ebook img

2008 Assisted Living State Regulatory Review PDF

239 Pages·2008·0.81 MB·English
by  
Save to my drive
Quick download
Download
Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.

Preview 2008 Assisted Living State Regulatory Review

Assisted Living State Regulatory Review 2008 March 2008 1201 L Street, NW Washington, DC 20005 www.ncal.org Assisted Living State Regulatory Review 2008 March 2008 Prepared by Karl Polzer, Senior Policy Director National Center for Assisted Living (202) 898-6320 Assisted Living State Regulatory Review 2008 About one million Americans now make their home in assisted living facilities, including about 115,000 receiving assistance under the Medicaid program. A long term care option preferred by many individuals and their families because of its emphasis on resident choice, dignity, and privacy, assisted living continues to grow while adapting to changes in consumer wants and needs. There are federal laws that impact assisted living but oversight of assisted living occurs primarily at the state level. The varying laws and regulations affecting assisted living settings have created a diverse and fluid operating environment for providers and a mix of terminology, settings, and available services for consumers. Overall, these variations reflect the development of assisted living to meet the needs of the individuals in each particular state. More than two-thirds of the states use the licensure term “assisted living” and some states use a similar term (e.g., Tennessee uses “assisted care living facilities”). While the second most used term is “residential care,” other state licensure terms include “boarding home, basic care facility, community residence, enriched housing program, home for the aged, personal care home, and shared housing establishment.” In 2007, the pace of regulatory change quickened across the country as the assisted living industry continued to develop and diversify. More than 20 states made statutory and/or regulatory changes impacting assisted living residents and facilities – up from about one third of the states in 2006. Of these, about 12 states overhauled or made significant changes to their assisted living regulations in 2007 – many more than in each of the previous two years. Several states intend to make major regulatory changes in 2008. As in the previous year, three states initiated new levels of licensure in 2007, in part to accommodate increased resident acuity. Pennsylvania and the District of Columbia began offering “assisted living” licensure alongside their existing licensure categories, while Wyoming added new rules allowing secure dementia units under a tiered licensing system. Other states continued refining multi-tiered licensing systems. In 2007, states continued the trends of developing enhanced standards for © 2008 National Center for Assisted Living Alzheimer’s/dementia populations and standards for disclosure of information to consumers. Several states established or tightened criminal background check requirements, augmented fire safety and emergency preparedness standards, and strengthened food safety and dietary standards. States also added to requirements relating to staff training, staffing, medication management, reporting and record keeping, and infection control. Other focal points of state assisted living regulatory change include survey procedures, licensure fees, requirements when closing or expanding operations, resident rights, dispute resolution procedures, move-in/move-out requirements, and resident assessments. In 2007, at least two of the few remaining states without Medicaid coverage for assisted living services took steps toward including such coverage under Medicaid waivers. And North Carolina passed legislation that bans smoking in licensed assisted living facilities statewide. NCAL publishes this report as a service to its members, consumers, policy makers, researchers, and the media. As always, we would like to thank the many people from state agencies and NCAL state affiliates who provided information for this report and reviewed the contents. Karl Polzer, NCAL Senior Policy Director March 2008 © 2008 National Center for Assisted Living This report summarizes regulation of assisted living in each state and the District of Columbia. Information in the report is obtained from state regulatory agencies, state provider associations affiliated with NCAL, and through review of state regulations. Because many states are developing and refining their assisted living rules and guidelines, readers are encouraged to contact the identified state agencies and to obtain copies of the regulations in their entirety if they desire more detailed information. This review is based on the applicable statutes and regulations in each state and specifically summarizes the following information: • Agency/Phone Number is the name and general phone number of the state assisted living regulatory agency. • Contact Name/Phone Number/Email is the name, direct phone number, and e-mail address of the state agency representative who is knowledgeable about state regulatory classifications and new initiatives regarding assisted living. • Web Site is the Web site for the agency that regulates assisted living. • Licensure Term is the term (or terms) used by the state that most closely fits the general definition of “assisted living.” • Opening Statement includes comments about new assisted living legislation or regulation that is being discussed, drafted, or proposed by the state. • Definition summarizes the state’s definition of the licensure term. • Disclosure Items includes