enforcement action for the same or similar type of violation of the same statute or rule, or has been given any previous statement of deficiency that included the same or similar type of violation of the same or similar statute or rule, or when the hospital failed to correct noncompliance with a statute or rule by a date established or agreed to by the department.
(ii) Proceeds from these fines may only be used by the department to offset costs associated with licensing hospitals.
(iii) The department shall adopt in rules under this chapter specific fine amounts in relation to:
(A) The severity of the noncompliance and at an adequate level to be a deterrent to future noncompliance; and
(B) The number of licensed beds and the operation size of the hospital. The licensed hospital beds will be categorized as:
(I) Up to 25 beds;
(II) 26 to 99 beds;
(III) 100 to 299 beds; and
(IV) 300 beds or greater.
(iv) If a licensee is aggrieved by the department's action of assessing civil fines, the licensee has the right to appeal under RCW 43.70.095.
(c) The department may suspend a specific category or categories of services or care or recovery units within the hospital as related to the violation by imposing a limited stop service. This may only be done if the department finds that noncompliance results in immediate jeopardy.
(i) Prior to imposing a limited stop service, the department shall provide a hospital written notification upon identifying deficient practices or conditions that constitute an immediate jeopardy, and upon the review and approval of the notification by the secretary or the secretary's designee. The hospital shall have 24 hours from notification to develop and implement a department-approved plan to correct the deficient practices or conditions that constitute an immediate jeopardy. If the deficient practice or conditions that constitute immediate jeopardy are not verified by the department as having been corrected within the same 24 hour period, the department may issue the limited stop service.
(ii) When the department imposes a limited stop service, the hospital may not admit any new patients to the units in the category or categories subject to the limited stop service until the limited stop service order is terminated.
(iii) The department shall conduct a follow-up inspection within five business days or within the time period requested by the hospital if more than five business days is needed to verify the violation necessitating the limited stop service has been corrected.
(iv) The limited stop service shall be terminated when:
(A) The department verifies the violation necessitating the limited stop service has been corrected or the department determines that the hospital has taken intermediate action to address the immediate jeopardy; and
(B) The hospital establishes the ability to maintain correction of the violation previously found deficient.
(d) The department may suspend new admissions to the hospital by imposing a stop placement. This may only be done if the department finds that noncompliance results in immediate jeopardy and is not confined to a specific category or categories of patients or a specific area of the hospital.
(i) Prior to imposing a stop placement, the department shall provide a hospital written notification upon identifying deficient practices or conditions that constitute an immediate jeopardy, and upon the review and approval of the notification by the secretary or the secretary's designee. The hospital shall have 24 hours from notification to develop and implement a department-approved plan to correct the deficient practices or conditions that constitute an immediate jeopardy. If the deficient practice or conditions that constitute immediate jeopardy are not verified by the department as having been corrected within the same 24 hour period, the department may issue the stop placement.
(ii) When the department imposes a stop placement, the hospital may not admit any new patients until the stop placement order is terminated.
(iii) The department shall conduct a follow-up inspection within five business days or within the time period requested by the hospital if more than five business days is needed to verify the violation necessitating the stop placement has been corrected.
(iv) The stop placement order shall be terminated when:
(A) The department verifies the violation necessitating the stop placement has been corrected or the department determines that the hospital has taken intermediate action to address the immediate jeopardy; and
(B) The hospital establishes the ability to maintain correction of the violation previously found deficient.
(e) The department may deny an application for a license or suspend, revoke, or refuse to renew a license.
(2) The department shall adopt in rules under this chapter a fee methodology that includes funding expenditures to implement subsection (1) of this section. The fee methodology must consider:
(a) The operational size of the hospital; and
(b) The number of licensed beds of the hospital.
(3)(a) Except as otherwise provided, RCW 43.70.115 governs notice of actions taken by the department under subsection (1) of this section and provides the right to an adjudicative proceeding. Adjudicative proceedings and hearings under this section are governed by the administrative procedure act, chapter 34.05 RCW. The application for an adjudicative proceeding must be in writing, state the basis for contesting the adverse action, including a copy of the department's notice, be served on and received by the department within 28 days of the licensee's receipt of the adverse notice, and be served in a manner that shows proof of receipt.
(b) When the department determines a licensee's noncompliance results in immediate jeopardy, the department may make the imposition of conditions on a licensee, a limited stop placement, stop placement, or the suspension of a license effective immediately upon receipt of the notice by the licensee, pending any adjudicative proceeding.
(i) When the department makes the suspension of a license or imposition of conditions on a license effective immediately, a licensee is entitled to a show cause hearing before a presiding officer within 14 days of making the request. The licensee must request the show cause hearing within 28 days of receipt of the notice of immediate suspension or immediate imposition of conditions. At the show cause hearing the department has the burden of demonstrating that more probably than not there is an immediate jeopardy.
(ii) At the show cause hearing, the presiding officer may consider the notice and documents supporting the immediate suspension or immediate imposition of conditions and the licensee's response and must provide the parties with an opportunity to provide documentary evidence and written testimony, and to be represented by counsel. Prior to the show cause hearing, the department must provide the licensee with all documentation that supports the department's immediate suspension or imposition of conditions.
(iii) If the presiding officer determines there is no immediate jeopardy, the presiding officer may overturn the immediate suspension or immediate imposition of conditions.
(iv) If the presiding officer determines there is immediate jeopardy, the immediate suspension or immediate imposition of conditions shall remain in effect pending a full hearing.
(v) If the presiding officer sustains the immediate suspension or immediate imposition of conditions, the licensee may request an expedited full hearing on the merits of the department's action. A full hearing must be provided within 90 days of the licensee's request.
[ 2023 c 114 s 7; 2021 c 61 s 2; 2011 c 302 s 3; 1991 c 3 s 335; 1989 c 175 s 128; 1985 c 213 s 22; 1955 c 267 s 13.]
Notes:
Effective date—2023 c 114: See note following RCW 70.41.410.
Effective date—1989 c 175: See note following RCW 34.05.010.
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Administrative actions against license—Rules—Procedure.


