Alabama Administrative Code
Title 420 - ALABAMA STATE BOARD OF HEALTH
Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES
Section 420-5-20-.01 - General
Universal Citation: AL Admin Code R 420-5-20-.01
Current through Register Vol. 42, No. 11, August 30, 2024
(1) Legal Authority for Adoption of Rules. Under and by virtue of the authority vested in it by the Legislature of Alabama, Code of Ala. 1975, Sections 22-21-20, et. seq., the Alabama State Board of Health does hereby adopt and promulgate the following Rules governing all specialty care assisted living facilities.
(2) Definitions.
(a) "Advisory Board" means the Licensure
Advisory Board established by law to serve as a consultant to the State Health
Officer and to assist in rule making necessary to carry out the provisions of
Code of Ala. 1975, Section
22-21-20, et. seq.
(b) "Assisted Living Facility" means an
individual, individuals, corporation, partnership, limited partnership, limited
liability company, or any other entity that provides, or offers to provide, any
combination of residence, health supervision, and personal care to three or
more individuals who are in need of assistance with activities of daily living
which include bathing, dressing, ambulation, feeding, toileting, grooming,
medication assistance, diet, and personal safety. Exceptions to this definition
are:
1. Individuals who provide residential
and personal care services solely to persons to whom they are personally
related, shall not be deemed to be an assisted living facility. "Personally
related" means that the person receiving the residential and personal care
services is the spouse, parent, sibling, adult child, adult grandchild,
grandparent, great-grandparent, adult niece, adult nephew, aunt, uncle, or
first cousin of the person providing such services, or stands in that relation
to the current spouse of the person providing the services. This exception is
only for individuals, and does not apply to corporations, partnerships, limited
partnerships, limited liability companies, or any other organized entity or
business.
2. Facilities whose
residents are under the care, oversight, or protection of another governmental
agency shall not be deemed to be assisted living facilities and shall not be
subject to these rules, if both of the following conditions are satisfied:
(i) A federal, state, or other governmental
body, agency, or authority has a fiduciary relationship or some other legally
recognized and enforceable relationship to the residents of the facility which
carries an obligation to oversee the health, safety, and welfare of the
residents.
(ii) The federal, state,
or other governmental body, agency, or authority licenses, certifies, or
otherwise legally authorizes the facility to provide accommodations and care
for the residents.
(c) "Abuse" means the willful infliction of
injury, unreasonable confinement, intimidation, or punishment with resulting
physical harm, pain, or mental anguish. Abuse shall also include mental abuse,
physical abuse, sexual abuse, and verbal abuse, as defined below.
(i) "Mental Abuse" means any willful act
directed at a resident that is intended to result in or that is likely to
result in mental distress or mental anguish. It includes humiliation,
harassment, threats of punishment, and threats of deprivation.
(ii) "Physical Abuse" means any willful act
directed at a resident that is intended to result in or that is likely to
result in injury or pain. Physical abuse includes slapping, pinching, kicking,
shoving, and corporal punishment of any kind.
(iii) "Sexual Abuse" means any sexually
oriented behavior directed at a resident by a staff member, any sexually
oriented behavior between residents that is not fully and freely consented to
by both residents involved, any sexually oriented behavior between residents
when either or both residents are incapable of consenting to the behavior
because of cognitive impairment, or any sexually oriented behavior by a visitor
directed at a resident incapable of consenting to the behavior because of
cognitive impairment.
(iv) "Verbal
Abuse" means the use of oral, written, or gestured language that willfully
includes disparaging or derogatory terms to residents or their families, or
that is used or uttered within the hearing distance of residents or their
families, regardless of their age, ability to comprehend, or disability.
Examples of verbal abuse include threats of harm, or saying things to frighten
a resident; such as telling a resident that the resident will never see his or
her family again.
(d)
"Bed Capacity" means the maximum number of beds which can be installed or set
up in a specialty care assisted living facility at any given time for use of
residents. The bed capacity shall be based upon space designed or specifically
intended for such use, whether or not the beds are actually
installed.
(e) "Bed Complement"
means the number of beds normally installed in a specialty care assisted living
facility for use of the residents.
(f) "Board," or "State Board of Health" means
the Alabama State Board of Health.
(g) "Bureau" means the Bureau of Health
Provider Standards, Alabama Department of Public Health.
(h) "Closure" means that the facility has no
current occupants which are classified as residents of the facility and is not
accepting and admitting new residents.
(i) "Congregate Specialty Care Assisted
Living Facility" means a specialty care assisted living facility authorized to
care for 17 or more adults.
(j)
"Department" means the Alabama Department of Public Health.
(k) "Elopement" means a resident who is
incapable of protecting himself or herself from harm is able to successfully
leave a safe area or safe premises.
(l) "Exploitation" means the deliberate
misplacement or wrongful temporary or permanent use of a resident's belongings,
money, or property without the resident's consent.
(m) "Group Specialty Care Assisted Living
Facility" means a specialty care assisted living facility authorized to care
for 3 to 16 adults.
(n) "License"
means the legal authority granted by the State Board of Health to operate a
facility.
(o) "License Certificate"
means the document issued by the State Board of Health and signed by the State
Health Officer that constitutes rebuttable evidence of the facility's legal
authority to operate.
(p) "Licensed
Bed Capacity" means the number of beds for which the facility has been issued a
certificate of licensure by the Department. The Licensed Bed Capacity is also
the maximum daily census that a specialty care assisted living facility may
have in its capacity.
