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Assisted Living Forum Recap

Wednesday, August 16, 2017   (0 Comments)
Posted by: Forbes McIntosh
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The Wisconsin Department of Health Services Assisted Living Forum was held Tuesday, August 15, 2017 at Madison College. Some discussion items include:

Wisconsin Coalition for Person Directed Care

Jeffrey McCabe of the Wisconsin Coalition for Person Directed Care spoke briefly about the coalition and encouraged people from throughout the long-term care industry to join the coalition. The coalition formed in 2005 with the mission “to create and change the culture within long-term care settings to one that fosters autonomy for people residing in those settings.” Although the coalition was originally focused on nursing homes, it has recently expanded its focus to include all LTC settings.

Transitions in Care – Draft Publication

A workgroup of stakeholders has developed a publication aimed at helping make a patient’s transition between hospital and long-term care facility more efficient. Alfred Johnson, director of the DHS Division of Quality Assurance Bureau of Assisted Living, said there have been issues of lack of communication or continuity of care when a person moves from hospital to LTC facility, or vice versa. This might include hospital staff making incorrect assumptions about a LTC facility’s level of equipment, staffing or expertise needed for a patient upon release from hospital. The draft document – which would provide both hospitals and LTC facilities guidance and best practices – among other things provides sample roles and responsibilities for each entity relating to a patient’s transition between settings. Although the document is still in a final review draft and has not yet been published, it is expected to be published on the DHS website soon. Four hospitals – Froedtert, Aurora, UW and Aspirus – took part in the document’s development, along with various health care associations, assisted living providers and other stakeholders.


State of Assisted Living – 2017

Alfred Johnson gave a State of Assisted Living update, with statistics about the industry for the first six months of 2017.

  • DHS is looking at making changes in geographic assignments for each BAL regional office.
  • Adult family homes continue to be the largest AL provider types (with 2,083 licensees).
  • However, most complaints received by BAL are about care received at community based residential facilities (CBRFs) – 63 percent of complaints received are for this license category.
  • The top complaints relate to program services, physical environment (primarily in AFHs), resident rights, and staff training/proficiency.
  • More than 77 percent of facilities serve more than three different client groups.
  • The top cites so far this year relate to fire drills for CBRFs and home environment for adult family homes.
Upcoming BAL Initiatives

Alfred Johnson said the bureau has a number of initiatives that are either underway or coming soon:

  • The creation of an “Ask BAL” webpage
  • Strategies to Enhance Resident Care publications
  • HCBS validation reviews
  • Transition in Care coordination guide
  • BAL self-report publication
  • Increase providers’ participation in the use of electronic licensing renewals.
  • Conduct regional forums
  • Study the use of technology in AL facilities
  • Examine updates to annual/biennial reports
  • Promote internal quality improvement strategies within AL facilities


Revised Licensing, Certification & Registration Process for AL Facilities

Alfred Johnson reviewed a revised licensing application document that recently went into effect.

Effective July 17, 2017, assisted living applicants must utilize the revised application materials and processes for any initial license/certification/registration or change of ownership. Earlier versions of the application materials will not be accepted after September 30, 2017. This applies to: community-based residential facilities (CBRFs), 3-4 bed adult family homes (AFHs), residential care apartment complexes (RCACs), and adult day care centers (ADCs) providers.


According to DHS, BAL is not currently implementing the Home and Community Based Setting (HCBS) rule and applicants may disregard the HCBS information listed on the application forms. Any HCBS compliance items included in the completed application are not required and will not be reviewed by DHS staff.


The revised application document also includes some revised terminology language:

  • Established Provider: A provider who previously or currently operates the facility type for which an application for licensure or certification is being made.
  • New Provider: A provider who has never held a license or certification for the facility type for which an application for licensure or certification is currently being made.
  • Attestation Prior to Onsite: BAL will require every applicant to complete an applicant compliance statement prior to scheduling an onsite licensing survey.
  • Fit and Qualified Application: Applicants will submit a completed fit and qualified application with the application.
  • Inactive Application: Applications not completed within six months of submission will be closed out.
  • Incomplete Application: If the application does not include the required documents, the application packet will be returned to the applicant without further processing. BAL will include a checklist identifying the missing item(s). The applicant may choose to resubmit the application with the required documentation. After a second unsuccessful submission, no further applications will be accepted from this applicant for the specified location for a period of one year.
  • Two Revisions: An application is not considered complete until all required documentation that meets regulations have been submitted. If the required documents do not meet the licensing/certification regulations, BAL will only send two revision letters per application. After a second unsuccessful revision, no further applications will be accepted from this applicant for the specified location for a period of one year.
Read More...(Revised Licensing, Certification, and Registration Process For Assisted Living Facilities)


CBRF Breakout

At the afternoon breakout session specific to CBRFs, representatives from the University of Wisconsin-Green Bay’s CBRF educational training program provided answers to some Frequently Asked Questions about the training programs for employees. They said the online registry is the only proof of training attendance – class instructors should not give out certificates of training completion.


DHS staff also noted that the new initial licensing application – specifically which restricts LTC facilities from submitting incomplete applications more than twice – has significantly streamlined the initial licensing process in Wisconsin, as submitted applications are complete and do not require as much DHS staff time sending back incomplete applications. Therefore, it has reduced the amount of time from receipt of application to having a surveyor assigned to a facility – from 127 days to 17 days.

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