title: RCW 70.41.150

text:
Information received by the department through filed reports, inspection, or as otherwise authorized under this chapter, may be disclosed publicly, as permitted under chapter 42.56 RCW, subject to the following provisions:
(1) Licensing inspections, or complaint investigations regardless of findings, shall, as requested, be disclosed no sooner than three business days after the hospital has received the resulting assessment report;
(2) Information regarding administrative action against the license shall, as requested, be disclosed after the hospital has received the documents initiating the administrative action;
(3) Information about complaints that did not warrant an investigation shall not be disclosed except to notify the hospital and the complainant that the complaint did not warrant an investigation. If requested, the individual complainant shall receive information on other like complaints that have been reported against the hospital; and
(4) Information disclosed pursuant to this section shall not disclose individual names.
[ 2005 c 274 s 333; 2000 c 6 s 1; 1985 c 213 s 24; 1955 c 267 s 15.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Denial, suspension, revocation of license—Disclosure of information.


title: RCW 70.41.155

text:
Any complaint against a hospital and event notification required by the department that concerns patient well-being shall be investigated.
[ 2000 c 6 s 2.]

catchline: Duty to investigate patient well-being.


title: RCW 70.41.160

text:
Notwithstanding the existence or pursuit of any other remedy, the department may, in the manner provided by law, upon the advice of the attorney general who shall represent the department in the proceedings, maintain an action in the name of the state for an injunction or other process against any person or governmental unit to restrain or prevent the establishment, conduct, or operation of a hospital without a license under this law.
[ 1985 c 213 s 25; 1955 c 267 s 16.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Remedies available to department—Duty of attorney general.


title: RCW 70.41.170

text:
Any person operating or maintaining a hospital without a license under this chapter, or, after June 30, 1989, initiating a tertiary health service as defined in *RCW 70.38.025(14) that is not approved under RCW 70.38.105 and 70.38.115, shall be guilty of a misdemeanor, and each day of operation of an unlicensed hospital or unapproved tertiary health service, shall constitute a separate offense.
[ 1989 1st ex.s. c 9 s 612; 1955 c 267 s 17.]
Notes:
*Reviser's note: RCW 70.38.025 was alphabetized pursuant to RCW 1.08.015(2)(k), changing subsection (14) to subsection (15).
Effective date—Severability—1989 1st ex.s. c 9: See RCW 43.70.910 and 43.70.920.

catchline: Operating or maintaining unlicensed hospital or unapproved tertiary health service—Penalty.


title: RCW 70.41.180

text:
Nothing contained in this chapter shall in any way authorize the department to establish standards, rules and regulations governing the professional services rendered by any physician.
[ 1985 c 213 s 26; 1955 c 267 s 18.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.

catchline: Physicians' services.


title: RCW 70.41.190

text:
(1) A hospital shall retain and preserve all medical records for a minimum period of 26 years from the date the record was created. A hospital may retain medical records on paper, microfilm, electronically, or on other media.
(a) This subsection applies to:
(i) Medical records created prior to July 27, 2025, and retained or preserved by the hospital on July 27, 2025; and
(ii) Medical records created on or after July 27, 2025.
(b) This subsection does not apply to medical records no longer retained and preserved by the hospital on July 27, 2025, if the hospital complied with this section as it existed prior to July 27, 2025, when it destroyed or otherwise disposed of the records.
(c) This subsection does not exempt hospitals from compliance with any other record retention requirements.
(2) All information collected at each unique visit is considered a medical record for the purposes of this section.
(3) If a hospital ceases operations, it shall make immediate arrangements, as approved by the department, for preservation of its records.
(4) The department shall by regulation define the type of records and the information required to be included in the medical records to be retained and preserved under this section; which records may be retained in photographic form pursuant to chapter 5.46 RCW.
[ 2025 c 131 s 1; 1985 c 213 s 27; 1975 1st ex.s. c 175 s 1.]
Notes:
Savings—Effective date—1985 c 213: See notes following RCW 43.20.050.
Medical records, disclosure: Chapter 70.02 RCW.

catchline: Medical records of patients—Retention and preservation.


