216 R.I. Code R. 216-RICR-40-10-2.5

Current through June 12, 2024

Section 216-RICR-40-10-2.5 - Alzheimer Dementia Special Care Unit/Program License Requirements

2.5.1Applicability

A. Any assisted living residence that offers to provide or provides services to residents with Alzheimer disease or other dementia by means of an Alzheimer Dementia/Special Care Unit/Program shall be required to meet all requirements of §§ 2.4 and 2.5 of this Part.

2.5.2Specific Requirements

A. A residence licensed at the "dementia care" level shall be licensed as an "F1 - M1" residence in accordance with the requirements of § 2.4.10(B) of this Part; and

B. Any assisted living residence which offers to provide or provides services to residents with Alzheimer disease or other dementia by means of an Alzheimer Dementia Special Care Unit/Program shall be required to disclose in writing the type of services provided.

C. The disclosure shall be made to the Department and to any person seeking placement in an Alzheimer Dementia Special Care Unit/Program of an assisted living residence.

D. The information disclosed shall explain the additional care that is provided in each of the following areas:

1. Philosophy: The Alzheimer Dementia Special Care Unit's/Program's written statement of its overall philosophy and mission which reflects the needs of residents afflicted with dementia;

2. Pre-Occupancy, Occupancy, and Termination of Residence: The process and criteria for occupancy, transfer or termination of residency from the unit;

3. Assessment, Service Planning amp; Implementation: The process used for assessment and establishing the plan of service and its implementation, including the method by which the plan of service evolves and is responsive to changes in condition;

4. Staffing Patterns amp; Training Ratios: Staff training and continuing education practices;

5. Physical Environment: The physical environment and design features appropriate to support the functioning of cognitively impaired adult residents;

6. Resident Activities: The frequency and types of resident activities;

7. Family Role in Providing Support and Services: The involvement in families and family support programs;

8. Program Costs: The cost of care and any additional fees, and the process used in the event that a resident can no longer afford the cost of care being provided.

E. The Department shall develop a standard disclosure form and shall review the information provided on the disclosure form by the assisted living residence to verify the accuracy of the information reported on it. Any significant changes in the information provided by the assisted living residence shall be reported to the Department at the time the changes are made.

F. Any residence that provides care for residents with Alzheimer disease or other dementia by means of an Alzheimer Dementia Special Care Unit/Program shall maintain written policies and procedures that detail specific services, including admission and discharge criteria, for residents and/or their responsible parties on the Unit/Program.

G. The Alzheimer Dementia Special Care Unit/Program shall operate and provide services to all residents of the unit/program in accordance with the prevailing community standard of care for residents with the particular needs and behaviors with dementia.

H. Staff assigned to provide direct care services to residents of the Alzheimer Dementia Special Care Unit/Program shall be a qualified licensed assisted living staff member as defined in § 2.3(A)(33) of this Part. Notwithstanding this requirement, staff hired before January 1, 2015, that are not qualified licensed assisted living staff members, may continue to provide direct care services to residents residing in existing Alzheimer Dementia Special Care Unit/Programs.

I. The Alzheimer Dementia Special Care Unit/Program shall have on staff, at a minimum, a registered nurse(s) with appropriate training and/or experience with dementia to manage and supervise all resident dementia-related health and behavioral issues. The nurse shall be on-site full-time (minimum of thirty-five (35) hours per week), and shall be available for consultation at all times.

J. Menus for the Alzheimer Dementia Special Care Unit/Program shall be developed under the direction of a nutritionist or registered dietician licensed by the Department.

K. All menus including alternate choices shall be planned at least one (1) week in advance, to meet the standards for nutritional care in accordance with Dietary Reference Intakes: The Essential Guide to Nutrient Requirements, incorporated above at § 2.2(A) of this Part, and to provide for a variety of foods, adjusted for seasonal changes, and reflecting the dietary preferences of residents.

1. Menus shall indicate nourishments available to residents between evening meal and bedtime.

2. Menus shall be posted in a conspicuous place in the dietary department and in resident areas.

3. Records of menus actually served shall be retained for thirty (30) days.

L. The Alzheimer Dementia Special Care Unit/Program shall provide a secure distinct living environment appropriate for the resident population. This requirement may include, but not be limited to, a locked unit, secured perimeter, or other mechanism to ensure resident safety and quality of life. The residence shall have elopement policies in place, specific to the Unit/Program.

M. Upon completion of the disclosures required pursuant to this section, a person who does not otherwise meet the requirements for the special care unit or program may choose to reside in the unit or area in accordance with § 23-17.4-16.

N. Staff Training - Dementia Care Level

1. The administrator shall ensure that all new employees who will assist residents with personal care at the dementia level of care receive at least four (4) hours of orientation and training in the areas listed below prior to beginning work alone in the assisted living residence, in addition to the areas stipulated in § 2.4.12(G) of this Part. Staff will be provided no less than twelve (12) hours of continued education in the following areas at intervals not to exceed twelve (12) months.

a. Understanding various dementias;

b. Communicating effectively with dementia residents;

c. Managing behaviors;

d. Elopement procedures for the Unit/Program;

e. Creating a safe environment for residents;

f. Medications commonly prescribed for resident residing in the unit/program and potential side effects.

2.5.3Emergency Power

A. The residence shall provide an emergency source of electrical power necessary to protect the health and safety of residents in the event the normal electrical supply is interrupted.

1. Such emergency power system shall supply power adequate at least for:

a. Lighting all means of egress; and

b. Equipment to maintain detection, alarm and extinguishing systems.

216 R.I. Code R. 216-RICR-40-10-2.5

Amended effective 7/3/2022
Amended effective 8/25/2022
Amended effective 3/18/2024