Application and admission process
One of the most important responsibilities a facility has is allowing a resident to age in place while maintaining compliance with state regulations. The best way to ensure residents are able to remain in your community for the duration of their life is to have a thorough application and evaluation process to qualify the client as a good fit for the scope of your community’s clinical care. If you cannot provide the care this person needs at the beginning, then it is certain they will not remain under your care for long. Check out the following regulation provided by the Department of Human Services the requirement for a resident evaluation prior to admission:
2800.22. Application and admission.
(a) Documentation. The following admission documents shall be completed for each resident:
(1) Medical evaluation completed within 60 days prior to admission on a form specified by the Department. The medical evaluation may be completed within 15 days after admission if one of the following conditions applies:
(i) The resident is being admitted directly to the residence from an acute care hospital.
(ii) The resident is being admitted to escape from an abusive situation.
(iii) The resident has no alternative living arrangement.
(2) Assisted living resident initial assessment completed within 30 days prior to admission on a form specified by the Department. The initial assessment may be completed within 15 days after admission subject to § 2800.224 (relating to initial assessment and preliminary support plan).
(3) Preliminary support plan developed within 30 days prior to admission. The preliminary support plan may be completed within 15 days after admission if one of the following conditions applies:
(i) The resident is being admitted directly to the residence from an acute care hospital.
(ii) The resident is being admitted to escape from an abusive situation.
(iii) The resident has no alternative living arrangement.
(4) Final support plan is developed and implemented within 30 days after admission.
(5) Resident-residence contract is completed prior to admission or within 24 hours after admission.
(6) Medical evaluations, resident assessments and support plans may be subsequently updated as needed, but no less frequently than required in §§ 2800.225 and 2800.227 (relating to additional assessments; and development of the final support plan).
(b) Certification.
(1) A certification shall be made, prior to admission, that the needs of the potential resident can be met by the services provided by the residence.
(2) The certification shall be made by one of the following persons:
(i) The administrator acting in consultation with the supplemental health care providers.
(ii) The individual’s physician or certified registered nurse practitioner.
(iii) The medical director of the residence.
(3) A potential resident whose needs cannot be met by the residence shall be provided with a written decision denying his admission and provide a basis for the denial. The decision shall be confidential and may only be released with the consent of the potential resident or his designated person. The potential resident shall then be referred to a local appropriate assessment agency.
(c) Supplemental health care. A potential resident who requires assisted living services but does not currently require assistance in obtaining supplemental health care services may be admitted to the residence, provided the resident is only provided supplemental health care services required or requested by the resident. When supplemental health care services are required, the residence shall develop a preliminary support plan as required in § 2800.224. This subsection applies to residents under any of the following circumstances:
(1) A resident who currently does not require assistance in obtaining supplemental health care services, but who may require supplemental health care services in the future.
(2) A resident who wishes to obtain assistance in obtaining supplemental health care services.
(3) A resident who resides in a residence in which supplemental health care services are available.
(d) Adults requiring services of a long-term care nursing facility. Adults requiring the services of a licensed long-term care nursing facility, including those with mobility needs, may reside in a residence, provided that appropriate supplemental health care services are provided those residents and the design, construction, staffing and operation of the residence allows for their safe emergency evacuation.
(e) Written disclosure. Upon application for residency and prior to admission to the residence, the licensee shall provide each potential resident or potential resident’s designated person with written disclosures that include:
(1) A list of the nonwaivable resident rights.
(2) A copy of the contract the resident will be asked to sign.
(3) A copy of residence rules and resident handbook. The resident handbook shall be approved by the Department.
(4) Specific information about the following:
(i) The services and the core packages that are offered by the residence.
(ii) The cost of those services and of the core packages to the potential resident.
(iii) When a potential resident may require the services offered in a different core package.
(iv) The contact information for the Department.
(v) The licensing status of the most recent inspection reports and instructions for access to the Department’s public website for information on the residence’s most recent inspection reports.
(vi) The number of living units in the residence that comply with the Americans with Disabilities Act (42 U.S.C.A. §§ 12101—12213).
(vii) Disclosure of any waivers that have been approved for the residence and are still in effect.
Top Takeaway:
- (1) Medical evaluation completed within 60 days prior to admission on a form specified by the Department. The medical evaluation may be completed within 15 days after admission if one of the following conditions applies:
(i) The resident is being admitted directly to the residence from an acute care hospital.
(ii) The resident is being admitted to escape from an abusive situation.
(iii) The resident has no alternative living arrangement.
One of the most important elements of admitting a new resident is the initial physical examination by a physician and the assessment your clinical team preforms. This process will determine if you are able to provide the services that this resident will require, ultimately deciding if you can move forward with admitting this resident. Unfortunately, your facility is not equipped to handle every person who walks through its doors and it is better to know this at the beginning rather than 3 weeks after the resident moves into your community. I can almost guarantee you will be cited if you do not have a medical evaluation on file from the required 30 days prior to admission. Ensure you are reviewing this on EVERY new resident moving into the facility.