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  • Senior Living Leadership: From Executive Director to Vice President of Operations for Corporations

    Senior living communities play a crucial role in providing a comfortable and supportive environment for aging individuals. Within these communities, leadership positions are essential for ensuring the well-being of residents and the efficient operation of the facility. In this blog post, we'll explore the hierarchy of leadership in senior living, from the Executive Director to the Vice President of Operations for corporations, highlighting the roles, responsibilities, and career progression. We'll also incorporate relevant keywords for SEO optimization. 1. Executive Director Role and Responsibilities: The Executive Director is the highest-ranking administrator within a senior living community. They are responsible for the overall management and operation of the facility. Their key responsibilities include: Strategic Planning: Developing and implementing strategies to improve the quality of care and resident satisfaction. Staff Management: Overseeing and managing all staff, ensuring they are well-trained and providing high-quality care. Financial Oversight: Managing the budget and financial aspects of the community, including cost control and revenue generation. Regulatory Compliance: Ensuring the facility complies with all state and federal regulations governing senior living. Resident and Family Relations: Building positive relationships with residents and their families to ensure their needs are met. Career Path: Many Executive Directors begin their careers as department heads or managers within senior living communities. Gaining experience in various leadership roles, such as Director of Nursing or Director of Sales and Marketing, can help prepare individuals for this top leadership position. 2. Regional Director or Regional Operations Manager Role and Responsibilities: Regional Directors oversee the operation of multiple senior living communities within a specific geographical area. Their primary responsibilities include: Operational Oversight: Ensuring consistent quality of care, adherence to company policies, and regulatory compliance across multiple facilities. Staff Development: Supporting and mentoring Executive Directors within their region, helping them enhance their leadership skills. Financial Performance: Monitoring the financial performance of facilities, identifying areas for improvement, and implementing strategies to drive revenue and control costs. Strategic Planning: Collaborating with corporate leadership to develop and implement regional strategies. Career Path: Regional Directors typically have extensive experience as Executive Directors. They demonstrate strong leadership, operational, and financial management skills, which qualify them for this regional role. 3. Vice President of Operations for Corporations Role and Responsibilities: The Vice President of Operations for senior living corporations is a high-level executive overseeing multiple senior living communities. Their responsibilities include: Strategic Leadership: Developing and implementing corporate strategies to drive the success and growth of senior living communities. Regional Oversight: Managing the regional directors and ensuring that each community meets corporate standards and goals. Financial Management: Overseeing financial performance, including budgets, cost control, and revenue generation, across all communities. Regulatory Compliance: Ensuring that all facilities adhere to state and federal regulations. Quality Assurance: Implementing programs and initiatives to maintain high-quality care and services for residents. Career Path: Individuals in this role often have a background as regional directors, extensive senior living experience, and a proven track record of effective leadership in the industry. Leadership in senior living communities is a dynamic and rewarding career path. The hierarchy of leadership, from the Executive Director to the Vice President of Operations for corporations, plays a crucial role in ensuring the well-being of residents and the efficient operation of senior living facilities. As individuals progress through these leadership roles, they gain valuable experience, build critical skills, and contribute to the overall success of senior living communities. Whether you're just starting your career or looking to advance in the field, the senior living industry offers a range of exciting leadership opportunities for those passionate about making a positive impact on the lives of seniors.

  • April 11, 2024

    Information from ODH Provider Quarterly Meeting: Survey Status: 232 overdue annual surveys. RCF Rule set Status:  RCF rules package 3701-16: Rules have been sent for original file and OPHAB/Director’s Hearing/JCARR are in the process of being scheduled. MyCare informational update The Ohio Department of Medicaid (ODM) has officially begun work on procuring the Next Generation of MyCare Ohio. In the coming months, ODM will release a request for applications for managed care plans to serve as the MyCare Ohio plans as we transition out of the Financial Alignment Initiative demonstration and move toward a Fully Integrated Dual-Eligible Special Needs Plan (FIDE SNP) model. Beginning in January of 2026, the selected FIDE SNPs will begin covering the full Medicare and Medicaid benefits for those who qualify in the current 29 demonstration counties, with statewide expansion as expeditiously as possible. Learn more by reading the full MyCare informational update.  See below for Updated contact information. Ohio Department of Aging Assisted Living Wednesday’s virtual meeting calls The Department of Aging is beginning monthly calls for waiver providers. These calls will be held virtually on the second Wednesday of each month from 2:00 p.m. to 2:30 p.m.  The meetings are meant to be informal, educational and, a platform where you can ask questions as well as learn about best practices. Please see the attached memo for meeting dates/topics and, a virtual link, as well as the slide presentation from today’s meeting. Member Questions Are RCFs allowed to outsource to home health to come in and do monthly vitals and weights for our residents? Yes, it is common that this takes place, provided your home health agency is willing to do so. Many facilities incorporate a type of “wellness clinic” monthly hosted by a home health agency to perform basic vitals. You would want this to be well documented and it would be the facility's responsibility to ensure documentation as well as ensure residents who might not take place in this event were still weighed regularly. Can a Certified Medication Aid check blood sugars? Yes, just as your direct care staff can do this, as long as they have been trained on the procedure and the training has been documented. If a resident is receiving Hospice services but does not have a skilled need i.e. catheter changes or wound care do we need to count Hospice visits as skilled days towards the 120 days? No, you would only count the day that an RN came to do an assessment as a skilled day. The days aides came to perform services would not be counted towards skilled days. Do we have to check caregivers who are not STNAs on the Nurse Aide Registry? Yes. All direct care applicants (including STNAs) must be checked on the nurse aide registry for abuse, neglect, misappropriation, and exploitation. They must also be checked on the nurse aide registry of any other state that the RCF believes or knows the applicant resided in. Additionally, all licensed professionals who provide direct care must be checked on the appropriate professional websites for disciplinary actions regarding abuse, neglect, misappropriation, and exploitation. If there is a finding, the individual cannot be employed. OAC 3701-16-06 A log or screenshot of the check is acceptable documentation. (L) No residential care facility shall employ a person for a position that involves the provision of direct care to an older adult if the person: (3) Is the subject of a finding of abuse or neglect of a resident or misappropriation of the property of a resident on the nurse aide registry, established pursuant to section 3721.32 of the Revised Code; (4) Is the subject of a finding of abuse or neglect of a resident or misappropriation of the property of a resident on the nurse aide registry established by another state where the home believes or has reason to believe the person resides or resided; or (5) Have had a disciplinary action taken against a professional license by a state licensure body as a result of a finding of abuse, neglect, mistreatment of residents or misappropriation of resident property. “Direct care” includes positions beyond resident caregivers. It covers any individuals with routine contact with residents, who are alone with residents or have access to their personal property or documents. Simply put, it is everyone you are required to do a criminal record background check on. The definition of direct care can be found at OAC 3701-13-01 (F) Please note that you must use your Facility ID when you access the Nurse Aide Registry to complete the required check. CLICK HERE for information to assist in finding your facility ID. Do resident caregivers in RCFs need a high school diploma or GED? What about age requirements? No. RCF rules do not require a resident caregiver in an RCF to possess a high school diploma or a GED. Rules do stipulate, however, that all resident aides must be at least 16 years of age and have on-site supervision by someone over the age of 18. OAC 3701-16-06 (D)(1). Additionally, anyone who “assists” residents with self-administration of medication must be able to read, write, and understand information and directions in English. OAC 3701-16-06 (D)(2). Staff members that are providing personal care assistance must also be trained in these procedures as well, OAC 3701-16-06 (E)(2)... (2) Have documentation that, prior to providing personal care services without supervision in the facility, the staff member met one of the following requirements: (a) Successfully completed training or continuing education that shall cover, as is necessary to meet the needs of residents in the facility, the following: (i) The correct techniques of providing personal care services as required by the staff member's job responsibilities; (ii) Observational skills such as recognizing changes in residents' normal status and the facility's procedures for reporting changes; and (iii) Communication and interpersonal skills. How to find facility survey results that are publicly available https://prod.ltc.age.ohio.gov/FacilitySearch The above screen will appear, Facility Type: Assisted Living, Use your County, use your City, then click on SEARCH. The above screen will come up, check the box in front of your facility, then Click SEARCH The above screen will show: Click on the actual date of the Survey ex: 7/6/2023. Then you will click on the actual date of the survey to see publicly available results. If individuals come to us for a “respite” stay, should they sign a different resident agreement? Recently, many providers have reached out regarding the resident agreement on “respite stays”, as they have become more prevalent; whether to help facilitate a needed move to the community or for actual respite care while families are in need of care for a loved one for a limited amount of time. It is important to recognize that currently, Ohio law does not provide any statutory authority for a "respite" stay in an RCF. Thus, a resident admitted under the anticipation of a "respite" stay is entitled to all of the same rights as a "standard" resident, including the right not to be discharged except for statutorily defined reasons. Put another way, from the law's perspective, there is no such thing as a "respite" resident, just an RCF resident. Facilities that admit residents under the anticipation that the stay will just be for a short term, bear the risk that they may not be able to legally discharge the resident at the end of the "respite" stay if the resident decides to remain a resident. All that being said, if an organization decides to offer a respite program, there is no prohibition on it, providing a separate agreement from its standard agreement, as long as it meets all law and rule resident agreement requirements.

  • Exploring Job Opportunities in Assisted Living and Senior Living: A Rewarding Career Path

    As the population ages, the demand for quality care and support in assisted living and senior living communities is on the rise. This growing need for senior care services has created a wide array of job opportunities in the field. In this blog post, we will delve into the various job roles available in assisted living and senior living, highlighting the rewarding aspects of working in this industry. We will also incorporate relevant keywords to ensure SEO optimization. 1. Assisted Living Jobs a. Caregivers and Certified Nursing Assistants (CNAs) Caregivers and CNAs are the heart of assisted living communities. They provide direct care to residents, helping with activities of daily living (ADLs) such as bathing, dressing, and medication management. Compassion and a commitment to improving residents' quality of life are essential qualities for these roles. b. Medication Technicians Medication technicians are responsible for administering and managing medications for residents. They ensure that residents receive the correct medications at the right time and in the proper dosage. c. Activities Directors Activities directors plan and organize social and recreational activities for residents. These activities promote engagement, physical and mental well-being, and a sense of community. d. Dietary Staff and Chefs Assisted living facilities often employ dietary staff and chefs to prepare and serve nutritious meals. They work closely with dietitians to ensure residents' dietary needs are met. 2. Senior Living Jobs a. Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) RNs and LPNs provide clinical care to senior residents, including administering medical treatments, coordinating healthcare services, and monitoring health conditions. b. Social Workers Social workers in senior living communities offer emotional support, assist with family communication, and help residents access community resources and services. c. Activities and Lifestyle Coordinators Similar to activities directors in assisted living, activities and lifestyle coordinators in senior living communities create programs that enhance residents' quality of life, promote wellness, and provide social opportunities. d. Administrative and Support Roles Senior living communities also employ administrative and support staff, including receptionists, maintenance personnel, and housekeeping staff, to ensure the smooth operation of the facility. Rewards of Working in Assisted Living and Senior Living Working in the assisted living and senior living industry can be incredibly rewarding. Here are some of the key benefits: 1. Fulfillment Providing care and support to seniors can be deeply fulfilling. Knowing that your work makes a positive difference in their lives is a powerful motivator. 2. Job Stability With the aging population, the demand for senior care services continues to grow, providing a high level of job security in the industry. 3. Diverse Opportunities The industry offers diverse career paths, allowing individuals to pursue roles in caregiving, healthcare, administration, and more. 4. Competitive Compensation Many senior living communities offer competitive salaries and benefits to attract and retain talented staff. 5. Training and Advancement The industry provides opportunities for professional development and career advancement. For example, CNAs can become LPNs, and LPNs can advance to RN positions. Job opportunities in assisted living and senior living communities are both abundant and rewarding. Whether you're interested in caregiving, healthcare, social work, or administration, there's a role for you in this growing field. The chance to make a positive impact on the lives of seniors and the job stability make these careers a promising choice. Consider exploring the various job opportunities available and embark on a career path that allows you to support and enrich the lives of seniors in your community. Your journey in the senior living industry can be a truly fulfilling one, both personally and professionally.

