Alzheimers Assisted Living

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Alzheimers Assisted Living

• Department of Medical Assistance Services
• 2006

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Alzheimers Assisted Living Waiver

• Purpose
• The waiver will allow people to
• Remain in a home-like setting for as long as
  possible
• Remain in an environment that maximizes their
  autonomy, privacy, and dignity, even if they
  require a high level of services
•  

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Alzheimers Assisted Living Waiver

• Recipient Qualifying Criteria

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Alzheimers Assisted Living Waiver

• 1. An individual must have a Alzheimers or
  Alzheimer's related Dementia diagnosed by a
  licensed clinical psychologist or a licensed
  physician. The individual must not have a
  diagnosis of mental retardation as defined by the
  American Association on Mental Retardation or a
  serious mental illness as defined in 42 CFR
  483.102(b)

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Alzheimers Assisted Living Waiver

• Related Dementia means a diagnosis of Dementia of
  the Alzheimers Type as defined by the Diagnostic
  and Statistical Manual of Mental Disorders.

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Alzheimers Assisted Living Waiver

• Recipient must also
• 2. Be receiving an Auxiliary Grant
• 3. Be 55 years old and
• 4. Meet nursing facility criteria for placement
  through the use of the full Uniform Assessment
  Instrument (UAI)

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Alzheimers Assisted Living Waiver

• Meeting Nursing Facility Criteria Means
• The individuals functional capacity as
  documented on the UAI is described by one of the
  following
• Rated dependent in 4 or more of seven ADLs (page
  4 of the UAI)

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Alzheimers Assisted Living Waiver

• Rated dependent in 2-4 ADLS and semi-dependent or
  dependent in Behavior and Orientation and
  semi-dependent in Joint Motion or semi-dependent
  in Medication administration
• Rated dependent in 5-7 ADLs and also dependent in
  Mobility
• Rated semi-dependent in 2-7 ADLs and dependent in
  Mobility and Behavior and Orientation.

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Alzheimers Assisted Living Waiver

• Provider Application Process

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Alzheimers Assisted Living Waiver Request an
Application from DMAS

• By Phone [phone]
• By Fax [phone]
• By Mail
• Department of Medical Assistance Services
• Division of Long Term Care
• Facilities and Home Based Services Unit
• Alzheimers Assisted Living Waiver
• Provider Application
• 600 East Broad Street Suite 1300
• Richmond, Virginia 23219

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Alzheimers Assisted Living Waiver

• Minimum Requirements
• Be a licensed Assisted Living Facility through
  DSS (submit copy of license)
• Have a DMAS provider agreement
• Solvency, record retention, freedom of choice for
  recipients, follow HIPAA guidelines, etc.

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Alzheimers Assisted Living Waiver

• Providers will submit a self-assessment package
  to DMAS for review. Key Elements
• Licensure verification
• Physical plant compliance (security system,
  limited access windows, etc.)
• Policy Procedures
• Staff training
• Activity schedules
• DMAS will conduct an onsite review of the
  facility prior to becoming a provider or within 6
  months of the first admission.

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Alzheimers Assisted Living Waiver

• Verification of other regulatory compliance
• (copies of current certificates must be
  submitted)
• Has a valid license with DSS for operating an
  assisted living facility safe and secure unit.
• Meets all VDSS safe and secure guidelines
• Restaurant certification for kitchen
• Fire Marshal approval
• All staff have and passed the criminal record
  check
• All staff has the correct credentials and staff
  training (per VDSS safe and secure license)

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Alzheimers Assisted Living Waiver

• Policies and Procedures
• (policies must be submitted for review)
• All staff meet education and skill criteria
• Administrator
• Registered Nurse
• Licensed Practical Nurse
• Unit Coordinator
• Activities staff

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Alzheimers Assisted Living Waiver

• Staff training provided by professional with
  expertise in Alzheimer's related Dementia
• One month staff schedule for the facility
• Activities will be developed coordinated and
  implemented by activities staff
• (MINIMUM OF 19 hours of group and 1 hour of one
  to one a week) (One month sample)

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Alzheimers Assisted Living Waiver

• All assessments and plans of care
• Initial and ongoing staff training
• Emergency plans for resident behavior problems
• Review staff schedule for compliance for awake
  staff coverage
• Guidelines for admission to the safe secure
  unit
• All the residents meet the criteria of the
  Alzheimers waiver

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Alzheimers Assisted Living Waiver

• Physical Plant
• Secure alarm system to building or unit
• Bedrooms provided have no more than 2 residents
  per room
• Windows cannot be used as exit by residents
• There is a secure outside area available to
  residents
• There is an interior walking area
• General interior is free of any items that may
  place resident at risk

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Alzheimers Assisted Living Waiver

• Monthly nurses summary
• Resident plan of care / ISP (annual and
  quarterly)
• Daily Census Log
• Validation that resident is 55 years in age

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Alzheimers Assisted Living Waiver

• Reimbursement Rate 50.00 per day per enrolled
  recipient
• Billing code T2031

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Contact Information

• Facility and Home-Based Services Unit
• Long-Term Care Quality Assurance Division
• Department of Medical Assistance Services
• 600 East Broad Street, 10th Floor
• Richmond, Virginia 23219
• Telephone [phone]
• Fax [phone]