Minn. R. 4659.0150 - UNIFORM ASSESSMENT TOOL
Subpart
1.
Definition. For purposes of this part "Uniform
Assessment Tool" means an assessment tool that meets the requirements of this
part and is used by a licensee to comprehensively evaluate a residents or
prospective residents physical and cognitive needs.
Subp. 2
Assessment tool
elements. Each facility must develop a uniform assessment tool. The
facility may use any acceptable form or format for the tool, such as an online
or a hard-copy paper assessment tool, as long as the tool includes the elements
identified in this subpart. A uniform assessment tool must address the
following:
A. the residents personal lifestyle
preferences, including:
(1) sleep schedule,
dietary and social needs, leisure activities, and any other customary routine
that is important to the residents quality of life;
(2) spiritual and cultural preferences;
and
(3) advance health care
directives and end-of-life preferences, including whether a person has or wants
to seek a "do not resuscitate" order and "do not attempt resuscitation order"
or "physician/provider orders for life sustaining treatment"
order;
B. activities of
daily living, including:
(1) toileting
pattern, bowel, and bladder control;
(2) dressing, grooming, bathing, and personal
hygiene;
(3) mobility, including
ambulation, transfers, and assistive devices; and
(4) eating, dental status, oral care, and
assistive devices and dentures, if applicable;
C. independent activities of daily living,
including:
(1) ability to self manage
medications;
(2) housework and
laundry; and
(3)
transportation;
D.
physical health status, including:
(1) a
review of relevant health history and current health conditions including
medical and nursing diagnoses;
(2)
allergies and sensitivities related to medication, seasonality, environment,
and food and if any of the allergies or sensitivities are life
threatening;
(3) infectious
conditions;
(4) a review of
medications according to Minnesota Statutes, section
144G.71,
subdivision 2, including prescriptions, over-the-counter medications, and
supplements, and for each:
(a) the reason
taken;
(b) any side effects,
contraindications, allergic or adverse reactions, and actions to address these
issues;
(c) dosage;
(d) frequency of use;
(e) route administered or taken;
(f) any difficulties the resident faces in
taking the medication;
(g) whether
the resident self administers the medication;
(h) the residents preferences in how to take
medication;
(i) interventions
needed in management of medications to prevent diversion of medication by the
resident or others who may have access to the medications; and
(j) provide instructions to the resident and
residents legal or designated representatives on interventions to manage the
residents medications and prevent diversion of medications;
(5) a review of medical,
dental, and emergency room visits in the past 12 months, including visits to a
primary health care provider, hospitalizations, surgeries, and care from a
postacute care facility;
(6) a
review of any reports from a physical therapist, occupational therapist, speech
therapist, or cognitive evaluations within the last 12 months;
(7) weight; and .
(8) initial vital signs if indicated by
health conditions or medications;
E. emotional and mental health conditions,
including:
(1) review of history of and any
diagnoses of mood disorders including depression, anxiety, bipolar disorder,
and thought or behavioral disorders;
(2) current symptoms of mental health
conditions and behavioral expressions of concerns; and
(3) effective medication treatment and
nonmedication interventions;
F. cognition, including:
(1) review of any neurocognitive evaluations
and diagnoses; and
(2) current
memory, orientation, confusion, and decision-making status and
ability;
G. communication
and sensory capabilities, including:
(1)
hearing;
(2) vision;
(3) speech;
(4) assistive communication and sensory
devices including hearing aids; and
(5) the ability to understand and be
understood;
H. pain,
including:
(1) location, frequency, intensity,
and duration; and
(2) effectiveness
of medication and nonmedication alternatives;
I. skin conditions;
J. nutritional and hydration status and
preferences;
K. list of treatments,
including type, frequency, and level of assistance needed;
L. nursing needs, including potential to
receive nursing-delegated services;
M. risk indicators, including:
(1) risk for falls including history of
falls;
(2) emergency evacuation
ability;
(3) complex medication
regimen;
(4) risk for dehydration
including history of urinary tract infections and current fluid intake
pattern;
(5) risk for emotional or
psychological distress due to personal losses;
(6) unsuccessful prior placements;
(7) elopement risk including history or
previous elopements;
(8) smoking,
including the ability to smoke without causing bums or injury to the resident
or others or damage to property; and
(9) alcohol and drug use, including the
residents alcohol use or drug use not prescribed by a
physician;
N. who has
decision-making authority for the resident, including:
(1) the presence of any advance health care
directive or other legal document that establishes a substitute decision maker;
and
(2) the scope of
decision-making authority of a substitute decision maker under subitem (1);
and
O. the need for
follow-up referrals for additional medical or cognitive care by health
professionals.
Subp. 3.
Record keeping. Assessment tool results, including those from an
assessment supplement, must be maintained in the residents record as required
under Minnesota Statutes, section
144G.43.
Subp. 4.
Licensee attestation.
An applicant for an assisted living facility license or a licensee renewing an
assisted living facility license must attest to the commissioner in a manner
determined by the commissioner that the uniform assessment tool used by the
applicant or licensee complies with this part.
Subp. 5.
Department access to uniform
assessment tool. At the time of a survey, investigation, or other
licensing activity, the licensee must provide the department access to or copy
of the uniform assessment tool as required under Minnesota Statutes, section
144G.30,
subdivision 4, to verify the compliance with this part.
Notes
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No prior version found.