  • March 27, 2024

    The Ohio Department of Health (ODH) Provider Resources and Education Program (PREP) has updated the Fire Safety Inspection Form. The Fire Safety Self-Inspection Form is a monthly checklist for nursing homes and residential care facilities to assist in ensuring fire safety in the facility. The form is a revision of the original form and highlights items that are required to be completed. https://odh.ohio.gov/know-our-programs/nursing-homes-facilities/forms/Fire-Safety-Self-Inspection-Form New Provider Memo from Erin Pettegrew, Deputy State Long-term Care Ombudsman The State of Ohio LTC Ombudsmen is publishing a new Provider Memo reminding facilities to remit their 2023 Bed Fee and 2023 Consumer Guide payments. Paper invoices will be sent this week to those who have an outstanding balance with us. Thanks for sharing with your networks. Outstanding 2023 Long-Term Care Consumer Guide Fee or LTC Ombudsman Bed Fee payments | Department of Aging (ohio.gov) Tube Feeds and Assisted Living Facilities - Refresher If you provide enteral tube feedings you need a dietitian. OAC 3701- 16-09.1 (C)... In addition to the requirements of paragraphs (A) and (B) of this rule, each residential care facility that provides enteral tube feedings on a part-time intermittent basis shall: (1) Establish in writing the types of enteral tube feedings that are routinely managed by the facility. The determination of the types of enteral tube feedings that are provided by the facility shall be based on staff education, staff competence, the amount of staff experience with the listed types of enteral tube feedings, and support services available in the facility; (2) Develop and follow policies and procedures which assure that enteral tube feedings are prepared and offered as ordered and that sanitary conditions are maintained in procurement, storage, preparation, and the administration of the enteral tube feedings; (3) Document the weight of the resident and the resident's acceptance and tolerance of the enteral tube feedings in accordance with policies and procedures developed by the dietitian and the nurse responsible for the overall nursing care of the resident; and (4) Provide or arrange for a dietitian. End of the month Refresher on Assisted Living Medicaid Waiver information Assisted Living Waiver Provider Training Information If you are an Assisted Living Waiver Provider, please ensure you have watched the below training video. ODA will be working closely with the PAA staff to ensure a smooth transition. Providers will have an on-site visit within the first six months of 2024 to verify compliance with the memory care service rule. Please contact Meredith Finley at mfinley@age.ohio.gov if you have questions. You may also contact Meredith Finley if you are receiving documentation that certifies you to be a Memory Care Provider and you do not wish to be certified for Memory Care. Assisted Living - ODA provider certification: assisted living service rule Assisted Living Service Update Training Topics: Community Transition Services Updates to the rates and billing codes Memory Care attestation Changes to the assisted living service rule Person-centered plans Next Steps COLA Increase for ALW Room and Board Providers should have received a notification stating the following: The Ohio Department of Aging is pleased to share the Social Security Administration announcement of a 3.2% Cost of Living Adjustment (COLA) to Social Security benefits effective January 1st, 2024. The established room and board rate for the Assisted Living Waiver participants is the current SSI Federal Benefit Rate of $943.00 minus $50.00: thus the 2024 monthly room and board payment is $893.00. (Additionally, the state minimum wage will increase from $10.10 to $10.45 per hour.) Member Questions: Are dining assistants required in RCFs if someone needs help with eating? No. Assistance with eating is defined as a personal care service in RCFs OAC 3701-16-01 (Z) under activities of daily living. Eating is defined as an activity of daily living in OAC 3701-16-01 (B). There is no definition of a dining assistant in RCF rules as in nursing home rules (dining assistant,  OAC 3701-17-07.2 Nursing home rule)  RCF care staff assisting residents with eating, for example, cutting items, holding utensils – or simply encouraging residents to eat – need to have training as appropriate, including recognition of distress and/or choking and what actions to take. Questions on Medications: Can we require medications to be packaged according to our specific packaging? What does this mean? 1. An RCF may require medications from the resident’s chosen pharmacy to be packaged in the mode the facility employs. If that is not possible, then residents should be asked to select another pharmacy of their choice which would package them in the mode they employ to ensure accuracy and safety. 2. An RCF should have a documented policy on this issue which they share with residents. If this is a change you would need to add an addendum to your resident agreement, if appropriate. 3. ODH has said a facility can draft a policy allowing for exceptions at their discretion. For instance, for veterans or others given the significant savings they receive on medications. Are vitamins considered medications? A list of dietary supplements (which encompasses vitamins) is a required part of the admission, annual, or change of condition resident health assessment in RCF regulation, OAC 3701-16-08 (C)(5) & (D)(4)… (5) Prescription medications, over-the-counter medications, and dietary supplements; So, it should be documented in the resident’s chart that the resident is taking them. If the resident is on medication administration or self-administration with the assistance of an aide, a doctor’s order would be needed for the RCF to administer, or assist with self-administration of, a vitamin or other dietary supplement. If a resident is completely independent with their medication, then you would just want to have as accurate a listing of them as possible. Can we send a resident’s unused (but in original packaging) controlled medication with them when they are permanently transferred or discharged? If transferring a resident to a nursing home or another RCF, you can coordinate with the receiving facility and send their medication with them (documenting how many pills of what medication you sent). What if you are discharging a resident to home or out for a trip with family members? If you are discharging a resident to home or with family members, you can also send their medication with them. Again, document what you sent and who you gave them to; asking the responsible person to sign that they received them. What if the resident dies? If the resident dies, any unused prescription medications would need to be either returned to the pharmacy or destroyed; with the exception of controlled medications which would need to be destroyed at the facility. Helpful Ohio Bureau of Compensation training Information Virtual training class: Crisis de-escalation tactics and safe work practices workshop The Ohio Bureau of Worker’s Compensation (BWC)’s Crisis de-escalation tactics and safe work practices workshop virtual training class is offered May 2, 2024. This course is focused on skills necessary for industries working directly with the public that may encounter belligerent patients, residents, or customers. The focus will be on how to recognize violent situations and defuse them, then, if necessary, use simple defensive tactics for self-protection. BWC is accredited by IACET to offer 0.4 CEUs for this program. Enroll through the BWC Learning Center or call 1-800-644-6292. Does our safety program need updated? The Ohio Bureau of Workers Compensation (BWC) has developed templates of written programs for various workplace safety and health topics. You can use these to develop your own customized programs tailored to your workplace. Each template has a welcome page with information on how to use the template, as well as Division of Safety & Hygiene (DSH) Assistant comments that provide added guidance, best practices, or links to resources or reference standards. Additionally, each offers supporting documents for training, checklists, definitions, and more. Reach out to your BWC safety consultant for assistance, or call 1-800-644-6292. Your workers’ compensation policy includes a wide range of services for all industries including safety consultations, safety education & training, and the BWC Safety & Video Library.

  • Delicious and Nutritious: The Importance of Culinary Excellence in Senior Living Communities

    As we age, maintaining a healthy diet becomes even more crucial for our well-being. For seniors living in assisted living or senior care communities, the dining experience can significantly impact their quality of life. In this blog post, we'll explore the role of culinary excellence in senior living communities, highlighting the importance of nutrition, variety, and the social aspects of dining. We'll also incorporate relevant keywords to ensure SEO optimization. The Role of Nutrition Good nutrition is the cornerstone of a healthy and fulfilling life, and senior living communities are well aware of this fact. Nutrient-rich meals designed to meet the specific dietary needs of residents are a key component of senior living. Trained chefs and dietitians work collaboratively to create menus that promote good health and well-being. Balanced Diets: Senior living communities focus on serving balanced meals that provide essential nutrients like vitamins, minerals, and fiber. These diets are tailored to accommodate common age-related dietary restrictions, such as low-sodium or diabetic-friendly options. Hydration: Adequate hydration is crucial, especially for seniors. Drinking enough water can help prevent various health issues and maintain cognitive function. Specialized hydration programs are often incorporated into meal plans. Diverse Menus: Offering diverse menus with various options allows residents to enjoy their favorite foods and discover new culinary delights. Incorporating seasonal ingredients and international cuisine can make dining more exciting. Culinary Excellence Culinary excellence goes beyond providing nutritious meals; it is about creating a memorable dining experience for seniors. This involves: Restaurant-Style Dining: Many senior living communities offer restaurant-style dining options. Residents can choose from a menu and enjoy their meals in a more elegant setting, complete with attentive service. Chef-Prepared Meals: Skilled chefs are integral to the culinary experience in senior living communities. Their expertise ensures that every meal is not only nutritious but also delicious. Special Dietary Needs: Culinary teams are equipped to handle various dietary restrictions and preferences. Customized meals are prepared to accommodate residents with specific needs. Fresh and Local Ingredients: Utilizing fresh, locally sourced ingredients enhances the quality of meals and supports the community's sustainability efforts. The Social Aspect of Dining Dining isn't just about nourishment; it's also a social experience that can positively impact the mental and emotional well-being of seniors. Community Dining: Encouraging communal dining allows residents to share meals with friends and build a sense of community. This is particularly important for seniors who may feel isolated. Special Occasions: Senior living communities often host special dining events for residents, such as holiday feasts and themed dinners. These events create a festive atmosphere and foster a sense of belonging. Family and Friends: Many senior living communities invite family and friends to join residents for meals. This strengthens the bonds between seniors and their loved ones. Culinary excellence plays a pivotal role in the senior living experience, impacting the physical, emotional, and social well-being of residents. Nutrition is a priority, and expert chefs and dietitians ensure that residents receive balanced and delicious meals that meet their specific dietary needs. The culinary experience is enhanced by the use of fresh, local ingredients and the provision of restaurant-style dining. Furthermore, the social aspects of dining cannot be overlooked. Sharing meals with friends and loved ones creates a sense of belonging and fosters meaningful connections within the senior living community. Whether it's enjoying a favorite dish, celebrating special occasions, or simply dining with friends, senior living communities are dedicated to creating a holistic dining experience for their residents. This commitment to culinary excellence makes senior living not just a place to reside but a place to savor life's flavors in good company.

  • March 20, 2024

    Cheat- Sheet on determining Expired Drugs on your Med Cart Members have reached out and asked for guidance on how to determine the expiration date on opened medication on the med carts, as well as other medication-related questions. Please see below for several references supplied by Diamond Pharmacy that you should find useful. Anticoagulation Beyond Use Medication Date Do Not Use Hazardous Medications – ALPA 2019 Look-alike Sound-alike – March 2017 Refresher on Assisted Living facilities and conditional employment OAC 3701-13-04, address this employment status. (A) A DCP(Direct Care Provider) may employ conditionally an applicant for whom a criminal records check request is required under rule 3701-13-02 of the Administrative Code prior to obtaining the results of a criminal records check regarding the applicant if the following requirements are met: (1) The DCP shall not employ an applicant prior to obtaining the completed form(s) and fingerprint impression sheet(s) from the applicant as required in paragraph (F) of rule 3701-13-03 of the Administrative Code. For purposes of this prohibition, the applicant cannot perform or participate in any job-related activity pertaining to a position involving the provision of direct care to an older adult that places the applicant in an active pay status. (2) The DCP shall request a criminal records check in accordance with paragraph (F) of rule 3701-13-03 of the Administrative Code by submitting the request to BCII not later than five business days after the individual begins conditional employment. (D) The DCP shall terminate the individual's conditional employment if: (1) The results of the criminal records check, other than the results of any request for information from the FBI, are not obtained within thirty days after the date the request is made; or (2) The results of any part of the records check indicate that the individual has been convicted of or pleaded guilty to any of the offenses listed or described in paragraph (A) of rule 3701-13-05 of the Administrative Code, unless the DCP chooses to employ the applicant pursuant to rule 3701-13-06 (Personal Character Standards) of the Administrative Code. (E) Termination under paragraph (D) of this rule shall be considered just cause for discharge for purposes of division (D)(2) of section 4141.29 of the Revised Code if the individual makes any attempt to deceive the DCP about the individual's criminal record. So… What does this mean? A facility may hire an applicant after they have collected their fingerprints under conditional employment (BCI must be submitted no later than 5 days after this conditional employment begins). During this time, the applicant is not in “active pay status”, meaning they have not yet been fully hired because remember, this is conditional employment that will be based on the upcoming BCI results.  If the BCI comes back with no disqualifying offenses, then the individual can be placed in active pay status.  If the BCI comes back and there are disqualifying offenses, but ones that allow the provider to utilize personal character standards and the provider chooses to do so, they would move to active pay status.  If the BCI comes back with disqualifiers that the provider cannot use Personal Character Standards, then the applicant would be terminated. What if the BCI check simply does not come back within the required 30 days? Conditional Employment- BCI Re-verification If the background check does not come back in 30 days and the individual is not terminated, then must be placed in a position of NON direct care employment in the community.  Once the BCI comes back if there are no disqualifying offenses, then an additional RE-VERIFICATION must be sent to BCI to verify the days between the gaps. The employee would be in active pay status, but still in a NON direct care position until background check re-verification came back in the allotted 30 days with no disqualifying offenses. The same code is used for re-verification 3721.121 .  The charge for this is approximately $8.00(re-verification charge only) When utilizing this re-verification process, you will need to include the original BCI number. Personal Character Standards Progressively, this is becoming more and more common for Assisted Living providers, and there are typically many questions involved.  OALA has again compiled a cheat sheet of sorts to help providers navigate through this sometimes difficult topic. There may be times when a Facility may want to utilize Personal Character Standards to employ an individual who has a disqualifying offense. This is found in OAC  3701-13-06. (A) … may employ an applicant who has been convicted of or pleaded guilty to an offense listed in paragraph (A) of rule 3701-13-05… in a position involving direct care to an older adult, if all of the following standards are met: Reference: Rule 3701-13-05- Disqualifying Offenses. This rule goes through the identifying name and number of each Disqualifying Offense (a)-(ccc). (A)(2) The offense is not a sexually oriented offense as defined in paragraph (O) of rule 3701-13-01 of the Administrative Code; So, the offense cannot in any way be a sexually-oriented or motivated disqualifying offense. (A)(3) The offense is not a violation of any of the following sections of the Revised Code or a violation of existing or former law of this state, any other state, or the United States, if the offense is substantially equivalent to the offenses or violations described in the following sections of the Revised Code: 2903.01 (aggravated murder), 2903.02 (murder), 2903.03 (voluntary manslaughter), 2903.34 (patient abuse or neglect), or 3716.11 (placing harmful objects in food or confection); (5) If the offense is an offense of violence as defined in paragraph (J) of rule 3701-13-01 of the Administrative Code, other than one listed in paragraph (A)(4) of this rule; ( So we have ruled out any offenses that are listed in (A)(4) (Aggravated murder, murder, voluntary manslaughter, patient abuse/neglect, placing harmful objects in food) AND (a) The victim of the offense was not an older adult; and (b) At least five years have elapsed since the applicant was fully discharged from imprisonment, probation, and parole; … The Rule 16-06 Requires..(3701-13-06(A)(4) If the applicant is a repeat theft-related offender as defined in paragraph (Q) of rule 3701-13-01 of the Administrative Code; Definition of Theft: Q) "Theft related offense" means a violation of any of the following sections of the Revised Code: 2911.01 (aggravated robbery), 2911.02 (robbery), 2911.11 (aggravated burglary), 2911.12 (burglary), 2911.13 (breaking and entering), 2913.02 (theft, aggravated theft), 2913.03 (unauthorized use of a vehicle), 2913.04 (unauthorized use of property - computer, cable, or telecommunication property), 2913.11 (passing bad checks), 2913.21 (misuse of credit cards), 2913.31 (forging identification cards or selling or distributing forged identification cards), 2913.40 (Medicaid fraud), 2913.43 (securing writings by deception), 2913.47 (insurance fraud), or 2913.51 (receiving stolen property). Convictions or guilty pleas resulting from or connected with the same act, or resulting from offenses committed at the same time, will be counted as one conviction or guilty plea. The Rule 16-06 Requires... (1) If the applicant is a repeat theft-related offender…3701-13-06(A)(4)… (4) If the applicant has more than one theft-related offense as defined in paragraph (Q) of rule 3701-13-01 of the Administrative Code; (a) The victim of either offense was not an older adult; and (b) At least seven years have elapsed since the date the applicant was fully discharged from imprisonment, probation, or parole for the most recent offense; So, to recap: If you can utilize Personal Character Standards and the disqualifying offense is an allowable violent offense…5 years must have elapsed since the applicant was fully discharged from imprisonment, probation, and parole. If the offense is not an offense of violence (6) If the offense is not an offense of violence as defined in paragraph (J) of rule 3701-13-01 of the Administrative Code or an offense listed in paragraph (A)(4) of this rule; and (a) The applicant is either discharged from imprisonment, sentenced to probation, is fined or is on parole; and (b) The applicant provides proof that all conditions regarding fulfillment of sentencing requirements are being met. (Then you need to consider the following) (7) The applicant's character is such that it is unlikely that the applicant will harm an older adult. In making that determination, the chief administrator shall consider the following factors for each offense: (a) The applicant's age at the time of the offense; (b) Regardless of whether the applicant knew the victim prior to the committing of the offense, the age and mental capacity of the victim; (c) The nature and seriousness of the offense; (d) The number of previous offenses or length of time since the most recent conviction or guilty plea; (e) The degree to which the applicant participated in the offense and the degree to which the victim contributed to or provoked the offense; (f) The likelihood that the circumstances leading to the offense will reoccur; (g) The applicant's employment record; (h) The applicant's efforts at rehabilitation and the results of those efforts; (i) If known, whether the applicant has been convicted of or pleaded guilty to any violation of an existing or former municipal ordinance substantially equivalent to any offense listed or described in rule 3701-13-05 of the Administrative Code; (j) Whether any criminal proceedings are pending; and (k) Any other factors related to the position that the chief administrator considers relevant to the performance of job duties. Reference: What are Violent Offenses? OAC 3701-13-01 (J) (J) "Offense of violence" means any of the following: (1) A violation of section 2903.01 (aggravated murder), 2903.02 (murder), 2903.03 (voluntary manslaughter), 2903.04 (involuntary manslaughter), 2903.11 (felonious assault), 2903.12 (aggravated assault), 2903.13 (assault), 2903.21 (aggravated menacing), 2905.01 (kidnapping), 2905.02 (abduction), 2905.11 (extortion), 2907.02 (rape), 2907.03 (sexual battery), 2907.05 (gross sexual imposition), 2911.01 (aggravated robbery), 2911.02 (robbery), 2911.11 (aggravated burglary), 2911.12 (burglary), 2919.25 (domestic violence), 2923.161 (improperly discharging firearm at or into habitation or school) or former section 2907.12 (felonious sexual penetration) of the Revised Code; Member Questions: Can a resident who has been in the RCF for less than 30 days be discharged without notice or without a full 30 days’ notice? The answer is No and Yes. No, a resident who has been in the RCF for less than 30 days may NOT be discharged without notice. The statutorily required notice must be provided in every facility-initiated discharge situation. But, yes, if a resident has been a resident for less than 30 days, then a 30-day notice is not required, and a more immediate notice may be provided. Please note that regardless of the amount of notice provided - from immediate to thirty days - all statutory obligations, including appeal rights apply. We do not allow pets to reside in our assisted living community. We have a potential resident with a service dog.  Are we required to accept this individual into our community with his service dog? If the RCF would be able to admit the potential resident and meet his needs if he did not have a service dog, then the facility must admit him with his service dog.  Under the Americans with Disability (ADA) law and regulations, individuals cannot be discriminated against because of the use of a service dog as an accommodation.  The dog must have appropriate documentation related to their status as a service dog.  If the individual would be declined admission on a basis other than the request for the service dog such as care needs were in excess of what the facility offers, then the individual can be declined to be admitted.  Each facility should be aware of the requirements under the ADA and be knowledgeable about the right to request accommodation as a resident or a potential resident in a facility. Continued information from the Ohio Department of Health on the upcoming solar eclipse