(q) "Licensed
Practical Nurse" (LPN) means a person currently licensed as a licensed
Practical Nurse by the State of Alabama Board of Nursing in accordance with
Code of Ala. 1975, Sections
34-21-1, et. seq.
(r) "Mechanical Restraint" means any manual
method or physical or mechanical device, material, or equipment that the
resident cannot remove which restricts freedom of movement or normal access to
one's body (e.g. leg restraints, arm restraints, hand mitts, soft ties or
vests, lap cushions, and lap trays). Facility practices that meet the
definition of a restraint include, but are not limited to: using side rails
that keep a resident from voluntarily getting out of bed; tucking in, tying, or
using devices or materials to hold a sheet, fabric, or clothing tightly so that
a resident's movement is restricted; using devices in conjunction with a chair,
such as trays, tables, bars, or belts that the resident cannot remove, that
prevent the resident from rising; placing a resident in a chair that prevents
the resident from rising; and placing a chair or bed so close to a structure
that the structure prevents the resident from rising out of the chair or
voluntarily getting out of bed.
(s)
"Medication" means all substances having medicinal properties intended for
external and/or internal use for the treatment, prevention, diagnosing, or
curing of any disease, illness, malady, etc., in humans. The term "medication"
as defined in the Pharmacological Basis of Therapeutics shall encompass all
other synonymous terms such as drugs, biologicals, chemicals, potions,
remedies, or poisons.
(t)
"Medication Administration" means the act of giving medications to residents by
a nurse or physician as defined in these rules.
(u) "Medication Error" means any preventable
event that causes or leads to inappropriate medication use or harm while
medication is in the control of the specialty care assisted living facility
staff or resident."
(v) "Neglect"
means the failure to provide goods and services necessary to avoid physical
harm or mental distress or anguish.
(w) "Pharmacist" means a person currently
licensed to practice pharmacy in Alabama under the provisions of
Code of Ala. 1975, Sections
34-23-1, et. seq.
(x) "Physician" means a person currently
licensed by the Medical Licensure Commission of Alabama to practice medicine
and surgery in Alabama. The use of the word "physician" in these rules shall
not be deemed to preclude a properly licensed nurse practitioner or a physician
assistant from performing any function in a specialty care assisted living
facility that is within that individual's scope of practice.
(y) "Qualified Dietitian" means a person who
is currently licensed in the State of Alabama in accordance with the provisions
contained in current state statutes as governed by the Board of Examiners for
Dietetic/Nutrition Practice.
(z)
"Registered Professional Nurse" (RN) means a person currently licensed as a
Registered Professional Nurse by the State of Alabama Board of Nursing in
accordance with Code of Ala. 1975,
Section 34-21-21.
(aa) "Resident" means any individual in need
of assistance with activities of daily living that receives residence, health
supervision, or personal care in an assisted living facility.
(bb) "Specialty Care Assisted Living
Facility" means a facility that meets the definition of an Assisted Living
Facility but which is specially licensed and staffed to permit it to care for
residents with a degree of cognitive impairment that would ordinarily make them
ineligible for admission or continued stay in an assisted living
facility.
(3) Procedure Governing Adoption, Amendment, and Rescission of Rules.
(a) Authority. The State Board of Health,
with the advice and approval of the Advisory Board defined in
Code of Ala. 1975, Section
22-21-27, has the legal authority
to adopt, reasonable rules governing the operation and conduct of specialty
care assisted living facilities, and it may amend or rescind any rules
previously adopted.
(b) Procedure.
In adopting, amending, or rescinding rules, the Board shall follow the
provisions of the Alabama Administrative Procedure Act. The effective date of
any rules adopted, amended, or rescinded shall likewise be governed by the
Administrative Procedure Act.
(c)
Joint Hearings. All hearings shall be joint hearings set by the State Board of
Health and the Advisory Board, at which time any interested member of the
public may be heard.
(4) Inspections.
(a) Inspections
Required. Each specialty care assisted living facility for which a license has
been granted may be inspected by the State Board of Health, or by its
authorized representatives at such intervals as the Board may direct. The State
Board of Health and its authorized representatives may inspect construction
work including new facilities, additions, and alterations at any time the
construction work is in progress or after it has been completed.
(b) Information Disclosure. Official reports,
such as statements of deficiencies generated by the State Board of Health as a
result of on-site inspections, and plans of correction submitted in response to
those statements of deficiencies, are subject to public disclosure. Information
received through other means and reports other than statements of deficiencies
shall be deemed to be confidential and shall not be publicly disclosed except
in response to a valid subpoena or court order or in proceedings involving the
affected facility's license or proceedings involving the license of another
facility operated by the same governing authority. Confidential records in the
possession of the Department are deemed to be records in the possession of the
State of Alabama, and shall be freely shared with any other State of Alabama
agency that presents a good reason for access to the records.
(5) Closures.
(a) Facility closures which are temporary, or
less than 30 days in length, must be reported to the Department in advance and
authorized. Such closures do not result in automatic termination of the
facility license.
(b) Facility
closures of greater than 30 days, unless authorized by the Department, will
result in the license becoming null and void. Any owner or operator wishing to
reopen the facility as a specialty care assisted living facility shall be
required to file an initial licensure application to include plan review and
building inspection and obtain a certificate of completion before processing of
the application by the Department.
Authors: Rick Harris, Kelley Mitchell
Statutory Authority: Code of Ala. 1975, §§ 22-21-20, et seq.
Disclaimer: These regulations may not be the most recent version. Alabama may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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