Part V. Admission, Retention, and Discharge of Residents
22VAC40-73-310. Admission and retention of residents.
A. No resident shall be admitted or retained:
1. For whom the facility cannot provide or secure appropriate care;
2. Who requires a level of care or service or type of service for which the facility is not licensed or which the facility does not provide; or
3. If the facility does not have staff appropriate in numbers and with appropriate skill to provide the care and services needed by the resident.
B. Assisted living facilities shall not admit an individual before a determination has been made that the facility can meet the needs of the individual. The facility shall make the determination based upon the following information at a minimum:
1. The completed UAI.
2. The physical examination report.
3. A documented interview between the administrator or a designee responsible for admission and retention decisions, the individual, and his legal representative, if any. In some cases, conditions may create special circumstances that make it necessary to hold the interview on the date of admission.
4. A mental health screening in accordance with 22VAC40-73-330 A.
C. An assisted living facility shall only admit or retain individuals as permitted by its use and occupancy classification and certificate of occupancy. The ambulatory or nonambulatory status, as defined in 22VAC40-73-10, of an individual is based upon:
1. Information contained in the physical examination report; and
2. Information contained in the most recent UAI.
D. Based upon review of the UAI prior to admission of a resident, the assisted living facility administrator shall provide written assurance to the resident that the facility has the appropriate license to meet his care needs at the time of admission. Copies of the written assurance shall be given to the legal representative and case manager, if any, and a copy signed by the resident or his legal representative shall be kept in the resident's record.
E. All residents shall be 18 years of age or older.
F. No person shall be admitted without his consent and agreement, or that of his legal representative with demonstrated legal authority to give such consent on his behalf.
G. The facility shall not require a person to relinquish the rights specified in § 63.2-1808 of the Code of Virginia as a condition of admission or retention.
H. In accordance with § 63.2-1805 D of the Code of Virginia, assisted living facilities shall not admit or retain individuals with any of the following conditions or care needs:
1. Ventilator dependency;
2. Dermal ulcers III and IV except those stage III ulcers that are determined by an independent physician to be healing;
3. Intravenous therapy or injections directly into the vein, except for intermittent intravenous therapy managed by a health care professional licensed in Virginia or as permitted in subsection K of this section;
4. Airborne infectious disease in a communicable state that requires isolation of the individual or requires special precautions by the caretaker to prevent transmission of the disease, including diseases such as tuberculosis and excluding infections such as the common cold;
5. Psychotropic medications without appropriate diagnosis and treatment plans;
6. Nasogastric tubes;
7. Gastric tubes except when the individual is capable of independently feeding himself and caring for the tube or as permitted in subsection K of this section;
8. Individuals presenting an imminent physical threat or danger to self or others;
9. Individuals requiring continuous licensed nursing care;
10. Individuals whose physician certifies that placement is no longer appropriate;
11. Unless the individual's independent physician determines otherwise, individuals who require maximum physical assistance as documented by the UAI and meet Medicaid nursing facility level of care criteria as defined in the State Plan for Medical Assistance Program (12VAC30-10); or
12. Individuals whose physical or mental health care needs cannot be met in the specific assisted living facility as determined by the facility.
I. When a resident has a stage III dermal ulcer that has been determined by an independent physician to be healing, periodic observation and any necessary dressing changes shall be performed by a licensed health care professional under a physician's or other prescriber's treatment plan.
J. Intermittent intravenous therapy may be provided to a resident for a limited period of time on a daily or periodic basis by a licensed health care professional under a physician's or other prescriber's treatment plan. When a course of treatment is expected to be ongoing and extends beyond a two-week period, evaluation is required at two-week intervals by the licensed health care professional.
K. At the request of the resident in an assisted living facility and when his independent physician determines that it is appropriate, care for the conditions or care needs (i) specified in subdivisions H 3 and H 7 of this section may be provided to the resident by a physician licensed in Virginia, a nurse licensed in Virginia or a nurse holding a multistate licensure privilege under a physician's treatment plan, or a home care organization licensed in Virginia or (ii) specified in subdivision H 7 of this section may also be provided to the resident by facility staff if the care is delivered in accordance with the regulations of the Board of Nursing for delegation by a registered nurse, 18VAC90-19-240 through 18VAC90-19-280, and 22VAC40-73-470 E. This standard does not apply to recipients of auxiliary grants.
