Code of Colorado Regulations
1000 - Department of Public Health and Environment
1011 - Health Facilities and Emergency Medical Services Division (1011, 1015 Series)
6 CCR 1011-1 Chapter 07 - ASSISTED LIVING RESIDENCES
Part 12 - RESIDENT CARE SERVICES
Current through Register Vol. 47, No. 5, March 10, 2024
Minimum Services
12.1 The assisted living residence shall make available, either directly or indirectly through a resident agreement, the following services, sufficient to meet the needs of the residents:
Nursing Services
12.2 Nurses may provide nursing services to support the personal services provided to residents of the assisted living residence, except that such services shall not rise to the level that requires resident discharge as described in Part 11.11 or becomes regular 24-hour medical or nursing care.
12.3 The following occasionally required services may only be provided by an external service provider or the nurse of the assisted living residence:
12.4 An assisted living residence shall not admit or keep a resident with a stage 3 or stage 4 pressure sore unless the resident has a terminal condition and is receiving continuing care from an external service provider.
Practitioner Assessment
12.5 The assisted living residence shall have a policy and procedure regarding when a practitioner's assessment of a resident is appropriate. At a minimum, the assisted living residence shall contact the resident's primary practitioner when any of the following circumstances occur and follow the practitioner's recommendation regarding further action.
Comprehensive Resident Assessment
12.6 At the time a new resident moves in, the assisted living residence shall complete a comprehensive assessment that reflects information requested and received from the resident, the resident's representative if requested by the resident, and a practitioner. Information from the comprehensive assessment shall be used to establish an individualized care plan.
12.7 The comprehensive assessment shall include all the following items:
12.8 The comprehensive assessment shall be documented in writing and kept in the resident's health information record.
12.9 The comprehensive assessment shall be updated for each resident at least annually and whenever the resident's condition changes from baseline status.
Resident Care Plan
12.10 Each resident care plan shall:
Care Coordination
12.11 The assisted living residence shall be responsible for the coordination of resident care services with known external service providers.
12.12 The assisted living residence shall notify the resident's representative whenever the resident experiences a significant change from baseline status.
Restraint
12.13 An assisted living residence shall not use restraints of any kind or deprive a resident of his or her liberty for purposes of care or safety except as allowed by Part 11.2(I), Part 25, or as set forth below.
12.14 A device that facilitates a resident's well-being and/or independence may be used only if all of the following criteria are met:
Fall Management Program
12.15 The assisted living residence shall develop policies and procedures to establish a fall management program. The program shall include the following:
Lift Assistance
12.16 Each assisted living residence shall direct staff to assist residents who have fallen or are otherwise unable to independently get up off the floor. The assisted living residence's policy on staff providing lift assistance shall be made available to its local emergency medical responders.
12.17 The assisted living residence shall ensure that it has trained staff available to evaluate residents who have fallen or are otherwise unable to independently get up off the floor and provide lift assistance when determined appropriate instead of relying on emergency medical responders.
12.18 The assisted living residence's policy shall also require documentation of the action taken by staff and ongoing efforts to prevent a reoccurrence of the situation in the future.
Resident Engagement
12.19 The assisted living residence shall encourage residents to maintain and develop their fullest potential for independent living through individual and group engagement opportunities.
12.20 The assisted living residence shall provide all residents with regular opportunities to participate in structured engagement and shall support the pursuit of each resident's interests.
12.21 If requested, the assisted living residence shall assist a resident with identifying and accessing outside services and community events.
12.22 Examples of resident engagement include, but are not limited to, the following:
12.23 The assisted living residence shall encourage residents to contribute to the planning, preparation, conduct, clean-up, and critique of any structured engagement offering.
12.24 The assisted living residence shall evaluate its resident engagement program at least every three months to ascertain whether the opportunities offered to residents are relevant and well-received and/or if changes are appropriate in response to resident feed-back.
12.25 The assisted living residence shall, whenever feasible, coordinate with local agencies and organizations to promote resident participation in community centered activities including, but not limited to:
12.26 Each assisted living residence shall place notices of planned resident engagement offerings in a central location readily accessible to residents, relatives, and the public. Copies shall be retained for at least six months.
Resident Engagement Management
19 or fewer residents
12.27 In assisted living residences that are licensed for 19 or fewer residents, the administrator shall be primarily responsible for organizing, conducting, and evaluating resident engagement. If an assisted living residence can demonstrate that its residents are self-directed to the extent that they are able to plan, organize, and conduct the ALR's resident engagement activities themselves, the ALR may request a waiver of this requirement.
20 to 49 residents
12.28 In assisted living residences that are licensed for 20 to 49 residents, the administrator shall designate one staff member to be responsible for organizing, conducting, and evaluating resident engagement. The designated staff member shall have had at least six months experience in providing structured resident engagement offerings or have completed or be enrolled in an equivalent education and/or training program.
50 or more residents
12.29 In assisted living residences that are licensed for 50 or more residents, there shall be at least one staff member whose sole responsibility is to organize, conduct, and evaluate resident engagement. The ALR shall provide such staff member with as much accommodation and staff support as necessary to ensure that all residents have on-going opportunities to participate in resident engagement activities that are planned in advance, documented in writing, kept up to date, and made available to all residents. The responsible staff member shall have had at least one year of experience or equivalent education and/or training in providing structured resident engagement offerings and be knowledgeable in evaluating resident needs, supervising other staff and in training volunteers.
Use of Volunteers
12.30 Each assisted living residence shall encourage participation of volunteers in resident engagement opportunities. All such volunteers shall be supervised and directed by the administrator or staff member primarily responsible for resident engagement.
Physical Space and Equipment:
12.31 Each assisted living residence shall have sufficient physical space to accommodate both indoor and outdoor resident engagement. Such accommodations shall include, at a minimum:
12.32 Each assisted living residence shall provide sufficient recreational equipment and supplies to meet the needs of the resident engagement program. Special equipment and supplies necessary to accommodate persons with special needs shall be made available as appropriate. When not in use, recreational equipment and supplies shall be stored in such a way that they do not create a safety hazard.
12.33 Each assisted living residence shall ensure that staff who accompany residents away from the assisted living residence have ready access to the pertinent personal information of those residents in the event of an emergency.