ALF Regulatory Compliance and Laws 3 — Questions and Answers
Question 1: A resident with capacity refuses her prescribed medication. Legally, the ALF staff should:
- Hide the medication in her food
- Document the refusal and notify the appropriate parties per policy (Correct answer)
- Threaten discharge unless she complies
- Administer the medication anyway for her safety
Correct answer: Document the refusal and notify the appropriate parties per policy
Residents with decision-making capacity have the legal right to refuse treatment, and staff must document and communicate the refusal.
Question 2: Which action would most likely constitute an illegal involuntary discharge from an ALF?
- Discharging a resident whose needs exceed the facility's licensed level of care
- Transferring a resident for nonpayment after proper notice
- Relocating residents during a declared emergency evacuation
- Evicting a resident without required written notice and cause (Correct answer)
Correct answer: Evicting a resident without required written notice and cause
Most states require written notice, permissible cause, and a specified notice period before an involuntary discharge.
Question 3: Under most state regulations, how must an ALF handle a resident's personal funds held by the facility?
- Keep them in a separate account with accurate records, not commingled with facility funds (Correct answer)
- Deposit them into the facility's operating account
- Invest them to earn revenue for the facility
- Hold them as cash in the administrator's office safe
Correct answer: Keep them in a separate account with accurate records, not commingled with facility funds
Resident trust funds must be safeguarded, separately accounted for, and never commingled with facility operating funds.
Question 4: An employee reports unsafe staffing levels to the state licensing agency and is then fired. This most likely violates:
- The Stark Law
- The False Claims Act's qui tam provisions only
- Whistleblower retaliation protections (Correct answer)
- Zoning ordinances
Correct answer: Whistleblower retaliation protections
State and federal whistleblower laws prohibit retaliating against employees who report regulatory violations in good faith.
Question 5: Which requirement is most commonly imposed by state law before an ALF may hire a direct-care employee?
- A minimum of a bachelor's degree
- A criminal background check and abuse registry screening (Correct answer)
- Proof of U.S. citizenship by birth
- Five years of prior ALF experience
Correct answer: A criminal background check and abuse registry screening
States generally require background checks and screening against abuse or exploitation registries before direct-care staff can work with vulnerable adults.
Question 6: A facility's license is up for renewal, but it has an uncorrected life-safety deficiency. The most likely regulatory outcome is:
- A provisional or conditional license pending correction (Correct answer)
- Automatic renewal with no conditions
- Immediate criminal charges against all staff
- Transfer of the license to another operator
Correct answer: A provisional or conditional license pending correction
Agencies commonly issue provisional or conditional licenses that require correction of outstanding deficiencies within a set timeframe.
Question 7: Under the Americans with Disabilities Act, an ALF acting as a public accommodation must:
- Hire only staff with disabilities
- Provide free transportation to all residents
- Exempt itself from fire codes
- Remove architectural barriers where readily achievable (Correct answer)
Correct answer: Remove architectural barriers where readily achievable
The ADA requires public accommodations to remove barriers to access when doing so is readily achievable.
ALF Regulatory Compliance and Laws 3
A resident with capacity refuses her prescribed medication.
Legally, the ALF staff should: