One of the biggest struggles that Assisted Living Facilities have is low census, which often leads to hasty decisions when it comes to who you accept as a resident into your community- remember not everyone is a fit nor will you be able to provide the care that each potential resident may need. The Hawaii Office of Health Care Assurance provides strict guidelines on who can be accepted into an ALF in the state. Take a look below:
- 11-90-10 Admission and discharge.
(a) The facility shall develop admission policies and procedures which support the principles of dignity and choice. The admissions process shall include completion of or the providing of the following:
(1) A service listing which details the services available, the base rates, the services included in the base rate, and the fees for all other additional services. A service listing shall also describe services which the facility does not provide, but will assist to arrange or coordinate;
(2) Handbook or house rules which state the assisted living philosophy and clearly define the privileges and responsibilities of the resident and the conditions under which apartment units may be occupied by the residents;
(3) A service plan for the resident developed by facility staff with the resident and significant others, specifying care and services to be provided, based on resident needs and choices;
(4) A service contract which documents a completed agreement between the resident and the facility, describing services to be provided, rates charged, and conditions under which additional services or fees may be charged;
(5) The resident shall be informed of his or her rights, including steps for complaints and appeals upon admission; and
(6) Designation of alternative decision-maker or legal representative.
(b) The facility shall develop discharge policies and procedures that include, but not be limited to, the following:
(1) Residents shall receive a written 14 day notice when:
(A) Resident’s behavior imposes an imminent danger to self or others;
(B) The facility cannot meet the resident’s needs with available support services or services are not available; and
(C) Resident or responsible person has a documented established pattern in the facility of not abiding by agreements necessary for assisted living; or
(2) Residents shall receive a written notice when:
(A) The facility has had its license revoked, not renewed, or voluntarily surrendered; or
(B) Non-payment of charges by the resident.
(3) Residents shall be given the opportunity of an informal conference if requested, in writing, within 10 days of receipt of discharge notice. The purpose of the conference is to determine if a satisfactory resolution can be reached. Participants in the conference may include the facility representative, the resident, and others as designated by the resident, a family member, or all of these individuals.
Top Takeaways:
- (4) A service contract which documents a completed agreement between the resident and the facility, describing services to be provided, rates charged, and conditions under which additional services or fees may be charged.
You must spell out exactly what services the community is providing to the resident both in terms of care and comfort measures. Ensure the resident and their representative understand what it is they are paying for.
- (1) Residents shall receive a written 14-day notice when:
(A) Resident’s behavior imposes an imminent danger to self or others;
(B) The facility cannot meet the resident’s needs with available support services or services are not available; and
(C) Resident or responsible person has a documented established pattern in the facility of not abiding by agreements necessary for assisted living; or
(2) Residents shall receive a written notice when:
(A) The facility has had its license revoked, not renewed, or voluntarily surrendered; or
(B) Non-payment of charges by the resident.
If you plan on discharging a resident, you must provide them with a written 14-day notice. Typically, the resident is being discharged for issues such as the community being unable to meet their needs, behavior that is causing danger to themselves or others and even the non-payment of their monthly fees. Ensure you have documented any situations that would denote the reasons as to why the resident is being discharged.
Pro Tip:
- Clinical, administration and marketing need to be on the same page when it comes to the type of resident you are looking to admit into the community. Ensure you have a process on how to identify the proper fit for you. A red light, yellow light, green light system has proven to work for many facilities.