ALIS Self-Onboarding Guide Part 3: Compliance, Observations, and Incidents

Completing Compliance Items

Compliance in ALIS is a system of unlimited electronic document storage and completion.

Your list of compliance items in ALIS is completely custom to your organization's needs. We work with you to set up exactly the items you need for residents, staff, incidents, and community compliance.

• Compliance tracking can be done for residents, staff, and at the community level. There are individual settings for each type of compliance where we can set up the exact list of documents you need.
  • For more information about these settings, read this article: Compliance Settings.
• Compliance items can all be completed by uploading files from your computer, and if you send us your form templates, we can make them available to fill out online.

The Compliance Table

In this guide we will describe Resident Compliance. This is the same exact feature if you are in other parts of ALIS managing Staff Compliance, Community Compliance, and Incident Report forms.

On a resident's profile, scroll about halfway down the page to find the Compliance Summary section. Click the Compliance Documents blue bar to see all resident compliance items and their completion statuses.

The checkboxes on the left side of the items allow you to perform some actions in bulk for multiple items at a time using the buttons above the table.

Here are the compliance table details:

• Compliance Item: This is the customizable name of the compliance item. The items may also be organized into custom groups.
• Status: The status can be Incomplete, Completed, or Expired.
• Expires on: This might be a specific date or "Never".
• File Location: This will say Not Available if the item has never been completed for the resident, or it will have a link to the most recently completed read-only Filled Online or Uploaded versions of the document. 
  • If you marked the item "In Cabinet", that status will show here.
  • If the most recently completed version of the item was Filled Online, people with administrator permissions will be able to edit the most recently completed version without having to create a new version. Click the pencil icon to do this.

Compliance Item Colors

Notice the thin stripe of color on the very left border of the compliance item rows. The colors indicate the following statuses:

• • Red: the item is required and is incomplete or expired.
  • Yellow/Orange: the item is optional and is incomplete or expired.
  • Green: the item has the completed status.
  • The red asterisk on a compliance item name means it is required.

Each item has three buttons on the right side:

• Choose File and Fill Online are the buttons you will use to complete the items. More on these in the next two sections of this guide.
• The Options button has many options!
  • Change expiration: This allows us to manually update the expiration date.
  • In Cabinet: This marks an item as Completed without any electronic submission of a document.
    • It is advised to use this option infrequently or never, because there is no way for you to access the completed item electronically. It means: "the completed document exists somewhere in physical storage".
  • Mark Required: This allows you to mark an optional compliance item as required. Items are set as required or optional by default for all residents, but you can change this for individual residents. The completion of required items impacts the resident's compliance percentage.
  • Mark Optional: This allows you to mark a required compliance item as optional. Items are set as required or optional by default for all residents, but you can change this for individual residents. Optional items do not affect compliance percentages.
  • Hide From List: This allows you to hide the compliance item from the list for this resident. To find it again, you need to find the "Show Hidden Compliance Items" link at the top right of the table. This link only exists if there are hidden items.
  • Show in List: This allows you to change a hidden item so that it shows the compliance item in the list for this resident.
  • Pre-populated Template: This generates a template with all the information that pre-populates from ALIS data on your form.
    • You can not fill online from this template, but it is convenient if you are printing the form to fill it out on paper, since some of the details are filled in automatically.
    • To then keep track of the form electronically, you will need to scan it to your computer and use the Choose File option to upload it.
  • Blank Template: This generates a template with no fields filled in. You might use this if you need to print a copy of the blank form.

Uploading a Compliance Item

If the document you need to add was completed on paper or is not a form (insurance cards, ID cards, vaccine cards), you can save the document to your computer using a scanner and upload it to the correct location in ALIS.

1. Scan the item and save it to your computer. 
2. Find the resident profile in ALIS for the person you need to upload the document. 
3. You can either drag the file from the folder on your computer to the ALIS window in the compliance item area, or you can click the Choose File button to open your file browser and find the correct file. 
4. This will change the status to Pending, and you can then select an expiration date if needed. Click the Complete button to save the document.

Drag and drop from your file folder right into ALIS:

Filling Online a Compliance Item

Filling online a compliance item is a very powerful and efficient way to keep your documents up-to-date!

