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Assisted Living Facilities Must Not Expose Residents to Unnecessary Risks of Harm

Posted in Elder Issues, Levels of Care, Nursing Home Information

In New Jersey, Assisted Living encompasses providing various coordinated supportive personal and health services, available 24 hours per day, to residents who need those services. Its purpose is to promote resident self-direction and participation in decisions, with an emphasis on independence, individuality, privacy, dignity, and homelike surroundings.

And thus, corporations that operate Assisted Living Facilities (ALF) must provide, at a minimum, services for:

  • Nursing
  • Recreation
  • Medical Transportation
  • Personal Care
  • Social Work
  • Activities
  • Housekeeping
  • Dining
  • Pharmacy

Indeed, ALFs and our nursing-home lawyers know that potential residents have the right to live in an ALF that does not admit more residents than it can safely accommodate while providing those services and other care. And for persons who currently live in an ALF, the corporations operating the ALFs know that those residents have the right to receive care and services at a level that addresses the residents’ changing physical and psychosocial status.

Developing and Implementing an Appropriate Therapy Regimen

Naturally, in order to safely accommodate residents, an ALF must develop and implement appropriate therapy regimens for residents that have medically unstable conditions or special health problems, because it knows that failing to do so exposes that person to an unnecessary risk of harm.

For example, if an ALF admits a person that has dementia, it should have specifically designed units to safely accommodate that person’s special needs. It should also have specially trained staff that is skilled in addressing the needs associated with cognitive impairments.

In the cases that our nursing-home lawyers litigate, experts from the ALF industry will testify that an ALF has deviated from the standard of care if it has failed to develop and implement an appropriate therapy regimen. Corporations that operate ALFs and our nursing-home lawyers know that under those circumstances, a resident may unnecessarily suffer catastrophic harm.

Some ALFs Do Not Have Sufficient Resources to Safely Care for Residents

In general, ALFs must not admit persons who cannot respond to the environment, express volition, interact with others, or demonstrate independent activity. That is because those individuals require a higher level of care that many ALFs cannot safely provide. Consequently, corporations that operate ALFs know that a resident’s continued stay in its ALF may expose the resident to an unnecessary risk of harm if that resident:

  • Requires 24-hour, seven day a week nursing supervision;
  • Remains in bed (bedridden) for more than 14 consecutive days;
  • Consistently depends on total assistance with four or more of the following activities of daily living (ADL): dressing, bathing, toilet use, transfer, locomotion, bed mobility, or eating;
  • Has a cognitive decline that prevents making simple decisions regarding ADLs and cannot respond appropriately to cueing and simple directions;
  • Requires treatment for stage III or IV pressure ulcers or multiple stage III pressure ulcers;
  • Requires more than assistance with transfer; or
  • Endangers their safety or others’ safety.

The standard of care requires that ALFs identify all individuals who exhibit any of those issues. Once identified, the corporation operating the ALF must evaluate whether it can safely care for the resident and either: (1) develop and implement an appropriate therapy regimen; or—as is routinely the central issue in cases that Stark & Stark prosecutes—(2) discharge the resident to a capable and resource enhanced long-term care facility to receive the appropriate care and treatment.

The ALF admission agreement or contract must clearly specify whether it will retain residents with one or more characteristics described above and to what extent; and, if applicable, at what additional cost.