  • How Therapy Services Support Residents in Assisted Living: A Comprehensive Guide

    Assisted living facilities play a crucial role in providing a safe and supportive environment for elderly individuals who require some assistance with their daily activities. One often-overlooked aspect of the care provided in these facilities is therapy services. In this blog post, we will explore how therapy services can significantly improve the quality of life for residents in assisted living, focusing on physical therapy, occupational therapy, and speech therapy. These therapy services enhance residents' well-being, boost their independence, and ensure they have a better and more fulfilling life. Physical Therapy 1. Enhanced Mobility and Independence One of the primary goals of physical therapy in assisted living is to improve residents' mobility and independence. Residents may face physical limitations due to age-related issues or health conditions, but physical therapy can help address these challenges. Keyword: "physical therapy for assisted living residents" Physical therapists work with residents to create personalized exercise routines and rehabilitation programs. These programs help residents regain strength and improve their balance, which can significantly reduce the risk of falls and injuries. By doing so, residents can continue to perform daily activities with greater ease and confidence. 2. Pain Management Chronic pain is a common issue among the elderly, and physical therapy can be a non-invasive way to manage and reduce pain. Whether it's arthritis, back pain, or joint problems, physical therapists can design exercises and treatments that alleviate discomfort and enhance overall well-being. 3. Preventing Decline Physical therapy is not only about addressing existing issues but also preventing further decline. It helps residents maintain their physical functions and stay as active as possible. This is essential for their emotional and mental well-being. Occupational Therapy 1. Daily Living Skills Occupational therapy focuses on helping residents with daily living skills. Keyword: "occupational therapy for daily living skills" Occupational therapists assess each resident's abilities and tailor their interventions to help them maintain or regain the skills needed for activities such as dressing, cooking, and grooming. This support enables residents to maintain their independence and dignity. 2. Cognitive Stimulation Cognitive decline can be challenging for many residents in assisted living facilities. Occupational therapists can provide cognitive stimulation exercises that help maintain and even improve cognitive functions. This not only improves the quality of life for residents but also eases the burden on their families. 3. Home Modifications Another essential aspect of occupational therapy is making necessary home modifications to ensure the safety and comfort of residents. This includes assessing the layout and recommending adjustments to prevent accidents and make everyday life more manageable for residents. Speech Therapy 1. Improved Communication Speech therapy is crucial for residents who face speech and language challenges due to various health conditions. Keyword: "speech therapy for assisted living residents" Speech therapists work with residents to improve their ability to communicate effectively. This includes speech articulation, language comprehension, and alternative communication methods. By enhancing residents' communication skills, they can interact more comfortably with staff and other residents, reducing isolation and frustration. 2. Swallowing Difficulties Residents may also experience difficulties with swallowing, which can lead to malnutrition and other health issues. Speech therapists address these concerns by providing exercises and strategies to improve swallowing function and ensure proper nutrition. 3. Cognitive Rehabilitation Speech therapy often includes cognitive rehabilitation, which helps residents recover or maintain their cognitive abilities. This is particularly important for those who have suffered strokes or other neurological conditions. In an assisted living setting, therapy services are indispensable for promoting residents' overall well-being. Physical therapy improves mobility, reduces pain, and prevents physical decline. Occupational therapy focuses on daily living skills, cognitive stimulation, and home modifications to enhance independence. Speech therapy helps residents communicate more effectively, overcome swallowing difficulties, and engage in cognitive rehabilitation. By optimizing these therapy services, assisted living facilities can provide a higher quality of life for their residents, ensuring they maintain their independence and enjoy a fulfilling and meaningful life. Families can rest assured that their loved ones are receiving the comprehensive care they need to thrive in an assisted living environment. So, when considering an assisted living facility for your loved one, remember the vital role that therapy services play in ensuring their well-being and quality of life.

  • March 7, 2024

    CDC updated COVID guidelines While the CDC released updated guidelines that relax their COVID-19 guidelines, it is important to note that these guidelines do not apply to facilities that provide healthcare. ODH has not given instructions for assisted living communities to follow these guidelines. Assisted living communities need to have policies in place that protect residents and staff when encountering cases of COVID-19. These need to be based on CDC guidelines and per your local health department. If you have an outbreak or occurrence of COVID in your building, you should reach out to your local health department to determine specific guidelines. OALA will continue to review and discuss with ODH the new guidelines and provide members with additional information. CDC standard infection control practices for COVID, RSV, and influenza The practices outlined in this document (LINK) are intended to serve as a standard reference and reduce the need to repeatedly evaluate practices that are considered basic and accepted as standard infection control. The core practices in this document should be implemented in all settings where healthcare is delivered. These venues include inpatient settings (e.g., acute, long-term care) and outpatient settings (e.g., clinics, urgent care, ambulatory surgical centers, imaging centers, dialysis centers, physical therapy and rehabilitation centers, alternative medicine clinics). In addition, these practices apply to healthcare delivered in settings other than traditional healthcare facilities, such as homes, and assisted living communities. The following guidelines are still in effect for assisted living communities and should be used for reference Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic (May 8, 2023) Providers should have received the following information from the Department of Health bulletin details: The Ohio Department of Health (ODH) provider resources and education program announces a new training, Total Solar Eclipse: What it Means for Long Term Care. This training is for leadership teams in long-term care and skilled nursing facilities who are interested in learning about the impact the April 8, 2024, solar eclipse may have on their facilities and how to prepare for it.  Please take the time to view this short video to fully understand the impacts that could occur. Persons who wish to view this training can find the link in the PREP section of the ODH website. Search under education resources below: Member Questions: Is there a maximum temperature coffee can be served in AL communities? Our residents are complaining that their coffee is not hot enough. This has been a recent question from several Providers. OALA discussed this issue with ODH and was told that there is no set maximum, however, a general range for safety would be 175 degrees to 180 degrees. What should I do if the facility does not have 24/7 nursing and the facility handles controlled substances? OALA inquired with ODH and was given advice that would lend itself that in circumstances in which there is only one nurse in the building, and they will leave their shift without another nurse coming onto shift, they should do an appropriate controlled substance count and sign the controlled substance sheet(s). They could have a staff member observe the count and then in parenthesis write the count had been observed by that individual staff member that participated in the count. The staff member observing the count should not sign the controlled substance count sheets, as those are for licensed personnel. A facility may want to utilize this technique if the nurse leaving is the same nurse later coming back to the facility to ensure counts are correct. Can we provide a fluid-restricted diet for a resident in Assisted Living? Would it be a diet that had to be supervised? Yes, a fluid-restricted diet is not prohibited. However, a fluid-restricted diet where an order specifies a maximum fluid intake, such as 1500 cc’s, would be a complex therapeutic diet requiring supervision, therefore also requiring a dietitian. It would require monitoring of intake and output. This is a very difficult diet to monitor in Assisted living given the free access residents always have to fluids. It is a different situation if the physician asks you to “watch” a resident’s fluid intake. Can RCFs accept residents that require a 2-person assist? Ohio licensed Residential Care Facility rules do not refer to 2-person assists. Your assisted living community can decide whether you wish to provide this staff-intensive level of service to residents, or not. Remember if you provide these services, you must still be able to meet other residents' needs in a timely fashion. Also, you need to consider your ability to evacuate residents if necessary. You do need to let residents know the extent and types of services you provide in your resident agreement. See. (Note that there is a list of prohibited care in A of rule OAC 3701-16-02; bedridden, constant monitoring, stage III or IV pressure ulcers, etc.) Do residents need to be trained annually on emergency procedures? ODH said the rule does not address the frequency OAC 3701-16-13 (R). Each residential care facility shall train all residents in the proper actions to take in the event of fire, tornado, disaster, or other emergency. However, initial training needs to be provided to residents on move-in, with ongoing training provided through participation in drills. OALA suggests you make this training a part of your new resident move-in orientation, perhaps using this opportunity for the maintenance department to meet with the resident. Both the resident and the staff member providing the “training” should document it in writing and make it part of the resident’s record. Tornado shelter signage clarification in a recent update we addressed the need for a tornado drill per regulation OAC 3701-16-13 (K)(2) and also stated that RCFs “should” have a designated, marked tornado shelter area. After receiving a member question, we further researched the need for a signed tornado shelter area and learned that the determination is made by individual municipalities’ building departments which may or may not require one. Therefore, if you do not have signs, and have not had any issue, it is likely your particular municipality does not require them.

  • February 29th, 2024

    ODA guidance regarding authorization of the memory care service - UPDATED INFORMATION Providers should have received the following information regarding the extension of the Assisted Living Waiver Memory Care Attestation extension deadline The Ohio Department of Aging (ODA) originally set a deadline of January 15, 2024, for currently certified assisted living providers to submit a memory care attestation. You may be pleased to learn that ODA is extending the deadline to April 5, 2024. ODA’s website has been updated to reflect this new deadline: Memory Care Service Certification | Department of Aging (ohio.gov).   Please note, there are no changes to the attestation form.  Additionally, the certification page has been updated with details to apply for the waiver, including the memory care service:   Assisted Living Waiver Provider | Department of Aging (ohio.gov). PAA case managers have been notified about the process for authorizing memory care in the service plan, and to send an updated copy of the service plan to the provider. If providers have questions about the service plan authorization for individuals or memory care certification, please contact your PAA provider relations and/or case manager. We also want to reiterate that providers who submitted an attestation have agreed to deliver the service in accordance with the rules. Providers will be expected to demonstrate compliance with the rule when an on-site visit is conducted by the PAA.  All onsite visits are to occur by June 30, 2024. Finally, as a reminder the training video for assisted living providers has been added to ODA’s YouTube website here:  Assisted Living Provider Training - Memory Care (youtube.com). Additional Information Assisted Living Facilities were given the opportunity to provide memory care services by signing an attestation indicating the Facility’s ability to meet the requirements in OAC 173-39-02.16 in December 2023. This attestation did not mandate the facility to provide memory care services to each individual with dementia. Case managers have been instructed to follow the steps below. Please contact the PAA case manager if you have questions. The case manager confirms an individual has a documented diagnosis of any form of dementia. The case manager contacts the individual to ask if they would like to receive memory care services as part of their person-centered services plan. The case manager contacts the Assisted Living Facility to ensure the Facility can meet the individual’s needs. If the provider is unable to provide memory care service to the specific individual, or the individual is not interested in memory care services, the case manager authorizes the basic assisted living service. If the provider is able to provide memory care services, and the individual agrees to receive memory care services, the case manager authorizes the memory care service on the person-centered services. Are there CPR regulations in RCFs in Ohio? OALA is providing the following information due to a recent call with the Ohio Department of Health regarding a concern of nurses in Assisted Living not providing CPR to residents identified as a full code because they have a policy not to provide CPR and the policy is stated in their resident agreement. Ohio RCF regulations do not require someone to be always present in the building with CPR certification. Many companies, however, have policies that require someone in the building at all times trained in CPR. Communities should communicate their procedures in relation to CPR prior to move in. (This should be in the Resident Agreement) All communities need to be aware of residents' end of life wishes and for those wishes, if possible, to be formalized (although advance directives cannot be a requirement for admission). RCFs are required to explain their policies regarding advance directives on admission of residents and to make any existing advanced directives a part of the resident's record. The discussion of the presence or absence of these directives provides an opportunity to discuss the options if none are in place. What are the expectations are in terms of nurses in assisted living settings providing or not providing CPR based on facility policy? It is assumed under nursing practice, that a nurse (RN or LPN), would be required by their nursing license to perform CPR on a resident that was a full code, while awaiting 911 to respond. OALA is sharing this information so that individual communities can determine their own course. It would be possible to have two policies in place, for example, when a nurse is present and the policy/protocol when a nurse is not present. Member Question: What does the Assisted Living Facility need if it “houses” a C-box or an E-box to distribute non designated medication to residents, even though they are prescribed / ordered by the physician? – OXYGEN UPDATE OAC 3701-16-09(I)(1)states…(I) Residential care facilities that handle residents' medication shall:  (1) Not stock or dispense medicines or drugs which may be sold only by prescription unless the facility has in its employ, on either a full-time or part-time supervisory and consulting basis, a pharmacist registered under Chapter 4729 of the Revised Code, who will be in complete control of such stock and the dispensing thereof;  In essence this means that because the medications are not designated to a particular resident, but rather in a lockbox to be used when an individuals medication is not available or for first doses of medication(until designated medication arrives) that your pharmacy should help you obtain the needed TDDD license that allows you to “house” these medications.  See below for a description and additional information. A Terminal Distributor’s of Dangerous Drug License (TDDD) allows for the distribution of prescription medications and dangerous drugs to those with medically appropriate orders or prescriptions.  This includes pharmacies, hospitals and certain congregate living spaces.  Specifically, convalescent homes, developmental facilities, long term care facilities, nursing homes, rehab facilities, detox facilities, correctional facilities and others that are listed in the Ohio Revised Code 4729-17. Facilities No Longer Required to Have a TDDD License for OxygenThe Board of Pharmacy (BOP) informed us that SNFs, residential care facilities, and other providers that possess oxygen for the purpose of administration to patients or installation or maintenance of home medical equipment no longer are required to have a terminal distributor of dangerous drugs license for this purpose. This exemption was part of the state budget bill. BOP began to implement it July 11, 2023, before the statutory change technically took effect. BOP encourages exempted providers not to try to renew their oxygen licenses when they expire. They also may surrender the licenses now. Please see this BOP guidance document and newsletter for written confirmation. Please also note that the end of the licensing requirement does not eliminate the requirements under other codes for safe storage of medical gases.

