Assessments Versus Monitoring: What’s the Difference?

With the implementation of the new assisted living requirements on Aug. 1, organizations are attempting to work out their policies and processes related to assessments and ongoing review and monitoring. A comprehensive assessment, with the items listed as required in the uniform assessment tool, must be offered to all residents moving into an assisted living. The resident has the option to refuse this assessment. If the resident refuses the assessment, the organization should document this refusal.

For residents who choose to participate in a nursing assessment and subsequently receive services based upon that assessment, follow-up assessment or monitoring can be done based on the type of services the resident receives. If the resident receives only services listed if 144G.08 subdv. 9 (1) – (5), monitoring can be done instead of an assessment. Monitoring does not need to be completed by the RN and can be completed by an LPN; an RN must complete the pre-admission assessment. The schedule will be:

• Pre-admission assessment
• A 30-day initial review
• Ongoing monitoring and review as needed but no less than every 90-days moving forward. 

The pre-admission assessment must be a comprehensive assessment with all required components of the uniform assessment tool. The content of ongoing monitoring and review is not addressed in rules or regulations. Organizations may create a monitoring and ongoing review document of their own. This is not required to include all areas listed for the uniform assessment tool. Focusing on the areas of assistance the resident receives and whether these are meeting resident needs is a good place to start. If your organization utilized a shorter 90-day assessment under the comprehensive home care license, reviewing that tool and revising if needed would be acceptable.

For residents receiving nursing services over and above what is listed in the above statute citation, assessments by an RN are required. The schedule for these assessments will be:

• Pre-admission assessment
• 14-day assessment, completed by an RN
• Ongoing assessment by an RN as needed but no less than every 90-days moving forward.

In this instance, all assessments, pre-admission, 14-day and ongoing assessments, must include all of the required elements required in the uniform assessment tool according to Minnesota rules. For a listing of what's needed in the uniform assessment tool, you could reference this document or the proposed rules listed on the MDH Assisted Living Draft Tools website.

If you have questions about resident assessment or monitoring for assisted living residents, please contact Kari Everson.

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