The first requirement is that you send the ALIS team your blank form templates. Once we have the forms, we complete a process of annotating them, which allows for certain ALIS fields to pull in automatically, and allows you to complete the fields while using ALIS. 

An additional benefit of this is that previously filled-online documents will always retain your previous entries on the form (except signatures). This means if you need to fill it out again, you only have to update the things that changed without having to fill out everything again!

1. Click Fill Online for a compliance item.
   • If this option is not available, your organization will need to send us a blank form template in order to make it available in ALIS. 
2. If the form has been filled online previously, you can click the Previous Form option to start working on the form with the previous entries (except signatures). This is really helpful for documents where most information doesn't change much, but some information may need to be periodically updated.
3. Click New Form to start fresh with no previously entered information. This will still pre-populate ALIS fields such as the resident name, room number, insurance information, resident contacts, and much more. 
   • For any fields that should contain information already stored in ALIS, we annotate the form to pre-populate your ALIS data. One example is that you should never have to type a resident's name, because it will always pre-populate with the name saved in ALIS. This is true for hundreds of details stored in ALIS!
4. Fill out the form to your satisfaction and add your signature if needed. Read this article for more information about signatures: Electronic Signatures for Compliance Documents and Incidents in ALIS.
5. Click Save, and close the form window.
6. This puts the item in the Edit in-progress status so that you can click the Edit button to pick up where you left off if needed, and add an expiration if needed. To complete the form, click Complete.
   
   • The most recently completed version of the item will display as a link in the File Location column. Click this to view the read-only version of the completed document.
7. There will now appear a View All Versions link below the item name, and you can view any version of the document that was ever marked complete for this resident.
8. You may have available a pencil icon in the File Location column if you have administrator permissions. This allows you to edit the most recently completed document without having to start a new version.

When you use the Fill Online option to complete a document, please note that the form fields will not expand to fit the size of text you enter.

• The text may automatically become smaller in order to fit, but it is ideal for the form field to be appropriately sized for the amount of text you want to add.
• If a form field is too small, you will need to update your form template to have larger text fields, and send the new version to ALIS Support. Please contact us if you need any help!

Special features with Fill Online

Form Field Validation

• If you would like to make some form fields required on a document, all you have to do is let us know! We can set up your form template to require information in any text box you need. This will prevent someone from completing a version of the document without adding text to your specified form fields. 
• It is also possible to set date or numeric fields to allow only specific formatting or numeric characters.
• To set this up on any compliance form, contact us to say which fields on your forms you would like to make required or restrict numeric formatting.

HelloSign Integration: Send your document as an email for a non-ALIS user to sign

ALIS integrates with the electronic signature tool HelloSign. This allows your team to collect signatures of resident family members or other outside parties by sending compliance documents directly from ALIS to their email. Read this article for more information: E-Sign Compliance Items.

Required Items and Compliance Percentage

The percentage of completed required items determines a resident's compliance percentage. 

• By default, all compliance items have the required status, but we can set any item to be optional in settings.
• You can also set items to be either required or optional for an individual resident using the Options button.
• The required items are identified by a red asterisk after their names. Look here for more explanation about the colors: Compliance Item Colors.

Accessing Resident Documents

When the items have been marked complete, you can easily access the most recent version and unlimited versions of the item that were completed earlier.

View All Versions

Click this link to see all previously completed versions sorted by date. You can click the links in the File Name column to view any of these versions. 

Click Hide All Versions to collapse.

Emergency Packet

Typically this is opened at the top of the resident's profile by clicking the button below their photo, but we also have the option in the Compliance section.

The items that generate in the Emergency Packet are set at the community level. Read this article for more information: How to set up your Emergency Packet.

Generate Custom Packet

The custom packet feature allows you to select specific completed documents from ALIS for a resident and compile them into a single file.

1. Click the checkboxes to the left of the compliance items you want to include in the custom packet. Only completed items can be included.
2. Click the Generate Custom Packet button above the table. A PDF will load containing all selected items, starting with a cover page listing the names of the items.

Reports

On the Reports page, we have a Resident Compliance Details report and a Staff Compliance Details report. These will show you a highly filterable view of all compliance items for all resident or staff profiles. 

