The written agreement

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 it’s not done yet! The state of 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:

22VAC40-73-390. Resident agreement with the facility.

  1. At or prior to the time of admission, there shall be a written agreement/acknowledgment of notification dated and signed by the resident or applicant for admission or the appropriate legal representative, and by the licensee or administrator. This document shall include the following:
  2. Financial arrangement for accommodations, services, and care that specifies:
  3. Listing of specific charges for accommodations, services, and care to be made to the individual resident signing the agreement, the frequency of payment, and any rules relating to nonpayment;
  4. Description of all accommodations, services, and care that the facility offers and any related charges;
  5. For an auxiliary grant recipient, a list of services included under the auxiliary grant rate;
  6. The amount and purpose of an advance payment or deposit payment and the refund policy for such payment, except that recipients of auxiliary grants may not be charged an advance payment or deposit payment;
  7. The policy with respect to increases in charges and length of time for advance notice of intent to increase charges
  8. If the ownership of any personal property, real estate, money or financial investments is to be transferred to the facility at the time of admission or at some future date, it shall be stipulated in the agreement; and
  9. The refund policy to apply when transfer of ownership, closing of facility, or resident transfer or discharge occurs.
  10. Requirements or rules to be imposed regarding resident conduct and other restrictions or special conditions.
  11. Those actions, circumstances, or conditions that would result or might result in the resident’s discharge from the facility.
  12. Specific acknowledgments that:
  13. Requirements or rules regarding resident conduct, other restrictions, or special conditions have been reviewed by the resident or his legal representative;
  14. The resident or his legal representative has been informed of the policy regarding the amount of notice required when a resident wishes to move from the facility;
  15. The resident has been informed of the policy required by 22VAC40-73-840 regarding pets living in the facility;
  16. The resident has been informed of the policy required by 22VAC40-73-860 K regarding weapons;
  17. The resident or his legal representative or responsible individual as stipulated in 22VAC40-73-550 H has reviewed § 63.2-1808 of the Code of Virginia, Rights and Responsibilities of Residents of Assisted Living Facilities, and that the provisions of this statute have been explained to him;
  18. The resident or his legal representative or responsible individual as stipulated in 22VAC40-73-550 H has reviewed and had explained to him the facility’s policies and procedures for implementing § 63.2-1808 of the Code of Virginia;
  19. The resident has been informed and had explained to him that he may refuse release of information regarding his personal affairs and records to any individual outside the facility, except as otherwise provided in law and except in case of his transfer to another caregiving facility, notwithstanding any requirements of this chapter;
  20. The resident has been informed that interested residents may establish and maintain a resident council, that the facility is responsible for providing assistance with the formation and maintenance of the council, whether or not such a council currently exists in the facility, and the general purpose of a resident council (See 22VAC40-73-830);
  21. The resident has been informed of the bed hold policy in case of temporary transfer or movement from the facility, if the facility has such a policy (See 22VAC40-73-420 B);
  22. The resident has been informed of the policy or guidelines regarding visiting in the facility, if the facility has such a policy or guidelines (See 22VAC40-73-540 C);
  23. The resident has been informed of the rules and restrictions regarding smoking on the premises of the facility, including that which is required by 22VAC40-73- 820;
  24. The resident has been informed of the policy regarding the administration and storage of medications and dietary supplements;
  25. The resident has been notified in writing whether or not the facility maintains liability insurance that provides at least the minimum amount of coverage established by the board for disclosure purposes set forth in 22VAC40-73-45 to compensate residents or other individuals for injuries and losses from negligent acts of the facility. The facility shall state in the notification the minimum amount of coverage established by the board in 22VAC40-73-45. The written notification must be on a form developed by the department; and
  26. The resident has received written assurance that the facility has the appropriate license to meet his care needs at the time of admission, as required by 22VAC40-73-310 D.
  27. Copies of the signed agreement/acknowledgment and any updates as noted in subsection C of this section shall be provided to the resident and, as appropriate, his legal representative and shall be retained in the resident’s record.
  28. The original agreement/acknowledgment shall be updated whenever there are changes to any of the policies or information referenced or identified in the agreement/acknowledgment and dated and signed by the licensee or administrator and the resident or his legal representative.

Top Takeaways:

  • Listing of specific charges for accommodations, services, and care to be made to the individual resident signing the agreement, the frequency of payment, and any rules relating to nonpayment

You need to provide residents a breakdown of everything they are paying for to ensure there is no miscommunication about finances. Talk through what they should expect with every service.

Pro Tip:

  • Often times a facility will be cited during an unexpected visit for not keeping proper record of the written admission agreement. Ensure that your community has a policy in place for 1. Identifying WHEN the contract will 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).