Assisted living centers Article 44:04 et seq.
There were 65 facilities with about 1,200 beds in 1996 and 100 facilities with a total capacity of 2,000 beds in 1998. About 30 more facilities are expected to be licensed in 1998.
An assisted living center is defined as "any institution, rest home, boarding home, place, building, or agency which is maintained an operated to provide personal care and services which meet some need beyond basic provision of food, shelter, and laundry to five or more persons in a free standing, physically separated facility."
In newly constructed or renovated facilities, there must not be more than two residents per room. In single bed rooms, there must be a minimum area of 120 square feet and in two-bed rooms there must be at least 200 square feet. Each resident room must have a toilet room and lavatory.
Prior to admission, residents must submit written evidence from their physician of a physical examination certifying that they are in reasonable good health and free from communicable disease, chronic illness, or disability which requires any services beyond supervision, cuing, or limited hands-on physical assistance to carry out normal activities of daily living and instrumental activities of daily living.
Assisted living centers may not admit or retain residents who require ongoing nursing care. Facilities that admit or retain residents who require administration of medications must employ or contract with a licensed nurse who reviews resident care and conditions at least weekly and a registered nurse or pharmacist who provides medication administration training to unlicensed assistive personnel who administer medications.
Facilities that admit or retain residents with cognitive impairments must have the resident's physician determine and document if services offered by the facility continue to enhance the functions in ADLs and identify if other disabilities and illnesses are impacting on the resident's cognitive and mental functioning. All staff members must attend an annual in-service training in the care of the cognitively impaired and those with unique needs. Such facilities must have exit alarms.
Centers must provide supportive services, activities, services to meet the spiritual needs of residents. Outside services utilized by residents must comply with and complement facility care policies. Assisted living centers must provide for the availability of physician services. All residents must be seen by a physician at least once a year.
The SSI payment for room and board assisted living facilities is $910 per month less a personal needs allowance of $30. If the Department of Social Services determines that a Medicaid eligible individual also needs medication administration, the facility receives $150 per month through the Medicaid HCBS waiver for a total of $1,030 per month. Thirty five facilities contract with Medicaid and serve 65 people.
For facilities with 10 or fewer beds, one staff person is permitted during sleeping hours. This staff person may sleep if the facility fire alarm is adequate to alert staff, a staff call system is available, the staff bedroom has an egress window, and the residents are capable of prompt evacuation. For facilities with 11 to 16 beds, one staff person who is awake is required during sleeping hours.
Administrator The administrator must have a high school diploma or equivalent and, if hired after July 1, 1995, complete a 75 hour training program and competency evaluation. The areas covered include: communication and interpersonal skills; infection control; safety/emergency procedures; promoting resident's independence; and respecting resident rights. Additional topics cover: basic nursing skills; personal care skills; mental health and social services; care of cognitively impaired residents; basic restorative services and resident rights.
Staff The facility must have a formal orientation program and an ongoing education program for all personnel. These programs must include the following subjects:
Fire prevention. The facility must hold at least one fire drill for each shift each quarter;
Infection control and prevention;
Accident prevention and safety procedures;
Proper use and documentation of restraints;
Patient and resident rights;
Confidentiality of patient information;
Incidents and diseases subject to mandatory reporting and the facility's reporting mechanism; and
Care of the cognitively impaired and of those patients or residents with unique needs.
A facility may not knowingly employ any person with a conviction for abusing another person.
The governing body of the facility must provide for an ongoing evaluation of the quality of services provided to residents. Quality assurance evaluations must include the establishment of facility standards; interdisciplinary review of resident services to identify deviations from the standards and plans of correction; resident satisfaction surveys, utilization of services provided; and documentation of the evaluation.