title: RCW 70.41.200

text:
(1) Every hospital shall maintain a coordinated quality improvement program for the improvement of the quality of health care services rendered to patients and the identification and prevention of medical malpractice. The program shall include at least the following:
(a) The establishment of one or more quality improvement committees with the responsibility to review the services rendered in the hospital, both retrospectively and prospectively, in order to improve the quality of medical care of patients and to prevent medical malpractice. Different quality improvement committees may be established as a part of a quality improvement program to review different health care services. Such committees shall oversee and coordinate the quality improvement and medical malpractice prevention program and shall ensure that information gathered pursuant to the program is used to review and to revise hospital policies and procedures;
(b) A process, including a medical staff privileges sanction procedure which must be conducted substantially in accordance with medical staff bylaws and applicable rules, regulations, or policies of the medical staff through which credentials, physical and mental capacity, professional conduct, and competence in delivering health care services are periodically reviewed as part of an evaluation of staff privileges;
(c) A process for the periodic review of the credentials, physical and mental capacity, professional conduct, and competence in delivering health care services of all other health care providers who are employed or associated with the hospital;
(d) A procedure for the prompt resolution of grievances by patients or their representatives related to accidents, injuries, treatment, and other events that may result in claims of medical malpractice;
(e) The maintenance and continuous collection of information concerning the hospital's experience with negative health care outcomes and incidents injurious to patients including health care-associated infections as defined in RCW 43.70.056, patient grievances, professional liability premiums, settlements, awards, costs incurred by the hospital for patient injury prevention, and safety improvement activities;
(f) The maintenance of relevant and appropriate information gathered pursuant to (a) through (e) of this subsection concerning individual physicians within the physician's personnel or credential file maintained by the hospital;
(g) Education programs dealing with quality improvement, patient safety, medication errors, injury prevention, infection control, staff responsibility to report professional misconduct, the legal aspects of patient care, improved communication with patients, and causes of malpractice claims for staff personnel engaged in patient care activities; and
(h) Policies to ensure compliance with the reporting requirements of this section.
(2) Any person who, in substantial good faith, provides information to further the purposes of the quality improvement and medical malpractice prevention program or who, in substantial good faith, participates on the quality improvement committee shall not be subject to an action for civil damages or other relief as a result of such activity. Any person or entity participating in a coordinated quality improvement program that, in substantial good faith, shares information or documents with one or more other programs, committees, or boards under subsection (8) of this section is not subject to an action for civil damages or other relief as a result of the activity. For the purposes of this section, sharing information is presumed to be in substantial good faith. However, the presumption may be rebutted upon a showing of clear, cogent, and convincing evidence that the information shared was knowingly false or deliberately misleading.
(3) Information and documents, including complaints and incident reports, created specifically for, and collected and maintained by, a quality improvement committee are not subject to review or disclosure, except as provided in this section, or discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or who participated in the creation, collection, or maintenance of information or documents specifically for the committee shall be permitted or required to testify in any civil action as to the content of such proceedings or the documents and information prepared specifically for the committee. This subsection does not preclude: (a) In any civil action, the discovery of the identity of persons involved in the medical care that is the basis of the civil action whose involvement was independent of any quality improvement activity; (b) in any civil action, the testimony of any person concerning the facts which form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (c) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality improvement committees regarding such health care provider; (d) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any and the reasons for the restrictions; or (e) in any civil action, discovery and introduction into evidence of the patient's medical records required by regulation of the department of health to be made regarding the care and treatment received.
(4) Each quality improvement committee shall, on at least a semiannual basis, report to the governing board of the hospital in which the committee is located. The report shall review the quality improvement activities conducted by the committee, and any actions taken as a result of those activities.
(5) The department of health shall adopt such rules as are deemed appropriate to effectuate the purposes of this section.
(6) The Washington medical commission or the board of osteopathic medicine and surgery, as appropriate, may review and audit the records of committee decisions in which a physician's privileges are terminated or restricted. Each hospital shall produce and make accessible to the commission or board the appropriate records and otherwise facilitate the review and audit. Information so gained shall not be subject to the discovery process and confidentiality shall be respected as required by subsection (3) of this section. Failure of a hospital to comply with this subsection is punishable by a civil penalty not to exceed two hundred fifty dollars.
(7) The department, the joint commission on accreditation of health care organizations, and any other accrediting organization may review and audit the records of a quality improvement committee or peer review committee in connection with their inspection and review of hospitals. Information so obtained shall not be subject to the discovery process, and confidentiality shall be respected as required by subsection (3) of this section. Each hospital shall produce and make accessible to the department the appropriate records and otherwise facilitate the review and audit.
(8) A coordinated quality improvement program may share information and documents, including complaints and incident reports, created specifically for, and collected and maintained by, a quality improvement committee or a peer review committee under RCW 4.24.250 with one or more other coordinated quality improvement programs maintained in accordance with this section or RCW 43.70.510, a coordinated quality improvement committee maintained by an ambulatory surgical facility under RCW 70.230.070, a quality assurance committee maintained in accordance with RCW 18.20.390 or 74.42.640, or a peer review committee under RCW 4.24.250, for the improvement of the quality of health care services rendered to patients and the identification and prevention of medical malpractice. The privacy protections of chapter 70.02 RCW and the federal health insurance portability and accountability act of 1996 and its implementing regulations apply to the sharing of individually identifiable patient information held by a coordinated quality improvement program. Any rules necessary to implement this section shall meet the requirements of applicable federal and state privacy laws. Information and documents disclosed by one coordinated quality improvement program to another coordinated quality improvement program or a peer review committee under RCW 4.24.250 and any information and documents created or maintained as a result of the sharing of information and documents shall not be subject to the discovery process and confidentiality shall be respected as required by subsection (3) of this section, RCW 18.20.390 (6) and (8), 74.42.640 (7) and (9), and 4.24.250.
(9) A hospital that operates a nursing home as defined in RCW 18.51.010 may conduct quality improvement activities for both the hospital and the nursing home through a quality improvement committee under this section, and such activities shall be subject to the provisions of subsections (2) through (8) of this section.
(10) Violation of this section shall not be considered negligence per se.
[ 2019 c 55 s 14; 2013 c 301 s 2. Prior: 2007 c 273 s 22; 2007 c 261 s 3; prior: 2005 c 291 s 3; 2005 c 33 s 7; 2004 c 145 s 3; 2000 c 6 s 3; 1994 sp.s. c 9 s 742; 1993 c 492 s 415; 1991 c 3 s 336; 1987 c 269 s 5; 1986 c 300 s 4.]
Notes:
Effective date—Implementation—2007 c 273: See RCW 70.230.900 and 70.230.901.
Finding—2007 c 261: See note following RCW 43.70.056.
Findings—2005 c 33: See note following RCW 18.20.390.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
Legislative findings—Severability—1986 c 300: See notes following RCW 18.57.245.
Board of osteopathic medicine and surgery: Chapter 18.57 RCW.
Washington medical commission: Chapter 18.71 RCW.

