Section 325.1922. Admission and retention of residents.  


Latest version.

All data is extracted from pdf, click here to view the pdf.

  • (1) A home shall have a written resident admission contract, program statement, admission and discharge policy and a resident's service plan for each resident.

    (2)    The admission policy shall specify all of the following:

    (a)      That at the time of admission, the home shall document the needs of each individual seeking admission. The documented needs shall be used to develop the resident's service plan.

    (b)       That a home shall not accept an individual seeking admission unless the individual's needs can be adequately and appropriately met within the scope of the home's program statement.

    (c)         That the individual seeking admission and his or her  authorized representative,   if  any,  shall  participate  in  the  development   of  the individual's service plan.

    (d)         The home's policy governing the annual screening of residents for tuberculosis.

    (3)      At the time of an individual's admission, a home or  the  home's designee shall complete a written resident admission contract between the resident and/or the resident's authorized representative, if any, and the home. The resident admission contract shall, at a minimum, specify all of the following:

    (a)     That the home shall provide room, board, protection, supervision, assistance, and supervised personal  care consistent with the resident's service plan.

    (b)     The services to be provided and the fees for the services.

    (c)     The notice to be provided by the home to the resident and/or the resident's authorized representative, if any, upon any change in fees.

    (d)      The transportation services that are provided, if any, and the fees for those services.

    (e)     The home's admission and discharge policy.

    (f)    The home's refund policy.

    (g)      The resident's rights and responsibilities, which shall include those rights and responsibilities specified in MCL 33.20201(2)  and (3) and MCL 333.20202.

    (4)      If there is a change in a term or condition in the written resident admission contract, then the home or home's designee shall review the change with the resident and the resident's authorized representative, if any.

    (5)     A home shall update each resident's service plan at least annually or if there is a significant change in the resident's care needs. Changes shall be communicated to the resident and his or her authorized representative,  if any.

    (6)     A home shall require an individual who, at the time of admission, is under the care of a licensed health care professional for ongoing treatments or prescription medications that require the home's intervention or oversight, to provide a written statement from that licensed health care professional completed within the 90-day period before the individual's admission to the home. The statement shall list those treatments or medications for the purpose of  developing   and  implementing   the resident's service plan. If this statement is not available at the time of an emergency admission, then the home shall require that the statement be obtained not later than 30 days after admission.

    (7)        An individual admitted to residence in the home shall have evidence of tuberculosis screening on record in the home  which  consists  of  an intradermal skin test, chest x-ray, or other methods recommended by the local health authority performed within 12 months before admission.

    (8)     A home shall not retain a resident if the resident has harmed himself or herself or others, or has demonstrated behaviors that pose a risk of serious harm to himself or herself  or others,  unless  the  home has  the capacity to manage the resident's behavior.

    (9)      A home shall not admit a resident who requires continuous nursing care services of the kind normally provided in a nursing home as specified in MCL 333.21711(3) and MCL 333.21715(2).

    (10)       A home shall not retain a resident who requires continuous nursing care services of any kind normally provided in a nursing home as specified in MCL 333.21711(3) and MCL 333.21715(2) unless the home meets the provisions of MCL 333.21325, or the individual is enrolled in and receiving services from a licensed hospice program or a home health agency.

    (11)      In accordance with MCL 333.20201(3)(e), a home's discharge policy shall specify that a home for the aged resident  may be  transferred  or discharged for any of the following reasons:

    (a)     Medical reasons.

    (b)     His or her welfare or that of other residents.

    (c)     For nonpayment of his or her stay.

    (d)    Transfer or discharge sought by resident or authorized representative.

    (12)      The reason for transfer or discharge shall be documented in the resident record.

    (13)        A home shall provide a resident and his or  her  authorized representative, if any, and the agency responsible  for  the  resident's placement, if any, with a 30-day written notice before discharge from the home. The written notice shall consist of all of the following:

    (a)    The reasons for discharge.

    (b)     The effective date of the discharge.

    (c)      A statement notifying the resident of the right to file a complaint with the department. The provisions of this subrule do not preclude a home from providing other legal notice as required by law.

    (14)     If the department finds that the resident  was  discharged   in violation of these rules or the home's discharge policy, then the resident may return to the first available bed in the home that can meet the resident's needs as identified in the resident's service plan.

    (15)      A home may discharge a resident before the 30-day notice if the home has determined and documented that either, or both, of the following exist:

    (a)      Substantial risk to the resident due to the inability of the home to meet the resident's needs or due to the inability of the home to assure the safety and well-being of the resident, other residents, visitors, or staff of the home.

    (b)     A substantial risk or an occurrence of the destruction of property.

    (16)     A home that proposes to discharge a resident for any of the reasons listed in subrule (15) of this rule shall take all of the following steps before discharging the resident:

    (a)     The  home  shall   notify the  resident,  the   resident's  authorized representative, if any, and the  agency   responsible  for  the  resident's placement, if any, not less than 24 hours before discharge. The notice shall be verbal and issued in writing. The notice of discharge shall  include all of the following information:

    (i)       The reason for the proposed discharge, including the specific nature of the substantial risk.

    (ii)     The alternatives to discharge that have been attempted by the  home, if any.

    (iii)     The location to which the resident will be discharged.

    (iv)     The right of the resident to file a complaint with the department.

    (b)     The department and adult protective services shall be notified not less than 24 hours before discharge in the event of either of the following:

    (i)         A resident does not have an authorized representative or an  agency responsible for the residents placement.

    (ii)     The resident does not have a subsequent placement.

    (c)      The notice to the department and adult protective services shall include all of the following information:

    (i)       The reason for the proposed discharge, including the specific nature of the substantial risk.

    (ii)     The alternatives to discharge that have been attempted by the  home, if any.

    (iii)   The location to which the resident will be discharged, if known.

    (d)      If the department finds that the resident was improperly discharged, then the resident may return to the first available bed in the home that can meet the resident's needs as identified in the resident's service plan.

    (e)      The resident shall not be discharged until a subsequent setting that meets the resident's immediate needs is located.

History: 2004 AACS.