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Who is responsible for deciding whether an assisted living facility can properly care for a resident?

“Who is responsible for deciding whether an assisted living facility can properly care for a resident?”

-Mrytle, Chicago Heights, IL

Who is responsible for deciding whether an assisted living facility can properly care for a resident?Assisted living facilities are generally governed by state law.  In Illinois, assisted living facilities (ALF’s) are licensed, regulated, and inspected by the Illinois Department of Health (IDPH). The IDPH ensures that all ALF’s in Illinois comply with the provisions of the state Illinois Nursing Home Care Act (210 ILCS 45). IDPH is responsible for the initial licensing and continued recertification and inspection of the facility.

If a patient feels that his or her resident rights are being violated, a complaint may be filed with IDPH, which may prompt a complaint investigation to ensure that the facility is properly caring for all residents.

Before admission, the assisted living facility must screen all persons seeking admission in order to determine the services needs. (Administrative Code – Section 300.615) The Illinois Department on Aging is responsible for the screening requirement for persons aged 60 and older who are not developmentally disabled or do not have a severe mental illness. The Illinois Department of Human Services is responsible for the screening requirement for persons aged 18-59 and persons aged 60 or older who are developmentally disabled or have a severe mental illness.

If the facility cannot readily provide an individual necessary services at the facility or through arrangement with a qualified outside resource, the resident should not be admitted or kept in the facility. (Administrative Code – Section 300.620 – Admission, Retention, and Discharge Policies) Each facility must have an advisory physician or medical advisory committee that is responsible for advising the administrator on the medical management of the residents. Each resident admitted must have a physical examination within five days prior to admission or within 72 hours following admission. Any changes to the resident’s health or condition must be reported to the resident’s physician. (Administrative Code – Section 300.1010 – Medical Care Policies)

There are special requirements for residents with a serious mental illness (including but not limited to: schizophrenia, delusional disorder, bipolar disorder, major recurrent depression). (Administrative Code – Subpart S – Providing Services To Persons With Serious Mental Illness) The facility must consider the resident’s aggressive behavior, supervision needs, noise levels, and interests in determining the location of the resident’s room. The ALF facility must establish and Interdisciplinary Team (IDT) for each resident with a serious mental illness in order to design a program to meet the resident’s needs. The IDT must perform a comprehensive assessment in order to determine the individual’s needs prior to admission to the facility in order to determine an appropriate treatment plan. (Administrative Code – Section 300.4010 – Comprehensive Assessments for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S) (Administrative Code – Section 300.4030 – Individualized Treatment Plan for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S)

About Assisted Living Facilities

Assisted living facilities are not nursing homes— nor are they intended to provide the same services.  Rather, assisted living provide a transitional living environment for people who are unable to live independently, yet do not need the skilled nursing care of a nursing home.

Assisted living facilities provide residents with help with daily living needs such as: eating, bathing, dressing, laundry, housekeeping, and assistance with medications.  Some ALF’s have medical centers on their facilities to provide quick access to medical care.

Sources:

Illinois Nursing Home Care Act

Illinois Administrative Code – Section 300.615 – Determination of Need Screening and Request for Resident Criminal History Record Information

Illinois Administrative Code – Section 300.620 – Admission, Retention, and Discharge Policies

Illinois Administrative Code – Section 300.1010 – Medical Care Policies

Illinois Administrative Code – Section 300.4010 – Comprehensive Assessments for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S

Illinois Administrative Code – Section 300.4030 – Individualized Treatment Plan for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S

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