Assisted Living Facilities

Consumer's Guide 

OTHER ISSUES 
Bed Hold Policies: Most facilities don't have specific bed hold policies if the resident leaves the assisted living facility for personal reasons or must recuperate in a hospital or nursing home for an extended period of time. The facility will simply expect the basic daily rate to be paid or expect the resident to terminate the contract if he or she doesn't want to be responsible for the bill. It is a good idea to question the facility about this situation and to find out if in fact some reduced fee is allowed in that situation. 

Transfer of the Resident: Most contracts do not provide that the resident is contracting for a specific room. This does allow discretion to management to transfer the resident, perhaps involuntarily. However, this can be a matter of negotiation between the resident and the management. If the facility wants to maintain the resident's occupancy they should be reasonably accommodating to the resident's comfort and desires. 

A more frequent issue of transfer is involved when a different level of care is required for the resident. This frequently results in greater expense to the resident. Who should decide if a change in the level of care is necessary? Virginia regulations require that anytime a person's health needs change a new assessment of the resident by the UAI must be conducted. Again, the UAI must lead to an appropriate plan of care. If a request is made to transfer the resident to a part of the facility that can better provide for the residents health and care the resident may have to agree to the change. But the decision must be made on objective criteria and not based upon subjective reasons or out of convenience to the facility. 


Do Not Resuscitate (DNR) Orders: Assisted living facilities are not licensed as health care facilities. Regulations of DNRs in medical facilities do not apply to assisted living facilities. However, by statute the management of assisted living facilities can issue instructions to employees who have been trained in CPR. If a resident has a valid DNR, CPR-certified employees may be instructed that they are not required to resuscitate the resident in the event of cardiac or respiratory arrest. This however requires staff to readily identify those residents who have a valid DNR order. The resident needs to wear their DNR bracelets, identifying them as holding a DNR order. 



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