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Overview and Trends in Nevada’s Non-Medical Care
Bureau of Health Care Quality and Compliance- A Pro-Active Approach
currently serve as a member of the Assisted Living Advisory Council and
a consultant in the residential care/assisted living industry. My
background spans 35 + years as an active administrator, developer and
operator of these facilities.
For the past year, I have had
the privilege of being engaged as a consultant/liaison for the Bureau of
Health Care Quality and Compliance serving the dependant care provider
types. Part of this responsibility included working as a compliance
consultant for personal care agencies, homes for individual residential
care and residential care/assisted living facilities with the mission
of assisting them through the licensure process and expanding their
understanding of regulations of the state of Nevada. All of these
entities are important components of the long term care continuum.
Personal Care Agencies (PCA’s)
are non medical home care agencies providing personal care services in
the home or residence of individuals. The HCQC did a tremendous job
this past year licensing over 90 agencies with regulations that are
still waiting to be codified by LCB.
Homes for Individual
Residential Care are facilities that are licensed to care for 2 or fewer
residents in a home. Through legislative action these entities are
meeting increased criteria to protect the residents in their care. HCQC
again has ramped up the survey time for these entities for more frequent
Facilities/Assisted Living Facilities are those with 3-300 residents.
Recently they have been reeling with the implementation of the grading
system, “A,B,C,D”, during their surveys in 2009. The HCQC has
experienced an increasing workload to bring facilities up to grade as
additional surveys have been conducted to assure compliance.
What have been the positive trends?
I personally have observed
increased accountability, better outcomes for the residents in the
facilities and increased interest in compliance among many providers.
Provider support and education has been beneficial.
The HCQC has offered workshops
in the north and south on the following topics:
Preparing for survey-
“The Big 3”- top regulatory
“Medication Management or
“Rap With The Regulator”
To date, over 1000 providers
have participated in these educational opportunities and the response to
these workshops has been exceptionally positive, with the most common
comment being an appreciation for better understanding of regulations
Follow-up technical support has
been given to PCA, HIRC and RCF/AL providers post survey for those with
issues or lower grades at their request or at the direction of HCQC.
Over 70 facilities have accessed that support.
The increased reporting
requirement by HCQC to other regulatory authorities such as the Board of
Examiners for Long Term Care Administrators (BELTCA) has expanded the
disciplinary result for the licensed administrators of those facilities.
The posting of survey results,
for all entities licensed by the HCQC, on the Health Division website
has increased public knowledge of the survey process and anxiety among
providers to have better survey results.
What are the current issues and those of the
The report card/grading system
for RCF/AL will require another year to properly evaluate the benefits
or detriments of the program.
Owners of facilities or parent
corporations need to understand the importance of the regulatory
requirements and compliance issues as well as dedicated staff resources
to correcting deficient practices.
Administrators licensed by
BELTCA need to remain aware of their responsibilities and liability and
Regulations will need to be
expanded, changed and modified to reflect challenges and trends in the
evolution of the models of long term care services.