(a) General.
(1) A program provider may provide residential services
as:
(A) licensed assisted living, either 18-hour or 24-hour;
or
(B) licensed home health assisted living, either 18-hour
or 24-hour.
(2) A program provider must:
(A) provide personal assistance with ADLs and IADLs;
(B) provide assistance with housekeeping;
(C) provide therapeutic social and recreational activities;
(D) provide on-site response staff to meet scheduled
or unpredictable needs;
(E) provide supervision of an individual's safety and
security; and
(F) provide, make arrangements for, transportation
other than medical transportation.
(3) An individual receiving either licensed assisted
living or licensed home health assisted living must not receive:
(A) in-home respite;
(B) out-of-home respite;
(C) transportation provided as a residential habilitation
activity;
(D) chore services;
(E) CFC PAS/HAB; or
(F) nursing services except those required for program
eligibility.
(4) A program provider must ensure that an individual
transitioning from institutional services to either licensed assisted
living or licensed home health assisted living does not receive TAS.
(5) If an individual is absent from the individual's
residence for six or more hours in a day, the program provider may
bill for 18-hour licensed assisted living or 18-hour licensed home
health assisted living and must not bill for 24-hour licensed assisted
living or 24-hour licensed home health assisted living.
(6) If an individual's IPC includes day habilitation,
the program provider may bill for 18-hour licensed assisted living
or 18-hour licensed home health assisted living for a day on which
the individual participates in day habilitation, but must not bill
for 24-hour licensed assisted living or 24-hour licensed home health
assisted living.
(7) A program provider must maintain documentation
of the daily census using the HHSC Daily Census Documentation form
or a form developed by the program provider that documents the information
on the HHSC Daily Census Documentation form.
(8) A program provider must ensure that an individual's
record includes the individual's progress or lack of progress in achieving
the following outcomes for residential services:
(A) the ability to effectively communicate the individual's
wants and needs to a residential services service provider;
(B) the ability to actively participate in activities
of daily living to the extent of the individual's ability;
(C) the ability to implement the individual's choices;
(D) the ability to access and participate in community
activities; and
(E) the ability to move safely and efficiently within
home and community settings.
(b) Licensed assisted living.
(1) A program provider must provide licensed assisted
living to no more than six persons in an ALF owned by the program
provider.
(2) A program provider must not bill HHSC for the cost
of a minor home modification for an individual who is receiving licensed
assisted living.
(3) A program provider must not charge an individual
or LAR a pet deposit for a service animal, including a guide dog,
signal dog, or other animal individually trained to provide assistance
to an individual who is receiving licensed assisted living.
(4) A program provider must maintain a ledger in accordance
with generally accepted accounting principles with amounts paid for
room and board by an individual who is receiving licensed assisted
living.
(5) A program provider must provide a receipt for amounts
paid for room and board by an individual who is receiving licensed
assisted living.
(c) Licensed home health assisted living.
(1) A program provider must not allow more than three
persons to reside in a residence in which the program provider provides
licensed home health assisted living.
(2) A program provider must ensure that a residence
in which licensed home health assisted living is provided:
(A) is accessible to and usable by the individuals
receiving services in the residence;
(B) is maintained in good repair;
(C) has at least two means of egress from:
(i) the living areas; and
(ii) the individuals' bedrooms;
(D) has working smoke alarms installed to detect smoke
in the kitchen, living areas, and the individuals' bedrooms;
(E) has a universal, fully-charged, and unexpired fire
extinguisher easily accessible:
(i) from the kitchen;
(ii) from the laundry area;
(iii) from the vicinity of a hot water heater or furnace;
(iv) from each bedroom area; and
(v) on each floor of a multi-level residence;
(F) has a first aid kit that complies with American
Red Cross recommendations with contents that are not out-of-date;
(G) has water temperature that does not exceed 110
degrees Fahrenheit from faucets used by an individual who cannot self-regulate
the water temperature from a faucet the individual uses;
(H) has a locked container that can be used to store
the medications for the individual as required by paragraph (3) of
this subsection;
(I) has a place to store flammable or poisonous substances
in a manner that makes them inaccessible to the individuals; and
(J) has a working carbon monoxide detector installed
in each individual's bedroom.
(3) A program provider must ensure:
(A) an individual's prescribed medication is stored
in a locked container and in the original container labeled with:
(i) individual's name;
(ii) date dispensed;
(iii) instructions;
(iv) name of medication with dosage; and
(v) physician's name;
(B) a medication requiring refrigeration is kept separate
from food in a clearly labeled, designated locked container;
(C) a medication that is no longer needed by the individual
or that is past its expiration date is disposed of according to federal
and state laws and regulations;
(D) a medication prescribed for one individual is not
given to another individual; and
(E) an individual takes prescribed medications according
to the physician's instructions and over-the-counter medications according
to the package directions.
(4) A program provider must conduct a home inspection
and document the results of the inspection to determine compliance
with the requirements in paragraph (2) of this subsection for a residence:
(A) before providing services and annually thereafter
for a residence not used to provide licensed home health assisted
living services before September 1, 2014; or
(B) before September 30, 2014 and annually thereafter
for a residence used to provide licensed home health assisted living
before September 1, 2014.
(5) A program provider must ensure correction of any
noncompliance found during the home inspection and document the correction.
(6) A program provider must:
(A) develop and implement a written emergency response
plan for the residence that describes the actions a program provider
will take in the event of an emergency, such as a fire or other man-made
or natural disaster, including evacuation or sheltering-in-place of
the individual, as appropriate; and
(B) ensure that:
(i) the emergency response plan takes into account
the abilities of the individual to follow the plan;
(ii) the individual receives instruction concerning
the emergency response plan:
(I) within 48 hours after the individual moves into
the residence and annually thereafter; and
(II) if the individual's ability to follow the emergency
response plan changes;
(iii) the individual's service providers demonstrate
competence in implementing the emergency response plan at the time
job duties are assumed and annually thereafter;
(iv) the emergency response plan is reviewed and revised
by the program provider when necessary and at least annually; and
(v) a copy of the current emergency response plan is:
(I) maintained in the residence; and
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