How to build a Resident Evaluation Tool in ALIS

An integrated Resident Evaluation Tool (RET) allows your organization to assess resident needs, determine care levels, and generate Service Plans. When configured correctly, the RET connects the evaluations, service plans, care documentation, and billing.

This guide walks administrators through how to plan, build, and integrate a fully functional RET within ALIS. 

About Building RETs

Building an RET requires the security role permission to access Resident Evaluation Tool settings. This access is typically restricted to company or community clinical administrators.

There are several components involved in building an RET. While many backend settings can be configured in any order, they are all essential to ensuring the tool integrates correctly with ALIS workflows, service plans, and billing processes.

RET Planning Considerations

Because RETs influence multiple operational areas, thoughtful planning before building the tool will save significant time and prevent future rework. 

Plan the RET before building it in ALIS. Using a spreadsheet or digital document makes it easier to copy and paste content into the RET builder in ALIS.

Best practice is to document:

• Domains
• Questions and Answer Choices
• Needs, Goals, and Interventions
• Points Structure
• Care Packages 
• Evaluation Reasons

Domains (Evaluation Sections)

Determine how questions will be organized in the evaluation. Grouping related questions into sections makes the evaluation easier for staff to navigate and complete. 

Domain examples:

• Activities of Daily Living (ADLs)
• Instrumental Activities of Daily Living (IADLs)
• Medication Management
• Safety / Cognitive Status

Questions and Answer Choices

Determine the exact questions and answer choices you want evaluators to select. Planning the exact language ensures consistent documentation and clearer Service Plans.  

Question and Answers example:

Needs, Goals, and Interventions

Not every answer choice requires a Need. Before adding one, determine whether the response should appear on the Service Plan, the Care Plan, or both.

Needs

If no Need is added: 

• The information will not appear on the Service Plan, and therefore will not generate a Care Plan task for caregivers.

If a Need is added: 

• It pushes that service into the Service Plan, however it will not generate a care task in the Care Plan unless a Care Identifier is associated to it. 
• If assistance is required and should appear in caregiver workflows, add a Need so it flows into the Care Plan. In those cases, the service must be documented with a frequency such as PRN (as needed) or another appropriate care frequency (e.g., Daily, Days of the Week).
• If a resident is Independent, you may want that information documented on the Service Plan, but it typically does not need to appear on the Care Plan since staff are not actively providing assistance. In this case, you would set the Service Plan frequency to Independent. 

Goals and Interventions

Each Need includes a Goal (the intended outcome for the resident) and one or more Interventions (the actions staff take to support the resident). These are visible when completing the Service Plan.

Example: 

• Need: "Bathing Assistance - Reminders"
• Goal: Resident will remain clean, safe, and properly oriented during bathing. Skin integrity will remain intact.
• Intervention: Staff will provide reminders and cueing for bathing/showering and encourage the resident to participate to the greatest extent possible. 

Note that Interventions display on the Service Plan only, while caregiver-facing instructions in the Care Plan should be configured using Default Notes.

Care Points Structure 

Determine whether your evaluation will use a points-based system. Points are commonly used when care levels are automatically determined based on the total score from the evaluation.

Points are added to individual answer choices that typically represent a specific assistance level.

Example:

Sub-Assessment Group Points

Determine whether the evaluation will track additional clinical scoring areas (e.g., cognitive status, frailty, ADLs, or behavioral indicators). 

Sub-Assessment Groups allow these scores to be tracked alongside Care Level without impacting billing or care workflows.

Key considerations:

• Groups are assigned at the question level.
• Group Points are separate from Care Points.
• Group Points often follow the standardized scoring structure of the assessment being built (e.g., BIMS).
• Questions may belong to multiple groups if needed.

Care Levels

Care Levels represent a resident’s overall acuity level. 

Examples:

Assisted Living

• Care Level 0 = 0 points
• Care Level 1 = 1 – 350 points
• Care Level 2 = 351 – 850 points
• Care Level 3 = 851 – 1350 points

Memory Care

• All Inclusive = 0 – 2499 points
• Enhanced Care = 2500+ points

It is also possible your community structure Care Levels with a Flat Rate vs. a points system. Care Levels commonly interact with resident billing, so you should consider including the associated target fees/rates. 