L. When care for a resident's special medical needs is provided by licensed staff of a home care agency, the assisted living facility direct care staff may receive training from the home care agency staff in appropriate treatment monitoring techniques regarding safety precautions and actions to take in case of emergency. This training is required prior to direct care staff assuming such duties. Updated training shall be provided as needed. The training shall include content based on the resident's specific needs. The training shall be documented and maintained in the staff record.
M. Notwithstanding § 63.2-1805 of the Code of Virginia, at the request of the resident, hospice care may be provided in an assisted living facility under the same requirements for hospice programs provided in Article 7 (§ 32.1-162.1 et seq.) of Chapter 5 of Title 32.1 of the Code of Virginia if the hospice program determines that such program is appropriate for the resident. However, to the extent allowed by federal law, no assisted living facility shall be required to provide or allow hospice care if such hospice care restrictions are included in a disclosure statement that is signed by the resident prior to admission. If hospice care is provided, there shall be a written agreement between the assisted living facility and any hospice program that provides care in the facility. The agreement shall include:
1. Policies and procedures to ensure appropriate communication and coordination between the facility and the hospice program;
2. Specification of the roles and responsibilities of each entity, including listing of the services that will generally be provided by the facility and the services that will generally be provided by the hospice program;
3. Acknowledgment that the services provided to each resident shall be reflected on the individualized service plan as required in 22VAC40-73-450 D; and
4. Signatures of an authorized representative of the facility and an authorized representative of the hospice program.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018; Errata, 34:12 VA.R. 1312 February 5, 2018.
22VAC40-73-320. Physical examination and report.
A. Within the 30 days preceding admission, a person shall have a physical examination by an independent physician. The report of such examination shall be on file at the assisted living facility and shall contain the following:
1. The person's name, address, and telephone number;
2. The date of the physical examination;
3. Height, weight, and blood pressure;
4. Significant medical history;
5. General physical condition, including a systems review as is medically indicated;
6. Any diagnosis or significant problems;
7. Any known allergies and description of the person's reactions;
8. Any recommendations for care including medication, diet, and therapy;
9. Results of a risk assessment documenting the absence of tuberculosis in a communicable form as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it;
10. A statement that the individual does not have any of the conditions or care needs prohibited by 22VAC40-73-310 H;
11. A statement that specifies whether the individual is considered to be ambulatory or nonambulatory as defined in this chapter;
12. A statement that specifies whether the individual is or is not capable of self-administering medication; and
13. The signature of the examining physician or his designee.
B. Subsequent tuberculosis evaluations.
1. A risk assessment for tuberculosis shall be completed annually on each resident as evidenced by the completion of the current screening form published by the Virginia Department of Health or a form consistent with it.
2. Any resident who comes in contact with a known case of infectious tuberculosis shall be screened as deemed appropriate in consultation with the local health department.
3. Any resident who develops respiratory symptoms of three or more weeks duration with no medical explanation shall be referred for evaluation for the presence of infectious tuberculosis.
4. If a resident develops an active case of tuberculosis, the facility shall report this information to the local health department.
C. As necessary to determine whether a resident's needs can continue to be met in the assisted living facility, the department may request a current physical examination by an independent physician or psychiatric evaluation by an independent physician, including diagnosis and assessments.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-325. Fall risk rating.
A. For residents who meet the criteria for assisted living care, by the time the comprehensive ISP is completed, a written fall risk rating shall be completed.
B. The fall risk rating shall be reviewed and updated under each of the following circumstances:
1. At least annually;
2. When the condition of the resident changes; and
3. After a fall.
C. Should a resident who meets the criteria for assisted living care fall, the facility must show documentation of an analysis of the circumstances of the fall and interventions that were initiated to prevent or reduce l risk of subsequent falls.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-330. Mental health screening.
A. A mental health screening shall be conducted prior to admission if behaviors or patterns of behavior occurred within the previous six months that were indicative of mental illness, intellectual disability, substance abuse, or behavioral disorders and that caused, or continue to cause, concern for the health, safety, or welfare either of that individual or others who could be placed at risk of harm by that individual.
