Confident Choices for Senior Living - LeadingAge Minnesota

Confident Choices for Senior Living

Application Instructions

Thank you for considering the Confident Choices for Senior Living designation.

LeadingAge Minnesota’s Confident Choices for Senior Living program is designed to:
 improve quality in Housing-with-Services settings, including those with assisted
living programs;
 increase public trust and consumer confidence; and,
 inform consumer decision-making.

Confident Choices can help consumers identify the housing providers that best meet
their needs. In addition, Confident Choices will help you celebrate and market what you
do. Over time, this review process and the information gathered may also positively
affect public perception and advocacy efforts.

These instructions are intended to explain the application process for the Confident
Choices program and to provide details for each section so that you may effectively
complete your application with ease.

PROCESS

Applications, along with a non-refundable fee, are accepted by LeadingAge
Minnesota at any time. The fee structure—which covers the costs associated with the
application process and review—is as follows:

Member Fee:
 The fee for first-time member applications is $150
 The fee for renewal member applications is $75.00
 If an applicant is not approved and re-applies within one year, the re-application
fee is $65.00

Non-Member Fee (HWS establishments not members of LeadingAge Minnesota):
 The fee for first-time non-member applications is $300.00.
 The fee for renewal non-member applications is $250.00
 If a non-member applicant is not approved and re-applies within one year, the
re-application fee is $200.00

LeadingAge Minnesota staff will review applications for completeness and will contact
applicants if there are any questions or missing information. Once the written application
is complete, either LeadingAge Minnesota staff or a member serving as the Confident
Choices District Coordinator will identify two trained Site Reviewers to complete the final
part of the application process—the site visit. Before the reviewers are formally
assigned, staff will check with the applicant to see if there are any known conflicts of

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interest regarding the two reviewers. If an applicant has any concerns about a reviewer,
LeadingAge Minnesota will identify another reviwer to take that person’s place.

One of the assigned Site Reviewers will take the lead in the site visit and will contact
you to schedule a date and time for the visit that is mutually convenient. These
volunteer reviewers are senior housing professionals who have been trained in the
Confident Choices requirements, screened for conflicts of interest regarding your
building and have signed statements of confidentiality.

Depending on the electives you select in your application, the Site Reviewers may ask
you to have some documentation available when they visit your building. We anticipate
the visit to take 1-2 hours, depending on the size of your building and the scope of your
submitted application.

The Site Reviewers completing the site visit will complete a form based on their
observations and will return that form with their recommendations to LeadingAge
Minnesota staff. LeadingAge Minnesota staff will then notify you whether your site will
be awarded the Confident Choices designation. If the reviewers do not recommend
approval of the Confident Choices designation for your building, you will be informed of
the reason(s) and what steps you can take to meet the Confident Choices standards
should you choose to re-apply in the future. Sometimes following the site visit,
applicants are asked to submit additional information before the designation can be
approved, and in these situations, LeadingAge Minnesota staff will contact you.

If you are awarded the Confident Choices designation, LeadingAge Minnesota will
provide you with a packet that includes marketing materials, such as a press release
and promotional ideas as well as a Confident Choices plaque that you can display. The
designation is valid for two years. Designees will be notified prior to the expiration of
their Confident Choices designation that it is time to renew. Should you choose not to
renew, the plaque must be returned and any use of the Confident Choices seal on
marketing or other materials must end.

Important: In order to be considered for Confident Choices, your building
must be registered as a Housing-with-Services establishment Each building
that is registered with the Minnesota Department of Health must apply separately for
the Confident Choices designation.

If the Housing-with-Services Contract Act applies to your building but you have not yet
completed this registration with the Minnesota Department of Health, go to
http://www.health.state.mn.us/ and register with MDH before submitting the
application.

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At this time, skilled nursing facilities or any other type of operation that is not eligible
for Housing-with-Services registration is not being eligible for the Confident Choices
program.

