| (T) preventive health needs (i.e., blood pressure monitoring,
hearing-vision assessment).
(2) The service plan must be approved and signed by
the resident or a person responsible for the resident's health care
decisions. The facility must provide care according to the service
plan. The service plan must be updated annually and upon a significant
change in condition, based upon an assessment of the resident.
(3) For respite clients, the facility may keep a service
plan for six months from the date on which it is developed. During
that period, the facility may admit the individual as frequently as
needed.
(4) Emergency admissions must be assessed and a service
plan developed for them.
(d) Resident policies.
(1) Before admitting a resident, facility staff must
explain and provide a copy of the disclosure statement to the resident,
family, or responsible party. An assisted living facility that provides
brain injury rehabilitation services must attach to its disclosure
statement a specific statement that licensure as an assisted living
facility does not indicate state review, approval, or endorsement
of the facility's rehabilitative services. The facility must document
receipt of the disclosure statement.
(2) The facility must provide residents with a copy
of the Resident Bill of Rights.
(3) When a resident is admitted, the facility must
provide to the resident's immediate family, and document the family's
receipt of, the DADS telephone hotline number to report suspected
abuse, neglect, or exploitation, as referenced in §92.102 of
this chapter (relating to Abuse, Neglect, or Exploitation Reportable
to DADS).
(4) The facility must have written policies regarding
residents accepted, services provided, charges, refunds, responsibilities
of facility and residents, privileges of residents, and other rules
and regulations.
(5) Each facility must make available copies of the
resident policies to staff and to residents or residents' responsible
parties at time of admission. Documented notification of any changes
to the policies must occur before the effective date of the changes.
(6) Before or upon admission of a resident, a facility
must notify the resident and, if applicable, the resident's legally
authorized representative, of DADS rules and the facility's policies
related to restraint and seclusion.
(e) Admission policies.
(1) A facility must not admit or retain a resident
whose needs cannot be met by the facility or who cannot secure the
necessary services from an outside resource. As part of the facility's
general supervision and oversight of the physical and mental well-being
of its residents, the facility remains responsible for all care provided
at the facility. If the individual is appropriate for placement in
a facility, then the decision that additional services are necessary
and can be secured is the responsibility of facility management with
written concurrence of the resident, resident's attending physician,
or legal representative. Regardless of the possibility of "aging in
place" or securing additional services, the facility must meet all
Life Safety Code requirements based on each resident's evacuation
capabilities, except as provided in subsection (f) of this section.
(2) There must be a written admission agreement between
the facility and the resident. The agreement must specify such details
as services to be provided and the charges for the services. If the
facility provides services and supplies that could be a Medicare benefit,
the facility must provide the resident a statement that such services
and supplies could be a Medicare benefit.
(3) A facility must share a copy of the facility disclosure
statement, rate schedule, and individual resident service plan with
outside resources that provide any additional services to a resident.
Outside resources must provide facilities with a copy of their resident
care plans and must document, at the facility, any services provided,
on the day provided.
(4) Each resident must have a health examination by
a physician performed within 30 days before admission or 14 days after
admission, unless a transferring hospital or facility has a physical
examination in the medical record.
(5) The assisted living facility must secure at the
time of admission of a resident the following identifying information:
(A) full name of resident;
(B) social security number;
(C) usual residence (where resident lived before admission);
(D) sex;
(E) marital status;
(F) date of birth;
(G) place of birth;
(H) usual occupation (during most of working life);
(I) family, other persons named by the resident, and
physician for emergency notification;
(J) pharmacy preference; and
(K) Medicaid/Medicare number, if available.
(f) Inappropriate placement in Type A or Type B facilities.
(1) DADS or a facility may determine that a resident
is inappropriately placed in the facility if a resident experiences
a change of condition but continues to meet the facility evacuation
criteria.
(A) If DADS determines the resident is inappropriately
placed and the facility is willing to retain the resident, the facility
is not required to discharge the resident if, within 10 working days
after receiving the Statement of Licensing Violations and Plan of
Correction, Form 3724, and the Report of Contact, Form 3614-A, from
DADS, the facility submits the following to the DADS regional office:
(i) Physician's Assessment, Form 1126, indicating that
the resident is appropriately placed and describing the resident's
medical conditions and related nursing needs, ambulatory and transfer
abilities, and mental status;
(ii) Resident's Request to Remain in Facility, Form
1125, indicating that:
(I) the resident wants to remain at the facility;
or
(II) if the resident lacks capacity to provide a written
statement, the resident's family member or legally authorized representative
wants the resident to remain at the facility; and
(iii) Facility Request, Form 1124, indicating that
the facility agrees that the resident may remain at the facility.
(B) If the facility initiates the request for an inappropriately
placed resident to remain in the facility, the facility must complete
and date the forms described in subparagraph (A) of this paragraph
and submit them to the DADS regional office within 10 working days
after the date the facility determines the resident is inappropriately
placed, as indicated on the DADS prescribed forms.
(2) DADS or a facility may determine that a resident
is inappropriately placed in the facility if the facility does not
meet all requirements referenced in §92.3 of this chapter (relating
to Types of Assisted Living Facilities) for the evacuation of a designated
resident.
(A) If, during a site visit, DADS determines that a
resident is inappropriately placed at the facility and the facility
is willing to retain the resident, the facility must request an evacuation
waiver as described in subparagraph (C) of this paragraph to the DADS
regional office within 10 working days after the date the facility
receives the Statement of Licensing Violations and Plan of Correction,
Form 372, and the Report of Contact, Form 3614-A. If the facility
is not willing to retain the resident, the facility must discharge
the resident within 30 days after receiving the Statement of Licensing
Violations and Plan of Correction and the Report of Contact.
(B) If the facility initiates the request for a resident
to remain in the facility, the facility must request an evacuation
waiver as described in subparagraph (C) of this paragraph from the
DADS regional office within 10 working days after the date the facility
determines the resident is inappropriately placed, as indicated on
the DADS prescribed forms.
(C) To request an evacuation waiver for an inappropriately
placed resident, a facility must submit to the DADS regional office:
(i) Physician's Assessment, Form 1126, indicating that
the resident is appropriately placed and describing the resident's
medical conditions and related nursing needs, ambulatory and transfer
abilities, and mental status;
(ii) Resident's Request to Remain in Facility, Form
1125, indicating that:
(I) the resident wants to remain at the facility; or
(II) if the resident lacks capacity to provide a written
statement, the resident's family member or legally authorized representative
wants the resident to remain at the facility;
(iii) Facility Request, Form 1124, indicating that
the facility agrees that the resident may remain at the facility;
Cont'd... |
