What The Law Expects from Assisted Living Centers and Home Health Providers
Pursuant to R.61-77 § 701, ” [s]ervices, treatment, and care relative to the needs of the patient… shall be provided in a safe, effective manner, coordinated among those responsible in the continuum of care [and] modified as warranted based on any changing needs of the patient. Such changes shall be reflected in the treatment plan. The physician… shall be notified when… there is a significant change in the patient’s clinical condition.” The same applies to nursing and therapeutic services.
R.61-77, § 901 requires that ” [a] comprehensive, patient-specific assessment shall be conducted at the time of admission for each patient… The assessment shall be used in making individual treatment decisions and shall meet the patient’s medical, nursing, rehabilitative, social, and discharge planning needs; reassessment shall be accomplished based upon change in the patient’s condition.” Further, “[a] treatment plan shall be developed based on the interdisciplinary needs of the patient as determined by the assessment.”
Home Health Services are to include: “part-time or intermittent skilled nursing care; physical, occupational or speech therapy; home health aide services; medical supplies as indicated in the treatment plan, and the use of medical appliances, to include durable medical equipment.”
South Carolina Department of Health and Environmental Control (DHEC) Regulation 61-84, Standards for Licensing Community Residential Care Facilities, is the applicable South Carolina regulation governing assisted living facilities in this State. Some are classified by DHEC as an “Alzheimer’s special care unit or program.” DHEC defines this as “a facility or area within a facility providing a secure, segregated special program or unit for residents with a diagnosis of probably Alzheimer’s Disease and/or related dementia…and that advertises, markets, or otherwise promotes the facility as providing specialized care/services for persons with Alzheimer’s disease and/or related dementia or both.”
Pursuant to DHEC regulations, this includes a facility that “offers or represents to the public that it offers a beneficial or protected environment specifically for individuals who have mental illness or disabilities.” Franke was required, pursuant to R.61-84 § 401, to have in place “policies and procedures addressing each section” of R.61-84. Furthermore, the policies and procedures are required to “address the provision of any special care offered by the facility which would include how the facility shall meet the specialized needs of the affected residents such as Alzheimer’s disease and/or related dementia.”
R.61-84 § 503 requires the facility to have persons “on duty at all times…and immediately accessible to all residents to whom…persons can report injuries, symptoms of illness, or emergencies, and who is responsible for assuring that appropriate action is taken promptly.”
Pursuant to R.61-84 § 1000, Rights and Assurances, the facility has to “comply with all current federal, state, and local laws and regulations concerning resident care, resident rights and protections, and privacy and disclosure requirements, e.g., Section 44-81-810, et seq., of the S.C. Code of Laws, 1976, as amended, Resident’s Bill of Rights, Alzheimer’s Special Care Disclosure Act, and the Omnibus Adult Protection Act Notice, Section 43-35-5, et. seq.
Pursuant to §61.84, “[i]ndividuals seeking admission shall be identified as appropriate for the level of care, services, or assistance offered. The facility shall establish admission criteria that are consistently applied and comply with local, state, and federal laws and regulations… The facility shall admit and retain only those persons whose needs can be met by the accommodations and services provided.” Further, “[p]ersons not eligible for admission/retention are: [a]ny person who is likely to endanger him/herself or others… [a]ny person needing hospitalization or nursing home care, or… [a]nyone needing the continuous daily attention of a facility staff licensed nurse.”
Significantly, “[r]esidents whose condition changes to a degree that nursing home care or the daily attention of a nurse may be required… shall be examined… regarding the possible necessity for transfer to a facility where the resident’s eligibility for admission is appropriate.” Further, “[w]hen the provision of care/services in the facility… does not meet the needs of the resident, or if any resident becomes in need of continuous medical or nursing supervision… the resident shall be transferred.”