specific information that must be provided to a prospective resident prior to signing a residence or services contract. • Facility Scope of Care summarizes the nursing and personal care services that may be provided by the facility. • Third Party Scope of Care indicates whether third parties, such as home health agencies or hospice providers, may provide services. • Move-in/Move-out Requirements summarizes the types of resident conditions that would prevent move-in or mandate move-out. • Resident Assessment indicates if the state requires a particular form or process to be used when a prospective or current resident is assessed to determine if the individual’s needs can be met by the provider and to indicate the services that the resident will need. © 2008 National Center for Assisted Living • Medication Management indicates whether administration of medication is permitted and the extent to which assistance with administration is permissible. • Physical Plant Requirements summarizes the square footage requirements for resident units and any other special physical plant requirements. • Residents Allowed Per Room summarizes the maximum number of residents allowed per resident unit. • Bathroom Requirements indicates whether bathrooms may be shared and how many toilets, lavatories, and/or bathing facilities are required per resident. • Life Safety summarizes fire safety requirements and other standards ensuring residents’ physical safety. • Alzheimer’s Unit Requirements indicates whether facilities are permitted to care for residents with Alzheimer’s disease and/or summarizes special requirements for facilities that care for such residents. • Staff Training for Alzheimer’s Care indicates any additional training that may be required for staff that provide care for individuals with Alzheimer’s disease or other forms of dementia. • Staffing Requirements lists required staff and may indicate if a certain number of staff are required at particular times or based on the number of residents. • Administrator Education/Training summarizes qualifications for administrators. • Staff Education/Training summarizes qualifications for various staff positions. • Continuing Education (CE) Requirements summarizes the number of hours of continuing education required annually of administrators and staff. • Entity Approving CE Program identifies the state entity that gives prior approval for continuing education courses, if applicable. • Medicaid Policy and Reimbursement summarizes whether the state offers Medicaid coverage to pay for services in assisted living. © 2008 National Center for Assisted Living Alabama Agency Department of Public Health, Bureau of Health Phone (334) 206-5575 Provider Standards Contact Diane A. Mann Phone (334) 206-5366 E-mail requires any care beyond assistance with ADLs must be discharged. Despite these requirements, a resident who requires medical care, administration of oral medications, or skilled nursing care for no longer than 90 days, or if a resident has been admitted to a certified and licensed hospice program because of a condition other than dementia, may remain in the facility by arrangement of such care to be delivered by properly licensed individuals. In these instances the facility is responsible for the delivery of the appropriate care. Resident Assessment Each resident must have a medical examination prior to entering an assisted living facility and a plan of care developed by the facility in cooperation with the resident and, if appropriate, the sponsor. There is certain information that must be included in the plan of care, but there is no required standard form. Two assessments on required forms must be completed for individuals who move into a specialty care assisted living facility: a Physical Self Maintenance Scale and a Behavior Screening Form. Each resident must have a specified score on the Physical Self Maintenance Scale to be able to live in the specialty care assisted living facility. Medication Management A resident may either manage, keep, and self-administer his or her own medications or receive assistance with the self- administration of medication by any staff member. Medications managed and kept under the custody and control of the facility shall be unit-dose packaged. In specialty care assisted living facilities that care for residents with dementia, medication must be administered by a registered nurse (RN), licensed practical nurse, or an individual licensed to practice medicine or osteopathy by the Medical Licensure Commission of Alabama. Physical Plant Private resident units must be a minimum of 80 square feet, and Requirements double occupancy resident units must be a minimum of 130 square feet. Residents Allowed Per A maximum of two residents is allowed per resident unit. Room Bathroom Requirements Bathrooms may be shared and resident rooms may have common toilets, lavatories, and bathing facilities. When shared, there must be at least the following: one bathtub or shower for eight residents; one lavatory for six residents; and one toilet for six residents. Life Safety The state of Alabama has two types of licensed assisted living facilities for the elderly: standard assisted living facilities and specialty care assisted living facilities for residents with dementia or Alzheimer's symptoms. Each of these is divided into the three categories of Family (three residents or less), Group (4-16 residents), and Congregate (17 or more residents). Page 2 Copyright 2008 National Center for Assisted Living

See more

The list of books you might like

Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.