Dignity Privacy Independence
"How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant with the weak and strong, because some day in your life you will have been all of these"
- George W. Carver

State Certified Senior Facilities in Plano and Allen TX

Aylesbury House

Vendor/Facility ID 103687
AL State License #: 126125
Alzheimer's Certificate #: 101839

Groom Senior Living, Inc. @ Aylesbury successfully passed the State Life Safety Code Inspection for a "Type B" Alzheimer's unit on December 2nd, 2008, and as of January 21st, 2009 we have completed the final State Health Survey.

Ambrosia House

Vendor/Facility ID 103683
AL State License #: 127423
Alzheimer's Certificate #: 101963

Groom Senior Living, Inc. @ Diane successfully passed the State Life Safety Code Inspection for a "Type B" Alzheimer's unit and on July 8, 2009 we have completed the final State Health Survey.

Diane House

Vendor/Facility ID 103683
AL State License #: 127423
Alzheimer's Certificate #: 101963

Groom Senior Living, Inc. @ Diane successfully passed the State Life Safety Code Inspection for a "Type B" Alzheimer's unit and on July 8, 2009 we have completed the final State Health Survey.

Willowcreek House

Vendor/Facility ID: 104406
AL State License #: 130726
Alzheimer's Certificate #: 102265

Groom Senior Living, Inc. @ Willowcreek successfully passed the State Life Safety Code Inspection for a "Type B" Alzheimer's unit and we have completed the final State Health Survey.


Groom Senior Care Facilities

What is a "Residential or Personal Care Home?"

Residential Care Homes have been around for many years. However, they are not very well known to the general public due to the lack of public advertising outside of the elder care community.

A Residential Care Home is a house in a regular neighborhood which has been modified with safety devices to meet state regulations, which allow elderly residents to live in the house. Having gone throughout the licensure process, and having met all of the state regulations, the house becomes an Assisted Living Facility licensed by the State of Texas.

Summary of a Residential Facility

A residential care home takes care of seniors in a home environment. When choosing an environment for seniors a lot of families think about what is pleasing to them. Not to disregard what is right for the elder but, we all prefer an environment that is aesthetically pleasing to ourselves sometimes its not what we want but what they want and what they need.

Residential homes are a small environment where both residents and family preferences can be upheld. Preferences may be: wanting to seep in, wanting special food accommodations, religious beliefs or enjoying outdoor walks.

Residential homes offer private and semi-private rooms roommate preferences are always met. A lot do prefer for their loved ones to have a private room but, in many cases semi-private rooms do provide companionship. The buddy system is a good thing from positive reinforcement to having someone to look out for your best interest.

We encourage family participation in your loved ones life as well as the other seniors in the home. You're always welcome to bring your church friends of girl/boy scout group in for a visit. The residents always enjoy a visit from a group or a visit from pet therapy dogs.

Advantages

A Residential Care Home will have fewer people in the environment, resulting in a more tranquil setting. Fewer residents mean fewer and consistent staff. In a small environment the residents get to know each other and the people who are taking care of them, thereby making them feel more comfortable. This is critical in the more advanced stages of Alzheimer's.

A personalized touch means the world to someone who can no longer provide the simple daily activities of living IE: bathing/hygiene, cooking, cleaning, dressing. If they are able to help with some of the daily activities, like cooking and cleaning a home, a Residential Care Home is a perfect environment to allow them to build strength and confidence and feel better about themselves. Whereas in a larger facility this type of activity not only is not an option but is not allowed.

People with Alzheimer's / Dementia typically behave and stay healthier in a smaller environment because they have fewer unknown people with whom they may have to interact, and the staff have the ability to get to know the individuals personal needs.

Disadvantages

Residential Care Homes typically do not staff full time RN's. The homes will contract with, or in some cases, have an RN on staff over several facilities. This may become a disadvantage when the resident needs full time RN care for what could be a number of needs. An example of some of these needs would be: resident has to be on a IV care, Trache care, or stage IV wounds.

However, the Residential Care Home does have the ability to utilize a Home Health or Hospice companies as a resource for daily / part time RN service needs. Groom Senior Living is able to provide care for many high need residents. Please inquire about needs and levels of care, which we provide at no additional cost.

What to Ask a Facility

When looking for a place for your loved one there are certain things you should ask, including finding a legitimate facility licensed by the State of Texas. Below are a few questions we consider "need to knows" before making a critical decision about care for your family.

We have also provided a Facility Comparison Checklist for your use while considering services for your family. Please select the "Facility Comparison" link to the left and print the page.

