ASSISTED LIVING: NEW STANDARDS & NEW LAWS IN 2017

Transcription

1 VHCA-VCAL Presents ASSISTED LIVING: NEW STANDARDS & NEW LAWS IN 2017 Tara Davis-Ragland Department of Social Services Mary Chiles Chiles Healthcare Consulting, LLC Emily Towey & Andrew Schutte HDJN April Payne VHCA-VCAL April 25, Objectives: Explore what is new and different in the standards Understand the legal implications of the new regulations Explore strategies and approaches you can use to address the challenges facing your facility and to ensure operational compliance 1

2 3 Disclaimer: The regulations are currently under review at the Governor s office and that there remains the potential for additional changes The information presented today is a preliminary overview of the draft regulations at this point Facilities should be cautious in making changes that are not consistent with the current assisted living standards 4 22VAC Adds licensee to persons who may not act as attorney-in-fact or trustee unless a resident has no other preferred designee and so requests 2

3 5 22VAC Provides for the development and implementation of an enhanced infection control program that addresses the surveillance, prevention and control of disease and infection 6 22VAC Adds to administrator training requirements that administrators who supervise medication aides, but are not registered medication aides themselves, must have annual training in medication administration 3

4 7 22VAC Adds that an unlicensed shared administrator for smaller residential living care facilities must be at each facility for six hours during the day shift of the 10 required hours a week 8 22VAC Increases the annual training hours for direct care staff 4

5 9 22VAC Adds requirements regarding private duty personnel 10 22VAC Adds requirement that at least one person with first aid certification and at least one person with cardiopulmonary resuscitation (CPR) certification must be in each building, rather than on the premises 5

6 11 22VAC Changes an exception (allowing staff to sleep at night under certain circumstances) to one of the staffing requirements to limit its application to facilities licensed for residential living care only 12 22VAC Adds to admission and retention requirements, additional specifications regarding an agreement between a facility and hospice program when hospice care is provided to a resident 6

7 13 22VAC Adds a requirement for a fall risk rating for residents who meet the criteria for assisted living care 14 22VAC Adds that mental health, behavioral, and substance abuse issues are included in personal and social information for all residents, not just those meeting criteria for assisted living care 7

8 15 22VAC Adds a requirement that staff who complete individualized service plans (ISPs), complete uniform assessment instrument (UAI) training as a prerequisite to completing ISP training 16 22VAC Reduces the number of times annually required for health care oversight when a facility employs a full-time licensed health care professional; adds a requirement that all residents be included annually in the health care oversight, adds to the oversight evaluating the ability of residents who self- administer medications to continue to safely do so, adds additional requirements for oversight of restrained residents 8

9 17 22VAC Specifies that visiting hours may not be restricted unless a resident so chooses 18 22VAC Adds requirement that snacks be available at all times, rather than bedtime and between meals 9

10 19 22VAC Reduces the number of times annually for oversight of special diets 20 22VAC Adds an allowance for a master list of staff who administer medications to be used in lieu of documentation on individual medication administration records (MARs) 10

11 21 22VAC Adds prohibition of additional types of restraints and adds review and revision of individualized service plan following application of emergency restraints 22 22VAC Adds a provision that a resident may determine not to have certain furnishings that are otherwise required in his bedroom 11

12 23 22 VAC Adds to the standard that in a bedroom with a thermostat where only one resident resides, the resident may choose a temperature other than what is otherwise required 24 22VAC Town Hall Agency Background Document Form: TH Adds that when there is a new facility licensee, there can be no more than two residents residing in a bedroom 12

13 25 22VAC Adds to the provision for signaling/call systems that for a resident with an inability to use the signaling device, this must be included on his individualized service plan with frequency of rounds indicated, with a minimum of rounds every two hours when the resident has gone to bed at night, with an exception permitted under specific circumstances 26 22VAC Specifies that review of emergency plan with staff, residents, and volunteers is semi-annual, rather than quarterly 13

14 27 22VAC Adds requirement for first aid kit in each building, rather than at the facility, eliminates activated charcoal, adds requirement that 48 hours of emergency food and water supply be on-site and can be rotating stock 28 22VAC Specifies that participation in resident emergency practice exercise every six months is required of staff currently on duty, rather than all staff, and adds review of resident emergency procedures every six months with all staff 14

15 29 22VAC Removes the exception (for facilities licensed for 10 or fewer with no more than three with serious cognitive impairment) that applied to all requirements for mixed population 30 22VAC Increases the training required in cognitive impairment for direct care staff, and except for administrator, other staff 15

16 31 22VAC Increases the number of hours per week of activities for residents in a safe, secure environment 32 22VAC Adds requirement that when there are 20 or fewer residents present in a special care unit, there must be at least two direct care staff members awake and on duty in the unit, and for every additional 10 residents, or portion thereof, there must be at least one more direct care staff member awake and on duty in the unit, rather than two direct care staff in each unit 16

17 33 22VAC Increases the number of hours of training in cognitive impairment for the administrator and changes the time period in which the training must be received for both the administrator and for direct care staff who work in a special care unit, also increases training in cognitive impairment for others who have contact with residents in a special care unit 34 Summary As of the date of this presentation, the final regulations are being reviewed by the Governor. If approved by the Governor, the regulations will be finalized and an effective date will be announced. The Department of Social Services (DSS) has committed to educating DSS staff and providers as well as developing resources and tools once the regulations are finalized. 17

18 35 Thank You It has been our pleasure to share this information with you. We will gladly answer questions and look forward to successful implementation o these new regulations. Tara Davis-Ragland Department of Social Services Mary Chiles Chiles Healthcare Consulting, LLC Emily Towey & Andrew Schutte HDJN April Payne VHCA-VCAL 18