(a) Resident care and services. The adult foster care
provider must:
(1) provide services to residents according to the
individual service plan and the resident/provider agreement;
(2) meet all requirements and conditions stated on
the resident/provider agreement, approval of foster care, and resident
service plan;
(3) ensure that an approved substitute provider is
present in the home if at least one resident remains in the home when
the provider plans to be absent from the home for more than three
hours in a 24-hour period. Residents whose care plans specify the
need for 24-hour supervision may not be left without the supervision
of an approved substitute provider for any period of time;
(4) receive prior approval from the adult foster care
caseworker or supervisor if he plans to be absent for more than 24
hours. The proposed substitute provider must have prior Department
of Aging and Disability Services (DADS) approval. The provider must
ensure that the substitute provider is aware of and takes responsibility
for meeting resident needs and providing services according to the
residents service plans and the requirements of these standards. If
two adults in the home have been approved as dual providers, this
notification is not necessary when one provider leaves for more than
24 hours;
(5) ensure that residents are not abused, neglected,
or exploited while in foster care. Validated reports of the provider,
the provider's family, or employees willfully inflicting injury,
physical suffering, intimidation, or mental anguish on any resident
in the home shall constitute grounds for immediate removal of the
home from enrollment;
(6) respond to, investigate, and document resident
complaints and report unresolved complaints to the adult foster care
caseworker within five days of receipt of the complaint;
(7) have clearly defined house rules, including smoking
policies. House rules must be shared with the resident before moving
to the foster home;
(8) take appropriate action if he finds that a resident
threatens the health or safety of others or himself; and
(9) provide the resident with a final accounting of
the resident's funds and refund any monies owed to the resident within
five days of discharge. Any unused room and board money must be reimbursed
within 30 days.
(b) The foster care provider providing services to
three or less residents must comply with Title 42 United States Code
§1396a(w) regarding advance directives.
(c) Recordkeeping. The adult foster care provider must:
(1) maintain for each resident a record with the following
information:
(A) the names, addresses, and telephone numbers of:
(i) person(s) other than DADS staff to be notified
in case of emergency, (if any);
(ii) the resident's physician, (if any); and
(iii) the resident's adult foster care caseworker;
(B) current and past copies of the client and provider
agreement, signed by the resident and/or responsible party, provider,
and the adult foster care caseworker;
(C) current and past copies of the approval of adult
foster care;
(D) current and past copies of the client service plan;
(E) any DADS communications regarding the resident;
(F) personal papers of the resident, such as life insurance
policies, burial arrangements, savings accounts, etc., if requested
by the resident; and
(G) records related to assistance provided the resident
with money management, payments, distribution of personal allowance,
expenditures, etc.;
(2) file claims for services according to DADS rules
using the appropriate DADS forms and agree to accept the claimed amount
as full payment from DADS for services provided. Nursing facility
waiver residents are required to pay a co-payment.
(d) Reporting and notification. The adult foster care
provider must:
(1) report to the adult foster care caseworker, within
24 hours or the next work day after awareness of the change, all significant
changes in the resident's physical health, mental and/or behavior
status;
(2) report to the adult foster care caseworker pending
resident hospitalizations before the hospitalization, and unplanned
hospitalizations within 24 hours of the hospitalization or the next
work day;
(3) report pending hospital discharges of approved
residents to the adult foster care caseworker before the actual discharge,
or on the day the resident returns to the foster care setting, to
ensure continued resident appropriateness;
(4) notify the adult foster care caseworker, at a minimum,
within 24 hours or the next work day after a resident is away from
or vacates the adult foster home;
(5) notify the adult foster care caseworker immediately
by telephone upon becoming aware of the following: death of a resident,
serious physical injury or distress of a resident, offense against
the resident, or public indecency of a resident. The provider must
submit a written report within 48 hours of the verbal report. The
provider must also notify the police in the following situations:
the death of a resident in the foster home, serious physical injury
resulting from assault or battery, offenses against the resident,
and public indecency;
(6) notify the adult foster care caseworker about serious
occurrences involving the provider, the home, or the residents. These
may include, but are not limited to, fire, accidents, altercations
among residents, break-ins, or illness of the provider or residents.
The provider must notify the caseworker by telephone no later than
the next calendar day after awareness of the occurrence;
(7) notify the adult foster care caseworker before
any resident receives home health services;
(8) notify the adult foster care caseworker when the
provider, substitute provider, or a family member is the subject of
an adult protective services investigation. The provider must notify
the adult foster care caseworker within 24 hours of the beginning
of the investigation or the next work day; and
(9) report to the adult foster care caseworker's supervisor
or another adult foster care staff person any of the required notifications
if the caseworker is not available to speak with the provider.
(e) Responding/acting. The adult foster care provider
must:
(1) upon awareness, obtain medical attention for a
resident exhibiting signs of physical injury, pain, or discomfort;
(2) seek medical attention/care on the same day of
awareness for a resident exhibiting acute changes in physical health,
mental or behavior status; and
(3) follow DADS adult foster care directives related
to resident care within the specified time frames.
(f) Nutrition. The adult foster care provider must:
(1) provide a resident with at least three meals daily
which meet each resident's dietary and nutritional needs;
(2) consider a resident's food preferences and make
reasonable accommodations within his dietary needs;
(3) serve a variety of foods, within the resident's
dietary needs; and
(4) follow special diets as prescribed in writing by
the resident's physician.
(g) Medications. The adult foster care provider must
comply with the following rules regarding the storage and management
of medications:
(1) prescription medications must be in the original
container labeled with the resident's name, date, instructions, name
of medication and dosage, and the physician's name;
(2) medications requiring refrigeration must be separated
from food in a clearly labeled, designated locked container;
(3) medications must be transferred with the resident
when the resident leaves the home. Medications must be disposed of
when resident medication regimen changes, or when the medication is
out of date;
(4) medications prescribed for one resident must not
be taken by or given to any other resident;
(5) the adult foster care provider must ensure that
a resident takes over-the-counter medications according to the package
directions. Excessive use of these medications must be reported to
the adult foster care caseworker;
(6) the adult foster care provider must ensure that
all medications are taken as prescribed and in a timely manner according
to the instructions on the medication label or instructions from the
resident's physician;
(7) the adult foster care provider may administer medications
only as allowed by state law or regulation; and
(8) prescription medications must be kept in a locked
container.
(h) Resident rights and responsibilities. The adult
foster care provider must:
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