What Are Your Employee Requirements?

At Groom Senior Living, Inc. we go well beyond the above state standards, so much so that we included our actual Employee Hiring Policy as a link to show everyone exactly what the steps are and what is expected to become an employee. See "Employee Requirements" link listed above.

Are the caregivers licensed by the State of Texas?

If so, what license? CNA's (Certified Nurse Aides), RN(Registered Nurse), Med-Aides (Medication Aide), LVN (Licensed Vocational Nurse).

If the staff are not licensed you should be concerned and inquire of their experience level. Having someone who has not been trained according to state guidelines and regulations can make the difference between life or death.

How many hours of training do your employees receive when they are new hires?

They should be able to answer: the state requires a minimum of 4 hrs of orientation, and 16 hrs of on the job training up front before any other activities.

Our Employees receive the minimum 4 hours of orientation and 36 hrs (instead of the required 16 hrs) of on the job training prior to being placed on the schedule full time

How often are the staff trained? (called "In-Service")

The state requires a minimum of 12 hours of in-service training annually.

Well trained staff need continuing education to stay up to speed on current environments and care needs. The representative of whom you are asking these questions should be able to answer them at will, if not there may be a lack of educational training within the facility.

Are There ANY Hidden Costs?

Ask if there are any hidden cost. Many facilities will charge extra for specific types of care as care needs increase. At Groom Senior Living Inc. there are no hidden care costs . We charge one flat fee for the duration of your stay regardless of care level needs. Here is a list of some of the "hidden costs" which other facilities may charge for and not tell you up front.

  • Incontinence
  • Overweight
  • Assistance with eating
  • Assisted Eating Devices
  • Special diets
  • Assistance with bathing
  • Assistance with hygiene
  • Medication dispensing
  • Laundry service
  • Daily room cleaning
  • Diabetic care
  • Colostomy or any external tube or wound care
  • Normal wound care IE: sores on the feet, bed sores
  • Furniture for the room IE: bed, dresser
  • Cable TV or Sat. TV
  • Telephone usage
  • And the list goes on...

Ask them specifically what they DO NOT provide that you will be charged extra for.

What we ask of you. What do they ask of you?

There are a few things that you will have to provide for your family member, which we do not provide:

  • Personal clothing.
  • Personal items for the room, including furnishings such as dressers, lamps, photo's, etc. (Normally a bed will be provided by Medicare)
  • Haircuts / beauty care / grooming care supplies (we provide normal bathing and grooming, however, we do have a beautician that comes out as requested for a nominal fee).
  • Briefs or Depends (we do not provide the product itself, but there is never an extra charge for changing or assisting someone with this type of care).
  • Medications, including foods such as Jevity, and Diabetic strips. (We do not charge for administering medications)
  • Physician, Skilled Nursing, Rehab, Transport fees. (We do not charge for coordinating other services)
  • Special equipment IE: oxygen, wheelchair, hospital bed, etc. (most of the time we can utilize Medicare part B via a selected Home Health, Durable Medical Equipment Company (DME) or Hospice Company for these expenses).

Compare Facilities

When looking for a place for your loved one there are certain things you should ask, including finding a legitimate facility licensed by the State of Texas. Below are a few questions we consider "need to knows" before making a critical decision about care for your family.

We have also provided a Facility Comparison Checklist for your use while considering services for your family. Please select the "Facility Comparison" link to the left and print the page.

Senior Care Facility Comparison Chart

Unlicensed Facilities

The most important question to ask "Is your facility Licensed by the State of Texas"?

If so, they should be able to tell you the classification of license they have or are seeking. They should fall into one of the classifications: Type "A, B, C or E" and a sub type under "B" as an "Alzheimer" unit. See bottom of page for a picture of a facility license. Every facility should have one posted at the front entrance, along with past state survey results.

Below is a quote from the DADS (Department of Aging and Disability Services for the State of Texas) web site about "Unlicensed Facilities"

"DADS is aware of some unlicensed facilities; agency employees are either working to get the facilities licensed and in compliance with health and safety requirements or are in the process of closing them. If you have a question about the license status of a facility, call DADS Consumer Rights and Services at 1-800-458-9858."

All Residential Care Homes are required to follow the Texas Department of Aging and Disability Services (DADS) rules and regulations of Chapter 92, most importantly Sections 92.41- 92.129 and Life Safety Code NFPA 101 1988 Edition. Below is the link to DADS Rules and Regulations Handbook for licensure requirements for all Assisted Living Facilities. DADS: http://www.dads.state.tx.us/handbooks/ls-alf

There is a large amount of information on the pages of the link above. The regulations within are required of all Assisted Living Facilities in the state of Texas. We at Groom Senior Living must pass a periodic state survey, which becomes public knowledge. You can see how we are doing. Unlicensed facilities remain invisible to scrutiny. You won't know how good or bad they are until after you move in.


