22VAC40-73-1130 – Adds a requirement that when there are 20 or fewer residents present in a special care unit, there must be at least two direct care staff members awake and on duty in the unit, and for every additional 10 residents, or portion thereof, there must be at least one more direct care staff member awake and on duty in the unit, rather than two direct care staff in each unit.

This requirement places an undue burden on assisted living facilities by requiring additional staff, even when the assisted living facility has determined that the facility is adequately staffed to attain and maintain the physical, mental, and psychosocial well-being of each resident as determined by resident assessments (UAI) and individualized service plans (ISP).  If there are additional direct care staff in the building and the community has determined that there is adequate staff readily available to assist with emergencies in the special care unit, then this requirement of additional staff is unnecessary.  At night, in particular, a majority of residents are asleep in their beds.  This requirement presupposes that more staff will result in a higher level of care when the UAI and ISP should drive the required staffing levels based on overall resident acuity.  The average cost to add one staff member to one facility to meet this requirement is approximately $43,680 annually.  This will result in an increased rent of approximately $2,080 per year per resident.  We have three (3) memory care units, housing 21 residents on each unit, so those staffing numbers would have to triple. The current staffing pattern is more than sufficient to meet the care needs of the residents in our memory care units.  We also have additonal assisted living staff for a unit outside of the memory care areas, who would be available to assist if needed. This requirement should be reconsidered so that any staffing requirements are driven by resident care needs.