Services in the Community

The look of each individual facility may vary from place to place, but the backbone of services that are required to be provided always stays the same. The Georgia Department of Community Health specifically states what each resident is entitled to in the following regulation:

111-8-63-.17 Services in the Community

(1) The assisted living community must provide assisted living, including protective care and watchful oversight, which meets the needs of the residents it admits and retains.

(2) Resident Needs Assessment. The assisted living community must complete an assessment of the resident that addresses the resident’s care needs taking into account the resident’s family supports, the resident’s functional capacity relative to the activities of daily living, physical care needs, the medical information provided, cognitive and behavioral impairments, if any, and personal preferences relative to care needs.

(3) Written Care Plan. Utilizing the information acquired during the admission process and the move-in adjustment period, the assisted living community must develop the resident’s individual written care plan within 14 days of admission and require staff to use the care plan as a guide for the delivery of care and services to the resident. The care plan must include the following:

(a) a description of the resident’s care and social needs and the services to be provided, including frequency to address care and social needs;

(b) resident’s particular preferences regarding care, activities, and interests;

(c) specific behaviors to be addressed with interventions to be used;

(d) any physician order or order of a nurse practitioner or physician assistant working under protocol or job description, respectively for assistive devices;

(e) staff primarily responsible for implementing the care plan;

(f) evidence of family involvement in the development of the plan when appropriate; and

(g) evidence of the care plan being updated at least annually and more frequently where the needs of the resident change substantially or the resident is assigned to a specialized memory care unit.

(4) Social Activities. Each assisted living community must provide social activities on a daily basis that promote the physical, mental and social well-being of each resident and take into account the personal preferences of the residents.

(5) Activity Resources. The assisted living community must provide, books, current newspapers or magazines, and games for leisure time activities. The assisted living community must offer assistance to residents who wish to participate in hobbies, music, arts and crafts, religion, games, and sports, social, recreational, and cultural activities available in the assisted living community and in the community.

(6) Available Telephone. The assisted living community must have at least one operable, non-pay telephone which is accessible at all times for emergency use by staff on the

premises. Residents must also have access to an operable, nonpay telephone in a private location, both to make and receive personal calls. The same telephone may be used for staff and resident access.

(7) The assisted living community must not restrict a resident’s free access to the common areas of the assisted living community or the specialized memory care unit or lock the resident into or out of the resident’s bedroom.

(8) Proxy Caregiver Services. Where the assisted living community chooses to allow proxy caregivers to function in the community to perform certain health maintenance activities that are not covered in the basic assisted living care the community is required to provide, the assisted living community must do either of the following:

(a) Provide employees who are available for designation by a resident to serve as proxy caregivers to perform certain health maintenance activities; or

(b) Permit the resident or a person legally authorized to act on behalf of the resident to employ designated proxy caregivers to provide health maintenance activities.

(9) Proxy Caregiver Records. The community must maintain documentation on all proxy caregivers performing health maintenance activities that comply with the Rules and

Regulations for Proxy Caregivers, Chapter 111-8-100.

(10) Prohibited Proxy Caregiver Services. Where the assisted living community employs proxy caregivers, the community must not permit proxy caregivers to provide assistance with or administer medications.

(11) Medical, nursing (other than developing and updating care plans, training, medication administration, and skills competency determinations) health services required on a periodic basis, or for short-term illness, must not be provided as services of the assisted living community. When such services are required, they shall be purchased by the resident or the resident’s representative or legal surrogate, if any, from appropriately licensed providers that are managed independently and not owned or operated by the assisted living community. The assisted living community may assist in an arrangement for such services, but

not in the provision of those services.

These may seem like no brainers, but you wouldn’t believe how many facilities find themselves cited after failing to provide the following:

(3) Written Care Plan. Utilizing the information acquired during the admission process and the move-in adjustment period, the assisted living community must develop the resident’s individual written care plan within 14 days of admission and require staff to use the care plan as a guide for the delivery of care and services to the resident. The care plan must include the following: A-G

This is the single biggest takeaway from these regulations. You MUST have an updated care plan for each resident laying out the specific services they will be receiving. It is not enough to say “They are on level 2” to a surveyor. They will not accept that, and you will be cited. 

(6) Available Telephone. The assisted living community must have at least one operable, non-pay telephone which is accessible at all times for emergency use by staff on the premises. Residents must also have access to an operable, nonpay telephone in a private location, both to make and receive personal calls. The same telephone may be used for staff and resident access.

Believe it or not, this is one issue that often comes up and it relates directly to the dignity of the resident and being able to communicate with others outside of the facility. This should be a phone in a private area (not the common living room, or the front desk business phone). So, think about where you can place a phone that residents can use for private conversations. 

(11) Medical, nursing (other than developing and updating care plans, training, medication administration, and skills competency determinations) health services required on a periodic basis, or for short-term illness, must not be provided as services of the assisted living community. When such services are required, they shall be purchased by the resident or the resident’s representative or legal surrogate, if any, from appropriately licensed providers that are managed independently and not owned or operated by the assisted living community. The assisted living community may assist in an arrangement for such services, but not in the provision of those services.

When a resident is requiring services that are outside of your scope of care it is 100% necessary to contract third-party providers such as medical home health care or private duty home care to ensure the resident is receiving the right care at the right time by the right personnel. 

FEATURED COMMUNITY PARTNERS

If your organization has a collaborative relationship with the assisted living facilities and would like to be included on our website, ALF BOSS is happy to help you.