A. Assessment, Service Coordination, and Monitoring
1. Once the resident is admitted, the Provider shall conduct an assessment to determine the needs and preferences of the resident which will be kept in the
resident’s record and shall at a minimum, include:
a. the resident’s interests, likes, and dislikes;
b. review of physical health, psycho-social status, and cognitive status and determination of services necessary to meet those needs;
c. a summary of the resident’s health needs, if any, including medication, treatment, and special diet orders obtained from professionals with
responsibility for the resident’s physical or emotional health;
d. a written description of the activities of daily living and instrumental activities of daily living for which the resident requires assistance if any,
obtained from the resident, the resident’s physician, family, or representative;
e. recreational and social activities which are suitable or desirable;
f. a plan for handling special emergency evacuation needs, if any; and,
g. additional information or documents pertinent to the resident’s service
planning, such as guardianship papers, power of attorney, living wills, do-not-resuscitate orders, or other relevant medical documents.
2. Within 30 days after admission, the Provider, with input from the resident, and/or his/her representative shall develop a service plan using information from the
assessment.
3. The service plan shall be responsive to the resident’s needs and preferences.
4. The service plan shall include:
a. the resident’s needs;
b. the scope, frequency, and duration of services and monitoring that will be provided to meet the resident’s needs; and,
c. staff/Providers responsible for providing the services inclusive of third-party providers.
5. The resident’s service plan shall be revised when a resident’s condition or preferences change. The revised service plan shall be signed by the resident and
the representative, if applicable, and the designated facility staff.
6. The service plan shall be monitored on an ongoing basis to determine its continued appropriateness and to identify when a resident’s condition or
preferences have changed. A documented review of the service plan shall be made at least every quarter. However, changes to the plan may be made at any
time, as necessary.
7. All plans and reviews shall be signed by the resident, facility staff, and the representative, if applicable.
B. Personal and Supportive Services
1. The facility shall provide adequate services and oversight/supervision including adequate security measures, around the clock, as needed for any resident.
2. The facility shall provide or coordinate, to the extent needed or desired by residents, the following services:
a. some assistance with all activities of daily living and all instrumental
activities of daily living;
b. up to three varied, appetizing meals a day, seven days a week, that take into account residents’ preferences and needs;
c. basic personal laundry services;
d. opportunities for individual and group socialization and to utilize community resources to create a normal and realistic environment for
community interaction within and outside the Facility (i.e. barber/beauty services, social/recreational opportunities);
e. services for residents who have behavior problems requiring ongoing staff support, intervention, and supervision to ensure no danger or
infringement of the rights of other residents or individuals;
f. household services essential for the health and comfort of resident (e.g.
floor cleaning, dusting, bed making, etc.);
g. assistance with self-administration of medications; and,
h. a program of recreational activities.
3. Each Provider shall, if requested by the resident and/or the representative, if applicable, assist in arranging for access to another provider for residents who,
due to a mental, medical, or emotional condition, cannot benefit from the facility’s program.
C. Medications
1. The Provider shall have clear written policies and procedures on medication assistance.
2. The Provider shall assist residents in the self-administration of prescription and non-prescription medication as agreed to in their contract or service plan and as
allowed by state statute/regulations.
3. Assistance with self-administration of medications shall be limited to the
following.
a. The resident may be reminded to take his/her medication.
b. The medication regimen, as indicated on the container may be read to the resident.
c. The dosage may be checked according to the container label.
d. The staff may open the medicine container (i.e. bottle, mediset, blister
Pak, etc.) if the resident lacks the ability to open the container.
e. The resident may be physically assisted in pouring or otherwise taking medications, so long as the resident is cognitive of what the medication is,
what it is for and the need for the medication.
4. If desired by the resident, the resident’s family, other relatives, the resident’s representative or other close friends may transfer medication from the original
container to a medication reminder container (pill organizer box).
5. The resident may contract with an outside source for medication administration just as they can if they were living in their private home.
6. A Provider shall not contract from an outside source for medication administration for residents.
7. An employee that provides assistance with the self-administration of medications to a resident shall have documented training on the policies and procedures for
medication assistance including the limitations of this assistance. Documentation shall include the signature of the employee. This training shall be repeated at least
annually.
8. Medications may be stored in the resident’s own living unit/bedroom or in a secure central location.
a. Residents who do not require assistance with self-administration of medications shall be allowed to keep prescription and non-prescription
medication in their living unit/bedroom as long as they keep them secured from other residents.
b. If a resident requires assistance with self-administration of medication, the medication may be kept in a secure area in the resident’s living
unit/bedroom or in a secure central area.
i. If medications are kept in a secure central area, facility staff shall handle them in the same manner as if they were kept in the
resident’s living unit/bedroom.
ii. Medications kept in a secure central area shall be delivered to the individual resident at the appropriate time regardless of where the
resident may be in the facility. Residents shall not be required to come to a “medication” area to receive medications.
