Required services in the CBRF
One of the most common reasons why a person may move into an assisted living facility is the fact that they need assistance with their activities of daily living. ADL’s may include tasks such as assistance with using the restroom, brushing their teeth, getting dressed for the day or even being tucked in for a night’s sleep. Residents also require a bevy of other services to augment their care such as social activies, coordintating with third party providers and even nursing services. That is where we come in- our job is to make our residents feel as independent as possible while providing assistance with things they either do not want to do or tasks they cannot perform. For more information on what services the state of Wisconsin expects your facility to perform check out the following regulation:
DHS 83.38 Program services.
(1) Services. As appropriate, the CBRF shall teach residents the necessary skills to achieve and maintain the resident’s highest level of functioning. In addition to the assessed needs as determined under s. DHS 83.35 (1), the CBRF shall provide or arrange services adequate to meet the needs of the residents in all of the following areas:
(a) Personal care. Personal care services shall be designed and provided to allow a resident to increase or maintain independence.
(b) Supervision. The CBRF shall provide supervision appropriate to the resident’s needs.
(c) Leisure time activities. The CBRF shall provide a daily activity program to meet the interests and capabilities of the residents. Employees shall encourage and promote resident participation in the activity program. The CBRF shall develop and post the activity schedule in an area available to residents.
(d) Community activities. The CBRF shall provide information and assistance to facilitate participation in personal and community activities. The CBRF shall develop, update and make available to all residents, monthly schedules and notices of community activities, including costs.
(e) Family and social contacts. The CBRF shall encourage and assist residents in maintaining family and social contacts.
(f) Communication skills. The CBRF shall provide services to meet the resident’s communication needs.
(g) Health monitoring.
- The CBRF shall monitor the health of residents and make arrangements for physical health, oral health or mental health services unless otherwise arranged for by the resident. Each resident shall have an annual physical health examination completed by a physician or an advanced practice nurse as defined in s. N 8.02 (1), unless seen by a physician or an advanced practice nurse as defined in s. N 8.02 (1)more frequently.
- When indicated, a CBRF shall observe residents’ food and fluid intake and acceptance of diet. The CBRF shall report significant deviations from normal food and fluid intake patterns to the resident’s physician or dietician.
- The CBRF shall document communication with the resident’s physician and other health care providers, and shall record any changes in the resident’s health or mental health status in the resident’s record.
(h) Medication administration. The CBRF shall provide medication administration appropriate to the resident’s needs.
(i) Behavior management. The CBRF shall provide services to manage resident’s behaviors that may be harmful to themselves or others.
(j) Information and referral. The CBRF shall provide information and referral to appropriate community services.
(k) Transportation. The CBRF shall provide or arrange for transportation when needed for medical appointments, work, educational or training programs, religious services and for a reasonable number of community activities of interest. CBRFs that transport residents shall develop and implement written policies addressing the safe and secure transportation of residents.
(2) Terminally ill resident services.
(a) A CBRF may provide more than 3 hours of nursing care per week to a resident who has a terminal illness and who requires the care under the following conditions:
- The resident’s primary care provider is a licensed hospice or licensed home health agency.
- The resident’s primary care provider is not a licensed hospice or licensed home health agency, and the CBRF obtains a waiver from the department.
(b) When a resident who requires less than 3 hours of nursing care or the resident’s legal representative waives the services of a hospice program or home health agency, the CBRF shall develop and implement the written plan of care required under par. (c), which the resident’s primary physician shall review and approve.
(c) The primary care provider and the CBRF shall develop a written, coordinated plan of care before the initiation of palliative or supportive care.
- (c)Leisure time activities. The CBRF shall provide a daily activity program to meet the interests and capabilities of the residents. Employees shall encourage and promote resident participation in the activity program. The CBRF shall develop and post the activity schedule in an area available to residents.
Administrators often fail to see the importance of the “activities” program. The first problem is we fail to see this as more than just “activities”. These are life enrichment tools that add value and give fulfillment to the lives of older adults. The enrichment programming in an ALF provides structure to the resident’s day and gives them different events to attend throughout the day. Make sure the schedule of activities is posted for residents to see.
- (k)The CBRF shall provide or arrange for transportation when needed for medical appointments, work, educational or training programs, religious services and for a reasonable number of community activities of interest. CBRFs that transport residents shall develop and implement written policies addressing the safe and secure transportation of residents.
Many CBRFs are now at the point where they have on site transportation available via bus or van for residents to be taken to facility scheduled leisure activities or even medical appointments for residents who do not drive. If your CBRF does not own its own transportation you must arrange for the transportation through a third party.