What’s happening: In late August, DSS issued proposed fast-track changes the Standards for Licensed Assisted Living Facilities addressing involuntary discharge of assisted living facilities (ALF) residents.

• VCAL has determined that the regulations should be shifted to the normal regulatory promulgation process because ALFs need more information about the new appeals process and the role of the Division of Appeals and Fair Hearings
• The proposed regulations do not provide any details or timelines about the formal appeals process, therefore more time is needed for DSS to develop and publish those pertinent details for proper review and comment from stakeholders.
• DSS must receive comments from 10 or more persons by September 27 to stop the fast-track process or else the changes will take effect on November 27, 2023.

How to submit comments: VHCA-VCAL is asking members to submit comments online via the Virginia Regulatory Town Hall by September 27, 2023.

• Commentors should specifically object to the use of the fast-track process to indicate the nature of, and reason for, your objection to using this process.

Why it matters: A key component of the new regulations is the appeals process. The proposed regulations do not provide enough detail for ALFs to know what the newly created “Division of Appeals and Fair Hearing” process for appeals will require, such as when a resident may have filed an appeal, the documentation required to be submitted to the Division and the timeframe for response to such requests, as well as the timelines DSS will use for conducting an appeal hearing and providing the notice of findings to the resident and facility.

• This lack of specificity also raises concerns about how ALFs will handle situations, that are not considered an emergency discharge, when a resident must be discharged because the facility is unable to meet the resident’s care needs and/or how services will be provided in situations of non-payment.

For context: These changes provide ALFs and residents with the requirements for involuntary discharge situations and create a discharge appeal process should one be needed.

• This action is intended to expand protections and offer clarification for facilities and residents.
• The changes would add a definition of involuntary discharge, terms and conditions for an involuntary discharge, and an appeal process for ALF residents to appeal certain discharge decisions should they choose to do so, which is a remedy that did not previously exist.

• VHCA-VCAL worked with the bill patron on amendments to the bill and has been awaiting the publication of the regulatory text.

Other action for facilities: VHCA-VCAL recommends ALFs review the proposed changes and begin planning how to update your policies and procedures, including:

• needed updates to admission documents;
• proper notification and documentation of the discharge process; and
• staff training needs on the new requirements.

If you have questions or comments on the regulations, email April Payne.