If you select only one item in the Compliance Item filter and click the Refresh button, you have the Print Compliance Documents button available just above the table. This allows you to download a zipped folder of all your residents' completed documents for the filtered item. If you ever need to export all of a single item for all residents (or staff), this is the best option!

Expirations and Alerts

The compliance items can be set to expire after a specific length of time after they are completed. This interval can be selected for all residents in settings (and then updated for individuals if needed), or you can set expiration dates as you complete the items. 

Once an item has the Expired status, it will decrease the resident's compliance percentage if the item is required.

We have the ability to filter for expired items in the Compliance Details report, and we can also set up staff at your organization to be alerted when items will expire soon (in two weeks) and the day when the item actually expires. Please read this article to learn more about setting up alerts: Managing ALIS Alerts.

Miscellaneous Documents

This section is located below the main Compliance Documents table. The best practice is to use this sparingly! 

If you have an item to store for only one or a small number of people, you can upload the documents here in Miscellaneous Documents. Once uploaded, they will always be available sorted by name of the item in alphabetical order. No dates are tracked for these.

It is recommended to create items to be part of the main Compliance Documents table in order to track their completion and easily find them later if needed. If you ever need help adding an item to your Compliance Documents, please contact us!

Compliance Settings

This guide will help you navigate the settings for your Resident, Staff, and Community compliance items. These settings are typically managed by your onboarding manager or ALIS support, so please contact us if you would like help!

This article will overview the settings for Resident Compliance, but the information applies to Staff and Community Compliance. Find those settings on the Staff Settings and Community Settings pages.

If you want to set your form template to be Filled Online, you must send it to the ALIS team for processing.

• We will setup annotations on the form that allow it to pull in ALIS data for you and allow the forms to retain information when you complete the same form multiple times.
• We can also set up your form template to require information in any text box you need. This will prevent someone from completing a version of the document without adding text to your specified form fields. 
• Submit your form templates to your onboarding manager or ALIS Support.

Create a Compliance Item

Find these settings in Resident Settings in the Compliance Configuration section.

• To add an item, click the +Create Compliance Item button at the top of the table.
• This opens a pane on the right of your screen. The only required fields are the Name and the Compliance Stages.
  • Compliance Stages for resident items should typically be Applicant, Resident, and Moved Out. You may also choose to select Prospect if you would like to make the item available on your prospect profiles.
• Non-required fields:
  
  • Template: This is hugely impactful! This is the form template meant to be Filled Online on the resident profiles. Do not upload a template here that has not been processed by the ALIS team. 
  • Group: This is a setting to group the items on the compliance table so it is easy to find and complete items you are looking for. It is not recommended to add groups here, but to instead create the item and group it from the main Compliance Configuration section on the settings page.
  • Description: This will save and display your information on this page only. It is likely not necessary.
  • Classification: These options allow you to set this item in other parts of the resident profile beyond the Compliance Documents table.
    • Either the Evaluation or ISP item can be set to pull into the Evaluations and Service Plans section of a resident's profile if you are not using an ALIS electronic evaluation. This is not commonly used.
    • The Directives item will be pulled into the Advance Directive area of the Basic Information section on a resident's profile. 
    • Facesheet will allow you to use your own template for the resident Facesheets instead of the ALIS Facesheet.
  • Tags: This allows us to select the item to pull into the Emergency Packet. This can also be done on the main Compliance Configuration section on the settings page.
  • Expires: This option allows us to set how often the compliance item expires after it is initially completed. Expiration dates can also be set on an individual basis on the resident profiles.
  • Does the document start as compliant? This setting will create the item so that it always positively impacts your residents' compliance percentage. 
  • Is this compliance document optional to complete? This is a very commonly used setting to create items that do not impact your residents' compliance percentages.

• Click the Create and Apply to All option to create the item for all residents. Some details about the two buttons:

  • Create and Apply to All: This makes the compliance item available to all current residents. This will drop down the compliance level for each resident until it is marked Complete (if it is not set as Optional).
  • Create Going Forward: This will create the item only for resident profiles created in ALIS going forward. It will not exist on current resident profiles. 
• Click Submit.

