22 VAC 40-72-10 Definition of high risk behavior-I disagree with the part of the definition that states "such as floor pacing that might indicate anxiety or stress".  If a resident has been on antipsychotics for any length of time, this could be a side effect of the medications or a resident who has Parkinson's Disease.

22 VAC 40-72-70 Risk Management --This provision invites litigation, creates additional liability for the assisted living facility and will be duifficult for the staff to implement.  Leave out all but the first line.

22 VAC 40-72-80 Quality Improvement --Recommend deleting portions of B and C (the examples) regarding self assessment and quality improvement and to change the number of years the document must be retained.

22VAC  40-72-90 Infection Control-Remove all the requirements and leave it to each facility

22 VAC 40-72-100 Incident and Occurrence Reports--Recommend deleting part A

22 VAC 40-72-580 Food Service and Nutrition-Recommend deleting B3, C, D, and F.  Under G recommend deleting the word "automatic".

22 VAC 40-72-810 Resident Councils- Recommend deleting E 3-I This part permits the resident council to work with administration to make recommendations re:  P&P.

22 VAC 40-72-950 Evacuation Drills-Recommend deletion or change frequency to every 6 months and restore to fire drills.

 

 

 

Section 22 VAC 40-72-70 Risk Management

• This provision should be revised.  As written, the provision invites litigation, creates liability for the assisted living facility and will be difficult for the staff to implement. 

 Section 22 VAC 40-72-80 Quality and Improvement

• This provision should be revised to eliminate the list of examples regarding self-assessment and quality improvement.  This section also creates duplicative and unnecessary documentation and may create a significant incidence of unwanted litigation.

 Section 22 VAC 40-72-100 Incident and Occurrence Reports

• The proposed changes would be burdensome to the facilities.  They are overreaching.  This section would require a facility to report a resident that was considered to be missing and found unharmed within the facility in a short period of time. Additionally, reporting even where no resident’s health, safety, or welfare is threatened is inefficient, unnecessary, and overly burdensome.

 Section 22 VAC 40-72-110 Provision of Data

• Recommend that this section be deleted totally due to reporting requirements being too vague, too costly, and overly burdensome.  Additionally, they do not have any apparent benefit.

 Section 22 VAC 40-72-300 First Aid and CPR Certification

• Request that Sections F & G be deleted, as these sections create overly burdensome requirements regarding personnel certified in CPR.  Further, it is unclear if a CPR employee must remain at all off-site events.  Requiring this would severely impair the facilities’ ability to offer off-site events and would greatly limit residents’ activity.

 Section 22 VAC 40-72-320 Staffing

• Section B should be stricken in its entirety as it is overly broad and burdensome, is impractical, and is beyond the scope and intent of the law. 

  Section 22 VAC 40-72-360 Mental Health Assessment

• This section created a myriad of challenges.  Many of the behaviors listed are common to all assisted living residents.  This regulation could require all ALF residents to receive a mental health assessment. 

 Section 22 VAC 40-72-810 Resident Councils 

• Section E., which permits the resident council to work with the administration to make recommendations regarding policies, procedures and other functions should be removed.

 Section VAC 40-72-950 Evacuation Drills

• This section should be reevaluated.  Consideration should be given to the impact of evacuating residents at all times of the day and seasons of the year, as well as the increased risk of injury to residents during drills through stairways of multi-level buildings.  The term Evacuation should revert to the term Fire Drill.  The process should comply with the facility’s Fire and Evacuation plan as approved by the Fire Marshal.  Also recommend that an exception be added saying buildings with an I-2 certification do not need to fully evacuate in accordance with the Fire Safety Code.

I believe that changes do need to take place in the qualifications of AL administrators, but due to the large number of administrators that don't meet the requirements, I believe a longer time period should be given for their ability to obtain the requirements needed to run a successful AL. I also believe further research is necessary for the requirements of an AL administrator needs to be continued due to the vast differences in each of the ALs.

As someone who is pursuing a career in becoming a Licensed Assisted Living Admininstrator, I would want to be as knowledgeable of the current regulations as possible.  I know that those who are an currently an administrator are always seeking out areas in which to become not only more knowledgeable but stronger in.  In order to obtain your LALA, the person should be placed through a detailed procedure to ensure thorough knowledge and understanding to the current policies and procedures in place to operate an Assisted Living.  Of course, experience speaks for itself.   However, we as "caretakers" for this population, always need to keep abreast of changes in the population and their needs and to enhance current practices in order to have a well-rounded environment for these residents that call this their home.  You need to give ample opportunity and time in order to achieve this goal and license.  The more time someone has to learn about laws and policies, the more effective that person will be as an administrator as well as in compliance.

Don't lose sight as to why we are in this business.  I am a highly effective administrator in the assisted living home I manage.  I have over 40 years of experience in health care.  I have proven myself in this field and my experience should speak for itself.  Ongoing training is important and welcomed, but don't tell me I am incapable just because I don't have a degree.  Exceptional  personal care of the elderly is a hands on learning experience, you don't get it from a book.  Please give us credit for what we have done over the years.  "Grandfather" us for our life experience, keep training us also, but allow us to do our "caring" as we should.  Don't run your small homes out of business if they can't afford an MBA candidate-give the small home owners the credit they deserve for trying to take care of your parents and maybe some day they will  have to care for you.  That care should come from the heart.