Missouri Assisted Living Stakeholders Taskforce Operations

163 Pages·2004·0.9 MB·English

by  Terry Seabaugh

Assisted Living Stakeholders Taskforce
Report to the Missouri House of Representatives
Interim Committee on
Assisted Living
November 2004
The Future of Assisted Living in
Missouri
A Report to
The Missouri House of Representatives Interim
Committee on Assisted Living
From the
Assisted Living Stakeholders Taskforce
November 2004
This report is available on line at www.moaha.org
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Missouri Assisted Living Stakeholders Taskforce Report
Acknowledgements
This report would not have been possible without the generous contributions and commitment from many
individuals and organizations. While it is not possible to list everyone who has influenced or provided input into
this endeavor, we wish to express our thanks to all.
The first recognition goes to the members of the Taskforce for their expertise, enthusiasm and commitment to
the many meetings, conference calls and research they did to support this effort. Besides the work commitment
of countless hours, participants also bore the cost of long distance conference calls, and for some long distance
travel. Several Taskforce members also served as chairs for the Topic Sub-group discussions. Thanks to
Norma Collins for chairing the Resident’s Rights Workgroup and thanks to Sylvia Nissenboim for chairing the
Direct Care Workgroup. In addition, thanks to AARP for hosting the long distance conference call expense for a
portion of the Topic Sub-Groups.
Our sincere thanks to Terry Walkenhorst with the Missouri Department of Health and Senior Services
(DHSS) and Debbie Shockley with the Missouri Department of Social Services for the on-going technical
assistance given to the Taskforce. Also to DHSS and the American Association of Homes for the Aging for the
financial support given to the Taskforce to help bring the national co-chairs of the National Assisted Living
Workgroup (ALW) to Missouri: Doug Pace of the American Association of Homes for the Aging and Karen
Love of the Consumer Consortium on Assisted Living.
Appreciation is also given to the Aetna Insurance for the grant to purchase copies of the national ALW report
that was used as a template for Taskforce deliberations.
Thanks to Carol Scott for arranging for the nourishment of our bodies and to AARP and LTCOP who paid for
two of our lunches. Also to the LTCOP who paid for the administrative assistant.
We also acknowledge the work and support of Carol Hudspeth, Connie Arriola and Alison Robison of the
Missouri Association of Homes for the Aging staff and Terry Seabaugh, Administrative Assistant, for meeting
minutes and documentation of the deliberations.
We are indebted to Denise Clemonds, Missouri Association of Homes for the Aging and Carroll Rodriguez,
Missouri Coalition of Alzheimer’s Association Chapters for their leadership and determination to see this
collaboration through.
This report is available on-line at www.moaha.org
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Missouri Assisted Living Stakeholders Taskforce Report
Assisted Living Stakeholders Taskforce Member List
Carroll Rodriguez – Co-Chair Denise Clemonds – Co-Chair
MO Coalition of Alzheimer’s Assoc.’s. (MCAA) MO Assoc. of Homes for the Aging (MoAHA)
9374 Olive Blvd. 515 East High Street, Suite 101W
St. Louis, MO 63132 Jefferson City, MO 65101
[phone] [phone]
Assisted Living Stakeholders Taskforce Participating
Organizations
AGING/LONG TERM CARE PROVIDER ASSOCIATIONS
ORGANIZATIONS Missouri Assisted Living Association (MALA)
MO Chapter of the National Academy of Elder Kathy Miller
Law Attorneys (MONAELA) Missouri Association of Homes for the Aging
Reginald Turnbull (MoAHA)
Denise Clemonds
Missouri Association of Nursing Home
Administrators (MANHA)
Jamie Seifert
Missouri Health Care Association (MHCA)
Cathy Rust
CONSUMER ADVOCATES RESIDENT/FAMILY
AARP Resident
Norma Collins Marie Bruton
Missouri Coalition of Alzheimer’s Family
Association Chapters (MCAA) Katherine Schedler
Carol Rodriguez
Long Term Care Ombudsman Program
(LTCOP)
Carol Scott STATE GOVERNMENT
Missouri Coalition for Quality Care (MCQC) Governor’s Advisory Council on Aging
Georgia Sanders Sylvia Nissenboim
Silver Haired Legislature (SHL) (SHL)
Jo Walker
HEALTH CARE PROFESSIONALS OTHER
MO Association of Long Term Care Physicians Aging Federation
(MALTCP) Bob Whitlock
Chuck Crecelius
University of Missouri, Sinclair School of
Nursing
Myra Aud
Missouri Assisted Living Stakeholders Taskforce Report 4
ASSISTED LIVING STAKEHOLDERS TASKFORCE
Table of Contents
Acknowledgement .............................................................................................2
Assisted Living Taskforce Member List ..........................................................3
Participating Organizations................................................................................4
Topics
Definition of Assisted Living ..................................................................8
Accountability and Oversight..................................................................12
Affordability...............................................................................................30
Direct Care Services...................................................................................38
Medication Management............................................................................65
Operations ..................................................................................................86
Resident Rights ..........................................................................................111
Staffing.......................................................................................................138
Appendices
Glossary of Terms ......................................................................................156