Editing a Compliance Item

Click Options > Edit on an existing compliance item if you need to make changes. This opens a pane similar to the one described above.

Once you are finished making changes or uploading a new template, click one of the update options described below and then the Submit button to save changes.

• Update Going Forward will set the template for anytime it is Filled Online going forward, but will not impact the resident's current compliance status. This is the recommended choice if you want to make an update to the form, but do not want to reset everyone as non-compliant for the item.
• Update For All will make the change for all current residents. If you updated the template, this will reset everyone's compliance item status to Incomplete until they complete the newest uploaded template.

Other Compliance Settings

Group Compliance Items

It is easiest to set the compliance groups from the Settings page. Click the checkbox next to each item you want to group and click the Group Compliance Items button above the table. 

In the pop-up, select a group that already exists or type the name of a new one. Click Apply.

Tag as Emergency

Use the Bulk Tag Items option or click Options > Tag for individual items to include them in resident Emergency Packets. For detailed steps, read this article: How to set up your Emergency Packet.

Retire

You can use Options > Retire for any items you want to keep on resident profiles if already completed, but remove it from others and prevent it from displaying going forward. These will then be grouped as Retired.

Delete

Click Options > Delete to remove an item from all resident compliance tables. For any residents who had this item completed, the most recently completed document will be moved to the Miscellaneous Documents section in their Compliance area of their profile.

How to set up your Emergency Packet

The Emergency Packet is an easy-to-generate collection of documents that is set up based on your organization's needs. For a guide to generating Emergency Packets for your residents, read this article: How to Generate a Resident Emergency Packet.

Read on to learn how to set up your Emergency Packets. ALIS Support and your onboarding team can always configure these settings for you if you prefer! 

1. Click the Settings link at the top right of your page near Logout. Settings are only available for administrators.
2. In the Resident section, click Resident.
3. Scroll down to Emergency Packet Configuration after the Compliance Items.
   
4. Any compliance items you have tagged for the emergency packet will display here. To tag a compliance item to display in the Emergency Packet:
   • Scroll up to the Compliance Configuration section of Resident Settings
   • Click the checkboxes to the left of any items that should go in the Emergency Packet.
   • Click the Bulk Tag Items button at the top of the table.
   • In the pop-up, click in the Tags area and click Emergency. Click Save.Note: For the compliance items tagged to generate in the Emergency Packet for a resident, they must be either Uploaded or Filled Online, and have the status Complete on the individual resident's profile. 
5. Review the four "Auto-generated by ALIS" items. To manage any of these items in the Emergency Packet, select "Enabled" or "Disabled" as needed.
   
   • Facesheet - Current resident Facesheet, can be ALIS-generated or a custom document.
   • MAR - Current month's MAR.
   • Physician Orders - Current Routine and PRN Medication and Treatment Orders in ALIS Manage Orders.
   • COVID-19 Vaccination - All Vaccine information added to the COVID-19 section of the resident's records.
6. Sort the order you would like all items to appear in the Emergency Packet. Click on an item to drag and drop the order of the documents.

How to Generate a Resident Emergency Packet

The Emergency Packet is a useful way to print all the important documents for a resident with one click.

It is easy to generate:

1. Go to a resident's profile using the search at the top right of your screen, or click their name from All Residents or any other page.
2. Click the Emergency Packet button beneath the resident photo.

All you need is one person staffed per shift who knows how to generate and print this file if needed in an emergency.

What items are included in the Emergency Packet?

• By default, the ALIS Facesheet, Physician Orders, MAR, and COVID-19 Vaccine details are contained in the Emergency Packet.
• Other Resident Compliance items can be included as well, and commonly included are Insurance Cards and Advance Directives documents.
• To learn more about configuring the Emergency Packet, read this article: How to set up your Emergency Packet

Once you know which items should be included in the Emergency Packet, it is necessary to verify that you have all of these items completed for all residents. If the item is not completed, it won't be included in the Emergency Packet.

