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Higher Acuity in Assisted Living

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Higher Acuity in Assisted Living

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This course will be discontinued effective October 1st, 2018. You will have until December 31st, 2018 to complete the course and print your certificate. The replacement course is located here.

This course is not approved by the California Department of Social Services (CDSS).

As a provider you know that acuity is on the rise. You have seen changes in the needs of your residents over the last five years. Residents are moving into your community at an older age, and further along in disease processes than in the past. This online course will explore the latest national data and trends on resident acuity as well as the first steps you should take to address higher acuity in your assisted living community.

Course Information:
  • Online Training Course
  • Credit Hours: 1
  • Latest National Trends in Resident Acuity Amongst Assisted Living Residents
  • Preparing an Organization/Community to Manage Higher Acuity Residents
Helpful Instructions
 Purchasing Courses for Yourself Purchasing Courses for Yourself:

This Training course is delivered 100% online through our Online Campus. In order to enroll you in a course we will need to collect your First Name, Last Name and Email Address.

When you place your order we will create an account for you, or add the courses to your existing account if you are a return customer. Access to the Online Campus is based on your email address. If you are a return customer, please purchase using the same email address used previously to avoid creating a duplicate account.

The course(s) you purchase will be available within 10 minutes of purchase and your login information will be sent to the email address you provide.
 Purchasing Courses for Others Purchasing Courses for Others:

This Training course is delivered 100% online through our Online Campus. If you are purchasing for others or your employees, please make sure to provide the First Name, Last Name, and Email Address of the person who you are purchasing for.

IMPORTANT: Access to the Online Campus is based on email addresses. If you are purchasing for multiple people, each person must have a unique email address to access the Online Campus. DO NOT USE THE SAME EMAIL ADDRESS FOR DIFFERENT INDIVIDUALS!

When you place your order we will create accounts for each individual you are purchasing for. If you are a return customer, please purchase using the same email address used previously to avoid creating duplicate accounts.

Example: Jim is buying a course for Bob. Jim will provide Bob’s First, Last and Email before the course is added to cart. Jim then uses his personal information for the checkout process.

We understand no one likes to give out their information and that’s why we only require the course attendee’s First Name, Last Name and Email to add the course to your shopping cart.

The course(s) you purchase will be available within 10 minutes of purchase and each person’s login information will be sent to the email address you provide.


Course Objectives

By the end of this course, the participant will be able to:

  • Describe the latest national trends in resident acuity amongst assisted living residents.
  • Describe factors that are contributing to rising acuity in assisted living.
  • Describe first steps in preparing an organization/community to manage higher acuity residents
  • Describe key considerations for staffing a community that retains higher acuity residents.

