Surveyor Perspective related to the Licensing Standards for Assisted Living Facilities Galveston TX April 1 2019 Surveyor Perspective This will include a broad understanding of a surveyors role of inspections related to the Licensing Standards for Assisted Living Facilitie ID: 815893
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Slide1
TALA
Annual Conference - 2019
Surveyor
Perspective related
to
the
Licensing Standards for Assisted Living Facilities
Galveston, TX
April 1, 2019
Slide2Surveyor Perspective …..
This will include a broad understanding of a surveyor’s role of inspections related to the Licensing Standards for Assisted Living Facilities and understanding the importance of maintaining compliance.
Slide3Surveyor – State Government
SURVEYOR
STATE GOVERNMENT
Statute
– state legislature
Rule
– state agency
STATE AGENCY –
Texas Health and Human Services Commission
Slide4Inspection Process
Purpose:
The Texas Health and Human Services Commission (HHSC), Regulatory Services Division (Long Term Care) inspects most assisted living facilities. The inspection and enforcement process is intended:
- protect the health, safety, and rights of residents
- ensure compliance with regulations, and
- ensure equitable and consistent enforcement of regulatory
requirements
Slide5License Required – Assisted Living Facility
State Law defines an assisted living facility as an establishment that
- furnishes, in one or more facilities, food and shelter to four or more persons who are unrelated to the proprietor of the establishment
- provides personal care services; or administration of medication by a person licensed or otherwise authorized in this state to administer the medication; and
- may provide assistance with or supervision of the administration of medication.
(Texas Health & Safety Code (HSC), Section 247.002(1))
Slide6License Required – Assistive Living Facility (
cont
)
Personal care services are defined by statute as:
- assistance with feeding, dressing, moving, bathing, or other personal needs or maintenance; or
-
general supervision or oversight
of the physical and mental well-being of a person who needs assistance to maintain a private and independent residence in an assisted living facility or who needs assistance to manage the person’s personal life, regardless of whether a guardian has been appointed for the person.
(Texas Health & Safety Code (HSC), Section 247.005(5))
Slide7License Required – Assisted Living Facility (
cont
)
Assisted Living Facility must comply with the
minimum
standards contained in:
- Chapter 247 of the Texas Health & Safety Code (HSC)
- Texas Administrative Code (TAC), Title 40, Part 1, Chapter 92, Licensing Standards for Assisted Living Facilities
Slide8Confidentiality
Generally, ALL licensed inspections, complaint investigations, and other visits are unannounced
During the inspection, the inspection team attempts to maintain resident confidentiality to the greatest extent possible, particularly regarding information gathered from interviews.
The inspection is usually assigned to one person. However, other team members (such as those with particular areas of expertise) may be assigned as needed.
The team size depends on the purpose of the inspection, the size of the facility, the services provided by the facility, and other factors.
Slide9Inspection Tasks
The seven inspection tasks include:
1. Off-site Preparation
2. Entrance Conference
Slide10Inspection Tasks (
cont
)
3. Initial Tour
4. Sample Selection
5. Information Gathering
Slide11Inspection Tasks (
cont
)
6. Decision Making
Immediate Threat is defined as follows:
Immediate threat to the health or safety of a resident –
A situation that causes , or is likely to cause, serious injury, harm, or impairment to or the death of resident. (effective 10/28/2018)
7. Exit Conference
Slide12Scenarios
Clinical Discussion
Slide13Scenarios
Clinical Discussion
Slide14Scenarios
Clinical Discussion
Slide15Assisted Living Facility (ALF) Rule
ALF TAC 92.41(e)(1)
A facility must
not
admit or retain a resident whose needs cannot be met by the facility or who cannot secure the necessary services from an outside resource.
As part of the facility’s
general supervision and
oversight
of the physical and mental well-being of its residents,
the facility remains responsible for all care provided at the facility.
If the individual is appropriate for placement in a facility, then the decision that additional services are necessary and can be secured is the resident’s attending physician, or legal representative. Regardless of the possibility of “aging in place” or securing additional services, the facility must meet all Life Safety Code requirements based on each resident’s evacuation capabilities, except as provided (f) of this section.
Slide16Assisted Living Facility (ALF)
Rule
ALF TAC §92.41(h)(2)(G) [Resident Records]
documentation by health care professionals of any services delivered in accordance with the licensing, certification, or other regulatory standards applicable to the health care professional under law;
ALF TAC §92.2(31) [Definition – Health Care Professional]
An individual licensed, certified, or otherwise authorized to administer health care, for profit or otherwise, in the ordinary course of business or professional practice. The term includes a physician,
registered nurse,
licensed vocational nurse,
licensed dietitian, physical therapist, and occupational therapist.
Slide17Risk Management
Risk management is the identification, evaluation prioritization of risks followed by coordinated and economical application of resources to minimize, monitor, and control the probability or impact of unfortunate events or to maximize the realization of opportunities.
(Wikipedia)
Slide18Resources
Texas Health and Human Services Commission (HHSC)
website:
https://hhs.texas.gov/
HHSC website:
Assisted Living Facilities Portal
https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/assisted-living-facilities-alf
Slide19Resources
HHSC Assisted Living Facilities Portal
:
Texas Health & Safety Code, Title 1, Chapter 247
Assisted Living Facilities
https://statutes.capitol.texas.gov/Docs/HS/htm/HS.247.htm
Texas Administrative Code, Title 40, Part 1, Chapter 92
Licensing Standards for Assisted Living Facilities
https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=92
Slide20Resources
Texas Board of Nursing (
BoN
)
website:
https://www.bon.texas.gov/
Slide21Questions
Slide22MJ Consulting
Mark Jeffers RN MS
MJ Consulting
Assisted Living Facilities
Email address:
mjeff0152@hotmail.com
Cell: (512) 787-5952