Care Packages

Care Packages represent additional ancillary or optional services that are not included in standard care levels.

Examples: 

• Incontinence Package
• Pet Fee
• Additional Care Service

Care Packages can be triggered from evaluation responses but do not affect points or care levels. 

Evaluation Reasons

Evaluation Reasons determine why an evaluation is being performed and help define the cadence of assessments. Consider which evaluations will occur regularly versus only once and whether or not different Product Types (e.g., AL, MC) require different evaluation types.

Examples:

• Pre-Admission
• Initial Assessment
• Change of Condition
• Annual Evaluation

⚠️Important: Configure settings before RET building

Some structural elements should be created before building the evaluation template. After planning the overarching tool structure, configure the following Resident Evaluation Tool settings first:

1. Care Levels
2. Care Packages
3. Roles and Locations

Evaluation Reasons are typically configured after the RET template is complete. 

For instructions on how to configure these settings, refer to this Resident Evaluation Tool Settings guide.

Step 1: Create a New Evaluation

1. Navigate to Settings → Resident Evaluation Tool.
2. Open the Evaluations tab.
3. Click +Create New Evaluation.
4. Enter a clear and descriptive Name (include identifiers such as community, region/state, or product type if applicable).
5. Click Create Evaluation Tool.
6. A Draft template will appear in the table. 
7. Click the template name to begin building.

Step 2: Add Domains

1. Click +Add New Domain.

2. In the pop-up, choose one of the following:

   • Create New Domain: Type the name of the new section. 

   • Copy Existing Domain: Copy domains from other environments on the same server. This includes their questions and answer configuration. Note that copied domains may require significant editing to align with your organization's practices.

3. Click Add Domain. 

Step 3: Add Questions and Configure Answers

At this stage, focus only on building the question and answer structure for the entirety of your tool. Within each Domain, you will add evaluation questions and configure answer options. 

To begin, click the Add Question button to open the configuration panel:

1) Question

Enter the question or prompt that will display to evaluators above the answer options.

Examples:

• Does the resident require bathing assistance?
• Bathing Assistance

2) Instructions (Optional)

Use this field to provide additional context or guidance for evaluators on how to interpret or answer the question.

This can be helpful for:

• Clarifying scoring expectations
• Providing assessment guidance
• Adding longer-form instructions that should not appear as the main question text

3) Parent Question (Optional)

This field is used to create question hierarchy and conditional logic within the evaluation. If no question dependency or grouping is required, leave this field blank.

When a Parent Question is selected, the current question becomes a dependent (child) question and will display grouped beneath it in the evaluation flow. This structure is commonly used to keep related questions organized and support conditional workflows.

Parent Questions are particularly useful when configuring Advanced Rules, where specific answers can show or hide follow-up questions based on the evaluator’s selection.

4) Answer Type

Select the response format:

• Single Choice - one selection only (most common for point-based evaluations)
• Multiple Choice - allows more than one selection
• Free-Form Text - open text entry field 

💡Tips: 

• If an answer needs to appear on the Service Plan, it must be set up as Single Choice in order to be able to trigger a Need. 
• If you select Free-form as the answer type, consider setting the Notes option to Not Allowed to avoid displaying an additional notes field for that question in the evaluation.

5) Notes 

Controls whether evaluators can add additional notes.

Options:

• Allowed - optional notes field
• Required - notes must be entered
• Not Allowed - no notes field displayed

6) Include Vitals Checkbox (Optional)

Enable this option to include vitals capture fields within the question on the evaluation. Common use cases include pre-admission baseline vitals or clinical assessment requirements.

7) Answer Text

Type each answer option individually (one per field). Click the +Add Answer button to continue adding answer choices for this question. 

8) Default Notes (Optional)

Use this field to attach pre-filled prompts or guidance to a specific answer choice that will carry forward into Service Plan and Care Plan documentation when applicable.

Examples:

• “Provide specific bathing instructions for this resident: ”
• "Resident is non-ambulatory. Notify Executive Director upon completion of evaluation.” 

💡Tip: Default Notes are the primary way to provide caregiver-facing instructions in the Care Plan. Unlike interventions, these notes carry into care documentation and workflows.

9) Care Points

Assign point values to answer choices when using a points-based care level model. Only assign points to answer choices that increase the resident’s level of care.

