August Health Co-Founder & Co-CEO Dr. Justin Schram recently hosted a Lunch and Learn in collaboration with the Florida Senior Living Association (FSLA). Justin's talk focused on alert charting and documentation in assisted living, with a particular focus on Florida regulations, including Rule 59A-36.007(1).
Check out the video above to watch the full webinar, or continue reading for some of the recording's highlights. Thanks to the entire FSLA staff, including Gail Matillo, Kristin Quirk, Katherine Upton, Monica Wilson, and Jimmie Griffin for their support in putting this on.
An Overview of Florida’s Rule 59A-36.007(1): Resident Care Standards - Supervision
Rule 59A-36 is a Florida Administrative Code that provides detailed regulations and guidelines for assisted living facilities. Rule 59A-36.007(1) covers resident care standards and supervision, with section (f) of the code outlining that assisted living facilities must “maintain a written record of any significant changes or any illnesses that resulted in medical attention.” For the purposes of alert charting and documentation, it’s essential that assisted living facilities in Florida are aware of this code and have existing systems and processes to document these instances when they occur.
Difficulties with existing systems for documentation: Justin's first-hand experience as a physician
Prior to founding August Health, Justin spent many years as a physician providing care to seniors in assisted living facilities. He was exposed to the many difficulties executive directors and clinical care teams face in responding to and documenting changes of resident condition given existing systems:
“Oftentimes the documentation is happening on paper across 100 charts with staff trying to figure out who had updates in their care plans, who had incidents, and whose condition was changing.” Experiencing this many times over, Justin knew there had to be a better way.
Justin’s simple approach to alert charting and documentation
In the Lunch and Learn, Justin outlines his six-step approach:
- Identify - staff are trained on when and how to trigger alert
- Mobilize - staff mobilize to take action when alert is triggered
- Monitor - staff monitor frequency outlined by the alert
- Intervene - if necessary, staff intervene with the resident
- Re-assess - staff determine if situation stabilizes or requires a transfer
- End Alert - if issue stops, staff end the alert and notify relevant care team members
For facilities, it’s key to build alignment around a common approach so all staff are aware of their responsibilities when there is a change of resident condition and an alert is triggered. And instead of documenting the change of condition on paper, Justin suggests adopting a digital system, like August Health’s modern EHR platform. Digital systems save staff time, improve compliance, and provide leadership visibility into how their residents are doing.
Simple alert charting in practice: Koelsch Communities transitions from paper to digital
Before implementing August Health, Koelsch Communities, which operates 42 communities across 15 states, used paper to manage its alert charting. As Justin notes in the Lunch and Learn, this paper system created many difficulties: it was onerous on staff, the team struggled to organize and filter the papers, and they didn’t have insight into trends. After implementing August Health to help them manage alert charting, Koelsch's approach was immediately simpler and more streamlined: staff time was saved, the data was easy to access and filter, and leadership had better visibility into how their residents were doing.