Exceptions:
1. If it is not possible for the screening to be conducted prior to admission, the individual may be admitted if all other admission requirements are met. The reason for the delay shall be documented and the screening shall be conducted as soon as possible, but no later than 30 days after admission.
2. The screening shall not be required for individuals under the care of a qualified mental health professional immediately prior to admission, as long as there is documentation of the person's psychosocial and behavioral functioning as specified in 22VAC40-73-340 A 1.
B. A mental health screening shall be conducted when a resident displays behaviors or patterns of behavior indicative of mental illness, intellectual disability, substance abuse, or behavioral disorders that cause concern for the health, safety, or welfare of either that resident or others who could be placed at risk of harm by the resident.
C. The mental health screening shall be conducted by a qualified mental health professional having no financial interest in the assisted living facility, directly or indirectly as an owner, officer, employee, or as an independent contractor with the facility.
D. A copy of the screening shall be filed in the resident's record.
E. If the screening indicates a need for mental health, intellectual disability, substance abuse, or behavioral disorder services for the resident, the facility shall provide:
1. Notification of the resident's need for such services to the community services board, behavioral health authority, or other appropriate licensed provider identified by the resident or his legal representative; and
2. Notification to the resident, authorized contact person of record, and physician of record that mental health services have been recommended for the resident.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-340. Psychosocial and behavioral history.
A. When determining appropriateness of admission for an individual with mental illness, intellectual disability, substance abuse, or behavioral disorders, the following information shall be obtained by the facility:
1. If the prospective resident is referred by a state or private hospital, community services board, behavioral health authority, or long-term care facility, documentation of the individual's psychosocial and behavioral functioning shall be acquired prior to admission.
2. If the prospective resident is coming from a private residence, information about the individual's psychosocial and behavioral functioning shall be gathered from primary sources, such as family members, friends, or physician. Although there is no requirement for written information from primary sources, the facility must document the source and content of the information that was obtained.
B. The administrator or his designee shall document that the individual's psychosocial and behavioral history were reviewed and used to help determine the appropriateness of the admission.
C. If the individual is admitted, the psychosocial and behavioral history shall be used in the development of the person's individualized service plan and documentation of the history shall be filed in the resident's record.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-350. Sex offender information.
A. The assisted living facility shall register with the Department of State Police to receive notice of the registration or reregistration of any sex offender within the same or a contiguous zip code area in which the facility is located, pursuant to § 9.1-914 of the Code of Virginia.
B. The assisted living facility shall ascertain, prior to admission, whether a potential resident is a registered sex offender if the facility anticipates the potential resident will have a length of stay greater than three days or in fact stays longer than three days and shall document in the resident's record that this was ascertained and the date the information was obtained.
C. The assisted living facility shall ensure that each resident or his legal representative is fully informed, prior to or at the time of admission and annually, that he should exercise whatever due diligence he deems necessary with respect to information on any sex offenders registered pursuant to Chapter 9 (§ 9.1-900 et. seq.) of Title 9.1 of the Code of Virginia, including how to obtain such information. Written acknowledgment of having been so informed shall be provided by the resident or his legal representative and shall be maintained in the resident's record.
D. At the same time that the person is informed as required in subsection C of this section, the assisted living facility shall provide notification that, upon request, the facility shall:
1. Assist the resident, prospective resident, or his legal representative in accessing the information on registered sex offenders; and
2. Provide the resident, prospective resident, or his legal representative with printed copies of the information on registered sex offenders.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-360. Emergency placement.
A. An emergency placement shall occur only when the emergency is documented and approved by (i) an adult protective services worker for public pay individuals or (ii) an independent physician or an adult protective services worker for private pay individuals.
B. When an emergency placement occurs, the person shall remain in the assisted living facility no longer than seven days unless all the requirements for admission have been met and the person has been admitted.
C. The facility shall obtain sufficient information on the person to protect the health, safety, and welfare of the person while he remains at the facility as allowed by subsection B of this section.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-370. Respite care.
If an assisted living facility provides respite care as defined in 22VAC40-73-10, the requirements of this chapter apply to the respite care, except as follows:
1. For individuals in respite care, the ISP shall be completed prior to the person participating in respite care and need not include expected outcome.