10) Need Triggered 

A Need represents a service provided by staff and determines what flows into the Service Plan. Add any associated Needs now only if applicable, but configure full Need, Goals, and Interventions later.

To add a Need:

1. Click + Create New Need.
2. Enter the Need name.

   • Example: "Bathing Assistance - Reminders"

3. Click Save.

11) Save Question 

Click Save Question. 

Add all questions and answers to each domain before starting Step 4: Configure Needs, Goals, and Interventions.

Add Sub-Assessment Group Points

If you plan to track additional clinical scoring categories within the RET, you can configure Sub-Assessment Groups. Evaluators can view live group totals during the evaluation workflow.

Sub-Assessment Groups are informational only and do not impact Care Levels, billing, rates, or care workflows. Unlike Care Points, Group Points are typically based on the standardized scoring structure of the assessment being built (e.g., BIMS scoring).

Configure Sub-Assessment Groups

First, create the group structure:

1. Navigate to Settings → Resident Evaluation Tool.
2. Open the RET in Draft mode.
3. Under Advanced Rules on the left, click Sub-Assessment Groups.
4. Click + Add New Group.
5. In the pop-up:
   • Type a Group Name.
   • Assign Questions to the group. (Questions may belong to multiple Sub-Assessment Groups if needed. )
6. Click Save. 

Then, assign Group Points to answer choices:

1. Open the Domain containing the grouped question. 
2. Click Edit on the question. 
3. Enter the applicable Group Point values for each answer choice. 
4. Click Save Question. 
5. Repeat for all questions included in the group.

Other Question Features

The following options provide additional control over how questions behave within the evaluation:

Required 

Select this checkbox to require the question to be completed before an evaluation can be finalized in ALIS.

New Answer Every Time

Select this option if the question should not carry forward previous responses during reassessments.

By default, ALIS pre-populates answers from the most recent evaluation to streamline the reassessment process. Enabling this setting ensures the evaluator must enter a new response each time, which is useful for questions that should always be reassessed (e.g., time-sensitive or variable conditions).

Previous responses are still retained within each completed evaluation for historical accuracy.

+ Add Frequency 

Use this feature to apply a frequency-based multiplier to the points assigned to a service. This is helpful when the frequency of a service impacts overall care level or pricing.

To configure:

• Enter a frequency label (e.g., 2x per week)
• Assign a corresponding points multiplier (e.g., 2)

The multiplier will adjust the total points calculated during the evaluation, which may impact the resident’s Care Level and associated cost.

Delete

Permanently removes the question from the RET. Use only if the question will not be needed in the future.

Disable

Temporarily removes the question from the evaluation without deleting it. This is useful if the question may be needed again later or for reference.

Move

Allows you to transfer the question to a different Domain within the same RET.

Copy

Duplicates the question and its configuration. This is useful for quickly creating similar questions and modifying only what changes.

Edit

Allows you to update the question and answer configuration. If the RET has already been published, refer to the below Editing the RET section for guidance on making updates.

Step 4: Configure Needs, Goals, and Interventions

After building your questions, configure the associated Needs, Goals, and Interventions (NGIs). This step defines how evaluation responses translate into Service Plan documentation and caregiver tasks.

When a Need is assigned to an answer choice, it will appear in the Needs tab count and become available for service planning. 

All NGIs must be fully configured in order to publish and integrate the evaluation.

💡Tip: Before configuring NGIs, determine whether each service should appear only on the Service Plan or also on the Care Plan for caregiver documentation. This decision should be consistent across staff completing evaluations.

How to Configure Needs, Goals, and Interventions

Select a Need requiring configuration (highlighted in red) and click Edit to open the configuration panel.

Each Need is configured using the following fields:

1) Need 

This is the name of the service, pre-populated from the answer choice. In most cases, this should not be edited, as changes can create language inconsistencies between the evaluation and service planning.

2) Description (Optional) 

Internal-only notes used for reference. This does not appear on resident-facing documentation.

3) Package 

Select a Care Package if this Need should trigger an additional service or fee.

• Leave as None if not applicable.
• If no options appear, Care Packages have not been configured in Resident Evaluation Tool Settings.