catchline: Quality improvement and medical malpractice prevention program—Quality improvement committee—Sanction and grievance procedures—Information collection, reporting, and sharing.


title: RCW 70.41.205

text:
(1) All meetings, proceedings, and deliberations of the governing body, its staff or agents, concerning the granting, denial, revocation, restriction, or other consideration of the status of the clinical or staff privileges of a physician or other health care provider as defined in RCW 7.70.020, if such other providers at the discretion of the governing body are considered for such privileges, must be confidential and may be conducted in executive session; however, the final action of the governing body as to the denial, revocation, or restriction of clinical or staff privileges of a physician or other health care provider as defined in RCW 7.70.020 must be done in public session.
(2) All meetings, proceedings, and deliberations of a quality improvement committee established under RCW 4.24.250, 43.70.510, or 70.41.200 and all meetings, proceedings, and deliberations of the governing body, its staff or agents, to review the report or the activities of a quality improvement committee established under RCW 4.24.250, 43.70.510, or 70.41.200 may, at the discretion of the quality improvement committee or the governing body, be confidential and may be conducted in executive session. Any review conducted by the governing body or quality improvement committee, or their staff or agents, must be subject to the same protections, limitations, and exemptions that apply to quality improvement committee activities under RCW 4.24.240, 4.24.250, 43.70.510, and 70.41.200. However, any final action of the governing body on the report of the quality improvement committee must be done in public session.
(3) For the purposes of this section:
(a) "Governing body" means the board or committee of a public hospital with authority to make final decisions concerning the granting, denial, revocation, restriction, or other consideration of the clinical or staff privileges of a physician or other health care provider, as defined in RCW 7.70.020; and
(b) "Public hospital" means any hospital owned or operated by the state or any of its subdivisions, including the University of Washington.
[ 2019 c 162 s 1.]

catchline: Public hospitals—Review of hospital privileges and quality improvement committee reports—Confidentiality.


