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Text Box: Wendy Simons




Overview and Trends in Nevada’s Non-Medical Care
Bureau of Health Care Quality and Compliance- A Pro-Active Approach



   I 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 monitoring.


   Residential Care 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- “Report Card

·        “The Big 3”- top regulatory issues

·        “Medication Management or Mismanagement”

·        “HIRC regulations explained”

·        “Rap With The Regulator”

·        “PCA regulations”


   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 and expectations.


   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 future?


·        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 increasing accountability.

·        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.



Wendy Simons



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