Here are some ways to audit the completeness of items often included in the Emergency Packet:

• For Facesheets, go to All Residents and click the Print Facesheets button in the middle of the page to generate a document containing all resident Facesheets. This will allow you to review each of them to determine if you need add information to any resident's profile in order to complete all the sections on a resident's Facesheet. For more details about the ALIS Facesheet, read this article: Reading the ALIS-Generated Facesheet
• The Physician Orders and MAR documents contain information that comes from a resident's Manage Orders page and their med administration records in ALIS.
• For COVID-19 certificates, it is necessary to review the COVID-19 Tracking section of the resident's profile and click the Vaccinations tab. Here, you can see on the left side of the table if there is a Vaccination Certificate already on file. To add a Vaccine certificate, click Upload Certificate.
• For other documents in the Emergency Packet, the easiest way to check for completion is to use the Resident Compliance Details Report. You can filter the report for a the specific item or items you are auditing, and the table will show the completeness of each item for each resident. If you need to make updates to any of the items (such as uploading an insurance card or filling out a form), you can click on the resident's name in the report and go to their Compliance Details section to complete the items you need. 

Guide to Observations

"Observations" in ALIS are notes. This solution is most often used to keep track of notes for a resident's official clinical chart and for staff member notes to keep track of information from other shifts. We can utilize this solution to keep track of any type of note, and the different types are kept separate in order to protect resident privacy. Keeping track of notes electronically keeps all information legible and easy to find later!   

Create a New Observation note

1. Click to add a new observation in one of these three places:
   • New Observation icon on the Dashboard
   • Observation Center +Record New Observation button
   • Resident's profile page +Observation button under the resident photo
2. All three options will open a pane from the right side of your screen to add all note details.
   • The top of this pane gives us an option to record this note about a specific resident or group of residents, or for the Community in general. While less common, some uses for the Community option would be notes or questions about building maintenance, staff meetings, or overall safety protocols.
   • In the Resident menu, usually we want to select one person. We also have the option to select multiple people if we would like a particular note to be on multiple peoples' charts. This can be used to report on vaccinations or testing that is done for multiple residents.
   • The options in the Type menu are very important for staff to understand. These types can be completely customized, and almost always include a Nurse's Notes type, Progress Notes, and a type for Care staff to use for internal communication. We can also restrict types to only be used by specific staff members. These types can be thought of as separate notebooks where we would record different types of notes. Contact ALIS Support to set up the types and any restrictions you need!
   • Date and Time can be updated if needed.
   • The Observation Summary is the note itself. This is a free text field where staff can type anything they want to communicate. It is a good idea to establish a policy at your building about the content you want staff to include in the notes.
   • The Severity menu gives you the option to mark any note as Critical. This will create a red Critical badge on this note in the Observation Center, and it is possible to set up staff to receive ALIS Alerts when notes marked Critical are added.
     
   • The Keep Active For menu determines how long the note will be editable to the person who creates it. Most of the time there is no reason to click on this menu. Administrators can always edit any note at any time.
3. All observation notes are accessible in ALIS forever! They can be viewed and printed from in the Observation Center, and you can search for a note using criteria such as Observation Type, resident name, and date.

The Observation Center

This page is a report of all Observation notes added to ALIS and Observation notes can be added here. The icon on the Dashboard will show a red badge number indicating how many Observations have been added to ALIS since you last visited the Observation Center page.

The Observation Center is the first place staff should visit when they log in to ALIS in order to review important information from other staff members. When we access this page, by default we see all Observations added at the community for the last two weeks.

Searching for notes and exporting information from the Observation Center

1. Become familiar with the filters at the top of this page. These are intended to make it easy for you to find any notes added for a specific resident for any range of time, and to give you the option to view only one or specific Observation Types.
2. Once you have updated the filters to show the desired Observations in the table below, you may choose to use the Print button to generate these in PDF format for easy reading, or use the Export to Excel button to look at larger sets of data in a spreadsheet.
3. For state surveys, a good practice is to update the Observation Type filter for Nurse's Notes only, search for a specific resident your surveyor is requesting in the Resident filter, and use the Date Range filter to either type a range of dates or click the calendar to select the date range your surveyor requests. When the desired list of notes is showing on the page, click the Print button to present the information to the surveyor on paper.

