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Alzheimers Assisted Living

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Be a licensed Assisted Living Facility through DSS (submit ... Has a valid license with DSS for operating an assisted living facility 'safe and secure' unit. ... – PowerPoint PPT presentation

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Title: Alzheimers Assisted Living


1
Alzheimers Assisted Living
  • Department of Medical Assistance Services
  • 2006

2
Alzheimers Assisted Living Waiver
  • Purpose
  • The waiver will allow people to
  • Remain in a home-like setting for as long as
    possible
  • Remain in an environment that maximizes their
    autonomy, privacy, and dignity, even if they
    require a high level of services
  •  

3
Alzheimers Assisted Living Waiver
  • Recipient Qualifying Criteria

4
Alzheimers Assisted Living Waiver
  • 1. An individual must have a Alzheimers or
    Alzheimer's related Dementia diagnosed by a
    licensed clinical psychologist or a licensed
    physician. The individual must not have a
    diagnosis of mental retardation as defined by the
    American Association on Mental Retardation or a
    serious mental illness as defined in 42 CFR
    483.102(b)

5
Alzheimers Assisted Living Waiver
  • Related Dementia means a diagnosis of Dementia of
    the Alzheimers Type as defined by the Diagnostic
    and Statistical Manual of Mental Disorders.

6
Alzheimers Assisted Living Waiver
  • Recipient must also
  • 2. Be receiving an Auxiliary Grant
  • 3. Be 55 years old and
  • 4. Meet nursing facility criteria for placement
    through the use of the full Uniform Assessment
    Instrument (UAI)

7
Alzheimers Assisted Living Waiver
  • Meeting Nursing Facility Criteria Means
  • The individuals functional capacity as
    documented on the UAI is described by one of the
    following
  • Rated dependent in 4 or more of seven ADLs (page
    4 of the UAI)

8
Alzheimers Assisted Living Waiver
  • Rated dependent in 2-4 ADLS and semi-dependent or
    dependent in Behavior and Orientation and
    semi-dependent in Joint Motion or semi-dependent
    in Medication administration
  • Rated dependent in 5-7 ADLs and also dependent in
    Mobility
  • Rated semi-dependent in 2-7 ADLs and dependent in
    Mobility and Behavior and Orientation.

9
Alzheimers Assisted Living Waiver
  • Provider Application Process

10
Alzheimers Assisted Living Waiver Request an
Application from DMAS
  • By Phone (804) 225-4222
  • By Fax (804) 786-0206
  • By Mail
  • Department of Medical Assistance Services
  • Division of Long Term Care
  • Facilities and Home Based Services Unit
  • Alzheimers Assisted Living Waiver
  • Provider Application
  • 600 East Broad Street Suite 1300
  • Richmond, Virginia 23219

11
Alzheimers Assisted Living Waiver
  • Minimum Requirements
  • Be a licensed Assisted Living Facility through
    DSS (submit copy of license)
  • Have a DMAS provider agreement
  • Solvency, record retention, freedom of choice for
    recipients, follow HIPAA guidelines, etc.

12
Alzheimers Assisted Living Waiver
  • Providers will submit a self-assessment package
    to DMAS for review. Key Elements
  • Licensure verification
  • Physical plant compliance (security system,
    limited access windows, etc.)
  • Policy Procedures
  • Staff training
  • Activity schedules
  • DMAS will conduct an onsite review of the
    facility prior to becoming a provider or within 6
    months of the first admission.

13
Alzheimers Assisted Living Waiver
  • Verification of other regulatory compliance
  • (copies of current certificates must be
    submitted)
  • Has a valid license with DSS for operating an
    assisted living facility safe and secure unit.
  • Meets all VDSS safe and secure guidelines
  • Restaurant certification for kitchen
  • Fire Marshal approval
  • All staff have and passed the criminal record
    check
  • All staff has the correct credentials and staff
    training (per VDSS safe and secure license)

14
Alzheimers Assisted Living Waiver
  • Policies and Procedures
  • (policies must be submitted for review)
  • All staff meet education and skill criteria
  • Administrator
  • Registered Nurse
  • Licensed Practical Nurse
  • Unit Coordinator
  • Activities staff

15
Alzheimers Assisted Living Waiver
  • Staff training provided by professional with
    expertise in Alzheimer's related Dementia
  • One month staff schedule for the facility
  • Activities will be developed coordinated and
    implemented by activities staff
  • (MINIMUM OF 19 hours of group and 1 hour of one
    to one a week) (One month sample)

16
Alzheimers Assisted Living Waiver
  • All assessments and plans of care
  • Initial and ongoing staff training
  • Emergency plans for resident behavior problems
  • Review staff schedule for compliance for awake
    staff coverage
  • Guidelines for admission to the safe secure
    unit
  • All the residents meet the criteria of the
    Alzheimers waiver

17
Alzheimers Assisted Living Waiver
  • Physical Plant
  • Secure alarm system to building or unit
  • Bedrooms provided have no more than 2 residents
    per room
  • Windows cannot be used as exit by residents
  • There is a secure outside area available to
    residents
  • There is an interior walking area
  • General interior is free of any items that may
    place resident at risk

18
Alzheimers Assisted Living Waiver
  • Monthly nurses summary
  • Resident plan of care / ISP (annual and
    quarterly)
  • Daily Census Log
  • Validation that resident is 55 years in age

19
Alzheimers Assisted Living Waiver
  • Reimbursement Rate 50.00 per day per enrolled
    recipient
  • Billing code T2031

20
Contact Information
  • Facility and Home-Based Services Unit
  • Long-Term Care Quality Assurance Division
  • Department of Medical Assistance Services
  • 600 East Broad Street, 10th Floor
  • Richmond, Virginia 23219
  • Telephone (804) 225-4222
  • Fax (804) 371-4986
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