Dementia Reg

[Stacy 0]

Does any one know where I can find the new Dementia reg? I don't know if this is just for Illinois, or if it is fed. Any help would be greatly appreciated

 

Stacy

[dawn 0]

Stacey, What deminta reg are you looking for?

[Stacy 0]

There are new regs coming out for SCU's. I haven't been able to find them on the net, and was wondering if anyone else has heard about it.

[Pennie 26]

Stacy

I haven't heard of the dementia regs. but doesn't mean they aren't there If you find them &/or learn more about these will you keep us all updated on it, please.

Thanks P

[Sally 0]

Stacy,

 

I got my copy from the Life Services Network which our home is a member of. It's under the "What's New" button. Scroll down to a 11/02/2004 posting titled, "Alzheimer's Special Care Unit New Regulations". If it won't let you in, email me & I'll send you a copy.

 

Sally

shodgson@gshq.org

[gina 2]

:-D Hi All,

I am wondering if anyone knows if the new regs. are state wide or just for Illinois.

Here is what I could find about what would concern us Directors working in Dementia units if this is a new state wide regulation.

 

Section 300.7030 Ability-Centered Care

a) Ability-centered care programming, also called activity-focused programming,

recognizes the resident's abilities and competencies in care planning. Tasks are

adapted and modified to provide for the resident's involvement at the maximum

level of the resident's ability. Ability-centered care programming embraces the

following concepts: activities are every event, encounter, and exchange with a

staff member, volunteer, relative, or other individuals; activities are redefined as

traditional (i.e., work related, recreational) and nontraditional (i.e., bathing,

eating, walking); both independent and structured events are used.

Flexibility is allowed in traditional staff roles and staff are encouraged to develop

relationships with residents. The use of staff in nontradictional roles shall be

documented in the unit's policies and procedures. Non-licensed staff who are not

certified nursing assistants shall not provide nursing or personal care but are

limited to assisting with activities of daily living and providing verbal cueing, for

which the staff have been trained.

c) Unit directors and activity professionals for units established before January 1,

2005 shall participate in ability-centered care training before July 1, 2005. Unit

directors and activity professionals for units established after January 1, 2005

shall have had course work in ability-centered care programming.

d) The unit shall use a distinct approach to resident care that is designed for persons

with Alzheimer's disease and related dementia. The use of ability-centered care is

recommended. If the facility uses an alternative approach, this approach shall be

reviewed by the Department to determine if the care goals of the ability-centered

care have been satisfied. Alternative methodologies shall not be implemented

until the Department has approved them.

e) Dining and mealtime approaches shall address the special needs of individuals

with dementia.

(Source: Added at 28 Ill. Reg. ______, effective ____________)

Section 300.7040 Activities

ILLINOIS REGISTER

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENT

a) The unit's activity program shall use ability-centered care programming.

Families shall have access to activity supplies and materials and shall be welcome

and encouraged to participate.

c) Units with a census of more than 40 residents shall have a full-time activity

professional who meets the requirements of Section 300.1410©. Units with a

census of 40 or fewer residents shall have an activity professional on duty at least

20 hours per week. This individual shall be responsible for providing activities

and training staff in an ability-centered programming approach.

d) Activity programming shall be planned and provided throughout the day and

evening, at least 7 days a week for an average of 8 hours per day.

e) Activities shall be adapted, as needed, to provide for maximum participation by

individual residents. If a particular resident does not participate in at least an

average of 4 activities per day over a one-week period, the unit director shall

evaluate the resident's participation and have the available activities modified

and/or consult with the interdisciplinary team.

(Source: Added at 28 Ill. Reg. ______, effective ____________)

Section 300.7050 Staffing

a) The unit shall have a full-time unit director.

1) The director may have other responsibilities, within the unit, in units with

fewer than 40 residents.

2) The unit director may support off-unit activities related to persons with

Alzheimer's disease and related dementia, such as providing training to

facility staff, assessment of potential residents, counseling to potential

residents and their families, and consultation/assessment/care planning for

facility residents with Alzheimer's disease and related dementia who do

not reside on the unit.

3) The unit director shall have documented course work in dementia care and

ability-centered care, and shall meet at least one of the following

requirements:

ILLINOIS REGISTER

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENT

A) Have an associate's or a bachelor's degree and/or be a registered

nurse and have at least one year of experience working with

persons with Alzheimer's disease and other dementia; or

Have a minimum of 5 years of experience working with persons

with Alzheimer's disease and other dementia, at least two years of

which are management experience working with persons with

Alzheimer's disease and other dementia.

