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From the desk of Andrea 

The current staffing turnover and retention rates in skilled nursing homes and assisted living facilities, as well as the previous focus on infection control surveys has contributed to regulatory oversight during the COVID-19 pandemic. Immediate Jeopardy tags are on the rise, with an increasing number related to inappropriate use of slings. Factors to consider include appropriate sling size, documentation of sling size on the service/care plan and specific instruction easily available to ULP and CNAs. Additional consideration should consist of adequate supply and how the condition of a sling is determined for replacement.  

Manufacturers have instruction and sizing charts available. It is recommended to keep these laminated and attached to the lift for easy reference and to verify appropriate sling size is in use. Routine audits should be conducted to ensure appropriate size selection and to ensure care/service plan matches the currently used sling. As a reminder, ensure equipment is cleaned thoroughly between resident rooms. While infection control remains a focal point in healthcare surveys, this is a reminder to shift the focus towards resident safety, which encompasses both clinical operation and infection prevention. 


Andrea Raeker
Director of Administration
Senior Care Solutions


From the desk of Naomi…

We are still seeing a lot of the usual corrections orders such as TB, orientation, training, service plan, documentation.  But here are some of the newer trends we are seeing with the new regulations.

144G.40 Subd. 2 Uniform checklist disclosure of services

Not providing a UDALSA- Make sure you are providing your residents a copy of the UDALSA and keeping receipt of doing so. Also, ensure you have a policy related to obtaining written acknowledgement of the UDALSA from all residents prior to the execution of the assisted living contract.

144G.41 Subdivision 1 Minimum requirements

Lack of posting a daily staffing schedule- Ensure your schedule is posted daily and that there is a policy reflecting this process.

144G.45 Subd. 2 (a) (1) Fire protection and physical environment

Make sure you are reading the regulations based on your facility.  We are seeing many smoke alarms not working when tested. Batteries chirping.  And smoke alarms not being interconnected where they should be.  

Fire extinguishers mounted in the correct areas. 

Ensure you have evacuation maps posted.

And ensure all employees receive training on the fire safety and evacuation plans upon hiring and at least twice per year thereafter.


Keep up the great work out there everyone!

Naomi Evans, VP of Clinical Services

Senior Care Solutions


From the desk of Naomi…

One thing I have learned over the years is that to be a successful leader, you must lead by example. What are some of the qualities that you appreciate in a leader that you have admired and respected? One thing that stands out to me from one of my previous supervisors came during the dreaded annual survey. Every facility I had worked at previously followed the same protocol. Survey enters, everyone freaks out, word spreads like wildfire, everyone starts checking residents, removes equipment from hallways, leaders start making rounds and answering call lights. But in this case, something different occurred. The Director of Nursing was notified, she calmly replied, “Ok, thanks!”. She did not panic, she did not freak out, she did not oddly go out and make rounds that she never normally does, and she did not start barking orders at everyone. She told everyone to do what they always do…the right thing for our residents. She had faith that she had taught and led the team to do the right thing EVERY day, not just in front of a surveyor’s eyes. The part that stands out to me is that even thought my heart was racing, seeing her calm demeanor helped ME to remain calm. I knew I had done what I needed to do, and I was confident when answering questions and providing documents requested. I learned a lot from the surveyor, instead of fearing them. We had a perfect survey that year.

Over my leadership career I have often had co-workers and other leaders tell me how much they appreciate my calm demeanor and my level-head. Although I do not always actually feel that way, I have learned how important it is to lead by example. I do not want MY team to freak out and be afraid. Therefore, I must remain calm and steady. Even when I am panicked inside, I know that projecting that energy onto my team will not help anyone. Watch what happens when you can remain confident and strong in front of your team. They see you. They watch you. You are their example. Speak greatness into them, and they will do a great job for you in their role.

For your Consulting, Training and Supplemental Staffing needs, visit our website at


Naomi Fluck, RN

Vice President of Clinical Services

Senior Care Solutions, Inc.

Cell: 651-271-9938




From the desk of Naomi…

Staffing Tidbits for the new AL Regulations

All assisted living facilities must have a clinical nurse supervisor who is a registered nurse licensed in Minnesota. The positions of both the assisted living director and the clinical nurse supervisor may be held by the same individual if the individual holds both licenses.

The staffing plan must be evaluated at least twice per year and include sufficient staffing at all times to meet the scheduled and reasonably foreseeable needs of each resident

A facility may not accept a person as a resident unless the facility has staff, sufficient in qualifications, competency, and numbers, to adequately provide the services agreed to in the assisted living contract.

Under the statute it does NOT give staff ratios that the facility must follow. They must be able to satisfy the requirement to meet the scheduled and reasonably foreseeable needs of each resident.

The statute dictates certain duties that must be completed by the RN:

  • Resident assessments
  • Delegation of nursing tasks
  • Training and competency testing of unlicensed personnel
  • Be available for consultation to staff performing delegated nursing tasks (either in person, by telephone, or by other means)
  • Supervision of staff based on statute requirements in 144G.62 Subd. 4
  • Certain policy development

For your Consulting, Training and Supplemental Staffing needs, visit our website at


Naomi Fluck, RN

Vice President of Clinical Services

Senior Care Solutions, Inc.

Cell: 651-271-9938



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