Vitals in Observation Notes

We can set certain Observation Types to provide specific fields for vitals records when your team is creating an Observation Note. This requires us to update the settings for your Observation Type to specify the Nurse security role. This allows us to exclude other security roles if needed. Contact ALIS Support or your onboarding manager for help setting this up!  

Vitals recorded here will be viewable in the Vital Sign Details and Vital Sign Summary reports!

Observations FAQs

What does the "Keep Active For" time length do?

This is how long the Observation will be editable to the creator and other people with the same permissions. Administrators can always edit any Observations regardless of this setting. The "Active" status of an Observation Note indicates only that it is editable to people who are not Administrators. This does not dictate notes being deleted, archived somewhere else, or somehow unavailable for viewing in the future. All notes can always be viewed in the Observation Center based on the filters at the top!

I want to export Nurse's Notes for my survey or to include in a resident's paper chart. How do I avoid exposing Observations made by care staff?

Notes made by care staff are sometimes less formal and should not be part of the resident's official chart. If we want to export or view only Nurse's Notes, this can be done using the Observation Type filter at the top of the Observation Center. From this menu, select only Nurse's Note.

Then, the table below will only show this note type, and we can Print this list or export to Excel. This is the recommended practice for state surveys. Also, any Observation Type can be restricted by ALIS Security Role, so if you want only Nurses and Administrators to be able to create Nurse's Notes, this can be achieved in settings! Contact ALIS Support for help with this setting.

How do I complete an incident report?

There are multiple Complete buttons in ALIS Incident Reports. The goal is to complete all forms and tasks, and then mark the overall Incident Report completed.

Follow the steps in order below to make sure all details are accounted for.

Step 1: Navigate to your Incident Report

After you create your incident report (this can be done on your ALIS home page, resident profile page, or in the Incident Center), it is a good practice to click the button on the right that says Create and Go To Incident Report.

• Even if you don't have time to finish everything immediately, this will take to you to the page where you can see all the next steps to complete the incident.

The Incident Center 

You can always access any Incident Report in the Incident Center. By default, this page only shows reports that were dated for the previous week. Update the date filter to include the report you want to complete.

Look at the Status, Forms, and Tasks columns to check for completion. Click the Edit button to the right of the Incident Report for next steps.

• Completed forms will display as blue clickable links and completed tasks will show as a fraction of the total required.
  • If you remember completing a form but it is not showing in the Incident Center as a clickable link, you need to edit the incident report and make sure the Status of the form is 'Completed' as explained in the steps below. It is easy to forget the last step of marking the form Complete!
• When everything is done correctly, the status should display 'Complete' only when all forms and tasks are complete.
  • If the status is showing Complete, but there are no links to the forms or it is showing that there are incomplete tasks, you may want to 'Unlock' the incident report and finish everything before marking it as Complete again.
  • The Unlock option is typically only available to administrators.
  • To unlock an Incident Report with the Complete status, click the View button to the right. 
    • At the top right of the Incident report page, click Unlock. A pop-up will ask you to confirm.
    • Once it is unlocked, you can complete the forms and tasks as described in the next steps.

Step 2: Complete the Forms

You may have one or more forms required for your incident report. The forms you have to complete are determined by the Incident Type, which we typically help your team set up during onboarding. These forms can always be adjusted in your settings. Contact us for help!

You may have forms available here that are optional, and you will need to be aware of your company's policy regarding which forms to do.

You can use the Choose File or Fill Online buttons to complete the document, and when you are done, click the Complete button to the right of the form. This step is often missed! Make sure when you are done with the forms, the Status column says 'Completed'. 

Step 3: Complete the Tasks

Often there are tasks set up for the Incident Types, but it is possible there are none. These are meant to be used like a checklist, and all you need to do to complete them is click the Mark Complete button and add a note.

A task may be asking a specific question, and you can answer this with the note. The task may also suggest that you call a specific person or review the resident's Care Plan. The tasks can be set up custom for your community's Incident Report process. 

Final Step: Mark Complete for the Incident Report

After completing the necessary forms and tasks, you may have already clicked several buttons labeled 'Complete'! Now we have a final Complete button to click at the top right of the Incident Report page. This button may be only available to people with higher security levels.