Admission and discharge requirements

It is always an exciting time when a new resident chooses to move into your community! Many hours of work from your team have paid off and now you welcome a new member to the “family”- but its not done yet! The state of West Virginia requires a written admission agreement for every new person moving into an Assisted Living Facility. Agreements should always be signed prior to the resident moving in or taking possession of the apartment. Check out the regulations below as to what needs to be included in the written admission agreement:

 

4.7.  Administrative Admission and Discharge.

 

4.7.1.  The licensee shall not discriminate against residents or a prospective resident on the basis of race, national origin, religion, age, gender, sexual orientation, or disability.  (Class III)

 

4.7.2.  The licensee shall enter into a written contract with the resident on admission to the residence that specifies, at a minimum, the following information:

 

4.7.2.a.  The type of resident population that the residence is licensed to serve and will serve;

 

4.7.2.b.  The health and nursing care services that the residence will provide to meet the resident’s needs, including cardiopulmonary resuscitation, and how they will be provided;

 

4.7.2.c.  An annual or monthly contract price, full disclosure of all costs including what changes in care needs will result in increases, additions or modifications to the costs, the refund policy, and an assurance that the resident shall not be held liable for any cost that was not disclosed;

 

4.7.2.d.  Discharge criteria, including notification policies;

 

4.7.2.e.  How to file a complaint;

 

4.7.2.f.  Medication storage, handling, distribution, and disposition, and responsibility for payment;

 

4.7.2.g.  Management of residents’ funds; and

 

4.7.2.h.  Whether or not the residence has liability insurance coverage.  (Class III)

 

4.7.3.  The licensee shall provide a copy of the contract to each party in the contract and maintain a copy of the contract on file in the residence. If the existing contract does not meet the requirements of this rule, the licensee shall provide current residents with a new or updated contract that includes the required provisions within 90 days of the effective date of this rule.  (Class III)

 

4.7.4.  At the same time as providing the contract, the licensee shall also provide the resident with the following information:

 

4.7.4.a.  House rules governing resident behavior and responsibilities, including the residence’s smoking policy;

 

4.7.4.b.  The resident’s bill of rights;

 

4.7.4.c.  How the resident’s personal property will be protected from loss and theft;

 

4.7.4.d.  The requirements for medical examinations and treatment orders;

 

4.7.4.e.  How the resident will be assisted in making appointments for medical, dental, nursing, or mental health services, and how transportation to and from these services will be arranged; and

 

4.7.4.f.  How to access the residence’s policies and procedures.  (Class III)

 

4.7.5.  The licensee is prohibited from entering into a life care contract without the prior written permission of the Secretary.  In making a determination to grant permission, the Secretary shall consider the licensee’s financial situation by reviewing the licensee’s financial statements for a minimum of three years and any related information he or she requests; the licensee’s experience in the management of a life care community; and the licensee’s ability to potentially manage residents with a catastrophic illness or disease.  (Class III)

 

4.7.6.  Thirty days prior to any increase, addition, or other modification of the rates of the resident’s care or services, the licensee shall give the resident a written notice of the proposed change.  However, when the increase, addition, or modification in cost is required by the resident’s increased care needs as determined by a licensed health care professional, and the licensee has informed the residents, in writing, of the possibility of such increase, addition, or modification at the time of admission and periodically during his or her stay, the 30-day notice shall be waived.  The licensee shall instead give the residents a choice between paying the increase, addition, or modification or moving to another residence.  If the resident chooses to move, the resident is required to give notice of the move as set out in the admission contract.  (Class III)

 

4.7.7.  The licensee shall give the resident notice of and file a copy of the notice in the resident’s record of the 30-day written notice prior to discharge, unless an emergency situation arises that requires the resident’s transfer to a hospital or other higher level of care, or if the resident is a danger to him or herself or others.  (Class III) The licensee shall assist the resident to find an alternative placement that is appropriate to the resident’s individual needs as identified by the service plan.

 

4.7.8.  The licensee shall maintain a register of all residents in order by the dates of the residents’ admissions.  The register shall include each resident’s name, the date of admission, the date of his or her last day in the residence, and if transferred, the name of the place to which the resident was transferred.  (Class III)

 

4.7.9.  The licensee shall keep resident records in safe storage for at least five years from the date of the death, discharge, or transfer of the resident.  If the residence ceases to operate, the licensee shall procure a holding area for the resident records that will ensure the confidentiality and safety of the records from loss, destruction, or unauthorized use.  (Class III)

Top Takeaways:

  • 7.2.c. An annual or monthly contract price, full disclosure of all costs including what changes in care needs will result in increases, additions or modifications to the costs, the refund policy, and an assurance that the resident shall not be held liable for any cost that was not disclosed;

One of the biggest complaint’s administrators see from residents is the misunderstanding of what they are paying for. You need to make sure each price point is set out in writing and explained in detail so the resident is fully aware of where their money is going.

  • 7.7. The licensee shall give the resident notice of and file a copy of the notice in the resident’s record of the 30-day written notice prior to discharge, unless an emergency situation arises that requires the resident’s transfer to a hospital or other higher level of care, or if the resident is a danger to him or herself or others.  (Class III) The licensee shall assist the resident to find an alternative placement that is appropriate to the resident’s individual needs as identified by the service plan.

If you plan on discharging a resident, you must provide them with a 30-day notice. It would behoove you to have documentation on the reasoning as to why you are discharging the resident to ensure it is justified.

Pro Tip:

Often times a community will be cited during a visit from the OHFLAC due to not providing record of a written resident agreement. You should have a system that 1. Identifies WHEN the contract shall be signed and WHO will be present for the signing. 2. Tracking system for resident written admission agreement after completion. (It is recommended to keep a binder or folder for each resident with any documents pertinent to their residency just as you would with a clinical chart).

 

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