  • Why Choose an Assisted Living Facility: Enhancing Quality of Life and Peace of Mind

    Choosing the right living arrangement for yourself or a loved one is a significant decision, especially as we age. Assisted living facilities have become increasingly popular for seniors seeking a balance between independence and support. In this blog post, we will explore the compelling reasons why many individuals and their families opt for assisted living facilities to enhance their quality of life and provide peace of mind. 1. Assistance with Daily Activities One of the primary reasons for choosing an assisted living facility is the support it offers with daily activities. These facilities provide help with tasks like bathing, dressing, grooming, and medication management. For individuals who may face physical limitations or need some extra assistance, this support is invaluable. 2. Safety and Security Assisted living facilities are designed with safety and security in mind. They often feature features like handrails, emergency response systems, and 24/7 monitoring to ensure a secure living environment. This safety net offers peace of mind to both residents and their families. 3. Social Engagement and Community Isolation and loneliness can negatively impact a senior's mental and emotional well-being. Assisted living facilities provide a social environment where residents can connect with peers, participate in group activities, and build meaningful relationships. The sense of community and belonging can greatly improve the overall quality of life. 4. Nutritious Meals and Dining Options Proper nutrition is crucial for seniors to maintain their health and vitality. Assisted living facilities offer well-balanced meals prepared by professional chefs. Residents can choose from a variety of menu options, accommodating dietary restrictions and preferences, ensuring they receive the nourishment they need. 5. Healthcare Services and Medication Management Many assisted living facilities provide professional healthcare services, including regular health check-ups, medication management, and assistance with chronic conditions. This ensures that seniors receive the necessary medical attention while living in a comfortable and convenient environment. 6. Transportation Services Assisted living facilities often provide transportation services, making it easy for residents to attend medical appointments, go shopping, and enjoy outings. This convenience helps seniors maintain an active and engaged lifestyle. 7. Freedom from Household Chores and Maintenance Living in an assisted facility means freedom from household chores and maintenance. Residents can enjoy their days without worrying about tasks like cleaning, laundry, or yard work, allowing them to focus on activities they enjoy. 8. Peace of Mind for Families For families, knowing that their loved ones are in a safe and supportive environment brings peace of mind. Assisted living facilities provide regular updates and open communication channels, allowing families to stay informed about their loved one's well-being and care. 9. Personalized Care Plans Assisted living facilities often create personalized care plans for each resident. These plans take into account individual needs, preferences, and health conditions, ensuring that each resident receives the right level of care. 10. Transition Assistance Assisted living facilities can make the transition from living independently to a more supportive environment smooth and stress-free. They provide guidance, emotional support, and resources to help residents adjust and feel at home. 11. Access to a Variety of Activities From educational programs to fitness classes and cultural events, assisted living facilities offer a wide range of activities that cater to diverse interests. Residents have the opportunity to engage in hobbies and explore new passions, enhancing their quality of life. Choosing an assisted living facility is a decision that can significantly improve the quality of life for seniors and provide peace of mind for their families. These facilities offer a supportive environment that balances independence with assistance, addressing the unique needs of each resident. As you consider assisted living for yourself or a loved one, the benefits of daily assistance, safety, social engagement, nutritious meals, healthcare services, and the overall peace of mind offered by these facilities are compelling reasons to make the choice. It's a decision that fosters a higher quality of life, enriches social connections, and ensures well-being as one ages. Making an informed choice about assisted living can lead to a fulfilling and supportive lifestyle in the senior years.

  • February 15th, 2024

    When are you required to have a dietitian in a licensed RCF? - Dietary Refresher The question of when an RCF must have a dietitian has been very popular recently because it is an area of some confusion as well as therapeutic diets in Assisted Living. See below for a recap. There is not one “overall” requirement for all RCFs to have a dietitian. Instead, the requirement is based on what dietary services individual RCFs choose to provide. If you provide 3 meals then OAC 3701-16-10 (B)…The meals shall be capable of providing the dietary referenced intake of the "Food and Nutrition Board" of the "National Academy of Science", be based on a standard meal planning guide from a diet manual published by a dietitian, approved by a dietitian, or both. If you only prepare special diets, then you can use a resident’s physician or a dietitian.  OAC 3701-16-10 (I)… Each residential care facility that elects to prepare special diets … shall: (1) Prepare and provide the special diets in accordance with the orders of a physician or other licensed health professional acting within their scope of practice, or a dietitian; and (2) Adjust special diet menus as ordered by the resident's attending physician or other licensed health professional acting within their scope of practice, or a dietitian. Special Diets (a “carve out from therapeutic diets”) are defined as:  OAC 3701-16-01(KK)…"Special diets" means a therapeutic diet limited to: (1) Nutrient adjusted diets, including high protein, no added salt, and no concentrated sweets (2) Volume adjusted diets, including small, medium and large portions; (3) The use of finger foods or bite-sized pieces for a resident's physical needs; or (4) Mechanically altered food. Ordered diets outside of these special diets must be supervised. If you supervise therapeutic diets, then you need a dietitian.  OAC 3701-16-10 (J)… Each residential care facility which elects to supervise therapeutic diets shall make available three daily meals in accordance with paragraph (B) of this rule and provide or arrange for a dietitian to plan, direct and implement dietary services that meet the residents' nutritional needs and comply with the requirements of this rule and for residents on therapeutic diets on an ongoing basis: (1) Determine that the diet ordered is appropriate according to the resident's individual nutritional assessment; (2) Monitor the resident's nutritional intake and acceptance of the diet; (3) Evaluate the home's compliance in the provision of the diet; and (4) Adjust nutritional assessments and diets as needed. (K) If required by paragraph (J) of this rule, the dietitian shall oversee, monitor and assist in the training of food service staff in the preparation and serving of foods for therapeutic diets and consult quarterly with the food service staff. Trained unlicensed staff, including the dietary manager, may perform routine tasks that: (1) May be assigned pursuant to Chapter 4759. of the Revised Code and this rule; and (2) Do not require professional judgment or knowledge. Additionally, if you provide enteral tube feedings you need a dietitian.  OAC 3701-16-09.1 (C)...  In addition to the requirements of paragraphs (A) and (B) of this rule, each residential care facility that provides enteral tube feedings on a part-time intermittent basis shall: (1) Establish in writing the types of enteral tube feedings that are routinely managed by the facility. The determination of the types of enteral tube feedings that are provided by the facility shall be based on staff education, staff competence, the amount of staff experience with the listed types of enteral tube feedings, and support services available in the facility;  (2) Develop and follow policies and procedures which assure that enteral tube feedings are prepared and offered as ordered and that sanitary conditions are maintained in procurement, storage, preparation, and the administration of the enteral tube feedings; (3) Document the weight of the resident and the resident's acceptance and tolerance of the enteral tube feedings in accordance with policies and procedures developed by the dietitian and the nurse responsible for the overall nursing care of the resident; and (4) Provide or arrange for a dietitian. Or in the case of hospice residents, either the hospice program plans the diet, or you need a dietitian.  OAC 3701-16-10 (M)…  A hospice patient's diet shall be planned by a dietitian, the hospice program, or both, as appropriate for that individual. While the above rule references list the specific requirements for a dietitian in a licensed RCF, an individual RCF, per company policy can utilize a dietitian as they deem appropriate. You must disclose in your resident agreement what type of dietary services you provide in terms of the number of meals (none, one, two or three) and what types of ordered diets you either prepare or supervise.  For example, if you only prepare special diets, the resident agreement needs to indicate that, or if you are willing to supervise other ordered diets then it needs to indicate that. Ohio Bureau of Workers' Compensation (BWC) Safety Services Updates OSHA recordkeeping electronic submission - are you prepared? Beginning March 2, 2024, businesses with 100+ employees in designated industries (including nursing care, residential intellectual and developmental disability, mental health, and substance abuse facilities) must electronically submit their annual injury and illness logs and reports to OSHA. The Ohio Bureau of Workers’ Compensation (BWC) has these OSHA record keeping training and consulting resources available for you: You will need to register as a video library borrower to access the streaming videos.  The instructions are on the safety videos page under “Streaming videos” > “How do I get access?” Please complete the borrower registration and write down your 6-digit borrower ID when finished.Once you are registered with the video library, send an email to library@bwc.ohio.gov.  Include your name and video library borrower ID number. The library will email you instructions on how to access the streaming videos. Once the library has provided you with a username and password for streaming services, you can access the streaming video site. Once you have a login for the streaming videos, they can go directly to the OSHA recordkeeping videos: OSHA Recordkeeping for Managers & Supervisors OSHA Recordkeeping for Employees Training: OSHA Record keeping 101 e-Course – 2-hours.  Register using the BWC Learning Center. OSHA recordkeeping half-day workshop virtual training class on Feb. 22, 2024 Streaming videos: OSHA Record keeping for Managers & Supervisors / 22 min / SKU: 3658 / English OSHA Record keeping for Employees / 16 min / SKU: 3659 / English Safety consultations: Request a consultation online with Ohio Bureau of Workers' Compensation or call 1-800-644-6292, and their consultants can help you with your OSHA recordkeeping questions. Member Questions: How many residents does an Assisted Living have to maintain its operational license? This is found in Ohio Revised Code (ORC) 3721.01(A)(1)(a)… (1)(a) "Home" means an institution, residence, or facility that provides, for a period of more than twenty-four hours, whether for a consideration or not, accommodations to three or more unrelated individuals who are dependent upon the services of others, including a nursing home, residential care facility, home for the aging, and a veterans' home operated under Chapter 5907 of the Revised Code. If for any reason, an Assisted Living facility would drop below the required 3 residents, they would immediately need to notify the Ohio Department of Health, survey and certification department to let them know and they would then communicate with the facility to formulate a plan of action. Are we required to have Automated External Defibrillators (AEDs) in RCFs? No. There is no requirement to have AEDs in RCFs.  Some companies may elect to do so, but it is not a requirement. Do we need to have a crash cart, or extra oxygen tanks on site in the event of an emergency in an assisted living?  Or is this optional per facility? There is no requirement in an RCF to have a crash cart with emergency resuscitation equipment, etc. onsite. Additionally, having extra oxygen tanks that are not resident specific would require a community to have a TD (terminal distributor) license through the Board of Pharmacy because the oxygen would not be designated for a specific resident. What does the Assisted Living Facility need if it “houses” a C-box or an E-box to distribute non designated medication to residents, even though they are prescribed / ordered by the physician? OAC 3701-16-09(I)(1)states…(I) Residential care facilities that handle residents' medication shall:  (1) Not stock or dispense medicines or drugs which may be sold only by prescription unless the facility has in its employ, on either a full-time or part-time supervisory and consulting basis, a pharmacist registered under Chapter 4729 of the Revised Code, who will be in complete control of such stock and the dispensing thereof;  In essence this means that because the medications are not designated to a particular resident(this includes undesignated stock oxygen), but rather in a lockbox to be used when an individuals medication is not available or for first doses of medication(until designated medication arrives) that your pharmacy should help you obtain the needed TDDD license that allows you to “house” these medications.  See below for a description and additional information. A Terminal Distributor’s of Dangerous Drug License (TDDD) allows for the distribution of prescription medications and dangerous drugs to those with medically appropriate orders or prescriptions.  This includes pharmacies, hospitals and certain congregate living spaces.  Specifically, convalescent homes, developmental facilities, long term care facilities, nursing homes, rehab facilities, detox facilities, correctional facilities and others that are listed in the Ohio Revised Code 4729-17. In Ohio, Oxygen is considered a dangerous drug.  Non-controlled medications (antibiotics) and controlled medications (anxiolytics / opiate pain relievers) are also prescription drugs. If your building is in the practice of distributing Oxygen or medications from a “house stock,”  “contingency stock,” or “emergency kit” supply you most likely need a TDDD.  "Contingency drugs" are those drugs which may be required to meet the therapeutic needs of patients when a licensed pharmacist is not available and personally in full and actual charge of the pharmacy stock. “Emergency drugs" are those drugs which are required to meet the immediate therapeutic needs of patients in order to sustain life in an emergent situation. The pharmacy that you are using to supply your clients will be the best advisor to help you determine if you need a TDDD and who should be responsible for the security and policies that surround the medications and the licensure of the stock.

