Current through Register Vol. 35, No. 18, September 24, 2024
An assisted living facility that provides a memory care unit
to serve residents with dementia shall comply with the provisions of subsection
A-J below in addition to the rules applicable to all assisted living
facilities, 8.370.14 NMAC.
A.
Additional definitions: The following definitions, in addition to
those in 8.370.14.7 NMAC, shall apply.
(1)
"Alzheimer's" means a brain disorder that destroys brain cells,
causing problems with memory, thinking and behavior that are severe enough to
affect work, lifelong hobbies or social life. Alzheimer's gets progressively
worse and is fatal.
(2)
"Care
coordination agreement requirement" means a written document that
outlines the care and services that are provided by other outside agencies for
assisted living residents that require additional care and services.
(3)
"Dementia" means loss of
memory and other mental abilities severe enough to interfere with daily life.
It is caused by changes in the brain.
(4)
"Memory care unit" means an
assisted living facility or part of or an assisted living facility that
provides added security, enhanced programming and staffing appropriate for
residents with a diagnosis of dementia, Alzheimer's disease or other related
disorders causing memory impairments and for residents whose functional needs
require a specialized program.
(5)
"Secured environment" means locked (secured/monitored)
doors/fences that restrict access to the public way for residents who require a
secure unit.
B.
Care coordination requirement. An assisted living facility that
accepts residents with memory issues shall determine which additional services
and care requirements are relevant to the resident and disease process.
(1) The medical diagnosis and ISP shall be
utilized in the determination of the need for additional services.
(2) The assisted living facility shall ensure
the coordination of services and shall have evidence of an agreement of care
coordination for all services provided in the facility by an outside health
care provider.
C.
Employee training: In addition to the training requirements for
all assisted living facilities, pursuant to 8.370.14.17 NMAC, all employees
assisting in providing care for memory unit residents shall have a minimum of
12 hours of training per year related to dementia, Alzheimer's disease, or
other pertinent information.
D.
Individual service plan (ISP): An assisted living facility that
admits memory care unit residents shall create an ISP in coordination with the
resident's primary care practitioner, in compliance with the requirements
outlined in "individual service plan," 8.370.14.26 NMAC, pursuant to a team
meeting as described in "exceptions to admission, readmission and retention,"
Subsection C of 8.370.14.20 NMAC, and which ensures the following criteria:
(1) identification of the resident's needs
specific to the memory care unit and the services that are provided; each
memory unit resident shall receive the services necessary to meet the
individual resident's needs;
(2)
medications shall be self-administered, self-administered with assistance by an
individual that has completed a state approved program in medication assistance
or administered by the following individuals:
(a) a physician;
(b) a physician extender (PA or
NP);
(c) a licensed nurse (RN or
LPN);
(d) the resident if their PCP
has approved it;
(e) family or
family designee; and
(f) any other
individual in accordance with applicable state and local laws.
E.
Assessments and
reevaluations:
(1) An assessment shall
be completed by a registered nurse or a physician extender within 15 days prior
to admission. When emergency placement is warranted the 15 day assessment shall
be waived and the assessment shall be completed within five days after
admission.
(a) The resident shall have a
medical evaluation and documentation by a physician, physician's assistant or a
nurse practitioner within six months of admission.
(b) The pre-admission assessment shall
include written findings, an evaluation of less restrictive alternatives and
the basis for the admission to the secured environment. The written
documentation shall include a diagnosis from the resident's PCP of Alzheimer's
disease or other dementia and the need for the resident to reside in a memory
care unit.
(c) Only those residents
who require a secured environment placement or whose needs can be met by the
facility, as determined by the assessment prior to admission or on review of
the individual service plan (ISP), shall be admitted.
(2) A reevaluation must be completed every
six months and when there is a significant change in the medical or physical
condition of the resident that warrants intervention or different care needs,
or when the resident becomes a danger to self or others, to determine whether
the resident's stay in the assisted living facility memory care unit is still
appropriate.
F.
Documentation in the resident's record: In addition to the
required documentation pursuant to 8.370.14.21 NMAC, the following information
shall be documented in the resident's record:
(1) the physician's diagnosis for admission
to a secure environment or a memory care unit;
(2) the pre admission assessment;
and
(3) the
reevaluation(s).
G.
Secured environment:
(1) Memory
care unit residents may require a secure environment for their safety. A
secured environment is any locked (secured/monitored) area in which doors and
fences restrict access to the public way. These include but are not limited to:
(a) double alarm systems;
(b) gates connected to the fire alarm;
and
(c) tab alarms for residents at
risk for elopement.
(2)
In addition to the interior common areas required by this rule, the facility
shall provide a safe and secure outdoor area for the year round use by the
residents.
(a) Fencing or other enclosures
shall prevent elopement and protect the safety and security of the
residents.
(b) Residents shall be
able to independently access the outdoor areas.
(3) Locked areas shall have an access code or
key which facility employees shall have available on their person or on the
locking unit itself at all times.
H.
Resident rights: In addition
to the requirements pursuant to 8.370.14.32 NMAC, the following shall apply:
(1) the resident's rights may be limited as
required by their condition and as identified in the ISP;
(2) the resident who believes that he or she
has been inappropriately admitted to the secured environment may request the
facility in contact the resident's legal guardian, or an advocate such as the
ombudsman or the primary care practitioner; upon request, the facility shall
assist the resident in making such contact.
I.
Disclosure to residents: A
facility that operates a secured environment shall disclose to the resident and
the resident's legal representative, if applicable and prior to the resident's
admission to the facility, that the facility operates a secured environment.
(1) The disclosure shall include information
about the types of resident diagnosis or behaviors that the facility provides
services for and for which the staff are trained to provide care for.
(2) The disclosure shall include information
about the care, services and the type of secured environment that the facility
and trained staff provide.
J.
Staffing: The facility shall
provide the sufficient number of trained staff members to meet the additional
needs of the residents in the secured environment. There must be at least one
trained staff member awake and in attendance in the secured environment at all
times.