4) Can this need be added to addendums on completed service plans? (if applicable)

This toggle determines whether the Need can be added later via a Service Plan Addendum.

• Default = No
• Only available if the Service Plan Addendums feature is enabled.

See the below Service Plan Addendums (Specialty Feature) section for more details.

5) Goal 

Enter the statement for the intended outcome of the service.

Example:
"Resident will remain clean, safe, and properly oriented during bathing. Skin integrity will remain intact." 

6) Possible Intervention 

Define the actions staff will take to support the goal. You may add multiple interventions if needed. 

Example:
"Staff will provide REMINDERS/CUEING for bathing/showering and encourage the resident to participate to the greatest extent possible."

⚠️Important: 

• Interventions configured within a Need appear on the Service Plan only and do not flow into the Care Plan as caregiver tasks or instructions. 

• If you need to provide guidance to caregivers within Care Tracking, use Default Notes on the answer choice. These notes carry forward into Care Plan documentation and are the appropriate place for caregiver-facing instructions. 

7) Schedule/Frequency 

Define how the service should be scheduled.

• Select No Schedule for services that should not appear on scheduling workflows. (This will disable Role/Location fields.)
• Most commonly, you will set a Default Frequency (e.g., Daily, PRN, specific days).

⚠️Important:

• Independent-level services typically appear only on the Service Plan.
• Scheduled services (e.g., Daily, PRN As Needed, Days of the Week) can appear on both the Service Plan and Care Plan.

8) Role/Location

If defaults were configured in Resident Evaluation Tool Settings, these will auto-populate. 

If no Defaults are set:

• Use dropdowns to select Role(s) and Location(s).
• If unavailable, click +Add New to create and save directly from this screen.

9) Care Idenitifer 

Care Identifiers link evaluation outcomes to care documentation and tracking workflows.

• Search existing identifiers first.
• Best practice is a 1:1 match between Need name and Care Identifier.
• If not found, click + Add New and create one using the same or similar name.

⚠️Important: Configure Care Identifiers for any Need that should appear on the Care Plan. This includes informational visibility and caregiver task documentation. For more information, refer to the below Step 10: Map Care Identifiers to Care Items section. 

10) +Add Intervention

A single Need may include multiple interventions.

Example:

• Fall intervention – Bed Rails
• Fall intervention – Safety Pendant

Click + Add Intervention as needed.

Note:

• If only one intervention exists, it is automatically selected during service planning
• If multiple interventions exist, the evaluator must select the appropriate option during Service Plan setup

11) +Goal 

Some Needs may support multiple distinct goals.

Click +Goal to add additional goal/intervention groupings under the same Need.

If needed, goals can be removed using the Remove Goal option.

12) Save Need

Click Save Need to complete configuration. 

Configure all NGIs in each domain before starting Step 5: Configure Signatures.

Service Plan Addendums (Specialty Feature)

While configuring NGIs, consider whether any services may need to be added to a Service Plan later without completing a new evaluation. 

The Service Plan Addendums feature allows you to add Needs to an existing Service Plan without modifying the original document or requiring new signatures. This is intended for updates that do not impact care level or billing. 

This feature must be enabled by ALIS. Contact your Account Manager or our ALIS Customer Success Team.

Plan for Addendums during RET Build

If you intend to use Addendums, it is best practice to configure this during the RET build:

• Mark applicable Needs as Addendum-eligible during setup.
• Ensure Needs are clearly defined and non-duplicative.
• Align Addendum-ready Needs with existing service categories.

You can also create standalone Needs specifically intended for Addendum use via + Add Need in any Needs tab. 

For more information about Service Plan Addendums, refer to this Service Plan Addendums guide.

Step 5: Configure Signatures

Configure the required and/or optional signature lines that must be completed when an Evaluation and/or Service Plan is finalized.

Common examples include:

• Evaluator signature (e.g., Executive Director, Nurse)
• Resident or Responsible Party signature

Add New Signature Lines:

1. Scroll below your RET Domains and click the Signatures button.
2. Click + Add New Signature Line (choose Evaluation or Service Plan).
3. In the pop-up, complete the following:
   • Title: Enter the role or legal designation (e.g., Executive Director, Responsible Party)
   • By: Select Community Staff or Non-Community Staff
   • Required / Optional: Toggle to indicate whether the signature is required to complete the workflow
4. Click Save. 

