Specialty Care Assisted Living Facilities - Alabama Department of ...

Specialty Care Assisted Living Facilities Chapter 420-5-20
performed by a physician so long as that function is within the nurse practitioner’s or
physician assistant’s scope of practice. A nurse practitioner or physician's assistant shall not
serve as the medical director of a specialty care assisted living facility.
(2) Health Supervision.
(a) Observation. Each specialty care assisted living facility shall provide general
observation and health supervision of the residents to the extent of being aware of changes in
health and physical abilities, noting the need for medical attention, nursing services or
changes in personal care and assistance with activities of daily living provided by the facility
and for arranging or assisting the residents to obtain such services.
(b) An RN shall consult with the administrator on all issues of resident safety and
health and well being.
(c) Assessment. The RN shall perform a comprehensive assessment of each
resident upon admission, when a significant change in health status or behavior occurs, and
when the monthly assessment identifies a problem in any of the following areas:
1. Weight loss:
(i)
resident.
Each month, the facility shall accurately weigh and record the weight of each
(ii) A comprehensive assessment and plan of care is required when a resident
experiences a significant unplanned weight loss.
(iii) A significant weight loss is defined as a 5% or greater weight loss in a period
of one month or less, or a 7.5% or greater weight loss in a period of three months or less, or a
10% or greater weight loss in a period of six months or less. Any weight loss shall be
considered to be an unplanned weight loss unless the affected resident has been placed on a
restricted calorie diet specifically for the purpose of reducing the resident's weight, and such
diet has been approved by the resident's attending physician.
2. Falls.
3. Elopements (a cognitively impaired resident exits a secure perimeter without
immediate and appropriate staff intervention).
4. Behavioral symptoms.
5. Adverse reactions to prescribed medications, or circumstances which
contraindicate medications that have been prescribed for the resident.
28