Missouri Assisted Living Stakeholders Taskforce Report 5
Assisted Living Stakeholders Taskforce
Introduction
Assisted living’s phenomenal growth over the past several years has been due largely to the
recognition - among consumers and providers - that it provides a desirable, cost-effective and
dignified living environment for older persons. Naturally, assisted living providers have responded
to this interest by focusing their attention on developing, designing and financing new projects and
enhancements to current infrastructure to meet the growing demand.
In an effort to advance quality assisted living for Missouri, Carroll Rodriguez, Missouri Coalition of
Alzheimer’s Association Chapters and Denise Clemonds, Missouri Association of Homes for the
Aging brought together a Taskforce of Stakeholders to discuss this important issue. The Taskforce
was charged with developing recommendations that promote quality and ensure that consumer’s
needs are met. Subsequently, the Assisted Living Stakeholders Taskforce (ALSTF) formed with 16
organizations representing consumers, providers, advocates, researchers, and long-term care and
health care professionals.
The first meeting was held August 20, 2004 to discuss the purpose of the Taskforce and to hear a
State of the State report on assisted living/Residential Care from the Missouri Department of Health
and Senior Services and the Missouri Department of Social Services. In addition, the national co-
chairs of the National Assisted Living Workgroup presented an overview of the National Assisted
Living Workgroup Report.
The National Assisted Living Workgroup Report resulted from an April 2001 hearing held by the
U.S. Senate Special Committee on Aging that called for the development of recommendations
designed to ensure more consistent quality in assisted living services nationwide. The report can be
accessed at www.alworkgroup.org The ALSTF utilized this National Workgroup Report as a
template for their deliberations.
The ALSTF used a three-stage approval process for the assisted living recommendations included in
this report:
• Topic workgroup recommendations
• ALSTF initial vote by all members present for the discussion
• ALSTF final vote by all participating members
The Assisted Living Stakeholders Taskforce Report is organized by topic sections. Each section
includes recommendations that received a two-thirds majority vote of the full ALSTF and
recommendations that did not receive a two-thirds majority vote.
The ALSTF also voted to omit several of the national recommendations from this report. Those that
received a two-thirds majority to omit are not included.
Each recommendation includes a proposed process for implementation:
Missouri Assisted Living Stakeholders Taskforce Report
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• State Regulation and Policy
• Operations
• Best Practices
• Federal Policy
The ALSTF allowed participating organizations to submit supplemental positions on any
recommendation in the report. These positions were submitted by either individual Taskforce
member organizations or jointly (i.e. by more than one member).
The Assisted Living Stakeholders Taskforce Report is designed to serve as a framework in the
development of assisted living policy for Missouri. It is our hope that it will be useful to a broad
range of stakeholders as we move forward to build quality assisted living for the residents of
Missouri.
The report is available on line at www.moaha.org
Missouri Assisted Living Stakeholders Taskforce Report
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Definition of Assisted Living
Missouri Assisted Living Stakeholders Taskforce Report 8
Missouri Assisted Living Stakeholders Taskforce
DEFINITION OF ASSISTED LIVING
Part A: Services and Regulation
Assisted living is a state regulated and monitored residential long-term care option. Assisted living
provides or coordinates oversight and services to meet the residents’ individualized scheduled needs,
based on the residents’ assessments and service plans, and their unscheduled needs as they arise.
Services that are required by state law and regulation to be provided or coordinated must include, but
are not limited to:
• 24-hour staff to provide oversight and meet scheduled and unscheduled needs.
• Provision and oversight of personal and supportive services (assistance with activities of daily
living and instrumental activities of daily living).
• Health related services (e.g. medication management services)
• Social services
• Recreational activities
• Meals
• Housekeeping and laundry
A resident has the right to make choices and receive services in a way that will promote the
resident’s dignity, autonomy, independence, and quality of life. These services are disclosed and
agreed to in the contract between the provider and resident. Assisted living may provide occasional
skilled nursing on a short-term basis only.
Organizations Supporting This Recommendation
Aging Federation, Family, Governor’s Advisory Council on Aging (GAC), Long Term Care
Ombudsman Program (LTCOP), MO Association of Homes for the Aging (MoAHA), MO
Association of Long Term Care Physicians (MALTCP), MO Coalition for Quality Care (MCQC),
MO Coalition of Alzheimer’s Association’s (MCAA), MO Chapter of the National Academy of
Elder Law Attorneys (MONAELA), Nurse Researcher, University of MO – Columbia, and Resident
Organizations Opposing This Recommendation
AARP, MO Assisted Living Association (MALA), MO Association of Nursing Home
Administrators (MANHA), and MO Health Care Association (MHCA)
Organizations Abstaining from the vote on This Recommendation
Silver Haired Legislature (SHL)
Supporting Comments:
Please note that MONAELA supports A, B, & C of the recommendations (B to be included, not
excluded) in the definition. All should be included in the definition.
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