  • Promoting Health and Well-Being: Healthcare Maintenance for the Elderly in Assisted Living and Nursing Homes

    As our loved ones age, their healthcare needs become increasingly important. For seniors residing in assisted living and nursing homes, healthcare maintenance is a vital component of ensuring their well-being and quality of life. In this blog post, we'll explore the significance of healthcare maintenance for the elderly in assisted living and nursing homes, and the strategies that can be employed to provide them with the best possible care. 1. Specialized Healthcare Services Assisted living and nursing homes provide specialized healthcare services tailored to the unique needs of elderly residents. These services include medication management, regular health check-ups, chronic disease management, and emergency care when needed. The presence of trained medical staff ensures that residents receive the care they require promptly. 2. Preventive Care and Wellness Initiatives Preventive care is a cornerstone of healthcare maintenance for the elderly in assisted living and nursing homes. Facilities prioritize wellness initiatives, such as vaccinations, health screenings, and fitness programs to keep residents healthy and reduce the risk of illness or injury. 3. Nutritious Meal Plans and Dietary Support Proper nutrition is essential for the well-being of seniors. Assisted living and nursing homes offer well-balanced meal plans, often prepared by professional chefs. These meals take into account dietary restrictions and preferences, ensuring residents receive the nutrition they need to maintain their health and vitality. 4. Regular Monitoring of Chronic Conditions Many elderly residents in assisted living and nursing homes manage chronic health conditions. These facilities provide regular monitoring and management of conditions like diabetes, heart disease, and arthritis. Close attention to these conditions helps residents maintain their health and quality of life. 5. Mental Health and Emotional Well-Being Healthcare maintenance isn't limited to physical health; it also includes mental health and emotional well-being. Assisted living and nursing homes offer mental health services, counseling, and activities designed to stimulate cognitive function and provide emotional support for seniors. 6. End-of-Life Care and Hospice Services For residents in need of end-of-life care, assisted living and nursing homes often provide hospice services. These services offer compassionate care, pain management, and emotional support, ensuring that residents and their families are as comfortable as possible during a challenging time. 7. Medication Management and Safety Medication management is a crucial aspect of healthcare maintenance for the elderly. Assisted living and nursing homes ensure that residents receive the right medications in the correct dosages and at the right times. Additionally, safety measures are in place to prevent medication errors. 8. Physical Therapy and Rehabilitation Services For residents who need physical therapy or rehabilitation, these services are often available on-site. This enables seniors to regain mobility and independence, promoting a higher quality of life. 9. Ongoing Assessment and Adjustments Healthcare maintenance in assisted living and nursing homes involves ongoing assessment and adjustments to care plans. As residents' needs change, their care plans are adapted to ensure they continue to receive the appropriate level of care. 10. Family Involvement and Communication Family members play a crucial role in healthcare maintenance for the elderly. Facilities encourage family involvement and maintain open communication channels, ensuring that families are informed about their loved one's health and well-being. Healthcare maintenance for the elderly in assisted living and nursing homes is essential to their overall well-being. These facilities provide a wide range of services, from specialized healthcare to emotional support, to help seniors maintain their health and quality of life. Families seeking the best care for their loved ones can find peace of mind in knowing that their elderly relatives are receiving the care they need to thrive in their later years. By prioritizing health care maintenance, assisted living and nursing homes create an environment where seniors can age with dignity, comfort, and the highest quality of life possible. For families making decisions about senior care, it's essential to choose facilities that prioritize healthcare maintenance as a top priority. For more information about Ohio Assisted Living, please visit their official website at https://www.ohioassistedliving.org.

  • February 7th, 2024

    Below is a compiled cheat sheet of Assisted Living Training websites to assist any Providers that are considering the Assisted Living Waiver Certification Program: Assisted Living Waiver Training Websites: New Assisted Living Provider Rates: https://aging.ohio.gov/agencies-and-service-providers/provider-rates-updates Change in Provider Certification Process: https://aging.ohio.gov/agencies-and-service-providers/certification/provider-certification-process-changes Provider Module Training Information: https://aging.ohio.gov/wps/wcm/connect/gov/5154bf3f-f872-47d1-abe2-23c1b42b22f3/Provider+Absorb+LMS+%26+Training+Sign+Up.pdf?MOD=AJPERES&CVID=o8C1x9W MyCare (Managed Care Training Information) https://managedcare.medicaid.ohio.gov/managed-care/centralized-credentialing The established room and board rate for the Assisted Living Waiver participants is the current SSI Federal Benefit Rate of $943.00 minus $50.00: thus the 2024 monthly room and board payment is $893.00. PNM system questions: PNMCommunications@medicaid.ohio.gov ODA application questions: Provider_Enrollment@age.ohio.gov Providers should ensure they are communicating with their PAA when receiving a care plan or an authorization to accept the Memory Care rate to ensure that you as the Provider are wanting to receive this rate and are meeting the requirements. This has been especially important for Providers that may have memory care residents interspersed throughout their community and may not be able to meet the staffing 20% increased staffing ratio requirement. This may have occurred when providers applied for memory care certification through the attestation of compliance. PAAs and providers should communicate promptly to ensure that their lists of authorized memory care residents are consistent, and all the residents meet the criteria, including being able to document elevated staffing levels, even if memory care is provided in an individual room rather than a designated memory care section of the RCF. If the memory care rate is billed and paid for a resident who does not meet the criteria, the payment is subject to recoupment. BCI background Code for ALL Assisted Living Providers Some Providers have received feedback from Area on Aging that the code they have used to run their BCII’s under is not correct (3721.121) and they are wanting them to rerun them under a different code.  OALA reached out yesterday to the Department of Aging and verified that the BCI background check code has NOT changed; it remains 3721.121 for all providers, whether Waiver Providers or non-Waiver Providers. Assisted Living Residents and Voting Please see the attached flyer provided by The Center for Vulnerable Voters. Some highlights below: Feb. 20, 2024 - Is the deadline for a resident to update their voter registration information. This is especially important for a resident that has just moved. Visit olvr.ohiosos.gov or preferably request election authorities to visit your community to assist residents. Now thru March 16 (noon), 2024 - Residents may request an absentee or vote by mail ballot. Visit: ohiosos.gov/globalassets/elections/forms/11-a english.pdf  or request election authorities visit your community to aid residents with absentee ballot requests. Feb. 21, 2024 - Residents who requested absentee ballots will soon be receiving them. If the residents ballot is mailed, it is important to protect the ballot chain of custody - ballot should be secured and no one should be handling your residents' ballot - unless requested by the resident. Residents may have their ballot delivered and returned by election authorities, along with election authorities providing assistance with ballot submissions, if requested. What are my responsibilities as a director? Protecting residents that may be considered "non compos mentis". If the resident cannot express they wish to vote, they should not have a ballot request filled out for them or a ballot marked for them Educating and training staff on the voting laws in your state Being aware of, and enforce ballot assistance laws Educating staff that it is never "ok" to tell a resident who to vote for Protecting staff from outside groups that offer financial compensation for ballot trafficking Protecting residents from outside groups that may coerce their choices, fill out their ballots and/or offer to take the ballots with the promise to submit them Ensure ballots are protected and secured at all times Member Questions: Do RCFs need to update our Residents Code status yearly? ODH stated there is no regulatory requirement to update residents’ code status annually.  Of course, if a status changes,  you will want to document the change or if your company policy required an annual updating. Your staff members should be able to easily identify residents code status, in the event of an emergency. Can the Resident Health Assessment and the Plan of Care be the same document?Resident Health Assessments must be completed, initially, annually and upon change of condition, ( OAC 3701-16-08) if the Care Plan includes all required aspects of the Resident Assessment, then they could be the same document to streamline documentation. Does working in a licensed RCF meet the STNA requirements to maintain an individual’s status on the nurse aide registry? Yes, for an STNA to remain on the Nurse Aide Registry, they must provide “nursing and nursing-related services” for 7.5 consecutive hours or 8 hours within a 48 hour period for monetary compensation within 24 months after they last met the requirements to be listed on the Registry.  The administrator or personnel director would email or fax on community letterhead, the name and social security number of the individual seeking to maintain their listing, plus their start date and end date or current employment date, verifying their employment and provision of “nursing and nursing-related services”.  fax (614) 564-2461 or e-mail:  NAR@odh.ohio.gov Let’s clarify the ability to utilize IVs in Assisted Living.  Does an LPN have to be IV Certified? How long can an IV run ? A resident can receive an IV that is administered by either a qualified staff licensed nurse (if LPN must be IV certified) or a Home Health nurse.  However, it can only run for less than 8 hours/day, since skilled care in a RCF needs to be “part-time intermittent”.   Defined in OAC 3701-16-09.1(A) as less than 8 hours/day or less than 40 hours/week.  The Ohio Dept. of Health also stated that you should have an IV qualified nurse in the building while an IV is running – either a member of your staff or the home health agency nurse.

  • January 31, 2024

    End of the Month - Refresher and Provider Question Review: Assisted Living Waiver Provider Training Information If you are an Assisted Living Waiver Provider, please ensure you have watched the below training video. ODA will be working closely with the PAA staff to ensure a smooth transition.  Providers will have an on-site visit within the first six months of 2024 to verify compliance with the memory care service rule.  Please contact Meredith Finley at mfinley@age.ohio.gov if you have questions.  You may also contact Meredith Finley if you are receiving documentation that is certifying you to be a Memory Care Provider and you do not wish to be certified for Memory Care. Assisted Living - ODA provider certification: assisted living service rule Assisted Living Service Update Training Topics: Community Transition Services Updates to the rates and billing codes Memory Care attestation Changes to the assisted living service rule Person-centered plans Next Steps Applying for the Memory Care Service after January 15th, 2024 Providers who are interested in being certified to deliver the memory care service and bill for the memory care rate starting March 1st, 2024, will be required to follow the process outlined in OAC 173-39-03.3. COLA Increase for ALW Room and Board Providers should have received a notification stating the following: The Ohio Department of Aging is pleased to share the Social Security Administration announcement of a 3.2% Cost of Living Adjustment (COLA) to Social Security benefits effective January 1st, 2024. The established room and board rate for the Assisted Living Waiver participants is the current SSI Federal Benefit Rate of $943.00 minus $50.00: thus the 2024 monthly room and board payment is $893.00. (Additionally, state minimum wage will increase from $10.10 to $10.45 per hour.) How can a Provider utilize Personal Character Standards when a potential employee has multiple counts of theft in the new Background check rules? The Rule 16-06 Requires… (A) If the applicant is a repeat theft related offender…3701-13-06(A)(4)… (4) If the applicant has more than one theft related offense as defined in paragraph (Q) of rule 3701-13-01 of the Administrative Code; (a) The victim of either offense was not an older adult; and (b) At least seven years have elapsed since the date the applicant was fully discharged from imprisonment, probation, or parole for the most recent offense; If the victim was not an older adult and 7 years have elapsed, then a provider can use Personal character standards to employee the applicant, if they choose to do so. If Personal Character Standards are determined to be able to be used, then what needs to be documented when using this process? (7) The applicant's character is such that it is unlikely that the applicant will harm an older adult. In making that determination, the chief administrator shall consider the following factors for each offense: ·        (a) The applicant's age at the time of the offense; (b) Regardless of whether the applicant knew the victim prior to the committing of the offense, the age and mental capacity of the victim; (c) The nature and seriousness of the offense; ·        (d) The number of previous offenses or length of time since the most recent conviction or guilty plea; ·        (e) The degree to which the applicant participated in the offense and the degree to which the victim contributed to or provoked the offense; ·        (f) The likelihood that the circumstances leading to the offense will reoccur; (g) The applicant's employment record; ·        (h) The applicant's efforts at rehabilitation and the results of those efforts; ·        (i) If known, whether the applicant has been convicted of or pleaded guilty to any violation of an existing or former municipal ordinance substantially equivalent to any offense listed or described in rule 3701- 13-05 of the Administrative Code; ·        (j) Whether any criminal proceedings are pending; and ·        (k) Any other factors related to the position that the chief administrator considers relevant to the performance of job duties. (B) If the applicant fails to provide proof that the personal character standards listed in this rule are met, or if the DCP determines that the proof offered by the applicant is inconclusive, the applicant shall not be employed in a position that involves providing direct care to older adults. Does an AL with a secured Memory Care Unit need to have a separate admission agreement for the unit, or just the policy on care? You do not need a separate agreement, however, the items highlighted below would need to be in the agreement if a resident is seeking or being transferred to a secure Memory Unit. OAC 3701-16-07 (D) A residential care facility shall enter into a written resident agreement with each prospective resident prior to beginning residency in the residential care facility. The agreement shall be signed and dated by the operator, administrator, or acting administrator and the prospective resident or, if the prospective resident is physically or cognitively unable to sign and consents, another individual designated by the prospective resident. The facility shall provide both the prospective resident and any other individual signing on the resident's behalf with a copy of the agreement and shall explain the agreement to them. (E) The agreement required by paragraph (D) of this rule shall include at least the following items: (1) An explanation of all charges to the resident including security deposits, if any are required; (2) A statement that all charges, fines, or penalties that shall be assessed against the resident are included in the resident agreement; (3) A statement that the basic rate shall not be changed unless thirty days written notice is given to the resident or, if the resident is unable to understand this information, to his or her sponsor; (4) An explanation of the residential care facility's policy for refunding charges in the event of the resident's absence, discharge, or transfer from the facility and the facility's policy for refunding security deposits; (5) An explanation of the services offered by the facility, the types of skilled nursing care that the facility provides or allows residents to receive in the facility, the providers that are authorized to render that care, and the limitations of the type and duration of skilled nursing care that is offered; (6) An explanation of the extent and types of services the facility will provide to the resident and who is responsible for payment; and (7) A statement that the facility must discharge or transfer a resident when a resident needs skilled nursing care beyond the limitations identified in paragraph (E)(5) of this rule. (F) Prior to admission or upon the request of a prospective resident or prospective resident's sponsor, the residential care facility shall provide the resident or resident's sponsor with a copy and explain the contents of the following policies: (1) The facility's residents' rights policy and procedures required by section 3721.12 of the Revised Code; (2) The facility's smoking policy required by paragraph (W) of rule 3701-16-13 of the Administrative Code; (3) The facility's policy regarding advance directives and an explanation of the rights of the resident under state law concerning advance directives. A residential care facility may not require an execution of an advance directive as a condition for admission; (4) The definition of skilled nursing care from rule 3701-16-01 of the Administrative Code; (5) For individuals seeking residency on a special care unit, the facility's policy on care for residents in the special care unit. The policy shall include:  (This policy should be given to the resident/sponsor as well as a signed copy kept with the resident agreement) (a) A statement of mission or philosophy that reflects the needs of the special population; (b) Admission criteria to the special care unit, including screening criteria, if applicable; (c) Transfer and discharge criteria and procedures; (d) A weekly staffing plan for the special care unit, if applicable, including: (i) A statement of how this plan differs from the staffing plan for the remainder of the facility; and (ii) The necessary increase in supervision, due to decreased safety awareness or other assessed condition, of residents with cognitive impairments or serious mental illness in the special care unit; (e) A description of activities offered, including frequency and type, and how the activities meet the needs of the type of residents in that special care unit, including how these activities differ from those offered in the remainder of the facility, if applicable; (f) A listing of the costs of the services provided by the facility to the resident; (g) Specialized staff training and continuing education practices; (h) The process used for assessment and the provision of services, including the method for altering services based on changes in condition; (i) If necessary, how the facility addresses the behavioral healthcare needs of residents; (j) The physical environment and design features to support the functioning of residents; (k) The involvement of families and the availability of family support programs for residents; and (l) Any services or other procedures that are over and above those provided in the remainder of the facility, if applicable; (6) An explanation of the facility's ability to accommodate disabled residents or potentially disabled residents and the facility's policy regarding transferring residents to units that accommodate residents with disabilities; and (7) Any other facility policies that residents must follow. Is it necessary to have a physician make a determination that a resident is required to be admitted to a secured / enclosed Memory Care Unit?  Does this have to be updated? Yes, OAC 3701-16-08(F)… (F) Prior to admitting or transferring a resident to a special care unit that restricts the resident's freedom of movement, the residential care facility shall ensure that a physician or other licensed healthcare professional working within their scope of practice, has made a determination that the admission or transfer to the special care unit is needed. This determination shall be updated, to include both improvement and decline, during the periodic reassessment required by paragraph (D) of this rule. Prior to admission to the special care unit, the residential care facility shall provide the resident with an updated resident agreement required by rule 3701-16-07 of the Administrative Code and with the facilities policy on care of residents by means of a special care unit required by paragraph (E)(5) of that rule. No resident shall be admitted to a secured special care unit based solely on his or her diagnosis. How often do resident health assessments need to be done? At least annually, and sooner if medically indicated. OAC 3701-16-08 (D) Subsequent to the initial health assessment, the residential care facility assesses each resident's health at least annually unless medically indicated sooner. (Change of Resident Condition) The annual health assessment shall be performed within thirty days of the anniversary date of the resident's last health assessment. The 30-day window is within 30 days before or after the resident’s last health assessment. The rule referenced includes all the assessment requirements. It mirrors the initial assessment with a few items deleted such as hobbies. What must be included per rule OAC 3701-16-08 in the initial and subsequent Resident Assessment? OAC 3701-16-08… (C) The initial health assessment shall include documentation of the following: (1) Preferences of the resident including hobbies, usual activities, bathing, sleeping patterns, socialization and religious; (2) Medical diagnoses, if applicable; (3) Psychological, intellectual disabilities, and developmental diagnoses history, if applicable; (4) Health history and physical, including cognitive functioning and sensory and physical impairments, and the risk of falls; (5) Prescription medications, over-the-counter medications, and dietary supplements; (6) Nutrition and dietary requirements, including any food allergies and intolerances, food preferences, and need for any adaptive equipment, and needs for assistance and supervision of meals; (7) Height, weight, and history of weight changes; (8) A functional assessment which evaluates how the resident performs activities of daily living and instrumental activities of daily living. For the purposes of this paragraph, "instrumental activities of daily living" means using the telephone, acquiring and using public and private transportation, shopping, preparing meals, performing housework, laundering, and managing financial affairs; (9) Type of care or services, including the amount, frequency, and duration of skilled nursing care the resident needs as determined by a licensed health professional in accordance with the resident's assessment under paragraph (C) of this rule; (10) A determination by a physician or other licensed healthcare professional working within their scope of practice, as to whether or not the resident is capable of self-administering medications. The documentation also shall specify what assistance with self-administration, as authorized by paragraph (F) of rule 3701-16-09 of the Administrative Code, if any, is needed or if the resident needs to have medications administered in accordance with paragraphs (G) and (H) of rule 3701-16-09 of the Administrative Code; Subsequent Assessments - Annual and Change of Condition: OAC3701-16-08(D)… (D) Subsequent to the initial health assessment, the residential care facility assess each resident's health at least annually unless medically indicated sooner. The annual health assessment shall be performed within thirty days of the anniversary date of the resident's last health assessment. This health assessment shall include documentation of at least the following: (1) Changes in medical diagnoses, if any; (2) Updated nutritional requirements, including any food allergies and intolerances; (3) Height, weight and history of weight changes; (4) Prescription medications, over-the-counter medications, and dietary supplements; (5) A functional assessment as described in paragraph (C)(8) of this rule; (6) If the resident has been determined to have medical, psychological, or developmental or intellectual impairment, an assessment as described in paragraph (C)(13) of this rule; (7) Type of care or services, including the amount, frequency, and duration of skilled nursing care, the resident needs as determined by a licensed health professional in accordance with paragraph (D) of this rule; (8) A determination by a physician or other licensed healthcare professional working within their scope of practice, as to whether or not the resident is capable of self-administering medications. The documentation also shall specify what assistance with self-administration, as authorized by paragraph (F) of rule 3701-16-09 of the Administrative Code, if any, is needed or if the resident needs to have medications administered in accordance with paragraphs (G) and (H) of rule 3701-16-09 of the Administrative Code;