title: RCW 70.41.210

text:
(1) The chief administrator or executive officer of a hospital shall report to the department when the practice of a health care practitioner as defined in subsection (2) of this section is restricted, suspended, limited, or terminated based upon a conviction, determination, or finding by the hospital that the health care practitioner has committed an action defined as unprofessional conduct under RCW 18.130.180. The chief administrator or executive officer shall also report any voluntary restriction or termination of the practice of a health care practitioner as defined in subsection (2) of this section while the practitioner is under investigation or the subject of a proceeding by the hospital regarding unprofessional conduct, or in return for the hospital not conducting such an investigation or proceeding or not taking action. The department will forward the report to the appropriate disciplining authority.
(2) The reporting requirements apply to the following health care practitioners: Pharmacists as defined in chapter 18.64 RCW; *advanced registered nurse practitioners as defined in chapter 18.79 RCW; dentists as defined in chapter 18.32 RCW; naturopaths as defined in chapter 18.36A RCW; optometrists as defined in chapter 18.53 RCW; osteopathic physicians and surgeons as defined in chapter 18.57 RCW; physicians as defined in chapter 18.71 RCW; physician assistants as defined in chapter 18.71A RCW; podiatric physicians and surgeons as defined in chapter 18.22 RCW; and psychologists as defined in chapter 18.83 RCW.
(3) Reports made under subsection (1) of this section shall be made within fifteen days of the date: (a) A conviction, determination, or finding is made by the hospital that the health care practitioner has committed an action defined as unprofessional conduct under RCW 18.130.180; or (b) the voluntary restriction or termination of the practice of a health care practitioner, including his or her voluntary resignation, while under investigation or the subject of proceedings regarding unprofessional conduct under RCW 18.130.180 is accepted by the hospital.
(4) Failure of a hospital to comply with this section is punishable by a civil penalty not to exceed five hundred dollars.
(5) A hospital, its chief administrator, or its executive officer who files a report under this section is immune from suit, whether direct or derivative, in any civil action related to the filing or contents of the report, unless the conviction, determination, or finding on which the report and its content are based is proven to not have been made in good faith. The prevailing party in any action brought alleging the conviction, determination, finding, or report was not made in good faith, shall be entitled to recover the costs of litigation, including reasonable attorneys' fees.
(6) The department shall forward reports made under subsection (1) of this section to the appropriate disciplining authority designated under Title 18 RCW within fifteen days of the date the report is received by the department. The department shall notify a hospital that has made a report under subsection (1) of this section of the results of the disciplining authority's case disposition decision within fifteen days after the case disposition. Case disposition is the decision whether to issue a statement of charges, take informal action, or close the complaint without action against a practitioner. In its biennial report to the legislature under RCW 18.130.310, the department shall specifically identify the case dispositions of reports made by hospitals under subsection (1) of this section.
(7) The department shall not increase hospital license fees to carry out this section before July 1, 2008.
[ 2020 c 80 s 45; 2008 c 134 s 14; 2005 c 470 s 1; 1994 sp.s. c 9 s 743; 1986 c 300 s 7.]
Notes:
*Reviser's note: The term "advanced registered nurse practitioner" was changed to "advanced practice registered nurse" by 2024 c 239 s 1, effective June 30, 2027.
Effective date—2020 c 80 ss 12-59: See note following RCW 7.68.030.
Intent—2020 c 80: See note following RCW 18.71A.010.
Finding—Intent—Severability—2008 c 134: See notes following RCW 18.130.020.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Legislative findings—Severability—1986 c 300: See notes following RCW 18.57.245.
Medical commission: Chapter 18.71 RCW.

catchline: Duty to report restrictions on health care practitioners' privileges based on unprofessional conduct—Penalty.


title: RCW 70.41.220

text:
Each hospital shall keep written records of decisions to restrict or terminate privileges of practitioners. Copies of such records shall be made available to the board within thirty days of a request and all information so gained shall remain confidential in accordance with RCW 70.41.200 and 70.41.230 and shall be protected from the discovery process. Failure of a hospital to comply with this section is punishable by [a] civil penalty not to exceed two hundred fifty dollars.
[ 1986 c 300 s 8.]
Notes:
Legislative findings—Severability—1986 c 300: See notes following RCW 18.57.245.

catchline: Duty to keep records of restrictions on practitioners' privileges—Penalty.


