NURSING HOMES AND MATERNITY HOMES

NURSING HOMES AND MATERNITY HOMES

(1) providing of care requires that actual services be furnished to the requisite number of patients;

(2) Maintenance of facilities requires only that the requisite number of facilities adequate under the statute be maintained, and the number of patients actually provided with care is immaterial.

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                                                                   June 28, 1955

Honorable J. A. Kahl
Acting Director
State Department of Health
14th Floor-Smith Tower
Seattle 4, Washington                                                                                                              Cite as:  AGO 55-57 No. 106

Dear Dr. Kahl:

            In your recent letter, receipt of which has been previously acknowledged, you set out the following three factual situations:

            1.         Where the operator of a home maintains facilities adequate to provide care for three or more convalescent or chronic patients, but has physically resident in the home only one or two patients receiving convalescent or chronic care, and devotes the remainder of such facilities either to a boarding-house operation or merely leaves them vacant;

            2.         Where the same situation as described in "1." exists as to having less than four pregnant women in the home;

             [[Orig. Op. Page 2]]

            3.         Where the home has adequate facilities to provide care either for four or more pregnant women, or three or more convalescent or chronic patients and actually contains, for example, two convalescent or chronic patients, and three pregnant women, with the additional facilities, if any, being used for a boardinghouse operation, or left vacant.

            You request our opinion on the above factual situations by means of the following three questions:

            1.         Does the home described in factual situation "1." come within the class of homes, places or institutions required to be licensed by chapter 18.51, RCW, and particularly by RCW 18.51.010?

            2.         Does the home described in factual situation "2." come within the class of homes, places or institutions required to be licensed by chapter 18.46, RCW, and particularly RCW 18.46.010?

            3.         Is the home described in factual situation "3." required to be licensed under both chapter 18.51 RCW and chapter 18.46 RCW, or may it comply with the law if it is licensed under only one of such chapters, or is it entirely free of the licensing requirements of both of such chapters?

            In our opinion the answer to question "1." is in the negative, the answer to question "2." is in the affirmative and the answer to question "3." is that the home described in factual situation "3." must be licensed under chapter 18.46 RCW but need not be licensed under chapter 18.51 RCW.

                                                                     ANALYSIS

            RCW 18.46.010 reads in part as follows:

             [[Orig. Op. Page 3]]

            "(1) 'Maternity home' means any home, place hospital or institution in which facilities are maintained for the care of four or more women, not related by blood or marriage to the operator, during pregnancy or during or within ten days after delivery:  * * *"

            RCW 18.51.010 (as amended by section 1, chapter 160, Laws of 1953) reads in part as follows:

            "(1) 'Nursing home' means any home, place or institution which operates or maintains facilities providing convalescent or chronic care, or both, for a period in excess of twenty-four consecutive hours for three or more patients not related by blood or marriage to the operator, who by reason of illness or infirmity, are unable properly to care for themselves.  * * *"

            We feel that we can more clearly analyze the problem presented by your three questions if we consider questions "1." and "2." above together, in connection with the above quoted definitions from the respective chapters from RCW.  We think the difference between the two definitions is clear.  In the definition of nursing home, there is contained a requirement that the facilities operated or maintained must provide convalescent or chronic care, or both, for a period in excess of twenty-four consecutive hours for the number of patients not excluded because of relationship therein set out.

            In the case of maternity homes, however, the above definition seems merely to require that the operator maintain facilities for the care of four or more women not within the prohibited relationship during pregnancy or during or within ten days after delivery.

            It seems to us that in the case of nursing homes if, at any time during a licensed year (which by chapter 18.51 RCW, is from July 1 in one year to and including June 30 of the next year), there are for a period of more than twenty-four consecutive hours three or more patients who are provided with convalescent or chronic care, and who come within the remainder of the definition, that home must procure a license under the provisions of that chapter of RCW.  If, on the other hand, there is no period of twenty-four  [[Orig. Op. Page 4]] consecutive hours in such licensed year in which the requisite number of persons not within the prohibited degree of relationship are provided with such care, then such home need not be licensed.

            Reading the definition of nursing home with the definition of maternity home, in our opinion, strengthens this conclusion, because when the legislature defined maternity home it did not deem it advisable to require that facilities be actually provided for any number of people coming within the definition for any particular number of hours, but the mere maintenance of facilities during the same year-licensed period as is required in the case of nursing homes which would be adequate for the care of four or more women during pregnancy or during or within ten days after delivery is controlling.  In other words, in the instance of nursing homes, the operator must during the licensed period actuallyfurnish the care set out in that definition, but in the instance of maternity homes the operator has only to maintain the necessary facilities to come within the purview of that definition.  It seems that the difference in the factual situation with which the legislature was necessarily dealing adds strength to our conclusion in this regard.  The person who is receiving convalescent or chronic care may remain a patient of a particular nursing home operator for a great number of years.  The period of pregnancy, delivery and ten days thereafter is one that is definitely delineated.  Thus a nursing home operator will have a rather constant group of patients and the actual providing of care for a certain number of those patients will remain fairly constant.  On the other hand, the maternity home operator may today have ten patients and tomorrow have only two.  Thus it is our opinion as above indicated that question "1." must be answered in the negative and question "2." in the affirmative.

            Turning our attention to question "3.", it would seem clear that consistent with the above answers, the answer to that question must be that a maternity home license should be procured for this type of operation, but that a nursing home license is not required.

             [[Orig. Op. Page 5]]

            We sincerely hope that the above will be of help to you.

Very truly yours,

DON EASTVOLD
Attorney General

J. D. THOMAS, JR.
Assistant Attorney General