Repeat these steps for all necessary signature lines. Ensure signature requirements align with your operational and regulatory expectations before publishing the RET.

Step 6: Set Advanced Rules (Optional) 

Use Advanced Rules to control evaluation behavior based on selected answers. This allows you to create dynamic evaluations that show, hide, or trigger specific content. 

Common use cases include:

• Conditional questions
• Showing or hiding sections (Domains)
• Triggering compliance items or documentation

💡Tip: Using a Parent Question can help organize related questions and simplify rule configuration. You may also create multiple rules for a single question as needed.

Add New Rule:

1. Click + Add New Rule.
2. Enter a Rule Name (for internal reference only).
3. Set the Condition to define when the rule should activate:
   • Domain: Select the Domain where the originating question is located.
   • Question: Select the question that contains the answer(s) you want to trigger the rule. (This is often a parent question, but not required.) 
   • When Answer Matches Any: Select one or more answer choices that will trigger the rule.
4. Set the Action to define what happens when the condition is met: 
   • Action Type: Choose one.
   • Target Selection: Based on the action selected, choose the Domain and/or Question(s) to show or hide, or select the Compliance Item to trigger.
5. Click Save to complete rule configuration. 

Test Rules:

Use the Test Rules feature to simulate the rule you created and validate your configuration before publishing. Testing ensures your rules behave as expected and helps prevent configuration errors.

1. Click the Test Rules button (top right).
2. In the Conditions panel (left):
   1. Questions with rules will display an “R” icon.
   2. Select an answer choice to simulate the rule.
3. Review the Impact panel (right):
   1. Greyed out = hidden / not required.
   2. Yellow eye icon = visible / required.

For additional support with complex rule setup, contact your Account Manager.

Compliance Forms in RET (Specialty Feature)

Compliance Forms allow evaluators to complete required sub-assessments directly within the RET, automatically generating documentation.

Common examples include:

• Elopement Risk Assessment
• Skin Assessment
• State-specific compliance forms

In order for Compliance documents to be available for use in the RET, they must be added in the Action section of Advanced Rules. In the Compliance Item Search, type the exact name of the form as listed in Resident Settings to locate the document to attach:

For configuration assistance, contact your Account Manager. 

Step 7: Publish the RET 

Once the evaluation is fully built and reviewed, click the Publish button in the top right of the RET builder. 

Alternatively:

• Navigate to Settings → Resident Evaluation Tool → Evaluations tab.
• Locate the template and click Publish.

Publishing makes the template available for integration in ALIS..

Step 8: Configure Evaluation Reasons

Evaluation Reasons must be configured in order to be available within the ALIS evaluation cycle workflow. Each reason determines why an evaluation is performed, how often it occurs, and which RET template is used for it.

These steps are completed in the Reasons and Care Levels tab of Resident Evaluation Tool Settings and also outlined in the Resident Evaluation Tool Settings guide.

Add New Evaluation Reason: 

1. Click +Add New Evaluation Reason. 
2. Complete the following fields:
   1. Product Type: Determines which product type(s) this evaluation applies to.
   2. Reason Name: The name that will appear in the dropdown when an evaluator begins an assessment.
   3. Expires In: Defines how long the evaluation remains valid before a new evaluation is due.
   4. (Optional) Evaluation Events: Limits this reason to specific move-in events (e.g., New Applicant, Readmit, Transfer).
   5. Associated RET: Select the Resident Evaluation Tool template that will be used when this reason is chosen.
   6. (Optional) Select Exclude from Next Evaluation Reason Suggestions: Use for non-recurring evaluations (e.g., Change of Condition) that should not affect ongoing scheduling. 
3. Click Create Evaluation Reason to save.

⚠️'Exclude from Next Evaluation' Consideration

Use Exclude from Next Evaluation Reason Suggestions for one-time or situational evaluations (e.g., Change of Condition).

When enabled:

• The evaluation does not interrupt the existing schedule
• The next evaluation remains based on the last recurring reason
• The Expires In field is not required

Properly configuring Evaluation Reasons ensures your RET is correctly tied to evaluation timing, workflows, and scheduling.

Step 9: Integrate the RET

This step enables your RET to be used within the evaluation workflow in ALIS.

