We get many calls from owners and administrators of Adult Day Care and Assisted Living asking if they should have a Client Council and how should it function? For nursing homes, Client Councils are an important monthly activity.

Client Councils are very important to Nursing Homes, Adult Day Care Center, Assisted Living, CCRC and Rehabilitation Centers.

Client Councils empower your residents to voice their opinions and provide suggestions to improving quality of care and quality of life for all residents residing in a facility. Assisted Living facilities in many states are not regulated. Client Councils offer seniors a forum for negotiating with management about concerns. Client Councils may not be a "regulated" but it is "standard of practice" across the country. In the long run, residents will meet informally or formally to discuss concerns anyway. Why not give them a forum, space and present this in a positive light with the management's blessing's.

All staff, visitors, family members, state representatives and Ombudsman representatives may only attend the Client Council if invited by the Client Council.

The meeting should be private and in a location that provides the proper environment with tables, chairs, temperature and light. The over head paging system should be turned off. The council should meet at a good time that is convenient for them. It should not be scheduled as the same time as a special event. The council should be provided with beverages and light snacks.

Think about your population skills and leadership background that they bring to the meeting. Many of the residents have a military background or held management positions and can offer great suggestions.

If The Client Council does not want staff attending, but needs someone to take the minutes, you may wish to ask them if you could provided a tape recorder. The minutes could be typed from that.

The minutes should provide to the Activity Director. The minutes are to be typed up immediately and distributed to the department heads who will follow up on all issues. The minutes should never state who is making a suggestion or complaining. Unless, it pertains to a specific resident or diet. For example, a resident states the door on her closet is coming off and needs it repaired. The Maintenance Director would need this information. But even then, I would strongly recommend that you not to include any names. The resident names could be supplied on a separate piece of paper. This is a real privacy issue for the residents.

The minutes should state by department category all issues. The minutes should show a date that the department heads need to return their resolution. There should be some type of proof attached to the response or resolution. The plan needs to be signed by the department head and dated. For example, a resident complains that the tray arrives in the room cold. The Dietary Director meets with the resident and conducts a Q/A that tracks the time trays are delivered to the floor, temperatures and the time temperature of the tray once it is delivered to the room. The Dietary Director submits his findings and what measures the director took to insure that the tray is delivered hot.

Once the Department Heads follow up on all suggestions and concerns, this information needs to be submitted in writing to the Client Council before the next meeting.

The Client Council minutes should clearly show the following:

Date of Meeting
Location of Meeting
Residents in attendance
Officers in attendance
Staff in attendance
Who is taking minutes
What staff has been invited to the meeting
Old Minutes and resolutions
New Minutes and concerns / suggestions for each department
New Minutes should include: Activities, Dietary, Nursing, Administration, Housekeeping, Maintenance, Social Service and the Business Office. This is also the forum to let the residents know of new information or announcements.
Review of one specific resident right.

Minutes should be provided to all departments with the permission of the council with in 72 hours. If there is an urgent matter, this needs to be addressed immediately.

An active Client Council is very important to the facility. The Client Council lets the administration know of all issues and concerns for many aspects of care. It is much better to find out now and respond to these concerns than to find out about a concern from a state surveyor! The residents should be empowered to meet often and frequently. They should feel comfortable to voice their opinions and comfortable having the department heads attend the meetings. The residents should feel that the issues they bring up are being addressed and taken care of in an appropriate time frame. They should feel safe from any reprisals or retaliation from staff. An active Client Council helps the administrator keep a pulse on the building and bring items to their attention that they may not even been aware of.

The other important reason to have a council, is that it provides an opportunity for residents to meet, get acquainted and socialize.

Administrators should take the Client Council minutes and look for trends. For example, the council complains constantly about a storage closet that is not locked. Or the food is always cold to the unit. These trends should be followed up and investigated and resolved. You don't want a situation where the residents are stating that problems are never resolved. The administrator does not need to report this to the Client Council. It would be up to the administrator.

The facility should supply copies of the Client Council minutes with resolutions to the council members. The president and officers should also be given a copy. It should not be a secret what goes on at the council meetings. The facility has nothing to hide, especially if the facility is clearly showing that all problems, concerns and suggestions are acted upon immediately. By providing copies of the minutes, there is less chance of inappropriate rumors about the meeting. It contains facts and shows clearly to the residents how issues are resolved. They can go back and read the minutes for themselves to see that issues are resolved.

All minutes from the meetings should be typed and kept in a binder. Many surveyors ask to see the last three to six months.

Meeting locations, dates and times should be well posted and announced. Staff should make every effort to get all of the residents who wish to attend to the meeting on time. The meeting should never be interrupted once it has begun.

In addition to the Client Council, residents should be encouraged and empowered to form other committees, such as Activity Planning Committee, Dietary Committee, News Letter Committees, Special Events Committees and Fund Raising Committees.

As a final note, for those facilities that are fund raising for the Client Council, those funds need to be in a bank and not co- mingled with the facility money. The bank account should clearly state, "Client Council." There should be a quarterly report on the funds and submitted to the Client Council. The Client Council would vote on how the funds will be used.