                                 CODE OF VIRGINIA

SAFE, SECURE ENVIRONMENTS FOR RESIDENTS WITH SERIOUS COGNITIVE IMPAIRMENTS (§
63.2-1802)

A. Assisted living facilities may provide safe, secure environments for
residents with serious cognitive impairments due to a primary psychiatric
diagnosis of dementia if they comply with the Board&#8217;s regulations
governing such placement. The Board&#8217;s regulations shall define (i) serious
cognitive impairment, which shall include, but not be limited to, an assessment
by a clinical psychologist licensed to practice in the Commonwealth or by a
physician and (ii) safe, secure environment.

B. Prior to placing a resident with a serious cognitive impairment due to a
primary psychiatric diagnosis of dementia in a safe, secure environment, an
assisted living facility shall obtain the written approval of one of the
following persons, in the specified order of priority: (i) the resident, if
capable of making an informed decision; (ii) a guardian or legal representative
for the resident; however, such an appointment shall not be required in order
that written approval may be obtained; (iii) a relative authorized pursuant to
the Board&#8217;s regulations to act as the resident&#8217;s representative; or
(iv) an independent physician who is skilled and knowledgeable in the diagnosis
and treatment of dementia, if a guardian, legal representative or relative is
unavailable. Such written approval shall be retained in the resident&#8217;s
file.

C. The Board of Social Services shall amend 22VAC40-73-1130 governing staffing
of units of assisted living facilities with residents who have serious cognitive
impairment due to a primary psychiatric diagnosis of dementia and are unable to
recognize danger or protect their own safety and welfare to require that the
following number of direct care staff members be awake and on duty and
responsible for the care and supervision of the residents at all times during
night hours:

   1. When 22 or fewer residents are present, at least two direct care staff
   members;

   2. When 23 to 32 residents are present, at least three direct care staff
   members;

   3. When 33 to 40 residents are present, at least four direct care staff
   members; and

   4. When more than 40 residents are present, at least four direct care staff
   members plus at least one additional direct care staff member for every 10
   residents or portion thereof in excess of 40 residents.
   				Nothing in this subsection shall apply to the provisions of
   22VAC40-73-280.

HISTORY: Code 1950, § 63-223; 1954, c. 259; 1968, c. 578, § 63.1-174; 1973, c.
227; 1991, c. 532; 1993, cc. 957, 993; 1995, c. 649; 1997, c. 397; 2000, cc.
804, 808, 845; 2001, c. 161; 2002, cc. 332, 747; 2003, c. 467; 2019, cc. 97,
294.