Enable Integrated Evaluations:

1. Navigate to Settings → Resident Evaluation Tool → Evaluations tab.
2. Click the Manage button.
3. In the side panel:
   • Locate your community in the list and move the toggle from Paper → Integrated, OR
   • Use the All Integrated checkbox to enable integration for all eligible communities at once.
4. Click Save.

Troubleshooting Integration

If the Paper → Integrated toggle is unavailable, first verify your Product Types and Evaluation Reasons configuration. 

Note that not every Evaluation Reason requires an associated RET, however each Product Type must have at least one valid Evaluation Reason linked to a template. 

1) Product Types

Each enabled Product Type must have at least one Evaluation Reason with an associated RET.

• Navigate to Company Settings → Product Types
• Confirm only relevant Product Types are enabled
• Disable any Product Types not in use

2) Evaluation Reasons

Each Product Type must have at least one Evaluation Reason linked to an RET in order to enable Integrated Evaluations.

1. Navigate to Settings → Resident Evaluation Tool → Reasons and Care Levels tab.
2. Confirm that at least one Evaluation Reason per Product Type has an Associated RET.

3. If needed:

   • Click Options → Edit
   • Select the correct RET
4. Click Update Evaluation Reason. 

After completing the above, return to:
Evaluations tab → Manage → toggle to Integrated → Save.

If issues persist, contact your Account Manager or the ALIS Customer Success Team.

Step 10: Map Care Identifiers to Care Items

This final step ensures that services identified in your RET generate Care Plan tasks for caregivers. Without mapping, services may appear on the Evaluation and Service Plan, but will not appear in the Care Plan. 

Why Mapping Is Required

• Care Identifiers = services defined in your RET
• Care Items = tasks caregivers complete and document

Mapping connects these so evaluation results become actionable care tasks.

How to Map (High Level)

1. Navigate to Settings → Resident Evaluation Tool → Evaluations tab.
2. Click Map on your RET and generate the file.
3. Review Care Identifiers in the file.
4. Go to Settings → Care → Care tab.
5. Add or edit a Care Item and select the matching Assessment Care Identifier.
6. Save and repeat for all applicable services.

Validate Mapping

Re-download the RET Map file and confirm all required Care Identifiers have associated Care Items.

For full instructions, refer to this How to map Care Identifiers to Care Items guide. 

Other Specialty RET Features

State-Specific Forms

Some forms are available or in development for specific regulatory requirements, including:

• RASP (Pennsylvania)
• UAI (Virginia)
• Resident Characteristic Roster (Washington)

Availability varies by configuration. Contact your Account Manager for enablement or questions.

Editing the RET

To edit an existing RET:

1. Navigate to Settings → Resident Evaluation Tool → Evaluations.
2. Click Edit on the template.
3. Make updates and click Publish.

Managing Domains

Remove Domain

Click Remove Domain to delete the domain and all associated questions.

The domain name will appear in Removed Domains, where it can be restored (name only).

Edit Domain

Edit the name of the domain without affecting its questions.

RET Draft Modes

Unpublished changes remain in Draft mode. The last published version continues to be used in ALIS until updates are published.

• Draft: New - Template has not been published.
• Draft: Edit - Changes made to a previously published template.

Click on the View current version link to reference the active (published) version.

Sync Care Documentation After RET Changes

ALIS preserves historical accuracy. Updates to the RET do not automatically apply to existing resident records.

To apply changes immediately:

• Start a new evaluation using the resident’s most recent evaluation details.

For full instructions, refer to this How to Sync Documentation to Resident Evaluation Tool Changes guide. 

Copying an RET Template

Copying templates is useful for creating variations, such as:

• State-specific evaluations
• Product-specific evaluations
• Pre-admission versions with fewer questions

Recommended workflow:

1. Create a base template.
2. Copy the template.
3. Modify the copy as needed and Publish. 

After copying, ensure the correct template is linked to the appropriate Evaluation Reasons.

Discard Evaluation Tool 

The Discard option deletes the RET template in progress. A confirmation prompt will appear before deletion.

Related Guides: 

• Resident Evaluation Tool Settings
• How to map Care Identifiers to Care Items

For more assistance: 888.404.ALIS (2547)  |  support@go-alis.com