4) The unit director shall obtain at least 12 hours of continuing education

every year, especially related to serving residents with Alzheimer's disease

and other dementia.

The unit shall have assigned, consistent staff. There shall be enough staff to meet

the scheduled and unscheduled needs of each resident, as defined in the care plan,

taking into account the purpose of the setting, the severity of dementia, and the

resident's physical abilities, behavior patterns, and social and medical needs.

c) All staff who ever work on the unit (e.g., nurses, CNAs, housekeepers, social

services and activities staff, and food service staff) shall receive at least four hours

of dementia-specific orientation within the first 7 days of working on the unit.

This orientation shall include:

1) Basic information about the nature, progression, and management of

Alzheimer's disease and other dementia;

2) Techniques for creating an environment that minimizes challenging

behavior from residents with Alzheimer's disease and other dementia;

3) Methods of identifying and minimizing safety risks to residents with

Alzheimer's disease and other dementia; and

4) Techniques for successful communication with individuals with

Alzheimer's disease and other dementia.

d) Nurses, CNAs, and social service and activities staff who work on the unit at least

50 percent of the time that they work at the facility shall participate in a minimum

of 12 additional hours of orientation within the first 45 days after employment,

specifically related to the care of persons with Alzheimer's disease and other

dementia. This orientation shall be defined in facility policies and procedures;

ILLINOIS REGISTER

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENT

shall be in a form of classroom, return demonstration, and mentoring; and shall

define to new staff the elements contained in Section 300.7050(e)(1)-(10).

e) Nurses, CNAs, and social services and activities staff who work on the unit at

least 50 percent of the time that they work at the facility shall attend at least 12

hours of continuing education every year, specifically related to serving residents

with Alzheimer's disease and other dementia. (Completion of the 12 hours of

orientation in accordance with subsection (d) of this Section may be counted as

continuing education for the year in which this orientation is completed.) Topics

shall include, but not be limited to:

1) Promoting the philosophy of an ability-centered care framework;

2) Promoting resident dignity, independence, individuality, privacy and

choice;

3) Resident rights and principles of self-determination;

4) Medical and social needs of residents with Alzheimer's disease and other

dementia;

5) Assessing resident capabilities and developing and implementing services

plans;

6) Planning and facilitating activities appropriate for a resident with

Alzheimer's disease and other dementia;

7) Communicating with families and others interested in the resident;

8) Care of elderly persons with physical, cognitive, behavioral, and social

disabilities;

9) Common psychotropics and their side effects; and

10) Local community resources.

f) Within 6 months after January 1, 2005, or within 6 months after hire, the facility

administrator and director of nursing shall attend the orientation for staff who

work on the unit at least 50 percent of the time in accordance with subsection (d).

ILLINOIS REGISTER

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENT

g) For each training requirement in this Section, staff shall be evaluated to determine

if they have met or exceeded stated learning objectives. Results shall be

documented.

h) Training requirements of this Section are in addition to requirements for nurse

aide training. Orientation requirements of this Section are in addition to regular

staff orientation.

(Source: Added at 28 Ill. Reg. ______, effective ____________)

Section 300.7060 Environment

a) The environment (cultural, social, and physical) shall support the functioning of

cognitively impaired residents. It shall accommodate behaviors, maximize

functional abilities, promote safety, and encourage residents' independence by

compensating for losses resulting from the disease process in accordance with

each resident's care plan.

The unit shall use a variety of sensory cues to differentiate rooms, spaces, and

uses.

c) The unit shall be designed and maintained to ensure an appropriate range of

environmental and sensory stimulation and information; e.g., using minimally

distracting security, pager and safety systems.

d) Visual supervision of indoor and outdoor activity areas shall be provided,

supported by architectural design. Staff shall be present in activity areas when

residents are in these areas.

e) Resident rooms shall not contain more than two beds. Rooms containing more

than 2 beds within units established prior to January 1, 2005 may retain more than

2 beds.

f) A secure out-of-doors space shall be provided in units established after January 1,

2005 and, whenever possible, in units established before January 1, 2005. If a

secure out-of-doors space is not available, the facility shall implement a plan to

provide residents with the opportunity for daily, routine outdoor activities,

weather permitting.