2. At the time an individual returns for respite care, the facility shall reevaluate the person's condition and care needs, and as needed, ensure that the uniform assessment instrument, the individualized service plan, and medication orders are updated. The reevaluation shall include observation of the person; interviews with the individual and his legal representative, if any; and consultation with others knowledgeable about the person, as appropriate. The reevaluation shall indicate in writing whether or not the person's condition or care needs have changed and specify any changes. The reevaluation shall be signed and dated by the staff person completing the reevaluation and by the individual in respite care or his legal representative and shall be retained in the individual's record.
3. If the period of time between respite care stays is six months or longer, a new physical examination report shall be required prior to the individual returning for respite care, except that a new tuberculosis screening would only be required one time per year. The examination shall take place within 30 days prior to the person's return for respite care.
4. The record for the individual in respite care shall include the dates of respite care.
5. The medication review required by 22VAC40-73-690 does not apply to individuals in respite care.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-380. Resident personal and social information.
A. Prior to or at the time of admission to an assisted living facility, the following personal and social information on a person shall be obtained:
1. Name;
2. Last home address, and address from which resident was received, if different;
3. Date of admission;
4. Birth date or if unknown, estimated age;
5. Birthplace, if known;
6. Marital status, if known;
7. Name, address, and telephone number of all legal representatives, if any;
8. If there is a legal representative, copies of current legal documents that show proof of each legal representative's authority to act on behalf of the resident and that specify the scope of the representative's authority to make decisions and to perform other functions;
9. Name, address, and telephone number of next of kin, if known (two preferred);
10. Name, address, and telephone number of designated contact person authorized by the resident or legal representative, if appropriate, for notification purposes, including emergency notification and notification of the need for mental health, intellectual disability, substance abuse, or behavioral disorder services - if the resident or legal representative is willing to designate an authorized contact person. There may be more than one designated contact person. The designated contact person may also be listed under another category, such as next of kin or legal representative;
11. Name, address, and telephone number of the responsible individual stipulated in 22VAC40-73-550 H, if needed;
12. Name, address, and telephone number of personal physician, if known;
13. Name, address, and telephone number of personal dentist, if known;
14. Name, address, and telephone number of clergyman and place of worship, if applicable;
15. Name, address, and telephone number of local department of social services or any other agency, if applicable, and the name of the assigned case manager or caseworker;
16. Service in the armed forces, if applicable;
17. Lifetime vocation, career, or primary role;
18. Special interests and hobbies;
19. Known allergies, if any;
20. Information concerning advance directives, Do Not Resuscitate (DNR) Orders, or organ donation, if applicable;
21. Previous mental health or intellectual disability services history, if any, and if applicable for care or services;
22. Current behavioral and social functioning including strengths and problems; and
23. Any substance abuse history if applicable for care or services.
B. The personal and social information required in subsection A of this section shall be placed in the person's record and kept current.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-390. Resident agreement with facility.
A. At or prior to the time of admission, there shall be a written agreement/acknowledgment of notification dated and signed by the resident or applicant for admission or the appropriate legal representative, and by the licensee or administrator. This document shall include the following:
1. Financial arrangement for accommodations, services, and care that specifies:
a. Listing of specific charges for accommodations, services, and care to be made to the individual resident signing the agreement, the frequency of payment, and any rules relating to nonpayment;
b. Description of all accommodations, services, and care that the facility offers and any related charges;
c. For an auxiliary grant recipient, a list of services included under the auxiliary grant rate;
d. The amount and purpose of an advance payment or deposit payment and the refund policy for such payment, except that recipients of auxiliary grants may not be charged an advance payment or deposit payment;
e. The policy with respect to increases in charges and length of time for advance notice of intent to increase charges;
f. If the ownership of any personal property, real estate, money or financial investments is to be transferred to the facility at the time of admission or at some future date, it shall be stipulated in the agreement; and
g. The refund policy to apply when transfer of ownership, closing of facility, or resident transfer or discharge occurs.
2. Requirements or rules to be imposed regarding resident conduct and other restrictions or special conditions.
3. Those actions, circumstances, or conditions that would result or might result in the resident's discharge from the facility.