  • Understanding the Silver Tsunami: Ohio's Aging Population and the Path Forward

    Ohio's population is experiencing a significant shift, with the number of senior citizens on the rise. The aging population brings both opportunities and challenges that impact various aspects of our society. In this blog post, we'll explore the changing demographics of Ohio, the challenges faced by its aging population, and the solutions and resources available to support the state's seniors. 1. Demographics of Aging in Ohio Ohio's aging population is growing at an unprecedented rate. The Baby Boomer generation, born between 1946 and 1964, represents a significant portion of this demographic shift. As this generation ages, Ohio has seen an increase in the number of senior citizens, and this trend is expected to continue for the next several decades. 2. Challenges Faced by Ohio's Seniors The increase in Ohio's senior population brings with it a series of challenges. These include healthcare demands, affordable housing, access to transportation, social isolation, and financial security. Meeting the needs of this demographic shift is a complex and multifaceted task. 3. Healthcare for Ohio's Seniors Access to quality healthcare is crucial for Ohio's aging population. Healthcare facilities, providers, and services need to be adequately prepared to address the unique healthcare needs of seniors, including chronic conditions, long-term care, and preventive health measures. 4. Affordable Housing Solutions Affordable and accessible housing is a growing concern for senior citizens in Ohio. Many are looking for housing options that offer safety, comfort, and community support. Programs and initiatives focused on affordable senior housing are crucial to addressing this issue. 5. Transportation Services for Seniors Maintaining mobility is essential for seniors to stay active and engaged in their communities. Ohio should invest in transportation services that cater to the needs of elderly residents, providing convenient and accessible options for getting around. 6. Combating Social Isolation Social isolation can have a significant impact on the mental and emotional well-being of seniors. Implementing programs and services that encourage social engagement, such as senior centers, community events, and volunteer opportunities, is vital to combating isolation. 7. Financial Security for Ohio's Seniors Many seniors face financial challenges in retirement, including insufficient savings, rising healthcare costs, and fixed incomes. Ohio can explore solutions such as financial literacy programs, pension protection, and access to benefits to enhance the financial security of seniors. 8. Support and Resources for Caregivers The aging population also places demands on family caregivers. Ohio can offer resources, respite care, and support for those who provide care to elderly family members, ensuring that caregivers receive the help they need. 9. The Role of Technology in Aging Services Incorporating technology into aging services can provide solutions to some of the challenges faced by Ohio's elderly. Telehealth, smart home technology, and digital communication tools can enhance access to healthcare and connect seniors with their loved ones. 10. Collaborative Efforts for a Brighter Future Addressing the needs of Ohio's aging population is a shared responsibility. It requires collaborative efforts from government agencies, healthcare providers, community organizations, and individuals. By working together, Ohio can create a supportive and inclusive environment for its senior citizens. Conclusion: Ohio's aging population presents both challenges and opportunities for the state. It is crucial to address the unique needs of senior citizens, from healthcare and housing to transportation and social engagement. By implementing comprehensive solutions, Ohio can ensure that its seniors continue to lead fulfilling lives and remain active contributors to the community. As the state continues to evolve demographically, a proactive approach to addressing the challenges of an aging population will pave the way for a brighter future for Ohio's seniors. By recognizing the needs of its elderly residents and prioritizing their well-being, Ohio can navigate the demographic shift with compassion and effectiveness, ensuring a high quality of life for its senior citizens. For additional information and resources related to Ohio's aging population, be sure to visit the official website of the Ohio Department of Aging at [https://aging.ohio.gov](https://aging.ohio.gov).

  • January 26th, 2024

    ODH Provider Meeting Updates: Backlog of RCF annual surveys: Currently 299 past 15.9 months. Rule Update:   Chapter 3701-16 Completed publication and waiting on CSI to review before filing. Chapter 3701-62- Do Not Resuscitate(DNR) rules: Beginning stakeholder meetings, rules will be under review. State Long-Term Care Ombudsman Update: Additional regional grants, allowing more positions-could result in faster moving resident satisfaction surveys next Fall. RCF Annual Reports- Departments will not have until after late February-March Surveyor issues: Any issues with ODH surveyors should be reported to ODH, this can be done via a link in your EIDC after survey is completed- if issues during survey, then contact ODH directly. ODH Discussion on April 8th Total Solar Eclipse and how it could affect your long-term care facility: See Attached Slide Deck COVID Vaccination Policy: While ODH did not state RCF’s are required to offer COVID vaccinations(as this is NOT in Rule), they did state a facility should follow it’s own policy- indicative that you need to have a policy on COVID vaccinations, whether you are offering to resident’s or referring to their PCP. Rule Clarification: RCF Rule 3701-16-15(C) Building maintenance, equipment and supplies: As was stated in a recent OALA Update - You must as a provider state if you DO or DO NOT supply these items…if you do not state this in your Resident Agreement, then it is considered that you purchase and supply these items. This has been a consistent issue with surveys, possibly because they are looking at this closely now.  One of the reasons they are looking closely is because if your resident agreement does not state you do not supply these items, Medicaid is not allowing them to be utilized under the Community Transition Service. See below for actual rule: (1) An individual bed equipped with springs and a clean comfortable flame resistant mattress or a clean comfortable mattress with a flame resistant mattress cover. The bed shall be sturdy, safe, and in good condition. Rollaway beds and cots, double deck beds, stacked bunk beds, hide-a-bed couches, or studio couches do not meet the requirements of this rule; (2) Bed linen which shall include at least two sheets, a pillow and pillow case, a bedspread, and one blanket that fit properly and are free of tears, holes, and excessive fraying or wear. The residential care facility shall: (a) Ensure that the mattresses of incontinent residents are protected with an intact waterproof material unless contraindicated or otherwise ordered by a physician or other licensed healthcare professional working within their scope of practice; and (b) Provide each resident with additional blankets and pillows upon request and ensure that two sets of bed linen are available for each bed at all times. Residential care facilities shall ensure that bed linen is changed weekly and more often if soiled or requested by the resident; (3) Closet or wardrobe space with a minimum width of twenty-two inches of hanging space sufficient in height and equipped for hanging full length garments and at least one shelf of adequate size within reach of the resident; (4) A bedside table, personal reading lamp, adequate bureau, dresser or equivalent space, a mirror appropriate for grooming, a waste basket with liners, and a chair with a padded back and seat, with arms for lateral support. If a resident has a wheelchair, the wheelchair may meet this requirement unless the resident indicates he or she wants a comfortable chair in addition to the wheelchair; (5) Bath linen that includes at least two full towels, two face towels, and two washcloths; (6) A shower curtain and appropriate hanging devices; and (7) Basic toiletry items and paper products. Senate Aging Committee Hearing on Assisted Living January 25,2024 (Yesterday) Argentum’s Response: Collaborating with our association partners ASHA and NCAL to develop unified messages on the value of assisted living; Engaging with our State Partners to communicate with members of the Senate Aging Committee and identify potential hearing witnesses; Preparing a potential industrywide response with our association partners in the form of joint testimony and media responses. See Argentum Post Senate Hearing Attached Mandatory Employer Reporting to The Ohio Board of Nursing – Follow up. OALA received multiple questions regarding the required Ohio Board of Nursing employer reporting information that went out in last week’s OALA Update. Please see below for some additional clarification: All nurse employers need to report any non-Ohio MSL holders into Nursys.com by January 31, 2024. That is all the mandate covers. Due to the automatic reporting features of Nursys.com, the OBN is suggesting employers upload all their nurses into the system, but this is optional and not a requirement. The reporting features include receiving alerts when a nurse may be disciplined, or if they have not renewed their license. It's a great tool to ensure compliance and give OALA member's more workforce visibility. Attached is a one-sheeter about uploading information into Nursys.com and the e-Notify system. The NCSBN's Jason Schwartz is the Nursys.com tech guru and is ready to help anyone with any questions. Jason A. Schwartz, Director of Outreach, jschwartz@ncsbn.org The National Council of State Boards of Nursing’s (NCSBN) FREE e-Notification system, e-Notify at Nursys.com, gives institutions the benefit of receiving automatic licensure renewal and nonrenewal alerts, and publicly available discipline/practice privileges notifications to an organization’s email quickly, easily, and securely. ORC 4723.114, along with rule 4723-11-03 OAC, requires employers to report to the Ohio Board of Nursing the number of nurses they employed in the previous year. OAC 4723-11-03…(A) As used in this rule, "person" has the same meaning as in section 1.59 of the Revised Code. (B) Beginning January 31, 2024, and each year thereafter, a person or governmental entity that employs, or contracts directly or through another person or governmental entity for the provision of services by, a nurse holding a multistate license shall do both of the following, if the multistate license was issued by a state other than Ohio: (1) Report to the board of nursing the number of nurses holding multistate licenses, issued by a state other than Ohio, who were employed by, or providing services for, the person or governmental entity in the prior calendar year. The information will be reported to the board of nursing through e-notification at https://www.ncsbn.org/nursing-regulation/licensure/license-verification.page (2) Provide each nurse holding a multistate license a copy of board-developed information concerning laws and rules specific to the practice of nursing in Ohio. As specified by the rule, organizations must report the information through the NCSBN's e-Notify system by January 31, 2024. For more information about the law, Nursys.com, and e-Notify, download our "Tips for Employee Mandated Reports" pdf, contact OBN at licensure@nursing.ohio.gov or call 614-466-3947. Reminder to pay ODH License Renewal: This is a reminder that license renewal applications received on or after February 1, 2024 that are not postmarked on or before January 31, 2024 will be charged a, or part thereof, that the renewal fee is not paid. For fastest processing, please renew and pay on-line via EIDC (on-line system) at http://publicapps.odh.ohio.gov/EID with Visa, MasterCard, American Express or an electronic check from a checking account. Requests for new EIDC accounts and existing account changes (e.g. resetting of password, adding facilities, updating e-mail address, etc.) can be submitted on-line by visiting http://publicapps.odh.ohio.gov/EID and selecting “EIDC User Account Request”. If paying by mail: 1. Complete the renewal form on-line; 2. print it; and 3. mail it with your non-refundable annual renewal licensing fee and current State Fire Marshal inspection report as an inclusive packet to ODH, Accounts Receivable #3212, PO Box 15278, Columbus, OH 43215. The renewal licensing fee is $320 for each 50 beds or part thereof of a facility’s licensed capacity (e.g. $320 for 1 to 50 licensed capacity, $640 for 51 to 100 licensed capacity, etc.) and must be made payable to the “Treasurer, State of Ohio.” An incomplete renewal packet will delay the renewal process. If you have questions regarding this communication or require additional information, please email liccert@odh.ohio.gov. Member Question: Are heating pads addressed in the RCF rules? What about electric blankets? In the past, the Ohio Department of Health has stated that a community should have a policy on these items and their use. They are not prohibited by RCF regulations or the Ohio Fire Code. The Fire Code, however, would require them to be plugged directly into an outlet (no extension cord or power strip) and their UL certification would need to be followed. A facility’s policy could prohibit or restrict them. If they are permitted by facility policy, the policy should call for an assessment of the individual for any health-related contraindications, and the individual’s ability to use the item safely, along with a process for staff to appropriately monitor the item’s use. Additionally, you need to address their accessibility to residents who could potentially be harmed by them. Perhaps, heating pads, for example, could be kept at the wellness center, so that a staff member is aware that they are being used. Essentially, ODH said it wouldn’t get involved in the use of these items, unless there was harm to a resident, and then they would expect to see that appropriate policies and procedures had been put in place and followed. The State Fire Marshal’s Code Enforcement Office stated their use would be covered as a portable electric appliance (no frayed wires, etc.) and any manufacturer’s instructions would need to be followed, such as a requirement to be directly plugged into an outlet. Recreational Marijuana in Ohio- OALA New Webinar For those providers that were unable to attend OALA’s “Weed in the Workplace: Ohio’s Solution”, please register on our Education/Webinar platform.  The webinar was conducted by Attorney Sam Lillard of Ogletree Deakins and has his contact information included. Below are a few Highlights: Employers have the right to prohibit the use, possession or distribution of marijuana in the workplace. Employers can choose to treat marijuana the same as any other legally prescribed drug. Drug-Free workplace and zero-tolerance drug policies are enforceable, although it is wise to update and document to specifically state that marijuana is prohibited. The current law specifically states that employees may not sue an employer for adverse action related to medical marijuana. Under current law, termination of an employee for the use of medical marijuana in violation of the employer’s policies is “just cause” which permits the denial of unemployment benefits. Get answers to Marijuana and the Americans with Disabilities Act (ADAAA) OALA RCF 2024 Rule Binders The 2024 Rule Binders are now ready for purchase!  As this is an RCF rule review period, OALA has included the current RCF rules(3701-16) as well as the Final Proposed rules, to give you guidance, as these rules come into effect.  You will notice that other tabs within the binder have been updated, such as Background Checks, Medicaid and Aging.  As a service to our providers that purchase the rule binder, when the RCF(3701-16) rules are in effect, OALA will send you a digital copy to replace the current rules.  CLICH HERE TO PURCHASE  (scroll all the way down to the OALA Store) Register Today to learn about the Proposed Final Draft New Rules…As well as a comprehensive day long educational experience of ALL CURRENT RCF Rules! OALA Member Dues OALA membership renewal fees are due by January 31, 2024.  Please make sure your dues are paid by then to ensure no interruption in your member service.  Invoices were initially sent via email and mail at the end of November. If mailing your payments via mail please note that our address has changed to: 1201 Dublin Road, Suite 149, Columbus, Ohio 43215.  If you have any questions about your dues, please contact Kim at Kimd@ohioassistedliving.org