ILLINOIS REGISTER

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENT

g) Social space appropriate to the needs of the individual with Alzheimer's disease

and other dementia shall be provided. Social space is any space that is

independently accessible to the resident, except for the resident's bedroom, the

bathroom, or shower/bathrooms or hallways. Social space includes, but is not

limited to, dining room, living room, family visitation areas, unit kitchen, and

activity areas.

h) In facilities establishing a unit after January 1, 2005, this social space shall equal

at least 40 square feet per resident bed.

(Source: Added at 28 Ill. Reg. ______, effective ____________)

Section 300.7070 Quality Assessment and Improvement

The unit shall have a written plan that is part of the facility's overall quality assurance plan to

assess residents' quality of care, quality of life, and overall well-being.

a) The licensee shall develop and implement a quality assessment and improvement

program designed to meet at least the following goals:

1) Ongoing monitoring and evaluation of the quality of care and service

provided at the facility, including, but not limited to:

A) Admission of residents who are appropriate to the capabilities of

the facility;

Resident assessment;

C) Development and implementation of appropriate individualized,

ability-centered treatment plans;

D) Resident satisfaction;

E) Infection control;

F) Appropriate numbers of staff; and

G) Staff turnover.

2) Identification and analysis of problems.

ILLINOIS REGISTER

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENT

3) Identification and implementation of corrective action or changes in

response to problems.

The program shall operate pursuant to a written plan that shall include, but not be

limited to:

1) A detailed statement of how problems will be identified, including

procedures to elicit insights from residents, residents' families, and

residents' representatives;

2) The methodology and criteria that will be used to formulate action plans to

address problems, which shall include the insights of residents, residents'

families, and residents' representatives;

3) Procedures for evaluating the effectiveness of action plans and revising

action plans to prevent reoccurrence of problems;

4) Procedures for documenting the activities of the program; and

5) Identifying the persons responsible for administering the program.

c) A copy of the plan shall be provided to residents, residents' families, or residents'

representatives.

(Source: Added at 28 Ill. Reg. ______, effective ____________)

Section 300.7080 Variances to Enhance Residents' Quality of Life

a) The Department will consider requests for variances from this Part where the

variance will enhance the residents' quality of life. The variance shall be

requested in writing and shall contain the following information:

1) Facility contact person;

2) The specific Section of this Part from which the applicant is requesting a

variance;

3) The proposed alternative plan, service, or approach to meet the needs of

the residents;

ILLINOIS REGISTER

DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENT

4) The benefit to the residents if the variance is approved; and

5) The facility plan to evaluate the effectiveness of the variance in meeting

the residents' needs, including eliciting insights from residents, residents'

families, and residents' representatives.

The facility shall not implement the variance prior to receiving written approval

from the Department.

c) The Department will advise the facility in writing if the variance is approved,

denied or approved with conditions or limitations within 90 days after receipt of

the request. The Department's decision to approve, deny, or approve the variance

with conditions or limitations shall be based on whether the proposed alternative

provides an equivalent level of care and safety to the residents.

d) Variances will not be granted for statutory requirements.

(Source: Added at 28 Ill. Reg. ______, effective ____________)

[Pennie 26]

Hey Gina,

Thanks for the info. I am waiting for a reply on the question, if ths is for Ill only or everyone. I will let you know as soon as I do.

Have a great Christmas. P

[Stacy 0]

Thanks everyone. That is just what I needed.

 

Hope you all had a great holiday.

 

Stacy

[Stacy 0]

I also don't know the answer if it is state wide or federal. My feeling is it is just state wide.

'

Stacy

[Pennie 26]

Hi,

I finally got the answer from Pam sanders on this reg. here is her reply:

This is Illinois state regs. As such they do not apply to Texas.

They are interesting but not any more explicit than the licensure regs for

assisted living facilities providing dementia care in the Texas

Licensure regulations for Assisted Living Facilities.

Now we know this is a State Reg for Ill. Probably we all have regs. simliar for our Alz/Dem units in some form or other. P

Thanks Pam ;-)

[Guest Guest_Dixie]

are these regs. for just dementia units or are these for nursing home pt..........??

[Stacy 0]

Dementia Units

[dawn 0]

It can be long term care as well.

[Guest Guest_Dixie]

called LSN, talked to Tess she says new regs. for dementia units that are only dementia care unit. not for general long term

[Jacki11 0]

You can also reg at dementia care plan suggested one year ago by my friend.