title: RCW 70.41.230

text:
(1) Except as provided in subsection (3) of this section, prior to granting or renewing clinical privileges or association of any physician, physician assistant, or *advanced registered nurse practitioner or hiring a physician, physician assistant, or *advanced registered nurse practitioner who will provide clinical care under his or her license, a hospital or facility approved pursuant to this chapter shall request from the physician, physician assistant, or *advanced registered nurse practitioner and the physician, physician assistant, or *advanced registered nurse practitioner shall provide the following information:
(a) The name of any hospital or facility with or at which the physician, physician assistant, or *advanced registered nurse practitioner had or has any association, employment, privileges, or practice during the prior five years: PROVIDED, That the hospital may request additional information going back further than five years, and the physician, physician assistant, or *advanced registered nurse practitioner shall use his or her best efforts to comply with such a request for additional information;
(b) Whether the physician, physician assistant, or *advanced registered nurse practitioner has ever been or is in the process of being denied, revoked, terminated, suspended, restricted, reduced, limited, sanctioned, placed on probation, monitored, or not renewed for any professional activity listed in (b)(i) through (x) of this subsection, or has ever voluntarily or involuntarily relinquished, withdrawn, or failed to proceed with an application for any professional activity listed in (b)(i) through (x) of this subsection in order to avoid an adverse action or to preclude an investigation or while under investigation relating to professional competence or conduct:
(i) License to practice any profession in any jurisdiction;
(ii) Other professional registration or certification in any jurisdiction;
(iii) Specialty or subspecialty board certification;
(iv) Membership on any hospital medical staff;
(v) Clinical privileges at any facility, including hospitals, ambulatory surgical centers, or skilled nursing facilities;
(vi) Medicare, medicaid, the food and drug administration, the national institutes of health (office of human research protection), governmental, national, or international regulatory agency, or any public program;
(vii) Professional society membership or fellowship;
(viii) Participation or membership in a health maintenance organization, preferred provider organization, independent practice association, physician-hospital organization, or other entity;
(ix) Academic appointment;
(x) Authority to prescribe controlled substances (drug enforcement agency or other authority);
(c) Any pending professional medical misconduct proceedings or any pending medical malpractice actions in this state or another state, the substance of the allegations in the proceedings or actions, and any additional information concerning the proceedings or actions as the physician, physician assistant, or *advanced registered nurse practitioner deems appropriate;
(d) The substance of the findings in the actions or proceedings and any additional information concerning the actions or proceedings as the physician, physician assistant, or *advanced registered nurse practitioner deems appropriate;
(e) A waiver by the physician, physician assistant, or *advanced registered nurse practitioner of any confidentiality provisions concerning the information required to be provided to hospitals pursuant to this subsection; and
(f) A verification by the physician, physician assistant, or *advanced registered nurse practitioner that the information provided by the physician, physician assistant, or *advanced registered nurse practitioner is accurate and complete.
(2) Except as provided in subsection (3) of this section, prior to granting privileges or association to any physician, physician assistant, or *advanced registered nurse practitioner or hiring a physician, physician assistant, or *advanced registered nurse practitioner who will provide clinical care under his or her license, a hospital or facility approved pursuant to this chapter shall request from any hospital with or at which the physician, physician assistant, or *advanced registered nurse practitioner had or has privileges, was associated, or was employed, during the preceding five years, the following information concerning the physician, physician assistant, or *advanced registered nurse practitioner:
(a) Any pending professional medical misconduct proceedings or any pending medical malpractice actions, in this state or another state;
(b) Any judgment or settlement of a medical malpractice action and any finding of professional misconduct in this state or another state by a licensing or disciplinary board; and
(c) Any information required to be reported by hospitals pursuant to RCW 18.71.0195.
(3) In lieu of the requirements of subsections (1) and (2) of this section, when granting or renewing credentials and privileges or association of any physician, physician assistant, or *advanced registered nurse practitioner providing telemedicine or store and forward services, an originating site hospital may rely on a distant site hospital's decision to grant or renew credentials and clinical privileges or association of the physician, physician assistant, or *advanced registered nurse practitioner if the originating site hospital obtains reasonable assurances, through a written agreement with the distant site hospital, that all of the following provisions are met:
(a) The distant site hospital providing the telemedicine or store and forward services is a medicare participating hospital;
(b) Any physician, physician assistant, or *advanced registered nurse practitioner providing telemedicine or store and forward services at the distant site hospital will be fully credentialed and privileged to provide such services by the distant site hospital;
(c) Any physician, physician assistant, or *advanced registered nurse practitioner providing telemedicine or store and forward services will hold and maintain a valid license to perform such services issued or recognized by the state of Washington; and
(d) With respect to any distant site physician, physician assistant, or *advanced registered nurse practitioner who holds current credentials and privileges at the originating site hospital whose patients are receiving the telemedicine or store and forward services, the originating site hospital has evidence of an internal review of the distant site physician's, physician assistant's, or *advanced registered nurse practitioner's performance of these credentials and privileges and sends the distant site hospital such performance information for use in the periodic appraisal of the distant site physician, physician assistant, or *advanced registered nurse practitioner. At a minimum, this information must include all adverse events, as defined in RCW 70.56.010, that result from the telemedicine or store and forward services provided by the distant site physician, physician assistant, or *advanced registered nurse practitioner to the originating site hospital's patients and all complaints the originating site hospital has received about the distant site physician, physician assistant, or *advanced registered nurse practitioner.
(4)(a) The Washington medical commission or the board of osteopathic medicine and surgery shall be advised within thirty days of the name of any physician or physician assistant denied staff privileges, association, or employment on the basis of adverse findings under subsection (1) of this section.