  • January 19th, 2024

    RCF Rule Updates The RCF chapter 3701-16 Final Proposed draft rules were posted by ODH.  They are still available to view- CLICK HERE . These rules were removed from public comment on January 1, 2024.  While there is always the ability to see some change, it is expected these rules will stand. With that in mind, Providers will want to pay close attention to OAC 3701-16-12, “Changes in Residents’ health status; incidents; infection control; tuberculosis control plan”, as this is where we will see many substantial changes. Providers that are wanting to “get ahead of the game” and have a clear understanding of the Proposed Final draft rules, so that they can be prepared, as well as learn/refresh on the Survey Process and all of the RCF rules that will remain in place, should join OALA on one of our upcoming RCF Rule Trainings! OALA has put the work into this, to simplify and make this comprehensive Rule and Regulation set, in an interactive and easy to learn format. Please CLICK HERE to register for one of OALA’s RCF Rule Trainings. OALA will continue to keep providers updated on the RCF rule set and changes that are to come. Providers should have received the following EIDC Bulletin Details from ODH regarding RCF License renewal: Dear Provider- This is a reminder that license renewal applications received on or after February 1, 2024 that are not postmarked on or before January 31, 2024 will be charged a, or part thereof, that the renewal fee is not paid. For fastest processing, please renew and pay on-line via EIDC (on-line system) at http://publicapps.odh.ohio.gov/EID with Visa, MasterCard, American Express or an electronic check from a checking account. Requests for new EIDC accounts and existing account changes (e.g. resetting of password, adding facilities, updating e-mail address, etc.) can be submitted on-line by visiting http://publicapps.odh.ohio.gov/EID and selecting “EIDC User Account Request”. If paying by mail: 1. Complete the renewal form on-line; 2. print it; and 3. mail it with your non-refundable annual renewal licensing fee and current State Fire Marshal inspection report as an inclusive packet to ODH, Accounts Receivable #3212, PO Box 15278, Columbus, OH 43215. The renewal licensing fee is $320 for each 50 beds or part thereof of a facility’s licensed capacity (e.g. $320 for 1 to 50 licensed capacity, $640 for 51 to 100 licensed capacity, etc.) and must be made payable to the “Treasurer, State of Ohio.” An incomplete renewal packet will delay the renewal process. If you have questions regarding this communication or require additional information, please email liccert@odh.ohio.gov. INFORMATION-UPDATED ODA Assisted Living Waiver TRAINING - Recap Assisted Living Service Update Training Topics: Community Transition Services Updates to the rates and billing codes Memory Care attestation Changes to the assisted living service rule Person-centered plans Next Steps A follow up to the Previous Washington Post Article From: Argentum’s President & CEO James Balda Re:  Senate Aging Committee to Hold Hearing on Assisted Living On January 16, The Washington Post published an online article reporting that Senate Aging Committee Chair, Senator Robert Casey (D-PA) has scheduled a January 25 committee hearing (Link for Live Hearing) on the assisted living industry, based in part on the recent New York Times series “Dying Broke” and The Washington Post investigation of elopements. Senator Casey also sent letters to a handful of assisted living providers requesting information about elopements, practices for disclosing incidents to families, staffing ratios, and costs. Argentum shared the following statement with The Washington Post: “The Washington Post’s reporting featured isolated incidents that assisted living communities take very seriously. It is clear that fatalities from wandering in these communities are exceedingly rare, occurring with 0.0015% of more than 6.2 million residents served over the course of the reporting. “Our communities look forward to demonstrating to the Committee that, as the nation grapples to care for our aging population, assisted living provides independence and dignity for seniors. “Nothing is more important than our residents’ safety, and any fatality is devastating for our staff, our residents, and their families. Argentum strongly supports state regulations already in place to investigate incidents and punish any wrongdoing. Argentum’s Response: In addition to submitting comments to the Washington Post, Argentum is preparing for the January 25 hearing. Our actions include: Collaborating with our association partners ASHA and NCAL to develop unified messages on the value of assisted living; Engaging with our State Partners to communicate with members of the Senate Aging Committee and identify potential hearing witnesses; Preparing a potential industrywide response with our association partners in the form of joint testimony and media responses. We will continue to keep you updated as we learn more. Please do not hesitate to reach out to Maggie Elehwany, senior vice president of public affairs (melehwany@argentum.org) with any questions or to share any relevant information on these activities. Mandatory Employer Reporting to The Ohio Board of Nursing The National Council of State Boards of Nursing’s (NCSBN) FREE e-Notification system, e-Notify at Nursys.com, gives institutions the benefit of receiving automatic licensure renewal and nonrenewal alerts, and publicly available discipline/practice privileges notifications to an organization’s email quickly, easily, and securely. ORC 4723.114, along with rule 4723-11-03 OAC, requires employers to report to the Ohio Board of Nursing the number of nurses they employed in the previous year. OAC 4723-11-03…(A) As used in this rule, "person" has the same meaning as in section 1.59 of the Revised Code. (B) Beginning January 31, 2024, and each year thereafter, a person or governmental entity that employs, or contracts directly or through another person or governmental entity for the provision of services by, a nurse holding a multistate license shall do both of the following, if the multistate license was issued by a state other than Ohio: (1) Report to the board of nursing the number of nurses holding multistate licenses, issued by a state other than Ohio, who were employed by, or providing services for, the person or governmental entity in the prior calendar year. The information will be reported to the board of nursing through e-notification at https://www.ncsbn.org/nursing-regulation/licensure/license-verification.page (2) Provide each nurse holding a multistate license a copy of board-developed information concerning laws and rules specific to the practice of nursing in Ohio. As specified by the rule, organizations must report the information through the NCSBN's e-Notify system by January 31, 2024. For more information about the law, Nursys.com, and e-Notify, download our "Tips for Employee Mandated Reports" pdf, contact OBN at licensure@nursing.ohio.gov or call 614-466-3947. Member Questions: Can Geri-chairs be used in RCFs? …Or are they considered a restraint? A Geri- chair is listed as a physical restraint in the RCF rules, so they would not be permitted in Ohio RCFs. See OAC 3701-16-09 (L) The residential care facility shall not physically, chemically or through isolation restrain residents. (1) For the purposes of this paragraph: (a) "Physical restraint" means, but is not limited to, any article, device, or garment that interferes with the free movement of the resident and that the resident is unable to remove easily, a geriatric chair, or a locked room door; … The only exception might be for a hospice resident based on OAC 3701-16-07 (C) which begins with… Except for residents receiving hospice care… and subsequently list prohibitions including ...chemical or physical restraints, bedridden, if residents on hospice were included in the prohibition on restraints. ODH stated the rule was written that way to permit pain medications for residents on hospice that might be considered chemical restraints and to allow dying residents to remain in the RCF if they become bedridden, not to suggest that hospice residents could be physically restrained. However, a hospice resident’s functional ability may become so limited that items that would otherwise be a restraint may not be for that individual as they do not “stop” them from doing something they would otherwise be able to do. In the case of any item that could be considered a restraint, the RCF should do an “assessment” of the item with the individual to document whether the item in question acts as a restraint for them. There is a helpful restraint determination tool on OALA’s Member Website that was developed in conjunction with Rolf Law’s consulting group.  OALA Restraint Determination Tool Can a resident’s family make a determination of what foods the resident can and cannot eat, if it goes against what the resident wants? What reg/resident right would cover this issue? The resident should be allowed to make their own decision regarding their food choices.  If a physician has made food recommendations, then the resident obviously must be told these advisements and regularly educated on their food choices and the risks involved, but they could still select to eat foods that were not within that parameter.  OAC 3701-16-10(H) (7) May provide a dining environment as natural and independent as possible, comparable with eating at home, with choices from a wide variety of food items tailored to the residents' wants and needs, which otherwise meet the requirements of this rule. How often do we need to check the room temperature in our building common areas to comply with OAC 3701-16-16 (A)(B)? Communities comply with this requirement in different ways. Some keep a temperature log, noting the temperature at specified intervals, for example weekly or monthly. While a log is not required by rules, some surveyors ask for one and it does provide documentation. Other communities have a policy of responding to staff or resident temperature concerns, by taking the temperature in areas when and where concerns are raised. RCFs should have a policy on complying with temperature regulations, with documentation of compliance per the policy, log or recorded responses to temperature concerns. Are there actions that need to be taken if temperatures are outside of the designated range? Yes. RCF rule OAC 3701-16-16 (D) requires written policies and procedures developed with a physician or other appropriate health care professional for the response to temperatures outside of the identified range (71-81 degrees) that include: 1) Identification of available sites within or outside the RCF to which residents could be temporarily relocated or other suitable transfer locations; 2) Measures to be taken to assure the health, safety and comfort of residents remaining in the facility when the temperatures are outside the identified range; 3) Circumstances requiring physician notification, medical examinations or interventions. Additionally, if temperatures outside of the designated range reach a point where they can adversely affect a resident or residents, the RCF is to implement the above policies, document the action and maintain this documentation for the current and preceding calendar year. Note: In the Final Proposed RCF rules, we will likely see the requirement to “have a device such as a handheld hygrometer or infrared thermometer, to check the ambient temperature of the rooms”. What happens if our fire alarm and sprinkler system will detect fire and sound off in the building, but It  won’t communicate with the fire department. If the fire system is working within the building, do we need to do fire watch? OALA reached out to Chief Vance, Fire Marshall and he stated that this would not require a Fire Watch.  It would require immediate staff inservice to let them know that upon any fire alarm, 911 should immediately be called to the facility to evaluate.