Licensure Required

Below is the legal regulation from the DADS handbook requiring any and all facilities to be licensed and the requirements for that license:

Subchapter D

§92.61 Introduction and Application

(2) For existing buildings and structures which are converted to assisted living occupancy, no residents will be admitted until all standards are met and approval for occupancy is granted by the licensing section of the Texas Department of Human Services (DHS).

This means legally NO residents (who are paying and/or non-family members) are allowed to be placed in a home or facility until such facility is inspected for Life Safety Code compliance, is in compliance and approved/recommended for licensure by the state. This can be my home, your very own home or any facility.

Three Resident Rule

There is also a question regarding a facility/home being able to accept up to 3 residents without having to have a license. THIS IS TRUE if there is only one facility with 3 people or less per entity. If the facility is part of a group with more than one facility, then the census from the other facilities counts against the total of 3 residents per entity. For example an entity can have 3 facilities with ONLY 1 resident per facility and still meet the rule. NO UNLICENSED ENTITY can have more than 3 residents in all of its facilities. If See actual law above from the state of Texas Subchapter D 92.61.

Fact is the State of Texas simply does not have the manpower to investigate every home which operates without a license. These facilities know this and are getting away with it until a loved one is not cared for properly. Or, the state is notified, visits the home, and forces the facility to become licensed or be shut down.

Do not get caught placing your loved one in a facility that is not following the state rules and regulations. Remember the only acceptable license in the state of Texas for "Personal Care Homes, Residential Care Homes" or other various names, must meet the the State of Texas DADS Assisted Living Guidelines Chapter 92, and the Life Safety Code NFPA 101 1988 Edition. There are NO EXCEPTIONS to this rule!

You or your family member could make the ultimate un-necessary sacrifice by choosing an illegitimate facility that is not following the proper guidelines or hiring the required staff.


Licensed Facilities and Survey Results

Below is the direct link to the DADS web site where you can determine if a facility is licensed by the state. If the facility is not listed on this site they are not licensed. However, there is a possibility that they are going through licensing procedures and are following the state regulations as Groom Senior Living, Inc. has done.

If the facility is licensed they are required to post their license and their past state survey results. If the facility is licensed this information is required to be made public and if faults were found these faults will be listed specifically.

Licensing Process consists of two parts:

  • The first part is a "Life Safety" inspection ensuring the facility meets structural, electrical and fire safety requirements.
  • The second part is a "Health" inspection, which requires residents living in the facility and provision of direct care to the residents. This inspection is based on a review of care and staffing procedures and ensuring the resident is receiving proper care.

Both of these inspections are very detailed and are not easily passed unless the facility is very knowledgeable of the rules and regulations and are following them exactly as required by the state. The majority of unlicensed facilities cannot pass either of the state surveys. Hence, the reason they are not licensed.


Assisted Living License (This is an image of an actual Assisted Living License


Community Based Alternative

Unlicensed facilities exist which will tell you they are not required to have a license as long as they only have 3 or fewer residents. This is true in a setting commonly referred to as a Community Based Alternative (CBA) program, under a "Personal Care 3". Below is the definition of a CBA, according to the State of Texas.

Community Based Alternatives (CBA) - A Medicaid program that provides services to eligible adults who are aged and/or disabled as an alternative to institutional care in a nursing facility. CBA services are provided in accordance with the waiver provisions of §1915(c) of the Social Security Act (42 U.S.C. §1396n(c)).

Here are the provisions from the state regulations/laws:

A Personal Care 3 setting is only available in the Community Based Alternatives (CBA) Assisted Living/Residential Care (AL/RC) Program, and must meet the following qualifications:

(A) The facility must be licensed for four to 16 beds in a residential care non-apartment setting.

(B) The facility must provide 60% or more of its CBA clients with a single occupancy bedroom.

