Delaware assisted living rules: what you must document about each resident

Who these rules cover

Chapter 3225 applies to every licensed assisted living facility in Delaware. Licensing and inspection sit with the Division of Health Care Quality inside the Department of Health and Social Services. Delaware licenses rest (residential) homes under a separate chapter, 3230, which this page does not cover.

The assessment: the UAI, done by an RN

Every facility must use the Uniform Assessment Instrument, a standardized tool developed by the Division. The glossary describes it as:

"A document setting forth standardized criteria developed by the Division to assess each resident's functional, cognitive, physical, medical, and psychosocial needs and status."16 Del. Admin. Code 3225-3.0

The timing is tight. The first assessment happens before the resident moves in:

"A resident seeking entrance shall have an initial UAI-based resident assessment completed by a registered nurse (RN) acting on behalf of the assisted living facility no more than 30 days prior to admission. In all cases, the assessment shall be completed prior to admission."16 Del. Admin. Code 3225-11.2

An RN reviews it within 30 days after admission and revises it if needed. The rule also says the assessment "shall be completed in conjunction with the resident", so the resident is a participant, not just a subject.¹

The separate interests and preferences instrument

This is the part that matters most for life-enrichment staff. Section 11.7 adds a second, distinct tool:

"The assisted living facility shall provide an instrument to assess interests, strengths, talents, skills and preferences of each resident within 30 days of admission to be used in activity planning."16 Del. Admin. Code 3225-11.7

Three things stand out. It applies to every resident, it has its own 30-day deadline, and its stated purpose is activity planning. The rule does not use the words "life history" or "social history", and it does not prescribe a format, so the design of the instrument is up to you. What it must capture is named: interests, strengths, talents, skills and preferences.

The service agreement

Delaware calls the care plan a service agreement. It is based on the UAI, signed by both parties, and completed "prior to or no later than the day of admission".² It must address a list of physical, medical and psychosocial services, including "psychosocial/emotional services including those related to memory impairment and other cognitive deficits."

The key sentence for person-centered documentation is 13.5:

"The service agreement shall be developed and followed for each resident consistent with that person's unique physical and psychosocial needs with recognition of his/her capabilities and preferences."16 Del. Admin. Code 3225-13.5

The agreement is reviewed when needs change and at least with each UAI, and a revised agreement is signed within 10 days of the assessment if one is indicated. It rests on "shared responsibility and resident choice", which is where Delaware's managed or negotiated risk agreements come in when a resident's preference carries risk.² Records must "document the implementation of the service agreement for each resident."⁷

Activities and social programming

The services section links activities to both assessment and background:

"The assisted living facility shall assess each resident and provide or arrange appropriate opportunities for social interaction and leisure activities which promote the physical and mental well-being of each resident, including facilitating access to spiritual activities consistent with the preferences and background of the resident."16 Del. Admin. Code 3225-12.7

Read with 11.7, the chain is clear: learn interests and preferences within 30 days, plan activities from them, and match spiritual activities to the resident's background.

Memory care: disclosure of your approach

Delaware does not license a separate dementia unit. Instead, any facility that offers "specialized care for residents with memory impairment" must disclose written policies to the Department and to anyone seeking that care.⁴ The disclosure must explain the additional care you provide in eleven areas, including:

• Assessment, care planning and implementation: how you assess and update the service agreement.
• Resident activities: "the frequency and types of resident activities".
• Family role in care: "the family involvement and family support programs".
• Psychosocial services: how you address mental health, behavior and social functioning needs.

Facilities serving people with Alzheimer's disease or other dementias must also give covered staff annual dementia-specific training, including communication and "the psychological, social, and physical needs of those persons".⁶

What surveyors tend to look for

Going only by what the rule text says to document, a reviewer can reasonably expect to find:

• A UAI dated before admission and completed by an RN, with an RN review within 30 days.
• A signed service agreement dated on or before the admission day.
• A completed interests, strengths, talents, skills and preferences instrument within 30 days, and some sign that it shaped the activity plan.
• For memory care, a written disclosure covering all eleven areas, kept current when anything significant changes.

Gathering interests and preferences well

A checkbox list of hobbies tells staff little. A few habits make the instrument useful:

• Ask open questions in the first two weeks. "Tell me about the work you did." "What did a good Saturday look like?" These surface talents a form never asks about.
• Include family, especially for residents with memory impairment. Delaware's own memory-care disclosure names the family role in care.
• Write down what brings comfort and what to avoid. A favorite hymn, a morning routine, a subject that upsets them. These are preferences too.
• Note spiritual background, since 12.7 ties spiritual activities to it.
• Revisit at each UAI update. Interests change after a move, an illness or a loss.

How Porchlight can help

Porchlight is a simple way to collect the interests and life-story material in the resident's own words. A resident taps one large button on a tablet, a life question is read aloud and shown in large type, and the answer is recorded and transcribed. There are 800+ human-written questions organized by life chapter; any question can be skipped, and nothing is scored. Staff can record profile facts, including topics to avoid, and get a "Know Your Resident" briefing with conversation starters and a printable life-story biography. Family get a private page to listen, reply, and add questions and photos. The UAI, the 11.7 instrument and compliance remain your responsibility; Porchlight helps you gather and keep the material they draw on.

Frequently asked questions

Does Delaware require assisted living facilities to document resident preferences?

Yes. 16 Del. Admin. Code 3225-11.7 requires an instrument that assesses each resident's interests, strengths, talents, skills and preferences within 30 days of admission, to be used in activity planning. Section 13.5 also requires the service agreement to recognize the resident's capabilities and preferences.

When must the Delaware UAI be completed?

A registered nurse completes the initial UAI-based assessment no more than 30 days before admission, and always before admission. An RN reviews it within 30 days after admission. Updates are required 30 days after admission, annually, and when there is a significant change in condition.

Is the interests instrument the same as the UAI?

No. The UAI is the Division's standardized assessment of functional, cognitive, physical, medical and psychosocial needs. Section 11.7 separately requires the facility to provide an instrument on interests, strengths, talents, skills and preferences within 30 days of admission.

Does Delaware require a life history or social history?

The rule does not use those words. It requires the interests and preferences instrument, a psychosocial assessment through the UAI, and spiritual activities consistent with the resident's preferences and background. Many facilities gather life history as part of meeting those requirements.

What does Delaware require for memory care in assisted living?

A facility that offers specialized care for memory impairment must disclose written policies to the Department and to prospective residents covering eleven areas, including assessment and care planning, resident activities, family role in care, and psychosocial services.