Assisted Living/Boarding Home
Last Updated: September 26, 2009 7:15 PM
• Interior Finish Checklist/Guidelines from Construction Review August 2009 Link
• Chart Orders and the DEA Issues Brief
AAHSA is part of a coalition effort led by the American Society of Consultant Pharmacists (ASCP), and including with a variety of other provider, pharmacy, and health professional groups to resolve the current concerns with DEA activities around the use of “chart orders” for providing timely access to Schedule II-V medications in nursing homes. Attached please find an issue brief explaining and summarizing these concerns. Link
• Boarding Home Rules Being Amended
Aging Services is involved in current rulemaking as DSHS/ADSA seeks to amend the boarding home licensing and Medicaid contracting WACs.
According to a recent Dear Administrator letter, changes to contracting WACs are: to clarify boarding home physical requirements for contracted assisted living services; to include kitchen sink requirements in resident units that were inadvertently omitted during a previous rulemaking; and to clarify rule language and delete unnecessary or redundant language
Changes to licensing WACs are to consider making editorial and clarifying changes, and to make them consistent with current laws and standards.
• Caregiver Training Revisions
With the coming implementation of I-1029 and resulting changes in training requirements for boarding home (assisted living) and nursing home caregivers, DSHS/ADSA is reviewing the existing 'learning outcomes' of the current Revised Fundamentals of Caregiving curriculum for necessary amendments. Aging Services is participating in this effort and will continue to keep its members apprised of any changes and potential impacts.
• Post Fall Assessment sample for 7-2009
•All licensed boarding homes are required to be in compliance with the following by July 26th
Sample #1 Medicaid Policy - Resident Applicant - Private Pay Non-Medicaid Participation Notification 7/15/09 Sample #2 Resident - Private Pay Non-Medicaid Participation Notification 7/15/09 Sample #3 Resident Applicant - Active Medicaid Contract Participation Notification 7/15/09 Sample #4 Resident - Active Medicaid Contract Participation Notification 7/15/09
DSHS is required to implement Substitute Senate Bill 6009 as passed during the 2009 legislative session, effective July 26, 2009. You will have received a Dear Provider letter regarding this change dated July 2, and numbered BH 2009-013. (It is linked below) While the department has yet to adopt rules incorporating the new law, you are required to comply regardless. http://www.aasa.dshs.wa.gov/Professional/letters/BH/2009/09-013.htm
You will recall that at the end of the 2008 legislative session, all boarding home providers were required to notify resident applicants of their Medicaid participation policies, regardless of whether or not a boarding home had a Medicaid contract or not. Specifically, these policies discussed Medicaid contract participation and/or termination policies. Above are four (4) revised sample Medicaid and Private-Pay Notification notices, written by Aging Services of Washington, which add the requirements of the new law to the 2008 forms. At the top of the policies you will see an italicized paragraph which highlights your responsibilities, and there are different sample forms for Resident Applicants and current Residents.
The new law added a few NEW requirements for notification. Resident applicants and residents alike must now be told of the policy, including your current residents. Other requirements include a minimum 14 point size font, signatures, dates, and other record-keeping items. Current residents must receive a copy of your new policy by the effective date of July 26, 2009. While the law does not specifically state that the current resident must also sign and date the new policy by July 26, it would be in your best interest to ensure that this accomplished in order to meet the intent of the requirement. If you are unable to obtain signatures and dates from all of your current residents by that date, it might be helpful to document your distribution of the policy itself and your efforts and/or requests for return.
• Medicaid Cuts to Medical & Nutritional Supplies for Residents
In light of the budget difficulties faced by our state, DSHS is instituting significant cutbacks or elimination of coverage on many of the medical supplies your residents may use, including diabetic supplies, bathroom aids, incontinence supplies and oral nutritional products. Attached is a fact sheet which clearly states which areas are being cut or significantly diminished: http://hrsa.dshs.wa.gov/News/DMEChanges.htm
PLEASE NOTE that these changes were effective July 1 in some areas, and will be effective August 1 for the remainder. The Dear Provider letter announcing the change is here:
http://www.aasa.dshs.wa.gov/Professional/letters/BH/2009/09-012.htm
There will be a Limitation Extension Request form/process which can be accessed for residents whose health care needs may not be met with these reductions. We will alert you when that form is available. Be aware, however, that we believe the approval of these requests may be difficult to obtain in all cases.
• If you’re still using EMS DNR forms in your resident files, you may wish to reconsider that policy. Standard policies and procedures for nursing homes and assisted living facilities now incorporate the POLST form. July 22
POLST Resources:
A link to the POLST resource page on the Wa. State Medical Association's web page: http://www.wsma.org/patient_resources/polst.cfm#download
Individual documents for your use and a greater understanding of the use of POLST in your community:
Sample POLST Nursing Home Policies - also use these for assisted living, edited as needed:
http://www.awphd.org/EndOfLife/NursingHomePOLSTPolicies.pdf
http://www.awphd.org/EndOfLife/MtBakerNursingHome.pdf
Sample POLST Flow Chart - amend as needed for assisted living:
http://www.awphd.org/EndOfLife/samplePOLSTflowCharts.pdf
Analysis of revisions to POLST form as of 12/2008:
http://www.wsma.org/files/Downloads/PatientResources/2008_polst_revisions.pdf
Revised POLST form 12/2008 - older versions are still accepted:
http://www.wsma.org/files/Downloads/PatientResources/polst_form.pdf
• BOARDING HOME DEAR PROVIDER LETTERS:
http://www.aasa.dshs.wa.gov/Professional/letters/BH/2009/09-013.htm
• Licensing Inspection Trends - Your Inspection Reports Needed
Aging Services of Washington, at the request of many of its members, will now be analyzing assisted living inspection reports AND nursing home survey reports for the purposes of sharing finding/citation trends, assisting with Plans of Correction and identifying opportunities for continued staff training.
For those members who wish to participate, all identifying data will be kept confidential. Sharing of inspection or survey reports with Aging Services is voluntary, but we encourage you to consider joining our efforts so that we can all learn together.
Please SCAN your reports, making a .pdf document, then email the .pdf file to Julie at jpeterson@agingwa.org. or FAX to (253) 964-8876
Senior Assisted Living / Boarding Home Providers now have a new resource for up-to-the minute news, rules and professional development opportunities:
Visit our BLOG through the link on our website, Aging Services of Washington, by clicking here: www.agingwa.org/members/online_communities.php, then choose "Assisted Living" on the left side of the page to be directed to AL/BH -related news.
Last updated: September 26, 2009 7:15 PM