Good Points to the Proposed Assisted Living Regulations
Good Points to the Proposed Assisted Living Regulations
The proposed regulations contain some crucial improvements that the Department made to what exists in the personal care home system. These must, at all costs, be retained.
As it is crucial that the Assisted Living regulations improve upon the regulations for personal care home, we are sincerely pleased with the provisions of the assisted living regulations that reflect such improvements upon the regulations for personal care homes. These are that the proposed regulations:
1) Establish licensure fees that are meaningful and potentially sufficient to fund the licensure and oversight and relocation efforts of the Department, as required by Act 56. 2800.11
2) Require fire safety approval to be renewed every 3 years (before got it at outset and was never required to be renewed). 2800.14
3) Limit the number of regulatory provisions that a facility could seek to have waived so that they not have to comply. 2800.19.
4) Add a few critical pre-admission disclosures that facilities will have to make to potential residents. 2800.22(b).
5) Standardize that the resident-residence contracts should all run month to month with 14 day advance notice by the resident required for termination. 2800.25(b)
6) Add a requirement that the person who manages and controls the operations of the facility have prior experience in the health or human services field. 2800.53
7) Require the facility to – at all times – be under the supervision of a person who is trained in how to operate and manage the facility. This is a massive improvement over the personal care home system where the only person with training and knowledge in how to manage, operate, and supervise need only be present in the facility 20 of the 168 hours in a week. 2800.56
8) Require a nurse to be on call 24 hours a day and a dietician to be involved in meal planning for residents’ whose support plans call for special diets. 2800.60
9) Call for air conditioning for the entire facility, whereas personal care homes have never been required to have air conditioning, despite the care needs or health conditions of their residents. By contrast to the requirement for fans only if the inside temperature exceeds 80 degrees, requiring air conditioning was critical and is a marked improvement. 2800.83
10) Require all stairs and steps to have strips to help ensure evacuation for those with vision impairments. 2800.94
11) Require facilities to have larger rooms than in personal care homes, with 250 square feet of living space for new construction and 175 square feet of living space for existing facilities, we had recommended 250 of living space for all and 175 is too small. It is not wheelchair accessible. 2800.101
12) Require living units to have kitchenettes with counter space, cabinet, microwave, fridge, and access to a sink. 2800.101
13) Require facilities to disclose their policies about pets and whether pets are already in the facility. 2800.109
14) Require smoke detectors in each living unit. 2800.129
15) Require access to all exits required to be marked with readily visible signs indicating the direction to travel. 2800.133
16) Prohibit unreasonable withholding of approval of providers of residents choice if resident has insurance. We wholly oppose limits on resident choice of provider. And, this does not exist in the personal care home system. We are only minimally comforted by the idea that a facility cannot unreasonably limit resident choice where health insurance or long term care insurance may pay only for specific providers. Please note, however, unreasonable withholding is not defined and there are no appeals processes or rights for consumers to challenge such determinations made by a provider.
17) Require assistance with meals and cueing for meals for residents who require this in order to make it to or through a meal. 2800.162.
18) Require vehicles for transportation to be accessible to residents with wheelchairs and other devices. 1800.171
19) Require facilities to obtain medications prescribed for resident and to maintain an adequate amount of the residents’ medications on site.
20) Require all residences to provide cognitive support services. 2800.119
21) Require a written decision if residency is denied with an explanation of why, but there remains no means for a potential resident to challenge a denial. 2800.224
22) Requires a nurse to review and approve the support plan, whereas in the current system, there are neither qualifications nor specific training requirements for the individual who conducts assessments or trainings. 2800.227
23) Mandate that a facility must ensure that residents that are discharged have a safe and orderly discharge and that the resident’s medications, durable medical equipment, and personal belongings go with the resident.
24) Improve upon the termination notice that consumers must receive, providing them more information on why they are being discharged and what limited steps they may take about the discharge. 2800.228
25) Require tracking of admissions and discharges and transfers by the facility – including those involving excludable conditions. 2800.228 and 2800.229.
26) Adopt a good standard for when an exception to the excludable conditions prohibitions would/should be granted. 2800.229.