Alzheimer’s Special Care Disclosure Act Sample Form

by Abbie J. Widger

This article was written for The Nebraska Health Care Association.

The Alzheimer’s Special Care Disclosure Act, passed by the Nebraska Legislature in 1994, and amended in 2010, provides for a disclosure by nursing homes and assisted living facilities that claim to provide special care for persons who have Alzheimer’s disease, dementia, or a related disorder.  The provisions from the Act are intended to require facilities to disclose the reasons for the claims, require records of such disclosures to be kept, and require the Department of Health and Human Services to examine the records.  Thus, if a nursing home or assisted living facility advertises, markets, or otherwise promotes the facility as providing specialized Alzheimer’s disease, dementia or related disorder care services, the facility is to disclose the form of care or treatment provided.  The disclosure is to be made to the Nebraska Department of Health and Human Services and to any person seeking placement within an Alzheimer’s special care unit.

The statute outlines the areas which are to be disclosed.  Please click here for a sample disclosure form for use by those nursing facilities or assisted living facilities which promote Alzheimer’s care, dementia care, or related disorder care services.  Please note that each facility should personalize the disclosure to meet the needs of the individual facility.