Demographic Section

Please provide us with the basic information noted on the application. If you have
multiple buildings on your campus or within your operation, each building that is
registered as housing-with-services must submit a separate application for the
Confident Choices designation. If you have chosen to register several of your buildings
under one Housing-with-Services registration, then you only need to complete one
Confident Choices application. Please call Mary Youle at LeadingAge Minnesota,
651.645.4545 if you have questions about this requirement.

Important Tips for Completing Your Application

 Be clear when describing how you meet the core and elective requirements. You
can attach additional paper if needed to supplement your application, but please
do not send in supporting documents unless the application form specifically
requests them. Supporting documents can be reviewed on-site by the Site
Reviewers if necessary.

 Some of your programs or systems may fit more than one application
requirement. Please note that you cannot use the same example to meet two
different requirements.

 The application should be completed by staff that work at that building and are
knowledgeable about the unique programs and services available there. We
encourage you to fill out the application with your management team to be sure
that your application reflects all the good programs you offer. Consider the
application process as a team-building exercise.

 During the site visit, please have staff available who are familiar with the
Confident Choices application and who can answer questions about the programs
and services described in the application.

 Although applicants are required to address only nine elective requirements, we
encourage you to address additional electives as “insurance” of a successful
application.

CORE REQUIREMENTS

The application has two parts, Core Requirements and Elective Requirements. In order
for your application to be considered, you must meet each of the Core Requirements
and at least nine of the Elective Requirements.

Ethical Conduct – Core Requirement

Requirement: Applicant must have adopted the LeadingAge Minnesota’s Code of
Ethics within the previous 2 years (or a national Code of Ethics or other equivalent). In
order to meet this requirement, your Code of Ethics (or appropriate alternative) must

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be current. LeadingAge Minnesota's Code of Ethics must be renewed every two
years, and applicants must send LeadingAge Minnesota a copy of the resolution
adopting the Code of Ethics. The Code of Ethics may be adopted by a large
organization for all of its sites and programs, or may be adopted separately for each
site—whatever works best for your organization. If you are unsure whether your site is
covered by a current resolution adopting LeadingAge Minnesota’s Code of Ethics,
contact Alecia Crumpler at LeadingAge Minnesota, 651-645-4545. If your Code has
lapsed, you will need to complete the paperwork to renew your Code before completing
the Confident Choices application. If you are not an LeadingAge Minnesota member or
have not completed the Code of Ethics process, and have an alternative process, please
provide a description of that the ethical considerations it addresses, such as integrity
and fairness, honesty and confidentiality; good communication and disclosure of
important consumer information; competent, well-trained employees; and a focus on
maximizing independence, autonomy and dignity for the people being served.

Experienced Leadership – Core Requirement

Requirement: For new Confident Choices applicants, the On-Site Housing Manager
must have at least one year of experience in the field of older adult housing and
services and must demonstrate a commitment to ongoing training and professional
development in the field of older adult services by obtaining at least 10 CEUs
(continuing education unit hours) per year. Each organization uses different job titles.
For the purposes of this application, the On-Site Housing Manager is defined as the
person responsible for the day-to-day operations of the housing-with-services building
that has applied for the Confident Choices designation.

If your manager is new to the position of housing manager and does not meet the
requirement of at least one year of experience in older adult housings, then wait until
he or she has had at least one year of experience before submitting the application. We
encourage managers with limited experience to participate in LeadingAge Minnesota’s
comprehensive Housing Manager Certificate program, our other certificate programs
and other educational programs. Documentation of the manager's ongoing training may
be reviewed during the site visit portion of the application process.

Consumer Satisfaction – Core Requirement

Requirement: Applicants must have conducted a resident (or family/responsible person)
satisfaction survey within the previous year.

At this time you will not be evaluated on your response rate, satisfaction score, or
follow through on items noted. Through the application or site visit process, you may be
asked to show the survey and results. You may use action plans or improvement plans
developed as a result of your satisfaction survey to fulfill Elective requirements included
in the application. During the on-site visit, reviewers will be looking for “best practices”
that can be shared with others, such as a successful change you made as a result of
feedback from your satisfaction survey.

