CCS/HCS/SCS/SB 616 - This act repeals the terms "residential care facility I" and "residential care facility II" and replaces them with "residential care facility" and the newly created term “assisted living facility," respectively.
Assisted living facilities contain services consisting of social models based on the premise that the resident's unit is his or her home. There are new definitions for "activities of daily living" which include eating, dressing, bathing, toileting, transferring, and walking and for "instrumental activities of daily living" which consist of preparing meals, shopping for personal items, medication management, managing money, using the telephone, housework, and transportation ability. There are also new definitions for "appropriately trained and qualified individuals," "community based assessment" and "social model of care."
This act prescribes requirements for assisted living facilities in order to accept or retain individuals. An individual in a facility must not require hospitalization or skilled nursing. The facility must employ a staff large enough and skilled enough to handle twenty-four hour care. The facility must also have a written plan for the protection of all residents in the event of a disaster. The signatures of an authorized representative of the facility and the resident or legal representative shall be contained in the individualized service plan. The facility must implement self-care and leisure activity programs.
The facility must complete pre move-in screening and resident assessments for community based services. This assessment will be used by the facility to implement an individualized service plan to be reviewed at least semi-annually by the resident or legal representative.
The residence must ensure that it does not accept or retain a resident who has exhibited behaviors that present a reasonable likelihood of serious harm to himself or herself. The resident must not require skilled nursing services or more than one person to physically assist the resident with any activity of daily living, except bathing. The resident must not be bed-bound or similarly immobilized due to a debilitating or chronic condition. There is an exception for certain conditions for residents on hospice.
The facility must also develop a plan to protect the rights, privacy, and safety of all residents and comply with dementia-specific training requirements.
The act repeals the requirement that residential care facilities can only admit persons who are capable mentally and physically of negotiating a normal path to safety under certain conditions. This acts now allows for an assisted living facility to accept or retain an individual with a physical, cognitive, or other impairment that prevents the resident from safely evacuating the residence with minimal assistance so long as the facility has sufficient staff present twenty-four hours a day to assist in evacuations and contains an individualized evacuation plan for such a resident. The facility shall also be equipped with an automatic sprinkler system, an automated fire door system and smoke alarms compliant with national fire codes. This act also provides a licensed hospice exception to the pathway to safety provisions.
The facility must take measures to allow residents the opportunity to explore the facility and grounds and use personal electronic monitoring device for any resident whose physician recommends the use of the device.
Licensed assisted living facilities must also disclose to a prospective resident information regarding the services the facility is able to provide, costs of such services to the resident, and the conditions that will require discharge or transfer from the facility.
This act provides for a grandfather clause regarding the new licensing requirements for existing residential care facility II entities. The grandfather provision does not exempt a residential care facility II from the 24-hour staff, written plan protection, screening and assessment requirements. Further, this act allows any residential care facility licensed as a residential care facility II immediately prior to the effective date of these provisions and for purposes of receiving supplemental welfare assistance payments under Section 208.030, RSMo, to continue to receive the payment amount allocated for a residential care facility II. Also, this act prohibits any facility from naming or advertising itself as an assisted living facility without obtaining a license from the department.
This act requires the departments of Social Services and Health and Senior Services to jointly prepare by January 1, 2008, a report to the Governor and General Assembly on the differences found in the evaluation of the requirements for inspectors or surveyors of facilities and the performance of the inspectors.
This act is similar to HB 1620 (2006).