1 Coordinate your admission visit with the facility's RN Coordinator (RNC) and the resident(s). Many are part-time employees who may be unavailable unless you call ahead to schedule an appointment.

2 The RNC has a long-term relationship with the resident and is aware of problems and concerns that may be unknown to you. Integrate this information in the assessment and OASIS.

3 Work with the RNC to ensure services are not duplicated. Facility staff members are available for activities of daily living and may vary in competency and training. Do not assume the assisted living staff are competent to perform at the same level as a certified home health aide.

4 Thoroughly evaluate homebound status-by definition most residents in an assisted living facility are not homebound due to outings, bus rides, etc.

5 Recognize the RNC is the person to communicate changes to the facility staff. The RNC delegates duties to the staff in accordance with the Nurse Practice Act.

6 Recognize Medicare will not pay for assisted living services. Most assisted living facilities are not Medicare certified and cannot bill either Medicare or Medicaid for skilled services. It is illegal for an assisted living facility to bill privately for services eligible under Medicare or Medical Assistance.

7 Communicate planned interventions, treatments, and visit frequency with the center's RNC in writing. Dietary changes, medication regimens, mobility restrictions, and treatment needs such as daily weights and blood pressures should also be documented in writing.

8 Recognize residents in an assisted living facility may not be accurate historians.

9 Keep the RNC abreast of discharge plans so there is no lapse in needed care. When you discharge a client, his or her responsibilities change.

10 Assisted living facilities must follow their own specific regulations and may need copies of your orders for their charts.