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Assisted Living Forum Summary from May 15, 2018

Wednesday, May 23, 2018   (0 Comments)
Posted by: Sarah Bass
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From Government Policy Solutions


The Wisconsin Department of Health Services held its Assisted Living Forum via webinar on Tuesday, May 15. Some highlights of the Assisted Living Forum:
CBRF Registry
Beginning January 1, 2017, the University of Wisconsin-Green Bay took over management of the Wisconsin CBRF Training Registry for the Department of Health Services, Division of Quality Assurance's Bureau of Assisted Living. The registry is a record of Community-Based Residental Facilities (CBRF) employees who have successfully completed any or all of the four required courses (Standard Precautions, Fire Safety, First Aid and Choking and Medication Administration). This registry is the sole verification of classes completed on or after April 1, 2010. Ninety-eight percent of the employees added to the registry are new to the CBRF training industry. There are more than 36,000 visits to the registry website per month. There are two curriculum updates: in July of 2017 the Standard Precautions curriculum was released, and by July 1, 2018, the new Fire Safety curriculum will be complete. They are also transitioning from the American Red Cross first aid curriculum to the CBRF-specific first aid and choking curriculum.
Administrative Code Review
BAL regional directors also reviewed and discussed the following administrative code chapters:
DHS 83.20(2) Department-approved training for CBRFs, approved courses: There have been some cites for CBRF employees who have failed to complete the four required courses for CBRF employees (mentioned above). Course completion is verified on the UWGB registry mentioned above (available online at
DHS 83.31 Discharge or transfer: For an involuntary discharge of a resident, an AL facility must include certain information on the 30-day discharge notice. Acceptable reasons for involuntary discharge can include: nonpayment, when the level of care needed exceeds care available and others. Facilities should have documentation on a resident's increasing needs and they should continue to be an advocate of the resident to receive appropriate care. One AL Forum participant noted that she gave a notice of discharge and was told by the MCO that it will take nine months to find another placement. Alfred Johnson, BAL bureau director, said DHS is considering creating a publication on best practices for involuntary discharge.
DHS 83.35 Assessment, individual service plan and evaluations: This is one of the top 10 cites statewide. BAL staff noted that individual service plans and measurable goals should be accessible to facility staff - it does no good sitting in a file cabinet where appropriate employees cannot refer to the ISP and goals for each resident. Residents' ISP should be updated as conditions or needs change.
DHS 83.38 (1)c Leisure Time Activities: Resident activities should be planned and posted, with staff encouraging participation in the organized activities.
DHS 83.38(1)d Community Activities: A representative of Rockport/A Heart to Serve initiative will be a guest speaker at the FOCUS conference in November. This program brings nursing home residents into the community to help prepare and serve meals at a homeless shelter. BAL staff noted that transportation and staffing can be obstacles for planning of community activities by an AL facility. And although the A Heart to Serve program is a big undertaking as a community activity, it is meaningful and shows it can be done.
Oral Health in Assisted Living
Angie Stone of HyLife Oral Health Alliance gave a presentation about the importance of oral health for the elderly. Stone, a dental hygienist, pointed to a 2012 Wisconsin Healthy Smiles survey, which found:
  • 42% people in nursing homes have untreated tooth decay;
  • 31% people in skilled nursing facilities have root fragments;
  • 22% people have severe gingival inflammation; and
  • 35% of people screened had substantial oral debris (food, plaque, etc.).
She said that if those statistics were for children, people would be outraged, however, it does not get much attention for the elderly.
Stone noted that the problem "really isn't anybody's fault" and there are many factors behind the problem, including: Lack of manual dexterity or memory by the elderly to use a toothbrush and a heavy workload by care workers that pushes oral health low on the priority list. She also noted that while some care facilities have partnerships with dentists, dentists' focus is primarily on treating existing dental problems and not preventative care, which is the focus of dental hygienists.
Stone asked long-term care facility representatives what types of services they provide to their residents (hair styling, etc.) and whether oral health care is among them. She encouraged they contact her to have an assessment of residents' oral health performed.

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