4. Specific acknowledgments that:
a. Requirements or rules regarding resident conduct, other restrictions, or special conditions have been reviewed by the resident or his legal representative;
b. The resident or his legal representative has been informed of the policy regarding the amount of notice required when a resident wishes to move from the facility;
c. The resident has been informed of the policy required by 22VAC40-73-840 regarding pets living in the facility;
d. The resident has been informed of the policy required by 22VAC40-73-860 K regarding weapons;
e. The resident or his legal representative or responsible individual as stipulated in 22VAC40-73-550 H has reviewed § 63.2-1808 of the Code of Virginia, Rights and Responsibilities of Residents of Assisted Living Facilities, and that the provisions of this statute have been explained to him;
f. The resident or his legal representative or responsible individual as stipulated in 22VAC40-73-550 H has reviewed and had explained to him the facility's policies and procedures for implementing § 63.2-1808 of the Code of Virginia;
g. The resident has been informed and had explained to him that he may refuse release of information regarding his personal affairs and records to any individual outside the facility, except as otherwise provided in law and except in case of his transfer to another caregiving facility, notwithstanding any requirements of this chapter;
h. The resident has been informed that interested residents may establish and maintain a resident council, that the facility is responsible for providing assistance with the formation and maintenance of the council, whether or not such a council currently exists in the facility, and the general purpose of a resident council (See 22VAC40-73-830);
i. The resident has been informed of the bed hold policy in case of temporary transfer or movement from the facility, if the facility has such a policy (See 22VAC40-73-420 B);
j. The resident has been informed of the policy or guidelines regarding visiting in the facility, if the facility has such a policy or guidelines (See 22VAC40-73-540 C);
k. The resident has been informed of the rules and restrictions regarding smoking on the premises of the facility, including that which is required by 22VAC40-73-820;
l. The resident has been informed of the policy regarding the administration and storage of medications and dietary supplements;
m. The resident has been notified in writing whether or not the facility maintains liability insurance that provides at least the minimum amount of coverage established by the board for disclosure purposes set forth in 22VAC40-73-45 to compensate residents or other individuals for injuries and losses from negligent acts of the facility. The facility shall state in the notification the minimum amount of coverage established by the board in 22VAC40-73-45. The written notification must be on a form developed by the department; and
n. The resident has received written assurance that the facility has the appropriate license to meet his care needs at the time of admission, as required by 22VAC40-73-310 D.
B. Copies of the signed agreement/acknowledgment and any updates as noted in subsection C of this section shall be provided to the resident and, as appropriate, his legal representative and shall be retained in the resident's record.
C. The original agreement/acknowledgment shall be updated whenever there are changes to any of the policies or information referenced or identified in the agreement/acknowledgment and dated and signed by the licensee or administrator and the resident or his legal representative.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-400. Monthly statement of charges and payments.
The facility shall provide to each resident or the resident's legal representative, if one has been appointed, a monthly statement that itemizes any charges made by the facility and any payments received from the resident or on behalf of the resident during the previous calendar month and shall show the balance due or any credits for overpayment. The facility shall also place a copy of the monthly statement in the resident's record.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-410. Orientation and related information for residents.
A. Upon admission, the assisted living facility shall provide an orientation for new residents and their legal representatives, including emergency response procedures, mealtimes, and use of the call system. If needed, the orientation shall be modified as appropriate for residents with cognitive impairments. Acknowledgment of having received the orientation shall be signed and dated by the resident and, as appropriate, his legal representative, and such documentation shall be kept in the resident's record.
B. Upon admission and upon request, the assisted living facility shall provide to the resident and, if appropriate, his legal representative, a written description of the types of staff persons working in the facility and the services provided, including the hours such services are available.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-420. Acceptance back in facility.