  • Enhancing Lives: The Role of Memory Care in Assisted Living Communities

    Memory care is a specialized and essential component of assisted living communities catering to individuals with Alzheimer's disease and other forms of dementia. These dedicated programs and facilities play a crucial role in ensuring the safety, well-being, and overall quality of life for seniors with memory impairments. In this blog post, we'll delve into the significance of memory care in assisted living and the benefits it offers to residents and their families. 1. Specialized Care for Cognitive Impairments Memory care programs in assisted living communities are specifically designed to cater to the unique needs of seniors with memory impairments. These programs feature specially trained staff who understand the challenges associated with Alzheimer's and dementia, ensuring residents receive the support and care they require. 2. Safe and Secure Environment Memory care units are designed to provide a safe and secure living environment. This includes features such as alarmed doors, secure outdoor areas, and constant supervision to prevent wandering and ensure residents' safety. Families can have peace of mind knowing their loved ones are in a protected setting. 3. Cognitive Stimulation Activities Engaging in cognitive activities is vital for maintaining mental acuity in seniors with memory impairments. Memory care programs offer a variety of activities tailored to residents' cognitive abilities, including puzzles, reminiscence therapy, and memory-enhancing games. These activities help slow the progression of cognitive decline. 4. Personalized Care Plans Each resident in a memory care program receives a personalized care plan. This plan takes into account their unique needs, preferences, and abilities. It ensures that they receive individualized care that focuses on their well-being while maintaining their quality of life. 5. 24/7 Supervision and Support Memory care communities provide around-the-clock supervision and support. This level of care ensures that residents receive immediate assistance when needed, including help with activities of daily living, medication management, and emotional support. 6. Nutritional Support Maintaining a balanced diet is essential for seniors, and memory care communities offer nutritious meals that cater to residents' dietary requirements. Specialized diets, which may be necessary due to medical conditions, are carefully managed. 7. Support for Families Memory care communities understand that dementia and Alzheimer's can be emotionally challenging for families. They offer support and resources, including educational programs and family counseling, to help loved ones cope with the changes associated with memory impairments. 8. Maintaining Dignity and Independence One of the primary goals of memory care is to help residents maintain their dignity and independence for as long as possible. By focusing on the individual's abilities and providing support when needed, memory care communities empower residents to live with purpose and self-respect. Memory care in assisted living communities is a vital resource for seniors facing memory impairments such as Alzheimer's disease and dementia. These specialized programs provide a safe and secure environment, cognitive stimulation, personalized care plans, and 24/7 support. For families, memory care offers peace of mind, knowing that their loved ones are receiving the best care and attention. As you consider senior living options for a family member with memory impairments, exploring memory care in assisted living communities should be a top priority. It ensures that your loved one receives the specialized care they need to enhance their quality of life and maintain their dignity and independence for as long as possible. By prioritizing memory care, assisted living communities create an environment where seniors with cognitive impairments can thrive and enjoy a fulfilling quality of life.

  • January 11th, 2024

    NEW INFORMATION-UPDATED ODA TRAINING Assisted Living Service Update Training Topics: Community Transition Services Updates to the rates and billing codes Memory Care attestation Changes to the assisted living service rule Person-centered plans Next Steps RCF Rule Updates The RCF chapter 3701-16 draft rules were posted by ODH.  They are still available to view: CLICK HERE These rules were removed from public comment on January 1, 2024.  While there is always the ability to see some change, it is expected these rules will stand. With that in mind, Providers will want to pay close attention to OAC 3701-16-12, “Changes in Residents’ health status; incidents; infection control; tuberculosis control plan”, as this is where we will see many substantial changes. One of the proposed changes is a required water management program.  The CDC has a webpage that allows you to look at an Overview of Water Management, then view a toolkit that allows you to enroll in a free on-line training program on developing a water management program to minimize the growth and transmission of Legionella and other waterborne pathogens in our building water systems.  The free training is through the Western Region Public Health Training Center at the University of Arizona. Click Here for more information. Another change that is proposed in the RCF rule set is the requirement of a written surveillance plan outlining the activities for monitoring and tracking infections based on nationally recognized surveillance criteria such as McGreer Criteria.  The McGreer Criteria is attached so that Providers can familiarize themselves with this information. OALA will continue to keep providers updated on the RCF rule set and changes that are to come. How can a Provider utilize Personal Character Standards when a potential employee has multiple counts of theft in the new Background check rules? The Rule 16-06 Requires… (A) If the applicant is a repeat theft related offender…3701-13-06(A)(4)… (4) If the applicant has more than one theft related offense as defined in paragraph (Q) of rule 3701-13-01 of the Administrative Code; (a) The victim of either offense was not an older adult; and (b) At least seven years have elapsed since the date the applicant was fully discharged from imprisonment, probation, or parole for the most recent offense; If the victim was not an older adult and 7 years have elapsed, then a provider can use Personal character standards to employee the applicant, if they choose to do so. If Personal Character Standards are determined to be able to be used, then what needs to be documented when using this process? (7) The applicant's character is such that it is unlikely that the applicant will harm an older adult. In making that determination, the chief administrator shall consider the following factors for each offense: ·        (a) The applicant's age at the time of the offense; (b) Regardless of whether the applicant knew the victim prior to the committing of the offense, the age and mental capacity of the victim; (c) The nature and seriousness of the offense; ·        (d) The number of previous offenses or length of time since the most recent conviction or guilty plea; ·        (e) The degree to which the applicant participated in the offense and the degree to which the victim contributed to or provoked the offense; ·        (f) The likelihood that the circumstances leading to the offense will reoccur; (g) The applicant's employment record; ·        (h) The applicant's efforts at rehabilitation and the results of those efforts; ·        (i) If known, whether the applicant has been convicted of or pleaded guilty to any violation of an existing or former municipal ordinance substantially equivalent to any offense listed or described in rule 3701- 13-05 of the Administrative Code; ·        (j) Whether any criminal proceedings are pending; and ·        (k) Any other factors related to the position that the chief administrator considers relevant to the performance of job duties. (B) If the applicant fails to provide proof that the personal character standards listed in this rule are met, or if the DCP determines that the proof offered by the applicant is inconclusive, the applicant shall not be employed in a position that involves providing direct care to older adults. Recent Questions Regarding RCF OAC 3701-16-15 Building maintenance, equipment, and supplies.(Provider Alert) A provider must state in the Resident Agreement if they are NOT suppling residents with a mattress, box springs and linens.  If you do not specify this in the resident agreement, then it is automatically assumed that you do supplies these items.  If you do not specify that you do not supply them, and a resident is on the Medicaid waiver, the community transition will not cover these items because it will be expected that your facility is suppling them.  This has come to light in recent surveys as well as in Medicaid admissions and OALA wants to bring this to your attention, so that you can ensure that your resident agreement reflects what you do offer our residents.  Please see below: OAC 3701-16-15(C) states: (C) Unless the resident chooses to bring his or her own or as specified in the resident agreement, the residential care facility shall provide each resident with the following bedroom furnishings and supplies: (1) An individual bed equipped with springs and a clean comfortable flame resistant mattress or a clean comfortable mattress with a flame resistant mattress cover. The bed shall be sturdy, safe, and in good condition. Rollaway beds and cots, double deck beds, stacked bunk beds, hide-a-bed couches, or studio couches do not meet the requirements of this rule; (2) Bed linen which shall include at least two sheets, a pillow and pillow case, a bedspread, and one blanket that fit properly and are free of tears, holes, and excessive fraying or wear. The residential care facility shall: (a) Ensure that the mattresses of incontinent residents are protected with an intact waterproof material unless contraindicated or otherwise ordered by a physician or other licensed healthcare professional working within their scope of practice; and (b) Provide each resident with additional blankets and pillows upon request and ensure that two sets of bed linen are available for each bed at all times. Residential care facilities shall ensure that bed linen is changed weekly and more often if soiled or requested by the resident; Member Questions: Can we admit or keep a resident with a venous “stasis” ulcer, or is that prohibited in RCFs? Yes. The prohibition is against a Stage III or IV pressure ulcer, OAC 3701-16-07 B (5); so residents with other “non-pressure” related types of ulcers can live in a RCF, as long as the appropriate care for their wound can be provided by staff nurses or home health. These other types of ulcers would include arterial, neuropathic (diabetic), or venous “stasis” ulcers. However, a RCF cannot admit or retain a resident that develops a pressure ulcer over a stage II, unless under the care of hospice.... (5) Has stage III or IV pressure ulcers. For purposes of this rule, "pressure ulcers" means any lesion caused by unrelieved pressure, or pressure in combination with shear and/or friction, which results in damage to the underlying tissue. Pressure ulcers must be staged in accordance with the "Updated Staging System" issued by the "National Pressure Ulcer Advisory Panel" (2007) Our Community would like to purge records, what is the required time element for retaining records? OAC 3701-16-17, address record retention for Resident medical records, Incident reports. staff records, documentation of compliance with OAC 3701-16- 16(temperature regulation), Licenses, inspections, fire reports, HVAC inspections, resident rights policies and procedures. Below is a Quick Reference: Resident medical records and Incident Reports - addressed in paragraph (A) (1-2) – Requires 7 years retention. The following documents are required to be kept for 3 years: Required by paragraphs (A)(3) to (A)(10) of this rule, for three years unless otherwise required by law. ·        (3) Copies of all current licenses, approvals and inspections required by rules 3701-16-01 to 3701-16-18 of the Administrative Code; ·        (4) A record of the name, address, working hours, medical statements, and training for staff members; ·        (5) Documentation of compliance with rule 3701-16-16 of the Administrative Code; ·        (6) Fire and evacuation procedures and records of fire drills required by rule 3701- 16-13 of the Administrative Code; ·        (7) Records of heating system checks required by paragraph (A) of rule 3701-16- 15 of the Administrative Code and fire extinguishing system checks; ·        (8) All records required by state and federal laws and regulations as to the purchase, dispensing, administering, and disposition of prescription medications including unused portions; ·        (9) The residents' rights policies, procedures and records; ·        (10) All other records required by Chapter 3721. of the Revised Code and rules 3701-16-01 to 3701-16-18 of the Administrative Code. Do we need to have a doctor’s order permitting a resident to consume alcohol in our community? The consumption of a reasonable amount of alcohol at a resident’s own expense is stipulated in residents’ rights, unless it is medically inadvisable or against disclosed community policy. ORC 3721.13 (A)(17) Therefore, a community should check with a resident’s primary care provider (perhaps include in the health assessment) to determine if the consumption of alcohol is contraindicated for the individual. If a resident wishes to consume alcohol and their primary care physician deems it inadvisable, documentation to that effect would help in terms of residents’ rights compliance and follow up counseling and discussion with the resident and their family. Where in RCF rules are restraints prohibited? Restraints are prohibited in OAC 3701-16-09 (L) The residential care facility shall not physically, chemically or through isolation restrain residents. The rule goes on to explain what constitutes restraints in those areas. For example, placement in a secure unit is not a restraint provided it is supported by an appropriate diagnosis and the individual’s physician determination that it is for the resident’s safety. (The physician determination needs to be reevaluated every year.) Any physical item that might be considered a restraint needs to be assessed to determine if it acts as a restraint for a particular individual. Such assessment should be documented in the resident’s chart. OALA has a “Restraint Determination Tool” available on our Member website. Do narcotics have to be in unit dose packages? No. There is no unit dose packaging requirement for narcotics in the RCF rules. OALA checked with Diamond Pharmacy, who confirmed that there is also no requirement for narcotics to be in unit dose packages in Ohio pharmacy law or under the federal DEA rules. Are Assisted Living communities allowed to “repackage” medications for administration? For instance, if the residents’ medications come in a 90 day quantity, could the RCF repackage them in something smaller or punch cards? No. Our rules specifically prohibit the “repackaging or relabeling” of medication by the RCF. OAC 3701-16-09 (I)(3)(b) Medicines and drugs dispensed by a health care facility pharmacy for administration by a licensed nurse or physician to residents whereby the medicines and drugs are not in the possession of the resident prior to administration shall be clearly labeled in accordance with rule 4729-17-10 of the Administrative Code; (c) Not repackage or relabel resident medication.

  • Enhancing Senior Living: The Importance of Activities in Assisted Living Communities

    Assisted living communities have come a long way from the institutional settings of the past. Today, facilities prioritize the well-being and happiness of their residents through a wide range of engaging activities and programs. In this post, we'll explore the significance of activities in senior living communities and how they contribute to a fulfilling and vibrant lifestyle for seniors. 1. Promoting Physical Health Regular physical activity is crucial for seniors to maintain their health and mobility. Assisted living communities offer various exercise programs, including yoga, tai chi, and group fitness classes. These activities help residents stay active, improve strength, and reduce the risk of common age-related health issues. 2. Fostering Social Connections Isolation and loneliness are prevalent concerns for seniors. Activities like group outings, game nights, and hobby clubs provide opportunities for residents to connect with peers, build meaningful relationships, and combat feelings of loneliness. Social engagement is essential for mental and emotional well-being. 3. Cognitive Stimulation Mental stimulation is key to maintaining cognitive function. Many senior living communities organize brain-teasing games, educational seminars, and book clubs to keep residents' minds sharp. Engaging in these activities can delay cognitive decline and enhance overall mental well-being. 4. Creative Outlets Assisted living communities recognize the importance of creativity in seniors' lives. Art classes, music sessions, and gardening clubs allow residents to express themselves and tap into their artistic talents. Engaging in creative activities can boost self-esteem and provide a sense of accomplishment. 5. Celebrating Life Milestones and Holidays Senior living communities make an effort to celebrate life's special moments and holidays. These festivities create a sense of community and joy. Whether it's a birthday party, a holiday-themed event, or an anniversary celebration, residents can enjoy the festive spirit with their peers. 6. Access to Nature and Outdoors Nature has a calming and rejuvenating effect on seniors. Many assisted living communities have outdoor spaces, gardens, and walking paths. These spaces enable residents to connect with nature, get some fresh air, and enjoy the therapeutic benefits of being outdoors. 7. Personalized Activity Plans Assisted living communities often provide personalized activity plans tailored to residents' interests and abilities. This individualized approach ensures that each resident can participate in activities that resonate with them, making the experience more enjoyable and meaningful. 8. Opportunities for Learning and Growth Seniors never stop learning, and senior living communities offer opportunities for continuous growth. From guest lectures to language classes, these communities facilitate educational activities that allow residents to pursue new interests and passions. In modern assisted living communities, activities play a central role in enhancing the lives of residents. The physical, social, cognitive, and emotional benefits of these activities are invaluable. As families consider senior living options for their loved ones, they should place a strong emphasis on the activity programs offered by the facilities. These programs not only contribute to a fulfilling and vibrant lifestyle but also promote overall well-being for seniors. Before choosing an assisted living community, it's essential to inquire about the variety and quality of activities provided. Ensuring that the facility aligns with your loved one's interests and needs will go a long way in making their senior years truly enjoyable. By prioritizing activities and social engagement, assisted living communities create an environment where seniors can thrive and enjoy a fulfilling quality of life.

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