Course Outcomes

  • 1. Module 1: Our Residents are Changing
  • a. Acuity in assisted living continues to climb.
  • i. Resident of yesterday
  • ii. Resident of today
  • iii. Resident of tomorrow
  • b. More and more healthcare will be offered directly in the community rather than in hospitals.
  • c. Activity
  • 2. Module 2: How do we know?
  • a. Truth or just rumors – we’ve been talking about higher acuity for years.
  • b. 30% of states made changes to assisted living regulations last year.
  • i. 15 bills being considered in California that will have an impact on assisted living
  • ii. States are trying to keep up with the evolving care setting.
  • c. 37% of residents receive assistance with 3 or more activities of daily living
  • d. 50% of residents in assisted living have 3 or more chronic health conditions. Imagine combinations of the following conditions and how it impacts client care.
  • i. High blood pressure
  • ii. Alzheimer’s/dementia
  • iii. Heart disease
  • iv. Depression
  • v. Arthritis
  • vi. Osteoporosis
  • vii. Diabetes
  • viii. COPD
  • ix. History of cancer
  • x. Stroke
  • e. Chronic disease management has historically been very task centered and will take greater sophistication to offer better care as the care setting and care needs evolve.
  • f. Specialized care for dementia should be a model for the other chronic conditions which affect this aging population.
  • i. Staff training
  • ii. Environmental considerations
  • iii. Dementia policy manual
  • g. Nursing services
  • i. 94% of NCAL communities have a licensed nurse available to residents 24 hours/day
  • ii. RNs historically were not a part of an assisted living care team; now, 94% of ALs have an RN available to residents 24 hours/day.
  • h. Activity
  • 3. Module 3: why is acuity on the rise?
  • a. What is driving the rise in acuity in assisted living?
  • i. Consumer demand
  • 1. Consumers want to stay in their assisted living communities as they age.
  • 2. Consumers and families are overwhelmingly satisfied with the quality of care, staff, and quality of life.
  • ii. Provider capabilities
  • 1. Expanded care in response to what consumers ask for
  • iii. Healthcare reform
  • 1. Affordable Care Act (ACA aka Obamacare) has begun to change the way healthcare is delivered and paid for in the U.S.
  • 2. Attempts to push the delivery of healthcare out into the community.
  • 3. Reduce overall cost of delivering healthcare in our country by pushing the care out of hospitals.
  • 4. This group of people, the elderly in ALs, are heavy users of healthcare services.
  • b. ACA
  • i. Accountable Care Organizations
  • ii. Readmission penalties
  • iii. Driving healthcare out of the hospital – stay home to receive care as much as possible.
  • c. Question – if an AL wants an RN to come provide services, who is going to pay for it? Often, insurance doesn’t cover it and many residents cannot afford the out of pocket expense.
  • i. This is a dilemma that will have to be resolved as the system evolves.
  • d. Activity
  • 4. Module 4: making it work – what do we do about rising acuity? The first steps in successfully managing higher acuity for consumers and providers.
  • a. Balance risks and rewards of managing higher acuity
  • i. Risks
  • 1. Resources
  • a. Quality, well trained staff
  • b. Money.
  • 2. Quality
  • a. Good quality keeps the consumer and their family happy
  • b. Bad quality leads to loss of resident retention and lawsuits.
  • 3. Lawsuits
  • a. Costs can be astronomical
  • b. Can cause insurance rates to increase
  • c. Effects on resident and family directly.
  • ii. Rewards
  • 1. Affordability
  • 2. Satisfaction
  • 3. Occupancy
  • 4. Supply
  • iii. Resident of yesterday is now in independent living; nursing home resident of yesterday is now in assisted living.
  • b. Making higher acuity work
  • i. Acceptance is the first step
  • 1. The train has left the station
  • 2. Who are you going to accept and retain
  • 3. Who is it we are prepared to care for
  • 4. Consider the list of chronic conditions
  • ii. Get everyone on the same page
  • 1. Small or large business
  • 2. Everyone must understand the mission and vision from maintenance to marketing, from caregiver to corporate staff – especially nurses and marketers as they tend to butt heads.
  • iii. Let the regulations be your guide
  • 1. Follow the rules – some conditions are prohibitive such as California; Oregon has a nurse delegation component and will accept virtually everyone.
  • iv. Manage high risk concerns
  • 1. Falls – management program, response, and documentation
  • 2. Medication management
  • 3. Dementia care – wandering and elopement management and response
  • v. Staffing
  • vi. Technology
  • vii. Documentation and risk management
  • viii. Data/metrics
  • 5. Module 5: staffing for higher acuity
  • a. Online staffing tools
  • b. Use of unlicensed staff
  • c. AL is a different environment – physical layout can demand more staff
  • d. Universal workers vs. department specific
  • e. Training – state regulations are minimum standards
  • f. Promises delivered – be mindful of residents you have accepted into your community
  • g. Caregiver needs budget formula – discover the staff you need to meet the unique needs of your residents.
  • h. Activity
  • 6. Final Exam

Instructor: Josh Allen, RN, C-AL

Josh Allen is a Registered Nurse with over 20 years of experience in senior living. As the Director of InTouch at Home, Josh oversees all aspects of business development, care, services, and operations for the organization. As a part of the SRG Senior Living family of companies, InTouch at Home delivers personalized care and services to clients living in senior living communities as well as private residences across three states.

Josh also serves on the board of the American Assisted Living Nurses Association, and represents AALNA on the boards of the Center for Excellence in Assisted Living and Coalition of Geriatric Nursing Organizations. Josh has previously served as President and CEO of Care and Compliance Group, a leading training solutions provider.

Additional Information

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Course Type Online Course

Higher Acuity in Assisted Living