ASSISTED LIVING POLICY MANUAL

WAIVER CONSULTING GROUP SAMPLE INSTRUMENT – ASSISTED LIVING POLICY & PROCEDURE

AL8019 - Medication Storage AL8020 - Medication Disposal and Destruction AL8021 - Resident's Own Medication Log AL8022 - Tapering of Medications AL8023 - Residents' Use of Herbals and "Natural" Remedies AL8049 - Medication Management Program Section 09 - Nutritional Services ALF9001 - Nutritional Services ALF9002 - Menus ALF9003 - Therapeutic Diets ALF9004 - Resident Meal Rounds ALF9005 - Food From Non-Facility Sources ALF9006 - General Requirements - Food Supply ALF9007 - Food Storage ALF9008 - Refrigerator/Freezer Temperature Check Sheet ALF9009 - Food Temperatures

Section 10 - Performance Improvement AL10001 - Organizational Performance Improvement Plan AL10034 - Assisted Living Staff Development PI Outcome Evaluation AL10026 - Assisted Living Resident Safety PI Monitoring and Evaluation Plan AL10027 - Assisted Living Resident Safety PI Trending Sheet AL10028 - Assisted Living Resident Safety PI Outcome Evaluation AL10029 - Assisted Living Social Service PI Monitoring and Evaluation Plan

AL10030 - Assisted Living Social Service PI Trending Sheet AL10031 - Assisted Living Social Service PI Outcome Evaluation AL10032 - Assisted Living Staff Development PI Monitoring and Evaluation Plan AL10033 - Assisted Living Staff Development PI Trending Sheet AL10035 - Reduce the Risk of Influenza and Pneumococcal Disease - PI Outcome Monitoring AL10024 - Assisted Living Environmental Services PI Trending Sheet AL10036 - PI Outcome Monitoring - Prevent Healthcare-Associated Pressure Ulcers (Decubitus Ulcers) AL10037 - PI Outcome Monitoring - Reduce the Risk of Patient/Resident Harm Resulting from Falls AL10038 - Assisted Living Facility PI Volume Measures/Statistics

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