Assisted Living communities face big challenges — and potential lawsuits — when it comes to taking care of their residents. The May/June issue of Assisted Living Executive, a stellar publication from the Assisted Living Federation of America (http://www.alfa.org/), featured a fascinating article on clinical care documentation in the “Compliance Corner” section. Attorney Robert J. Lightfoot (who is also a registered nurse) shared with readers the extreme importance of detailed record-keeping on the part of AL (assisted living) providers (specifically in terms of service delivery) to prevent “litigious situations” that can easily occur in the ever-changing world of assisted living.

This constantly shifting landscape has two main drivers: regulatory changes and rising acuity levels. Prospective and current assisted living dwellers have more complex needs: on the menu, co-morbidities, chronic diseases, and behavioral challenges, to name a few. And, according to Lightfoot, the previously accepted “social model” has evolved into a model whereassisted living communities are called upon to provide higher levels of care to meet the diverse array of clinical needs presented, both pre- and post-admission.

Regulations notwithstanding (and in each state, they may be restrictive, relaxed, or even non-existent), Lightfoot boils it down to two clinical issues that are most deserving of assisted living providers’ attention: fall prevention and medication management. When it comes to minimizing those “litigious situations,” these are the two to watch. No matter what their diagnoses may be, almost everyassisted living resident is at risk of falling at some point during their stay (and for any number of health or environmental reasons), and most (if not all) residents are on some type of medication upon admission. Therefore, thorough assessments and proactive, resident-focused care plans (all of which must be kept in the books with meticulous, yet germane details) are a surefire way to “combat negative resident outcomes associated with [these] common adverse clinical events,” says Lightfoot.

Lightfoot highlights another “emerging care issue” in the newassisted living world: nurse delegation, wherein communities need to be concerned about medication administration, treatment recommendations, and the clear allocation/subsequent monitoring and supervision of care giving tasks to various staff members — all of which require that meticulous documentation mentioned earlier.

The moral of the story: Assisted living providers, keep all your ducks in a row when it comes to policies, procedures, training, and regulatory compliance. And hope that those “litigious situations” never cross the threshold of your assisted living community.

-Michelle Seitzer