481-69.26(4) Individualized Service Plans

Finishing up with the service plan rules for assisted living tenants is the individualized service plan requirements at 481-69.26(4). Each tenant’s service plan must be individualized and indicate:

• Identified needs and individualized preferences for assistance with those needs.
• Services that are provided in accordance with the occupancy agreement.
• Who is providing that service if it is someone other than the program.
• If tenants have dementia and are unable to plan their own activities, a list of person-centered planned and spontaneous activities must be identified that meets the tenant’s abilities and interests.
• Preferences if any on nursing facility care, if that need should present itself during occupancy at the assisted living.

Service plans continue to be the most cited regulatory insufficiency (RI) in assisted living programs. As you can see with these rules, some are very straight forward such as preferences for nursing facility care and planned and spontaneous activities if the person has dementia. To ensure that you’re compliant with these rules, I would encourage you to automatically include these in your service plan template. This will prevent you from randomly forgetting to include these. If the person doesn’t have dementia, you could indicate not applicable under the planned and spontaneous activities section or delete it if you’re able to do that with your template.

The subjective rules can also be included in the template, and you could identify if they’re necessary. For example, under the identified needs you could include a list of activities of daily living and then indicate if the tenant needs assistance, what assistance level is needed, the frequency, and who provides the service. This would help provide clues on not forgetting each ADL. Similarly, you could outline in the template the services that are identified in your occupancy agreement and just individualize each service plan based on the individual tenants needs.