(b) The state board of nursing shall be advised within thirty days of the name of any *advanced registered nurse practitioner denied staff privileges, association, or employment on the basis of adverse findings under subsection (1) of this section.
(5) A hospital or facility that receives a request for information from another hospital or facility pursuant to subsections (1) through (3) of this section shall provide such information concerning the physician, physician assistant, or *advanced registered nurse practitioner in question to the extent such information is known to the hospital or facility receiving such a request, including the reasons for suspension, termination, or curtailment of employment or privileges at the hospital or facility. A hospital, facility, or other person providing such information in good faith is not liable in any civil action for the release of such information.
(6) Information and documents, including complaints and incident reports, created specifically for, and collected, and maintained by a quality improvement committee are not subject to discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or who participated in the creation, collection, or maintenance of information or documents specifically for the committee shall be permitted or required to testify in any civil action as to the content of such proceedings or the documents and information prepared specifically for the committee. This subsection does not preclude: (a) In any civil action, the discovery of the identity of persons involved in the medical care that is the basis of the civil action whose involvement was independent of any quality improvement activity; (b) in any civil action, the testimony of any person concerning the facts which form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (c) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality improvement committees regarding such health care provider; (d) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any and the reasons for the restrictions; or (e) in any civil action, discovery and introduction into evidence of the patient's medical records required by regulation of the department of health to be made regarding the care and treatment received.
(7) Hospitals shall be granted access to information held by the Washington medical commission, the board of osteopathic medicine and surgery, and the state board of nursing pertinent to decisions of the hospital regarding credentialing and recredentialing of practitioners.
(8) Violation of this section shall not be considered negligence per se.
[ 2025 c 58 s 5055. Prior: 2019 c 104 s 1; 2019 c 55 s 15; 2019 c 49 s 1; 2016 c 68 s 6; 2015 c 23 s 6; 2013 c 301 s 3; 1994 sp.s. c 9 s 744; 1993 c 492 s 416; 1991 c 3 s 337; 1987 c 269 s 6; 1986 c 300 s 11.]
Notes:
*Reviser's note: The term "advanced registered nurse practitioner" was changed to "advanced practice registered nurse" by 2024 c 239 s 1, effective June 30, 2027.
Expiration date—2025 c 58 ss 5004, 5005, 5006, 5010, 5012, 5013, 5014, 5016, 5017, 5018, 5019, 5020, 5024, 5029, 5030, 5043, 5044, 5045, 5047, 5048, 5049, 5051, 5052, 5053, and 5055: See note following RCW 18.79.040.
Explanatory note—2025 c 58: See note following RCW 1.16.050.
Intent—2016 c 68: See note following RCW 48.43.735.
Intent—2015 c 23: See note following RCW 41.05.700.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
Legislative findings—Severability—1986 c 300: See notes following RCW 18.57.245.
Washington medical commission: Chapter 18.71 RCW.
PDF
RCW 70.41.230
Duty of hospital to request information on physicians, physician assistants, or advanced practice registered nurses granted privileges. (Effective June 30, 2027.)
(1) Except as provided in subsection (3) of this section, prior to granting or renewing clinical privileges or association of any physician, physician assistant, or advanced practice registered nurse or hiring a physician, physician assistant, or advanced practice registered nurse who will provide clinical care under his or her license, a hospital or facility approved pursuant to this chapter shall request from the physician, physician assistant, or advanced practice registered nurse and the physician, physician assistant, or advanced practice registered nurse shall provide the following information:
(a) The name of any hospital or facility with or at which the physician, physician assistant, or advanced practice registered nurse had or has any association, employment, privileges, or practice during the prior five years: PROVIDED, That the hospital may request additional information going back further than five years, and the physician, physician assistant, or advanced practice registered nurse shall use his or her best efforts to comply with such a request for additional information;
(b) Whether the physician, physician assistant, or advanced practice registered nurse has ever been or is in the process of being denied, revoked, terminated, suspended, restricted, reduced, limited, sanctioned, placed on probation, monitored, or not renewed for any professional activity listed in (b)(i) through (x) of this subsection, or has ever voluntarily or involuntarily relinquished, withdrawn, or failed to proceed with an application for any professional activity listed in (b)(i) through (x) of this subsection in order to avoid an adverse action or to preclude an investigation or while under investigation relating to professional competence or conduct:
(i) License to practice any profession in any jurisdiction;
(ii) Other professional registration or certification in any jurisdiction;
(iii) Specialty or subspecialty board certification;
(iv) Membership on any hospital medical staff;
(v) Clinical privileges at any facility, including hospitals, ambulatory surgical centers, or skilled nursing facilities;
(vi) Medicare, medicaid, the food and drug administration, the national institutes of health (office of human research protection), governmental, national, or international regulatory agency, or any public program;
(vii) Professional society membership or fellowship;
(viii) Participation or membership in a health maintenance organization, preferred provider organization, independent practice association, physician-hospital organization, or other entity;
(ix) Academic appointment;
(x) Authority to prescribe controlled substances (drug enforcement agency or other authority);
(c) Any pending professional medical misconduct proceedings or any pending medical malpractice actions in this state or another state, the substance of the allegations in the proceedings or actions, and any additional information concerning the proceedings or actions as the physician, physician assistant, or advanced practice registered nurse deems appropriate;
(d) The substance of the findings in the actions or proceedings and any additional information concerning the actions or proceedings as the physician, physician assistant, or advanced practice registered nurse deems appropriate;
(e) A waiver by the physician, physician assistant, or advanced practice registered nurse of any confidentiality provisions concerning the information required to be provided to hospitals pursuant to this subsection; and
(f) A verification by the physician, physician assistant, or advanced practice registered nurse that the information provided by the physician, physician assistant, or advanced practice registered nurse is accurate and complete.
