Your Guide to Third-Party Compliance

Your Guide to Third-Party Compliance
Your Guide to Third-Party Compliance

Assisted living facilities are pivotal in providing care and support to residents, yet it’s essential to recognize that some residents may need services from third-party providers. To ensure the well-being and satisfaction of these residents, operators must understand and adhere to regulations governing third-party services. This article aims to guide assisted living facility operators through these regulations and offer practical strategies for compliance.

Resident Autonomy in Third-Party Services

Residents or their representatives have the right to independently arrange, contract, and pay for third-party services, such as those provided by licensed home health agencies, private nurses, or outpatient clinics, according to Rule Chapter 59A-36.007 Resident Care Standards. To comply, operators should establish clear policies detailing admission criteria, continued residency conditions, and guidelines for third-party service delivery. These policies must ensure third-party providers coordinate with the facility regarding the resident’s condition and the services being provided.

Facilitating Third-Party Services

When a resident requires or arranges third-party services, the facility administrator or designee must facilitate the receipt of these services, provided the resident meets the necessary criteria. To comply, operators should ensure open communication and coordination with the third-party provider to deliver care tailored to the resident’s needs. This coordination should happen whenever there is a significant change in the resident’s condition and at least once every 30 days.

Coordinating Care and Maintaining Documentation

The facility’s administrator or designee is responsible for ensuring proper care coordination with third-party providers. Compliance involves:

  • Documented Communications: Ensure all communications about the resident’s condition and response to treatment or services ordered by a physician are documented. This documentation impacts the resident’s appropriateness for continued residency.
  • Communication Frequency: Regular communications should occur at least once every 30 days and whenever there is a significant change in the resident’s condition.
  • Adhering to Treatment Schedules: If treatments or services are ordered less frequently than once a month, communications should align with the treatment schedule and any significant changes in the resident’s condition.
  • Recording Unsuccessful Attempts: If communication with a third-party provider fails, document at least two attempts on separate days. Include the name of the contact, the method of communication, and the date and time of attempts. This documentation should be included in the resident’s record within specified timeframes.

Assistance and Documentation

Assisted living facilities may assist residents in arranging and coordinating third-party services. However, if efforts to arrange these services are unsuccessful or declined by the resident, document the reasons in the resident’s record. This documentation serves as evidence of compliance and underscores the facility’s commitment to resident well-being.

Conclusion

Complying with regulations related to third-party services in assisted living facilities is vital for meeting residents’ needs and respecting their rights. By understanding these requirements and implementing appropriate policies and procedures, operators can foster a supportive environment that enhances the coordination and quality of third-party services. Effective communication and thorough documentation are essential to achieving compliance and maintaining transparency in care delivery.