Oklahoma assisted living center rules: what you must document about each resident

Oklahoma's assisted living chapter is short on detail about activities and care planning, and this page is shorter as a result. What it does require is specific: a Department-designated assessment, completed on a clear clock, built on a conversation with the resident.

Who these rules cover

The Oklahoma State Department of Health licenses assisted living centers and continuum of care facilities under Title 310, Chapter 663 of the Oklahoma Administrative Code. The same chapter applies to both; this page focuses on the assisted living center rules. Centers must also comply with several statutes the chapter lists, including the Alzheimer's Disease Special Care Disclosure Act.¹

Two assessments, two clocks

Each assisted living center shall use the admission and comprehensive assessment designated by the Department.OAC 310:663-5-1

The admission assessment is done within 30 days before, or at the time of, admission. It is mostly clinical: identification, diagnoses and infections, mental health history, physical functioning (including how many people are needed to help with ADLs), incontinence, medications, special treatments, and cognitive function.¹

The comprehensive assessment follows on this schedule:

(1) within fourteen (14) days after admission of the resident; (2) once every twelve (12) months thereafter; and (3) promptly after a significant change in the resident's condition.OAC 310:663-5-2(b)

It covers twelve areas. Most are clinical: physical and mental functional status, diagnoses, nutrition, medications, devices, treatments, skin, sensory impairments and medical history. Two are about the person: item 3, "customary routine," and item 10, "psychosocial status."¹

What "customary routine" means on the Department's form

The rule does not define the term. The Department publishes a Recommended Assisted Living Resident Assessment Form, and its customary routine section asks about sleep habits and hours, where the resident takes meals, bathing ("Prefers bath / Prefers shower / Preferred schedule"), usual time to rise, usual bedtime, and naps. Its psychosocial section asks about communication, usual mood, history of mood disorder or behaviors, and whether family and friends are involved.²

So Oklahoma asks you to write down daily routine and bathing preferences, and whether the resident has family and friends in their life. It does not ask for hobbies, work history, faith or a life story.

The personal interview

The assisted living center shall ensure that each comprehensive assessment includes a personal interview between the resident and the person completing the form. If the resident is mentally impaired, the assisted living center shall include in the interview at least one (1) of the persons listed in (d) (2) and (d) (3) of this section.OAC 310:663-5-4(c)

The persons listed in (d)(2) and (d)(3) are the resident's personal physician and the resident's representative. In practice, for a resident with dementia, that usually means bringing a family member into the conversation. Assessments are coordinated and signed by a registered nurse or the resident's physician and kept for five years.¹

The care plan

The assessment has two stated uses: to decide whether placement is appropriate, and

to develop a care plan for the resident, in consultation with the resident.OAC 310:663-5-5

The chapter does not give the care plan its own deadline or content list. It does define a significant change as one that "requires interdisciplinary review and/or revision of the care plan," so the plan is expected to be revisited when that happens.¹ A related rule sets the tone for how care is delivered:

An assisted living center shall ensure that routines of care provision and service delivery are directed by the resident to the maximum extent possible.OAC 310:663-3-1(b)

That sentence is the practical reason to learn a resident's customary routine well. You cannot let the resident direct their routine if no one wrote it down.

Activities and social programming

Oklahoma does not set activity hours or a calendar rule for assisted living centers. Each center must describe, in its license application and resident service contract, the services it provides, including "planned programs for socialization, activities and exercise."¹ Staff who provide socialization, activity and exercise services must be "qualified by training."

Dementia and specialized units

There is no separate dementia-unit subchapter in 310:663. The rules require a center to describe "any specialized service or unit for residents with Alzheimer's disease and related dementias" that it intends to market, to train staff in specialized units "to meet the specialized needs of residents," and to comply with the Alzheimer's Disease Special Care Disclosure Act (63 O.S. 1-879.2a et seq.). We have not quoted the Act here; see the statute for its disclosure requirements.¹

What surveyors tend to look for

Based only on the rule text, expect a reviewer to check:

• An admission assessment dated within 30 days before or at admission, on the Department-designated form.
• A comprehensive assessment within 14 days, annually after that, and after any significant change, with all twelve areas addressed, including customary routine and psychosocial status.
• Evidence of a personal interview, and of a physician or representative in the interview for a mentally impaired resident.
• RN or physician coordination and signature, and five years of retained assessments.
• A care plan developed from the assessment with the resident's involvement.

Getting the routine and psychosocial sections right

• Ask open questions in the first two weeks. "Walk me through a normal day at home." "What time did you like to eat supper?" "Who do you talk to most?"
• Include family in the interview, especially when memory is affected. The rule already expects it for impaired residents.
• Go a little past the form. Hobbies, work, faith and what brings comfort are not required, but they explain the routine and help staff connect.
• Note what to avoid. A topic that upsets the resident is useful to every shift.
• Revisit at 12 months and after a significant change.

How Porchlight can help

Porchlight helps you gather and keep routines, preferences 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 spoken answer is recorded and transcribed. More than 800 human-written questions are organized by life chapter; the resident or staff can pick a topic, skip any question, and nothing is scored. Staff can record profile facts, including topics to avoid. Family get a private page to listen, leave voice replies, and add their own questions and photos. Staff get a Know Your Resident briefing with conversation starters, story highlights, a printable life-story biography and a Monday email digest. The assessment, the care plan and compliance remain your team's responsibility.

Frequently asked questions

What are the assessment deadlines for Oklahoma assisted living centers?

The admission assessment is completed within 30 days before, or at the time of, admission. The comprehensive assessment is due within 14 days after admission, then once every 12 months, and promptly after a significant change in the resident's condition, under OAC 310:663-5-2.

Do Oklahoma rules require a life history or preferences?

Not by those names. The comprehensive assessment must cover customary routine and psychosocial status, among twelve items, and must include a personal interview with the resident. The Department's recommended form asks about sleep habits, meals, bathing preferences and schedule, usual times to rise and go to bed, mood, and family and friend involvement. Hobbies and life history are not listed.

Is a care plan required in Oklahoma assisted living?

Yes. OAC 310:663-5-5 requires the center to use the assessment results to develop a care plan for the resident, in consultation with the resident. The chapter does not set a separate deadline for the care plan, and a significant change is defined as one that requires interdisciplinary review or revision of the care plan.

Does Oklahoma have special rules for dementia units in assisted living?

The assisted living chapter has no separate dementia-unit subchapter. A center must describe any specialized Alzheimer's or dementia unit it intends to market, train staff in specialized units to meet residents' needs, and comply with the Alzheimer's Disease Special Care Disclosure Act at 63 O.S. 1-879.2a and following.