D. Health-Related Services
1. Each resident shall have the right to control his/her receipt of health-related services including but not limited to:
a. the right to retain the services of his/her own personal physician, dentist
or other health care provider;
b. the right to confidentiality and privacy concerning his/her medical and dental condition and treatment; and,
c. the right to select the pharmacy or pharmacist of their choice.
2. The Provider shall plan or arrange in conjunction with the resident, the resident’s
family and/or representative for the following:
a. health assessment;
b. assistance with health tasks as needed/requested by the resident; and,
c. healthcare monitoring. (Healthcare monitoring consists of a regularly occurring process designed by the facility to identify changes in a
resident’s healthcare status.)
3. A Provider shall only provide health-related services as allowed by these regulations. Health-related services above those allowed for by these regulations
shall not be arranged for or contracted for by a Provider. These services shall be arranged for by the resident and/or the resident’s representative.
4. The Provider shall have a reporting procedure in place for notifying appropriate
individuals of observed or reported changes in a resident’s condition.
E. Transportation
1. The Provider shall have the capacity to provide or to arrange transportation for the
following:
a. medical services, including ancillary services for medically related care
(e.g., physician, pharmacist, therapist, podiatrist);
b. personal services, including barber/beauty services;
c. personal errands; and,
d. social/recreational opportunities.
2. The Provider shall ensure and document that any vehicle used in transporting residents, whether such vehicles are operated by a staff member or any other
a person acting on behalf of the Provider is inspected and licensed in accordance with state law and has current commercial liability insurance in an amount
sufficient to ensure payment of any resident losses resulting from that transportation, including uninsured motorist coverage.
3. When transportation services are provided by the facility, whether directly or by third-party contract, the provider shall document and ensure that drivers have a
valid Louisiana driver’s license, that drivers have a clean driving record, and that they are trained/experienced in assisting residents.
F. Meals
1. The facility’s menus, at a minimum, are reviewed and approved by a nutritionist or
dietician to assure their nutritional appropriateness for the setting’s residents.
2. The Provider shall make reasonable accommodations, as contracted for by the residents, to:
a. meet dietary requirements;
b. meet religious and ethnic preferences;
c. meet the temporary need for meals delivered to the resident’s room;
d. meet residents’ temporary schedule changes as well as residents’
preferences (e.g. to skip a meal or prepare a simple late breakfast); and,
e. make snacks, fruits, and beverages available to residents when requested.
3. All food preparation areas (excluding areas in residents’ units) are maintained in accordance with state and local sanitation and safe food handling standards.
4. Staff shall be available in the dining area to serve the food and to give individual attention as needed.
5. Written reports of inspections by the Department of Health and Hospitals, Office
of Public Health, Sanitarian Services shall be kept on file in the facility.
6. Specific times for serving meals shall be established and posted.
7. Meals shall be prepared and served in a way that assures that they are appetizing, attractive, and nutritional and that promotes socialization among the residents.
8. Foods shall be prepared by methods that conserve the nutritive value, flavor, and appearance. It shall be palatable, properly prepared, and sufficient in quantity and
quality.
G. Menus
1. Menus shall be planned and written at least one week in advance and dated asnserved. The current week’s menu shall be posted in one or more conspicuous
places in the facility.
2. The Provider shall furnish medically prescribed diets to residents for which it contracts either in the contract or in the service plan. These menus shall be
planned or approved by a Registered Licensed Dietician.
3. Records of all menus as served shall be kept on file for at least 30 days.
4. All substitutions made on the master menu shall be recorded in writing.
H. Food Supplies
1. All food in the facility shall be safe for human consumption.
2. Grade “A” pasteurized fluid milk and fluid milk products shall be used or served.
Dry milk products may not be used, except for cooking purposes.
I. Food Protection
1. If food is prepared in a central kitchen and delivered to separate facilities, the provision shall be made and approved by the Department of Health and Hospitals,
Office of Public Health, Sanitarian Services for proper maintenance of food temperatures and a sanitary mode of transportation.
2. Facility’s refrigerator(s) shall be maintained at a temperature of 45 degrees F or
below. Freezers shall be maintained at a temperature of 0 degrees F or below.
Thermometers shall be provided for all refrigerators and freezers.
3. Food stored in the refrigerator shall be covered.
4. Poisonous and toxic materials shall be identified, and placed in cabinets that are used for no other purpose.
5. Pets are not allowed in food preparation and service areas.
J. Ice and Drinking Water
1. The water supply shall be adequate, of a safe sanitary quality, and from an
approved source. Clean sanitary drinking water shall be available and accessible
in adequate amounts at all times. Disposable cups, if used, shall be stored in such
a way as to prevent contamination.
2. The ice scoop shall be maintained in a sanitary manner with the handle at no time coming in contact with the ice.
K. Recreation
1. The facility shall have a range of indoor and outdoor recreational and leisure opportunities to meet the needs and preferences of residents.
2. The Provider shall provide and/or coordinate access to community-based activities.
3. A monthly posted list of recreational and leisure activities in the facility and the
the community shall be available to the residents.