If a facility is trying to get licensed as a CBA Personal Care 3 facility they can accept up to 3 residents prior to submitting for license by the state. However, the facility CANNOT use a Personal Assistance Services (PAS) company for any type of services. See exclusions below:

Revision 02-4; Effective Upon Receipt

The following services are considered to be mutually exclusive, and are not allowed under the waiver:

  • A participant may receive only one rate (level) of Adult Foster Care (AFC) for a time period.
  • A participant residing in Assisted Living/Residential Care (AL/RC) may not receive AFC for the same time period.
  • A participant residing in a CBA AL/RC setting may not receive Emergency Response Services (ERS), Respite Care, or Personal Assistance Services.
  • A participant residing in a CBA AL/RC setting, Type B, may not receive Minor Home Modifications.
  • A participant residing in an AFC setting may not receive Respite, ERS, or Personal Assistance Services.
  • A participant receiving out-of-home respite care in a nursing facility may not receive any other waiver service except for therapies, Adaptive Aids that he will take with him when he returns to his own home, and Minor Home Modifications that are being completed at his home.
  • A participant receiving respite care in an AFC home or AL/RC setting may not receive Personal Assistance Services.
  • A participant receiving in-home respite care may not receive Personal Assistance Services, AFC, AL/RC or any category of out-of-home respite for the same period of time.

A CBA Personal Care 3 facility is based on Medicaid payment which is subsidized by the government for individuals who can not afford private pay housing. These facilities can not use a PAS to provide services and they are still regulated under the Assisted Living rules and regulations.


Personal Assistance Services

There are several Personal Care Homes in the Dallas Metroplex which are NOT licensed and have no intention of getting licensed as an Assisted Living Facility. They say they are licensed under a PAS "Personal Assistance Services" The state of Texas does not recognize this license as an Assisted Living facility. Below is the DADS definition of a PAS provider:

Texas Department of Aging and Disability Services Licensing Standards for Home and Community Support Services Agencies Handbook
Revision: 09-1

Subchapter A

§97.2 Definitions

Personal Assistance Services - Routine ongoing care or services required by an individual in a residence or independent living environment that enable the individual to engage in the activities of daily living or to perform the physical functions required for independent living, including respite services. The term includes:

(A) personal care;

(B) health-related services performed under circumstances that are defined as not constituting the practice of professional nursing by the Texas Board of Nursing through a memorandum of understanding with DADS in accordance with Health and Safety Code, §142.016; and

(C) health-related tasks provided by unlicensed personnel under the delegation of a registered nurse or that a registered nurse determines do not require delegation.

What does this mean to you?

A PAS or Personal Assistance Services company is licensed by the state and has the ability to go into your home or other locations to provide specific services to your loved one as stated above. A PAS company only provides the services listed above, not the home or facility.

If the home or facility can legally use a PAS (as a contractor) company to perform the daily services. However, a facility/home is required to have its own license that is completely separate from a PAS license. A PAS license CANNOT take the place of an Assisted Living Facility license.

Anyone wishing to house residents for pay are required to submit to the state an application for licensure under the Assisted Living rules and regulations and specify the type of facility for which license is being sought. The facility is completely independent of a PAS company and thus requires a completely separate license.

State Regulations

Department of Aging and Disability Service: DADS: http://www.dads.state.tx.us/handbooks/ls-alf

§92.4 Types of Assisted Living Facilities

Types of assisted living facilities are defined by the State of Texas as follows

  1. Type A. In a Type A facility a resident:
    1. must be physically and mentally capable of evacuating the facility unassisted. This may include the mobile nonambulatory persons such as those who are in wheelchairs or electric carts and have the capacity to transfer and evacuate themselves in an emergency;
    2. does not require routine attendance during nighttime sleeping hours; and
    3. must be capable of following directions under emergency conditions.
  2. (2) Type B. In a Type B facility a resident may:
    1. (A) require staff assistance to evacuate;
    2. (B) be incapable of following directions under emergency conditions;
    3. (C) require attendance during nighttime sleeping hours; or
    4. (D) not be permanently bedfast, but may require assistance in transferring to and from a wheelchair.
  3. (3) Type C. A four-bed facility which meets the minimum standards and program rules for enrollment with the Texas Department of Human Services as an adult foster care facility and is so enrolled on the effective date of this rule will be deemed licensed as a Type C facility without having to apply for an assisted living facility license.
    1. (A) At least 45 days prior to the renewal of its enrollment as an adult foster care facility, the facility must submit an application and fee for an assisted living license.
    2. (B) Failure to submit the application and fee prior to the date of re-enrollment as an adult foster care facility will result in loss of deemed licensure.
    3. (C) A facility seeking licensure as a Type C facility must meet the requirements of this chapter with the exception of those found in §92.41 of this title (relating to Standards for Assisted Living Facilities) and §92.61-92.63 of this title (relating to Introduction and Application; General Requirements; and Plans, Approvals, and Construction Procedures), in lieu of which the facility must meet the minimum standards found in §§48.8901-48.8907 of this title (relating to Minimum Standards; Provider Qualifications; Substitute Provider Qualifications; Individuals Who May Not Provide Adult Foster Care Services; Home Enrollment Requirements; Enrollment and Licensure Requirements; and Provider Responsibilities).
  4. (4) Type E.
    1. (A) Limitation on types of residents. In a Type E facility, a resident:
      1. (i) must be physically and mentally capable of evacuating the facility unassisted. This may include persons who are mobile, although nonambulatory, such as persons in wheelchairs or electric carts having the capacity to transfer and evacuate themselves in an emergency;
      2. (ii) must not require routine attendance during nighttime sleeping hours; and
      3. item(iii) must be capable of following directions under emergency conditions.
    2. (B) Limitation on types of services. Notwithstanding any other provision in this chapter, Type E facilities may only provide medication supervision, in accordance with Health and Safety Code §247.002(5)(B), and general supervision of residents' welfare, in accordance with Health and Safety Code §247.002(5)(C), and may not provide substantial assistance with the activities of daily living, as described by Health and Safety Code §247.002(5)(A) - assistance with meals, dressing, movement, bathing, or other personal needs or maintenance.