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Consumer Information – Core Requirement

Requirement: The applicant must:
1. Have an operational process for welcoming and orienting new residents (and
their families/responsible person as applicable),
2. Have a current Resident Handbook or equivalent document with written
information for residents and their families; and
3. Demonstrate how the building communicates its “house rules” and other policies
and procedures (e.g. use of building equipment, emergency plans, personal
conduct, etc.) to residents (and their families/responsible person as applicable).

The content of the Resident Handbook will not be evaluated as a part of the applicant
review process. Please include the table of contents for your Resident Handbook as an
attachment to your application. (If your handbook does not have a table of contents,
please copy and attach at least 6 pages of the handbook to the application.)

Through the application or site visit process, you may be asked to show your resident
handbook. The Site Reviewers may ask you if you would be willing to share it or some
of its contents with other providers as a best practice.

Regulatory Compliance & Emergency Preparedness – Core
Requirement

Requirement: Applicants must sign a Statement of Compliance with applicable building
codes and licensing requirements and attestation that: (1) the applicant has
emergency/disaster preparedness and operational response plans for weather and other
emergencies; (2) employees and volunteers receive training on emergency/disaster
response plans during initial employee orientation (within 30 days of hire); (3) residents
receive training on emergency/disaster response plans annually (as appropriate to the
ability of each resident); (4) fire drills are conducted in accord with State Fire Code
requirements; (5) an annual emergency drill is conducted for weather or other non-fire
emergency; and, (6) the applicant is operating in compliance with any
operational/clinical requirements as dictated by its designation as a Housing-with-
Services establishment, its Assisted Living designation, and/or any other designation,
certification, or licensure status related to the applicant.

Note that even if a provider has had a survey finding related to home care services,
OSHA or other state requirements, as long as the provider is working to address the
issue, the provider can state that it is operating in compliance with applicable laws and
rules.

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Standards for Dementia Care – Core Requirement for Providers
with Dementia Care Programs or Units

You only need to complete this section if your HWS establishment provides a dementia
or memory care program of services as described under MN Statute 325F.72 and
144D.065.

Requirement: Applicant must follow currently recognized dementia care standards
(e.g. LeadingAge Minnesota's Guiding Principles for Dementia Care, guidelines published
by the national Alzheimer’s Association, or a comparable set of guidelines). Note that
the LeadingAge Minnesota's Guiding Principles must be adopted every 2 years by a
resolution of the governing board or owner(s).

If an applicant has chosen to follow guidelines other than LeadingAge Minnesota’s
Guiding Principles for Dementia Care, a brief description of the adopted guidelines must
be attached. In addition, applicants that qualify for this Core Requirement are required
to submit a copy of their Disclosures document as required under MN Statute 325F.72
and 144D.065.

Dementia Care providers must also submit a copy of the disclosures required in MN
Statutes 325F.72 and 144D.065 with their Confident Choices application. These
disclosures will provide the Site Reviewers with additional information about your
dementia care setting and program.

Core Requirements - Important: If your application does not address all of these
Core Requirements (six if you have dementia/memory care, five if you do not), your
application will not be processed. You will be notified if your submitted application does
not fulfill the Core Requirements and you will be given an opportunity to complete all
sections. If you application is complete except for a resolution adopting the Code of
Ethics or Guiding Principles for Dementia care, and a meeting has been scheduled for
that resolution to be passed, please explain when that remaining piece of information
will be submitted to LeadingAge Minnesota.

ELECTIVE REQUIREMENTS

You are required to meet at least nine (9) of the twenty-three (23) options for Elective
Requirements, and we encourage you to select more than nine Electives, if possible, to
provide extra “insurance” of having a successful application. The Electives have been
chosen so that all providers - small or large, with or without assisted living services,
rural or metro, stand-alone or multi-facility - have the capacity to achieve the Confident
Choices designation.

