Assisted Living Education 1

Current Trends and Practices 2019

2 CEU’s for RCFE and ARF Administrators

Copyright & Disclaimer

COPYRIGHT - This Course Material has been copyrighted © 2009 byAssisted Living Education. All rights reserved. No part of this coursematerial/content may be reproduced or utilized in any form, by any means,electronic or mechanical, including photocopying, recording, emailing, orany information storage and retrieval system, without permission in writingfrom Assisted Living Education.

DISCLAIMER - Assisted Living Education has attempted to offer usefulinformation and assessment tools that have been accepted and used byprofessionals within this industry, including the California Department ofSocial Services. Nevertheless, changes in health/medical care and healthcare regulations may change the application of some techniques andperceptions in this course material. Assisted Living Education therebydisclaims any liability for loss, injury or damage incurred as a consequence,either directly or indirectly, from the use and application of any of thecontents of this course material.

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Course Objectives

Review and discuss new PIN’s, newforms (LIC 606), DSS regulations,Quarterly Updates, etc.

Discuss current Assembly and SenateBills that passed for 2019

Discuss changes to Title 22 and theEvaluator’s Manual

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Definitions

DSS = Department of Social ServicesRCFE = Residential Care Facility for the ElderlyARF = Adult Residential FacilitySNF = Skilled Nursing FacilityAB = Assembly BillSB = Senate BillResident = anyone living in long-term care

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New 2019 Laws

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Assembly and Senate Bills

Assembly Bill 3098 – EmergencyPreparedness

• Went into effect January 1, 2019• Evacuation chair requirement goes into

effect July 1, 2019

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (in addition to current Title 22requirements (Section 87212):1. The LPA will confirm, during annual licensing

visits, that the Plan is on file at the facility andincludes the required content;

2. Staff training – upon hire and annual training onemergency preparedness, including staffresponsibilities during an emergency ordisaster;

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):3. Drills, at least quarterly, under varied

emergency situations (i.e., earthquake, fire), foreach shift and this must be documented.

4. The Plan must be reviewed at least annually bythe Administrator or Licensee and updated, asneeded (for example, the floor plan changed).

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):5. Evacuation chairs will be required for multistory

buildings starting July 1, 2019. Thisrequirement is one chair per stairwell, not perfloor. The next slide shows several chairs.There is no specific requirement on what typeof chair you must provide.

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):6. Identification of two evacuation sites with one

being outside of the immediate area (i.e., 25miles away).

7. Plans for the facility to be self-reliant for aperiod of not less than 72 hours immediatelyfollowing any emergency or disaster, includinga power failure.

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):

8. Procedures for confirming the location ofresidents during an evacuation.

9. Plan for how residents will contact staff if theiremergency call buttons are inoperable.

10. Location and operation of generators, if used.

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):11. Staff access to resident information and vehicle

and facility keys:• All occupied resident units• All facility vehicles• All facility exit doors• All facility file cabinets that contain emergency files,

the Disaster Plan, food supplies, etc.

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):12. Information readily available to facility staff

during an emergency:• A resident roster with the date of birth for each

resident (use the LIC 9020A form but this form doesnot list birthdates – add it!);

• An appraisal needs and services plan (LIC 625 orequivalent) for each resident;

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):12. Information readily available to facility staff

during an emergency:• A list of resident medications that are centrally stored;

and• Contact information for the responsible party and

physician for each resident (on the LIC 9020A and/orLIC 601)

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):13. A contact information list of all of the following:

• Emergency response personnel• DSS’ contact information• Ombudsman contact information• Transportation providers

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):14. Designated assembly point(s) for use during an

evacuation and identification on a facility sketch (LIC999).

15. Identification of utility shut-off locations.16. Staff knowledge of their role during an emergency.17. Communication means with DSS during an emergency.18. Encouraging residents to participate in drills.

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Assembly and Senate BillsAB 3098 – Emergency Preparedness

New Requirements (cont’d):19. Two methods of communicating during an emergency,

and resident/family awareness of those methods.20. Allowing the Plan to be reviewed by residents, any

responsible party, the Ombudsman and localemergency responders – make sure any resident andemployee information is kept confidential!

21. New Licensees must submit a copy of their Plan withtheir initial license application.

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Assembly and Senate Bills

Senate Bill 833 – Emergency Alerts:Evacuation Orders - PASSED

On or before July 1, 2019, it requires the Officeof Emergency Services to develop guidelinesfor alerting and warning the public of anemergency, reporting missing children, attacksupon law enforcement officers and missingpersons who are 65+ in age.

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DSS Updates

Review latest changes/updates to the DSShome page

Latest Quarterly Updates – review anddiscuss contents of the last 2 Updates

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DSS Updates

Discuss latest Regulations or Code changes(example: Title 22 update in October, 2018)

Discuss any newforms, such asthe LIC 606, PUB475, LIC 613C-2

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Title 22 & Code Updates

October, 2018 Title 22 updates includes:

• Changing the terminology of “dermal ulcer”or “pressure sore” to “pressure injury”

• Added definitions, such as “genderexpressions”, “gender identity” and “LGBT”

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Title 22 & Code Updates

Title 22, Section 87224 specifies that aLicensee can evict a resident with a 30 daynotice for “Change of use of the facility.”

The Health & Safety Codesstates this is a 60 day notice.

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Title 22 & Code Updates

So, what is it? 30 days? 60 days?

Per DSS, follow the H&S Codes – 60 daynotice.

What does your Admission Agreement say?If it is not correct, you must change it andsubmit it to your LPA.

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DSS Updates

Review and discuss the most recent 10PIN’s, for example:

PIN 18-10-CCLD - Reporting Requirementsfor Red Flag Fire Warnings and Shutting offPower for Safety

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Evaluator Manual Updates

ARF Manual – has not been updated since2016

RCFE Manual – updated December, 2018

What is new? Pages 93-93.2

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Evaluator Manual Updates

Pages 93-93.2:

Section 87458 “Medical Assessment”:• Discusses marijuana use and how to

document it• A waiver is required in order to allow a

Nurse Practitioner or Physician’s Assistantto sign an Physician’s Report – have youapplied for one yet???

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Waiver

IF you ONLY have physician’s sign the LIC602A’s, then you do not have to request awaiver.

Reality is that you probably DO have NP’sand PA’s sign these. Submit your waiver toyour LPA in order to be compliant……

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Sources

DSS websiteCalifornia Assisted Living AssociationCalifornia Department of Labor

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Conclusion

Assisted Living Education thanks you for attending thisCourse.

We look forward to seeing you again atanother of our Courses!