Assisted Living Facilities in Montana are 'licensed only

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Assisted Living Documentation

• DPHHS/QAD/Licensure Bureau

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What Is An Assisted Living Facility in Montana?

• Assisted Living Facilities in Montana are
  licensed only facilities, therefore are not
  Certified under Federal Regulations. Unlike
  Long-Term Care facilities (Nursing Homes),
  Assisted Living Facilities are not required to
  hire Certified Nurses Aides. The level of care
  provided in each facility is determined by the
  licensure endorsements and services each facility
  chooses to offer. The Assisted Living Resident
  Assessment, Resident Agreement , and Resident
  Service Plan provide the foundation and criteria
  for level of care and services. When considering
  moving into an Assisted Living Facility, please
  review the Resident Agreement carefully and work
  closely with the provider in the development of
  the Resident Service Plan, including Move-Out
  criteria, to provide clear expectations and
  greatest service satisfaction.
• Ruth Burleigh, RN/BSN/MA Health Care Facility
  Program Manager DPHHS/QAD/Licensure Bureau

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History

• Prior to 2001 each facility designed own system
  of documentation
• 2001 50-5-226 (6) MCA required Department to
  supply OPTIONAL forms
• 2003 MCA changes required ADL as foundation of
  assessment and level of care

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ADMISSION PROCESSResident Needs Assessment

• Prior to Move in
• Within 60 days if indicated
• Upon change of condition (improving or declining
• Annually for Category A
• Quarterly for Category B C

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ADMISSION PROCESSResident Service Plan

• From the resident needs assessment service plan
  meeting with resident and/or responsible parties
  specific service needs are identified
• HOW these needs are to be meet
• OUTCOME of services
• Can be general, special, and some health care if
  not too complicated
• ALL DIRECT CARE STAFF ARE RESPONSIBLE FOR THIS
  INFORMATION

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ADMISSION PROCESSResident Agreement

• The resident agreement is the contract between
  the facility and resident and/or responsible
  parties
• The agreement INCLUDES the RESIDENT SERVICE PLAN
• All 3 pieces Assessment, Plan, Agreement must
  match the residents actual needs and requests.

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DAY to DAY Documentation

• Each ALF has a unique way of documentation-some
  use commercial systems, others notebooks, and
  others computer files
• HOW does the facility validate that the resident
  is receiving the services within their contract?
• ALF is NOT a Nursing Home or Hospital

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Medications

• IF the resident needs self-medication assistance,
  then a Medication Self-administration Record is
  required. (MAR)
• The specific regulations for medications must be
  followed.
• IF the resident is independent, then no MAR is
  required by the STATE OF MONTANA.

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Meals

• What the facility actually served-3 months of
  meals provided for Department review
• If a resident is not eating, report to the
  administrator facility RN and document
• Resident weights are to be taken upon admission,
  annually and as indicated by professional health
  care providers.

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Activities

• A calendar of activities ACTUALLY offered is to
  be maintained for three months for Department
  review
• Posted monthly-change as things occur
• Diverse and frequent
• NOT TV
• Toys R USthink young!
• Photos and memories

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For additional information

• www.dphhs.mt.gov
• Click on May we help you
• License a health facility
• On the left hand green column heading
• ABOUT QAD
• LICENSING CERTIFICATION
• Assisted Living Facilities