Section 400.1407. Resident admission and discharge criteria; resident assessment plan; resident care agreement; house guidelines; fee schedule; physician's instructions; health care appraisal.  


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  • (1) A licensee shall not accept, retain, or care for a resident who, in accordance with a licensed physician's medical diagnosis and opinion, requires continuous nursing care. This does not  preclude  the accommodation of a resident who becomes temporarily ill while in the home, but who does not require continuous nursing care.

    (2)    A licensee shall not accept or retain a resident for care unless and until a resident assessment plan is made and it is determined that the resident is suitable pursuant to the following provisions:

    (a)    The amount of personal care, supervision, and protection required by the resident is available in the home.

    (b)   The kinds of services and skills required of the home to meet the resident's needs are available in the home.

    (c)   The resident appears to be compatible with other residents and members of the household.

    (3)   In situations where a resident is referred for admission, the resident assessment plan shall be conducted in conjunction with the resident or the resident's designated representative, the responsible agency, and the licensee. A licensee shall  maintain  a copy of the resident's written assessment plan on file in the home.

    (4)    In situations where a resident is referred for emergency admission and the licensee agrees to accept the admission, a resident assessment plan shall be conducted within 15 calendar days following the emergency admission. The resident assessment plan shall be conducted in accordance to the provisions outlined in subrules (2) and (3) of this rule.

    (5)    At the time of a resident's admission, a licensee shall complete a written resident care agreement which shall be established between the resident or the resident's   designated    representative,    the    responsible agency, and the licensee. A

    department form shall  be  used   unless  prior authorization for a substitute form has been granted in writing by the department. A resident shall be provided the care and services as stated in the written resident care agreement.

    (6)   A licensee shall review the written resident care agreement with the resident or the resident's designated representative and  responsible agency at least annually or more often if necessary.

    (7)   A licensee shall contact a resident's physician for instructions as to the care of the resident under the following conditions:

    (a)    If the resident is under the care of a physician at the time of the resident's admission to the home.

    (b)   If the resident requires the care of a physician while living in the home.

    (8)   A licensee shall record in the resident's   record  the  physician's instructions for the care of the resident as required in  subrule  (7)  of this rule.

    (9)   If a resident is not under the care of a physician at the time of the resident's admission to the home, the licensee shall require that the resident or the resident's designated  representative  provide  a   written health care appraisal  completed  within the  90-day  period   before   the resident's admission to the home. If a written health care appraisal is not available, a licensee shall require that the appraisal   be  obtained not later than 30 days after admission. A department form shall be used unless prior authorization for a substitute form has been granted in  writing   by the department.

    (10)   A licensee may establish house guidelines. House guidelines, if established, shall be provided in writing to the resident  or  the resident's designated representative and responsible agency upon admission to the home or, if established after a  resident's  admission  to  the  home, immediately thereafter. House guidelines shall not  conflict   with  these rules.

    (11)   A licensee shall provide a resident  or   his  or  her  designated representative and responsible agency with a statement of the fee policy at the time of admission. A fee   statement   shall   include  all   of  the following:

    (a)   A description of services to be provided and the fee.

    (b)   A description of additional costs above the basic fee policy.

    (c)    A description of the transportation costs in the basic fee structure and the transportation which is provided at extra cost.

    (12)    A licensee shall provide a resident with a 30-day written notice before discharge from the home. The written notice shall state the reasons for discharge. A copy of  the  written  notice  shall  be  sent  to  the resident's designated representative and responsible agency.

    (13)   A licensee may discharge a resident before the 30-day notice when it has been determined that any of the following exists:

    (a)   Substantial risk or an occurrence of self-destructive behavior.

    (b)   Substantial risk or an occurrence of serious physical assault.

    (c)   Substantial risk or an occurrence of destruction of property.

    (14)   A licensee who discharges a resident pursuant to subrule (13) of this rule shall  notify  the  resident's   designated  representative  and responsible agency within 24 hours  before   discharge.  Such   notification shall be followed  by  a  written  notice to the  resident's   designated representative and responsible agency stating the reasons for  discharge.

    (15)   A licensee shall not change the residency of a resident from one home to another without the written approval of the resident or the resident's designated representative and responsible agency.

    (16)   A licensee shall not  establish  any  policies  that   restrict   the resident's ability to make his or her own living arrangements.

    (17)    At the time of discharge, a  licensee  shall  provide  copies   of resident records to the resident and his or her designated representative when requested and as determined appropriate by the resident or his or her designated representative. A fee charged for copies of resident records shall not exceed the cost to the licensee for making the copies available.

History: 1984 AACS.