There are five categories of Electives and each category has multiple electives that you
may choose to address. To achieve the minimum requirement of nine Electives,
you may select Elective Elements from each of the categories as follows:

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 A: Quality of Care & Services (select at least 2 options)
 B: Open, Effective Communication (select 2 options)
 C: Resident Health, Wellness, and Life Enrichment (select 2 at least options)
 D: Employee Satisfaction & Development (select 2 at least options)
 Community Connectivity, Benevolence & Innovation (select at least 1 option)

In the application, identify the Electives Requirements you want to address and provide
a concise description of how your building meets that Elective. YOU DO NOT NEED TO
COMPLETE ALL Electives in each category – the minimum requirement is nine Electives.

During the application or site visit process, you may be asked to show more information
about how your program addresses the Electives you have chosen. And, you may be
asked if you would be willing to share identified best practices with other providers
through LeadingAge Minnesota.

A. Quality of Care & Services – Choose at least 2 of the Five
Electives in this Category

1. Clinical Performance Improvement Plans: To meet this elective, the
applicant must have evidence of regularly monitoring clinical outcomes within the
previous 12 months (such as falls, skin condition, hospitalizations, medication errors,
etc.) and using the information to implement process improvements to improve
residents' outcomes. Applicants can develop these clinical performance improvement
plans by using data available through a contracted resource (such as My InnerView) or
through their own internal process. Applicants are asked to:

 Provide examples of recent benchmarking project(s)
 Describe a new process or system(s) implemented as a result of benchmarking
 Describe the outcomes of these new processes or systems.

2. Non-Clinical Performance Improvement Plans: To meet this elective
requirement, an applicant must have evidence of regularly monitoring some
aspect of non-clinical operation and services and implementing process
improvements to enhance those outcomes. For example, applicants could
monitor items such as staff turnover/retention, complaint reduction, food
satisfaction, completion of maintenance tasks, etc., and use the feedback to
make changes in their systems. Applicants are asked to:

 Provide examples of recent performance improvement plans
 Describe the outcomes of completing these plans

3. Resident Transitions Coordination: To meet this elective requirement, an
applicant must have implemented systems or established relationships with other
providers to assure coordinated transitions for residents who may have a hospital or
nursing home stay and improve access to primary care providers (MD, NP, etc.).
Applicants are asked to describe how this elective requirement is met.

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4. Data Collection on Key Measures/Goals: To meet this elective requirement,
an applicant must have implemented a quality “dashboard” or system of key
measures/goals and must be collecting data to report progress toward meeting these
goals. Applicants are asked to describe how this elective requirement is met.

5. Involvement of Residents/Families/Responsible Parties in Improvement
Efforts: To meet this elective requirement, an applicant must demonstrate how
residents and/or families/responsible persons are involved in a Continuous Quality
Improvement (CQI) process. Applicants are asked to describe how this elective
requirement is met.

B. Open, Effective Communication - Address Both of the
Electives in this Category

1. Resident/Family/Responsible Party Meetings or Councils: To meet this
elective requirement, an applicant must regularly schedule resident/family/responsible
party meetings or councils to address resident input and concerns. Applicants are asked
to describe these meetings and some of the changes made as a result of the feedback
obtained.

2. Resident Communication System: To meet this elective requirement, an
applicant must have a system to regularly communicate with residents (newsletter,
internal TV channel, meetings, etc.). Applicants are asked to describe how this elective
requirement is met.

C. Resident Health, Wellness, and Life Enrichment - Choose at
least Two of the Six Electives in this Category

1. Resident Education/Learning: To meet this elective requirement, an
applicant must offer or facilitate resident education and learning enrichment programs
and experiences. Applicants are asked to describe how this elective requirement is met.

2. Referral Systems/Community Integration: To meet this elective requirement,
an applicant must have a system for referring residents to other providers
or agencies offering services that the applicant does not have available, and has
programs or ways to facilitate the integration of residents into the broader community
outside the building as appropriate. Applicants are asked to describe their system and
how it meets the needs of residents.

3. Resident Socialization and Recreation: To meet this elective requirement,
an applicant must provide opportunities for resident socialization and recreation both
within the building and, where appropriate to the residents’ needs, interests and
abilities, involving external programs or groups. Applicants are asked to describe how
this elective requirement is met.

