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Conversations with BALOctober 26, 2011
DQA/Bureau of Assisted Living Northeastern Regional Office
Laurie Arkens
Top 10 Cites for First 6 Months of 2011
• Adult Family Homes
• Community Based Residential Facilities
• Residential Care Apartment Complexes
Top Ten Citations CBRF (Jan. - June 2011)
30
27
25
22
21
21
19
19
18
16
16
LICENSEE ENSURES FACILITY COMPLIES WITH LAWS
SERVICE PLANS UPDATED ANNUALLY OR ON CHANGES
OTHER EVACUATION DRILLS
COMPREHENSIVE INDIVIDUALIZED SERVICE PLAN
CONTINUING EDUCATION
RIGHTS OF RESIDENTS: PROMPT AND ADEQUATETREATMENT
RIGHTS OF RESIDENTS: TO RECEIVE MEDICATION
PRN PSYCHOTROPIC MEDICATION
LISTED AREAS FOR ASSESSMENTS
CAREGIVER: INVESTIGATING ABUSE AND NEGLECT
BATH AND TOILET AREAS: WATER TEMPERATURE
Top Citations - AFH (Jan - June 2011)
17
16
15
13
12
10
10
9
7
7
7
7
7
RESPONSIBILITIES
HOME ENVIRONMENT
REVIEW OF ISP
SAFE PHYSICAL ENVIRONMENT
TRAINING-8 HOURS ANNUALLY
SMOKE DETECTORS-TESTING AND MAINTENANCE
FIRE EVACUATION ANNUAL EVALUATION
TRAINING-15 HOURS WITHIN 6 MONTHS
FREE OF HAZARDS
ANNUAL WELL WATER INSPECTIONS
FIRE SAFETY-SMOKE DETECTORS
EXITING FROM THE FIRST FLOOR
FIRE SAFETY EVACUATION PLAN REVIEW
Strategies
Strategies to Promote Regulatory Compliance:
• Adult Family Homes
• Community Based Residential Facilities
• Residential Care Apartment Complexes
*Based on Top 10 Cites for Calendar Year 2010
Abbreviated Survey
• Recognize communities with good compliance history
• Use all senses - if it feels good, looks good, smells good, sounds good… move on!
Proposal - less frequent reviews of providers with good compliance
• Criteria– Facility qualifies for an abbreviated survey and;
– Facility is a member of a major association in good standing (WALA, WAHSA, WiCAL, RSA of WI, WADSA) and;
– Facility has implemented a “provider association”, “department approved”, quality improvement program that adopts standards of practice and;
– Facility has signed a department “self attestation” document that they are in substantial compliance of the regulations.
Events so far …..
• Approval from DHS Secretary
• Met with Associations and Advocates
• BAL Developed Guiding Values
• Partnership with UW Madison for a research component
• Updated DQA database to recognize this new group
Next Steps …..
• Meeting to update the associations• DQA/UW Madison grant applications to
help fund the start up and the research component
• Associations to complete their comprehensive plan and submit to DQA/BAL for approval
• Associations to help members implement• Study the effectiveness
WI Coalition for Collaborative Excellence in Assisted Living
• Provider Association Sponsored
• Department Approved
• Comprehensive QA & QI
• Includes the following Guiding Values….
Standards of Practice• ADLs• Diabetes• Dementia• Pain• Pressure ulcers• Person-centered care• Abuse, neglect• Falls• Mental Health• Infection control• Emergency Management• Medication• Food safety
Consumer & Advocate Feedback
• Residents/Tenants• Families/legal rep.• Staff• Case Managers/Funding• Councils, surveys,
grievance process, questionnaires
Department Website Resources
• Survey Guidehttp://www.dhs.wisconsin.gov/publications/p6/p63186.pdf
• Post Survey Questionnairehttps://doa.wi.gov/dhssurveys/TakeSurvey.aspx?SurveyID=ml00584
• Enforcement Guidelineshttp://www.dhs.wisconsin.gov/publications/p6/p63200.pdf
• Strategies to Promote Regulatory Compliance http://www.dhs.wisconsin.gov/rl_dsl/Providers/resources.htm
• Medication Management Initiativehttp://www.dhs.wisconsin.gov/rl_dsl/MedManagement/asstlvgMMI.htm
• The Assisted Living Forumhttp://www.dhs.wisconsin.gov/rl_dsl/Providers/asstdLvgForum.htm
• Assisted Living Home Pagehttp://www.dhs.wisconsin.gov/bqaconsumer/AssistedLiving/AsLivindex.htm
• DQA Memos, ListServ, CBRF Training, CBRF Administrator’s Course, Family Care, Consultant List, Assisted Living Directories and Profiles, Resident Relocation Information, Forms (Fire Report, Evacuation Assessment Form, Licensure Checklists), OCQ Information, & MORE
Department Website Resources