July 17 2022 | Resident Move-In Process

The process of moving a new resident into an assisted living community can be daunting for the resident, their family members, staff, and the facility leadership. This process can be nuanced for facilities that accept assisted living (AL) residents as well as nonresident individuals (often termed “independent living” or IL). This article outlines the regulatory expectations and best practice regarding moving in both AL and IL residents.

Preadmission Assessment

The assisted living resident will need to be assessed prior to moving in. The minimum assessment topics are listed in WAC 388-78A-2060 and the assessment must be completed by a qualified assessor. This assessment determines whether the potential resident’s needs can be met in the facility; it is best to discuss any concerns amongst the leadership team before moving forward with the move-in process.

IL residents should not receive a preadmission assessment, unless they have requested the assessment for the purposes of determining the need for services in a licensed care setting.

Admission Agreement

Per RCW 70.129.030, the facility must provide the resident, in writing and in a language the resident or representative understands, the following:

Services, items, and activities customarily available
Charges for those services, items, and activities
Services, items, and activities not covered by the facility’s per diem rate or Medicaid
Individual resident rights as outlined in RCW 70.129.140(2), in addition to a statement that the resident may file a complaint with the state agency concerning alleged resident abuse, neglect, and misappropriation of resident property
A description of the manner of protecting personal funds as found in RCW 70.129.040
Reasons a resident may be transferred or discharged, as outlined in RCW 70.129.110.

If the facility serves both privately paying residents and residents whose care is paid for fully or partially by the Medicaid program, it is recommended that different admission agreements are used based on the resident’s payment source. This separation prompts the provider to ensure that services covered by the Medicaid program do not include additional charges. If a privately-paying resident transitions to Medicaid, ensure s/he reviews and signs a new Medicaid admission agreement.

IL residents are under the landlord-tenant act and should receive a different admission agreement that highlights the services they will receive under that law. If an IL resident transitions to AL, an assisted living admission agreement should be reviewed and signed; the IL resident at that point would be treated as a new move-in for the purposes of the assisted living regulations.

Disclosure

Per WAC 388-78A-2710 and -2720 prospective AL residents must receive a copy of the facility’s disclosure of services document on the DSHS-approved disclosure form. This form discloses the specific care and services provided in the facility. Signature and date of receipt suffices as proof this disclosure was shared with the resident or representative.

Prospective IL residents must receive a disclosure statement as well. DSHS does not offer a sample IL resident disclosure form; WAC 388-78A-2035 highlights that this disclosure must notify the IL resident that the following does not apply to them:

Resident rights statute (RCW 70.129)
Assisted living regulations
Jurisdiction of the long-term care ombuds

Written Notice of Rights, Rules, and Regulations

The same section of RCW 70.129 states that the facility must notify the resident both orally and in writing in a language the resident understands of the rights, rules, and regulations governing resident conduct and responsibilities. Acknowledgement of receiving this information must be documented and stored in the resident’s record. Many facilities/companies capture this information in a resident handbook, which the resident can reference later as needed.

IL residents might receive a different handbook or document that covers only the facility “house rules” and excludes rules and regulations that pertain specifically to AL residents.

Policies and Procedures

The following policies and procedures will highlight which type of resident (AL, IL, or both) need to receive copies. This is not an exhaustive list. Per WAC 388-78A-2600, all facility policies must be made available to AL residents and their representatives upon request.

AL – facility’s policy on accepting Medicaid as a payment source. Per RCW 70.129.180 this notice must be provided separate from other documents, in 14-font or larger, and provided orally and in writing in a language the resident understands
BOTH (suggested for IL) – CPR, honoring a resident’s advance directive(s) and/or signed POLST form
AL – how the facility accounts for residents who leave the building
BOTH (suggested for IL) – how a resident can file a grievance, and steps the facility takes to resolve grievances
BOTH – management of pets
BOTH – smoking, including location and safety
BOTH – cannabis, including if allowed, and limitations to its use
BOTH – valuables, including encouragement to store safely in the resident’s apartment or not bring to the facility

Other policies to consider include firearms/weapons, overnight guests, visitation/ essential support persons, and any infection control requirements. Some or all of these policies might be included in the resident handbook.

Washington Health Care Association

July 17 2022 | Resident Move-In Process

Assisted Living