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4. Fitness/Wellness Programs: To meet this elective requirement, an applicant
must offer or facilitate access to a fitness/wellness program(s) and take active steps to
encourage resident physical, mental, and spiritual wellness. Applicants are asked to
describe how this elective requirement is met.

5. Resident-Centered Technology: To meet this elective requirement, an
applicant must offer resident-centered technology that is available and used by
residents. Applicants are asked to describe any resident-centered technology in use
and how it has improved care and/or services to residents.

6. Resident Care Conferences: To meet this elective requirement, an applicant
must regularly schedule resident care conferences to address resident input and
concerns. Applicants are asked to describe these care conference meetings and some
of the changes made as a result of the feedback.

D. Employee Satisfaction & Development - Choose at least Two
of the Six Electives in this Category

1. Employee Satisfaction Survey: To meet this elective requirement, an
applicant must conduct an employee satisfaction survey within the last year that
receives a response rate of at least 50%, and must develop an action plan to address
any identified problems. Applicants are asked to describe how this elective requirement
is met.

2. Employee Education and Training: To meet this elective requirement, an
applicant must offer or have a system to make available ongoing education and training
opportunities for employees that go beyond the mandatory in-service training required
by regulatory authority. For example, the applicant employs individuals who have
obtained credentials beyond what is required for their position (e.g. the applicant has
supported an employee as they complete a certificate program, college degree, or
professional certificate/certification or enables employees to obtain other types of
continuing education). Applicants are asked to describe how this elective requirement is
met.

3. New Employee Orientation: To meet this elective requirement, an applicant
must have a formal employee orientation process that sufficiently prepares new
employees in the fulfillment of their jobs (e.g. employee handbook, copy of job
description, training on emergency plans, shadowing, etc.). Applicants are asked to
describe how this elective requirement is met.

4. Employee Recognition: To meet this elective requirement, an applicant must
have an ongoing program(s) to address team building, employee recognition, and/or
employee morale. Applicants are asked to describe how this elective requirement is
met.

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5. Employee Meetings: To meet this elective requirement, an applicant must
hold regularly scheduled employee meetings that provide opportunities for all
employees, including front-line staff, to identify issues and raise concerns. Applicants
are asked to describe how this elective requirement is met.

6. Exit Interviews: To meet this elective requirement, an applicant must conduct
exit interviews with departing employees to obtain feedback on successes, challenges,
opportunities for improvements, and suggestions to increase employee morale.
Applicants are asked to describe how this elective requirement is met.

E. Community Connectivity, Benevolence, and Innovation -
Choose at least One of the Four Electives in this Category

1. Social Accountability: To meet this elective requirement, an applicant must
implement a social accountability program(s) to demonstrate its commitment and
investment in the whole community (e.g. organizing employee or resident volunteer
work, school partnerships, work with civic groups, etc.). Applicants are asked to
describe how this elective requirement is met.

2. Resident/Employee Benevolence: To meet this elective requirement, an
applicant must have a benevolence fund established to assist residents or employees in
need. Applicants are asked to describe how this elective requirement is met.

3. Innovation: To meet this elective requirement, an applicant must have
implemented an innovative program, procedure, or physical plant design to enhance the
quality of services available to residents and/or to meet emerging needs. The
innovation may include small changes that have demonstrated improvements in
residents’ experience or quality of life. Applicants are asked to describe how this
elective requirement is met.

4. Volunteers: To meet this elective requirement, an applicant must make
effective use of volunteers to enhance community life and/or services for residents.
Applicants are asked to describe how this elective requirement is met.

Elective Requirements - Important: If your application does not address at least
nine of these Electives as directed in the instructions, it will not be considered. You will
be notified if this is the case and given an opportunity to meet the Elective
Requirements.

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If you have any questions regarding this application or the Confident Choices process,
contact Mary Youle at LeadingAge Minnesota, 651.645.4545 or
[email protected].

Thank you for considering Confident Choices!

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