CALA News & Views | Issue 46 | Relationships

Assisting Executive Directors in Meeting Challenges with LPAs CALA asked former LPA Edna Musoke, residential care program educator and compliance consultant with CareerSmart , to provide her insight. When asked what advice she can provide to Assisted Living professionals who encounter challenges with LPAs, she says it is extremely important to connect, communicate, and collaborate with their assigned LPA. “If there is a potential issue that may arise, the Licensee/Administrator/Executive Director should research the matter. When sufficient information has been gathered, they should communicate with the LPA and seek direction. If the LPA is not available, contact the Licensing Program Manager (LPM), or the duty officer of the day who are available Monday through Friday, 8:00am to 5:00pm.” “For example, if there is a disgruntled employee, the facility representatives should discuss that with the LPA so if a complaint is filed by the employee, the LPA will be aware of it which may help during the investigation. Facility representatives should always be professional, even when there is a disagreement between them and the analyst.” Expected Challenges There are a number of challenges that licensees, administrators and executive directors can expect to encounter in their positions. Musoke offers this advice for these specific challenges: • Licensees/Administrators/Executive Directors or their designated substitutes, need to know what they are cited for during any inspection. They should review the regulation sections from Title 22 Division 6 Chapter 8 or the Health and Safety Code sections (i.e., 1569 and their subsections), to determine whether the LPA is citing under correct regulations. Or, whether the LPA is citing for something that is not citable. If there is a discrepancy, the facility representatives should reach out to the LPM to discuss the issue and resolve it during the visit. Otherwise, the facility representative will have to pursue the appeal process with the Regional Manager, which may take a while to be resolved. In addition, the facility representative should avoid appealing citations when they know that the facility was at fault. • Licensees/Administrators/Executive Directors may have residents’ representatives direct them not to call 911 in certain cases. However, the facility representatives need to know when the emergency personnel must be called, despite the representatives’ wishes. This is because the facility must abide by Community Care Licensing Division’s (CCLD) requirements. • Facility representatives should clearly show the topics for staff training, the number of hours completed, and the individual who is qualified to perform the training. “This will save a lot of time for the LPA, because the LPA will not have to calculate the hours,” explains Musoke. “In addition, if the LPA asks for staff and resident records, all records for staff and residents that the LPA identifies should be provided for review. If some of the documents are in different locations, retrieve them so that a complete set of records will be provided to the LPA to avoid citations for incomplete records.” She adds that if any resident receives care from either a home health agency or hospice agency, the facility representatives must ensure that those agencies leave documentation after each visit to indicate what was performed for that resident. In addition, the staff should know what health services those agencies are performing for the residents. “Medications are another area where facilities tend to get cited. All Licensees/Administrators/Executive Directors should be familiar with the Technical Support Program (TSP) and they can access it at https://www.cdss.ca.gov/ inforesources/community-care/resource-guide-for-providers . The TSP has valuable information regarding Hospice Care for RCFEs, Pressure Injuries, Medications Guide for RCFEs and RCFE Self Assessment Guides. “These tools can be used to train staff and to help them prepare for LPA inspections.” She also stresses the importance of being proactive.

Edna Musoke is a Residential Care Program Educator and Compliance Consultant at CareerSmart in Brea, California. CareerSmart provides Continuing Education Units and Caregiver Training.

14 CALIFORNIA ASSISTED LIVING ASSOCIATION