(2) Except as provided in subsection (3) of this section, prior to granting privileges or association to any physician, physician assistant, or advanced practice registered nurse or hiring a physician, physician assistant, or advanced practice registered nurse who will provide clinical care under his or her license, a hospital or facility approved pursuant to this chapter shall request from any hospital with or at which the physician, physician assistant, or advanced practice registered nurse had or has privileges, was associated, or was employed, during the preceding five years, the following information concerning the physician, physician assistant, or advanced practice registered nurse:
(a) Any pending professional medical misconduct proceedings or any pending medical malpractice actions, in this state or another state;
(b) Any judgment or settlement of a medical malpractice action and any finding of professional misconduct in this state or another state by a licensing or disciplinary board; and
(c) Any information required to be reported by hospitals pursuant to RCW 18.71.0195.
(3) In lieu of the requirements of subsections (1) and (2) of this section, when granting or renewing credentials and privileges or association of any physician, physician assistant, or advanced practice registered nurse providing telemedicine or store and forward services, an originating site hospital may rely on a distant site hospital's decision to grant or renew credentials and clinical privileges or association of the physician, physician assistant, or advanced practice registered nurse if the originating site hospital obtains reasonable assurances, through a written agreement with the distant site hospital, that all of the following provisions are met:
(a) The distant site hospital providing the telemedicine or store and forward services is a medicare participating hospital;
(b) Any physician, physician assistant, or advanced practice registered nurse providing telemedicine or store and forward services at the distant site hospital will be fully credentialed and privileged to provide such services by the distant site hospital;
(c) Any physician, physician assistant, or advanced practice registered nurse providing telemedicine or store and forward services will hold and maintain a valid license to perform such services issued or recognized by the state of Washington; and
(d) With respect to any distant site physician, physician assistant, or advanced practice registered nurse who holds current credentials and privileges at the originating site hospital whose patients are receiving the telemedicine or store and forward services, the originating site hospital has evidence of an internal review of the distant site physician's, physician assistant's, or advanced practice registered nurse's performance of these credentials and privileges and sends the distant site hospital such performance information for use in the periodic appraisal of the distant site physician, physician assistant, or advanced practice registered nurse. At a minimum, this information must include all adverse events, as defined in RCW 70.56.010, that result from the telemedicine or store and forward services provided by the distant site physician, physician assistant, or advanced practice registered nurse to the originating site hospital's patients and all complaints the originating site hospital has received about the distant site physician, physician assistant, or advanced practice registered nurse.
(4)(a) The Washington medical commission or the board of osteopathic medicine and surgery shall be advised within thirty days of the name of any physician or physician assistant denied staff privileges, association, or employment on the basis of adverse findings under subsection (1) of this section.
(b) The state board of nursing shall be advised within thirty days of the name of any advanced practice registered nurse denied staff privileges, association, or employment on the basis of adverse findings under subsection (1) of this section.
(5) A hospital or facility that receives a request for information from another hospital or facility pursuant to subsections (1) through (3) of this section shall provide such information concerning the physician, physician assistant, or advanced practice registered nurse in question to the extent such information is known to the hospital or facility receiving such a request, including the reasons for suspension, termination, or curtailment of employment or privileges at the hospital or facility. A hospital, facility, or other person providing such information in good faith is not liable in any civil action for the release of such information.
(6) Information and documents, including complaints and incident reports, created specifically for, and collected, and maintained by a quality improvement committee are not subject to discovery or introduction into evidence in any civil action, and no person who was in attendance at a meeting of such committee or who participated in the creation, collection, or maintenance of information or documents specifically for the committee shall be permitted or required to testify in any civil action as to the content of such proceedings or the documents and information prepared specifically for the committee. This subsection does not preclude: (a) In any civil action, the discovery of the identity of persons involved in the medical care that is the basis of the civil action whose involvement was independent of any quality improvement activity; (b) in any civil action, the testimony of any person concerning the facts which form the basis for the institution of such proceedings of which the person had personal knowledge acquired independently of such proceedings; (c) in any civil action by a health care provider regarding the restriction or revocation of that individual's clinical or staff privileges, introduction into evidence information collected and maintained by quality improvement committees regarding such health care provider; (d) in any civil action, disclosure of the fact that staff privileges were terminated or restricted, including the specific restrictions imposed, if any and the reasons for the restrictions; or (e) in any civil action, discovery and introduction into evidence of the patient's medical records required by regulation of the department of health to be made regarding the care and treatment received.
(7) Hospitals shall be granted access to information held by the Washington medical commission, the board of osteopathic medicine and surgery, and the state board of nursing pertinent to decisions of the hospital regarding credentialing and recredentialing of practitioners.
(8) Violation of this section shall not be considered negligence per se.
[ 2025 c 58 s 5132. Prior: 2019 c 104 s 1; 2019 c 55 s 15; 2019 c 49 s 1; 2016 c 68 s 6; 2015 c 23 s 6; 2013 c 301 s 3; 1994 sp.s. c 9 s 744; 1993 c 492 s 416; 1991 c 3 s 337; 1987 c 269 s 6; 1986 c 300 s 11.]
Notes:
Effective date—2025 c 58 ss 5058-5170: See note following RCW 7.68.030.
Explanatory note—2025 c 58: See note following RCW 1.16.050.
Intent—2016 c 68: See note following RCW 48.43.735.
Intent—2015 c 23: See note following RCW 41.05.700.
Severability—Headings and captions not law—Effective date—1994 sp.s. c 9: See RCW 18.79.900 through 18.79.902.
Findings—Intent—1993 c 492: See notes following RCW 43.20.050.
Short title—Savings—Reservation of legislative power—Effective dates—1993 c 492: See RCW 43.72.910 through 43.72.915.
Legislative findings—Severability—1986 c 300: See notes following RCW 18.57.245.
Washington medical commission: Chapter 18.71 RCW.

catchline: Duty of hospital to request information on physicians, physician assistants, or advanced registered nurse practitioners granted privileges. (Effective until June 30, 2027.)