Type B vs Type A Assisted Living Facilities

Groom Senior Living, Inc. @ Aylesbury and @ Diane are Type "B" facilities specializing in and licensed for Alzheimer's care.
What does that mean?

  • A Type "B" facility is required if a resident is NOT able to evacuate a building or get to a designated location in the building without assistance. The residents CANNOT understand and act on direct orders if given to them. The residents may need assistance in the evening or sleeping hours. IE: medications, bladder or bowl control, (incontinence), or any other need.
  • In a Type "B" facility staff are required to be awake at all times in order to assist with resident needs. Type "B" facilities are required to have commercial Fire and Sprinkler systems installed.
  • A Type "A" facility is required if a resident is able to evacuate a building or get to a designated location in the building without assistance. The residents can understand and act on direct orders if given to them.
  • In a Type "A" facility staff are NOT required to be awake at all times in order to assist with resident needs. Type "A" facilities are NOT required to have commercial Fire and Sprinkler systems installed.

Common resident needs where a type "B" facility will apply and where a type "A" may not:

  • Medication management
  • Incontinence
  • Bathing
  • Clothing
  • Laundry service
  • Grooming
  • Pressure sore treatment
  • Wound care
  • Colostomy
  • Catheter
  • Feeding tube
  • Immobile

All of these things and more are part of the Type "B" environment at Groom Senior Living, Inc. For a detailed list of the differences between a facility "Type A" and "Type B" select the "Facility Types & Info" button.


Fire Alarm and Sprinkler Systems

"Type B" Environments are also required to conform to the regulations below where "Type A" facilities are not.
The 1988 edition of NFPA 101, as published by the National Fire Protection Association, Inc., Batterymarch Park, Quincy, Massachusetts 02269,
Fire alarm and sprinkler systems.

(1) Fire alarm and smoke detection system. An underwriter's laboratory (U.L.) listed manual fire alarm initiating system, with an interconnected automatic smoke detection and alarm initiation system, must be provided in accordance with the NFPA 101, §7-6. The operation of any alarm initiating device will sound an audible/visual alarm(s) at the site.

(A) Smoke detectors must be installed in resident bedrooms, corridors, hallways, living rooms, dining rooms, offices, and public or common areas. Service areas, such as kitchens, laundries and attached garages used for car parking may have heat detectors in lieu of smoke detectors. As well as many other Life Safety Devices and mechanisms.

(2) Sprinkler systems. When installed or required, sprinkler systems must be inspected, tested, and maintained in accordance with NFPA 25. The facility must have a written contract with a fire protection sprinkler firm, that has been issued a Sprinkler Certificate of Registration number (SCR) from the Texas State Fire Marshal's Office, to perform the required services semiannually. The facility must have documentation available to show that all the requirements of NFPA 25 have been met including the annual inspection, test, and maintenance by the registered fire sprinkler firm. The facility should retain one set of the fire sprinkler system plans and hydraulic calculations on the property.

(A) Small Type A facilities housing 16 or fewer residents may have a system that meets NFPA 13D requirements. Small Type B facilities housing 16 or fewer residents must be protected by a sprinkler system in compliance with NFPA 13 or NFPA 13D, with additional requirements for coverage in all habitable areas and closets as specified by NFPA 101, Chapter 21.