A. An assisted living facility shall establish procedures to ensure that any resident detained by a temporary detention order pursuant to §§ 37.2-809 through 37.2-813 of the Code of Virginia is accepted back in the assisted living facility if the resident is not involuntarily committed pursuant to §§ 37.2-814 through 37.2-819 of the Code of Virginia. The procedures shall include:
1. Obtaining written recommendations from a qualified mental health professional regarding supportive services necessary to address the mental health needs of the resident returning to the facility;
2. Documenting whether the recommendations specified in subdivision 1 of this subsection can be implemented based on facility or community resources and whether the resident can be retained at the facility or would need to be discharged;
3. Updating the resident's individualized service plan, as needed; and
4. Ensuring that direct care staff involved in the care and supervision of the resident receive clear and timely communication regarding their responsibilities in respect to the mental health needs of the resident and behavioral or emotional indicators of possible crisis situations.
B. If an assisted living facility allows for temporary movement of a resident with agreement to hold a bed, it shall develop and follow a written bed hold policy, which includes the conditions for which a bed will be held, any time frames, terms of payment, and circumstances under which the bed will no longer be held. For recipients of an auxiliary grant, the bed hold policy must be consistent with auxiliary grant program policy and guidance.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.
22VAC40-73-430. Discharge of residents.
A. When actions, circumstances, conditions, or care needs occur that will result in the discharge of a resident, discharge planning shall begin immediately, and there shall be documentation of such, including the beginning date of discharge planning. The resident shall be moved within 30 days, except that if persistent efforts have been made and the time frame is not met, the facility shall document the reason and the efforts that have been made.
B. As soon as discharge planning begins, the assisted living facility shall notify the resident, the resident's legal representative and designated contact person if any, of the planned discharge, the reason for the discharge, and that the resident will be moved within 30 days unless there are extenuating circumstances relating to inability to place the resident in another setting within the time frame referenced in subsection A of this section. Written notification of the actual discharge date and place of discharge shall be given to the resident, the resident's legal representative and contact person, if any, and additionally for public pay residents, the eligibility worker and assessor, at least 14 days prior to the date that the resident will be discharged.
C. The assisted living facility shall adopt and conform to a written policy regarding the number of days notice that is required when a resident wishes to move from the facility. Any required notice of intent to move shall not exceed 30 days.
D. The facility shall assist the resident and his legal representative, if any, in the discharge or transfer process. The facility shall help the resident prepare for relocation, including discussing the resident's destination. Primary responsibility for transporting the resident and his possessions rests with the resident or his legal representative.
E. When a resident's condition presents an immediate and serious risk to the health, safety, or welfare of the resident or others and emergency discharge is necessary, the 14-day advance notification of planned discharge does not apply, although the reason for the relocation shall be discussed with the resident and, when possible, his legal representative prior to the move.
F. Under emergency conditions, the resident's legal representative, designated contact person, family, caseworker, social worker, or any other persons, as appropriate, shall be informed as rapidly as possible, but no later than the close of the day following discharge, of the reasons for the move. For public pay residents, the eligibility worker and assessor shall also be so informed of the emergency discharge within the same time frame. No later than five days after discharge, the information shall be provided in writing to all those notified.
G. For public pay residents, in the event of a resident's death, the assisted living facility shall provide written notification to the eligibility worker and assessor within five days after the resident's death.
H. Discharge statement.
1. At the time of discharge, the assisted living facility shall provide to the resident and, as appropriate, his legal representative and designated contact person a dated statement signed by the licensee or administrator that contains the following information:
a. The date on which the resident, his legal representative, or designated contact person was notified of the planned discharge and the name of the legal representative or designated contact person who was notified;
b. The reason or reasons for the discharge;
c. The actions taken by the facility to assist the resident in the discharge and relocation process; and
d. The date of the actual discharge from the facility and the resident's destination.
2. A copy of the written statement shall be retained in the resident's record.
I. When the resident is discharged and moves to another caregiving facility, the assisted living facility shall provide to the receiving facility such information related to the resident as is necessary to ensure continuity of care and services. Original information pertaining to the resident shall be maintained by the assisted living facility from which the resident was discharged. The assisted living facility shall maintain a listing of all information shared with the receiving facility.
J. Within 60 days of the date of discharge, each resident or his legal representative shall be given a final statement of account, any refunds due, and return of any money, property, or things of value held in trust or custody by the facility.
Statutory Authority
§§ 63.2-217, 63.2-1732, 63.2-1802, 63.2-1805, and 63.2-1808 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 34, Issue 6, eff. February 1, 2018.