Current through Register Vol. 30, No. 38, September 20, 2024
A. An
administrator shall ensure that:
1. A resident
is admitted based upon:
a. The resident's
primary condition for which the resident is admitted to the behavioral health
residential facility being a behavioral health issue, and
b. The resident's behavioral health issue and
treatment needs are within the behavioral health residential facility's scope
of services;
2. A
behavioral health professional, authorized by policies and procedures to admit
a resident, is available;
3. Except
as provided in subsection (A)(4), general consent is obtained from:
a. An adult resident or the resident's
representative before or at the time of admission, or
b. A resident's representative, if the
resident is not an adult;
4. General consent is not required from a
patient receiving a court-ordered evaluation or court-ordered
treatment;
5. The general consent
obtained in subsection (A)(3) is documented in the resident's medical
record;
6. Except as provided in
subsection (E)(1)(a), a medical practitioner performs a medical history and
physical examination or a registered nurse performs a nursing assessment on a
resident within 30 calendar days before admission or within 72 hours after
admission and documents the medical history and physical examination or nursing
assessment in the resident's medical record within 72 hours after
admission;
7. If a medical
practitioner performs a medical history and physical examination or a nurse
performs a nursing assessment on a resident before admission, the medical
practitioner enters an interval note or the nurse enters a progress note in the
resident's medical record within seven calendar days after admission;
8. If a
behavioral health assessment is conducted by a:
a. Behavioral health technician or registered
nurse, within 24 hours a behavioral health professional, certified or licensed
to provide the behavioral health services needed by the resident, reviews and
signs the behavioral health assessment to ensure that the behavioral health
assessment identifies the behavioral health services needed by the resident;
or
b. Behavioral health
paraprofessional, a behavioral health professional, certified or licensed to
provide the behavioral health services needed by the resident, supervises the
behavioral health paraprofessional during the completion of the assessment and
signs the assessment to ensure that the assessment identifies the behavioral
health services needed by the resident;
9. Except as provided in
subsection (A)(10), a behavioral health assessment for a resident is completed
before treatment for the resident is initiated;
10. If a behavioral
health assessment that complies with the requirements in this Section is
received from a behavioral health provider other than the behavioral health
residential facility or if the behavioral health residential facility has a
medical record for the resident that contains a behavioral health assessment
that was completed within 12 months before the date of the resident's current
admission:
a. The resident's assessment
information is reviewed before treatment for the resident is initiated and
updated if additional information that affects the resident's assessment is
identified, and
b. The review and
update of the resident's assessment information is documented in the resident's
medical record within 48 hours after the review is completed;
11. A behavioral health
assessment:
a. Documents a resident's:
i. Presenting issue;
ii. Substance abuse history;
iii. Co-occurring disorder;
iv. Legal history, including:
(1) Custody,
(2) Guardianship, and
(3) Pending litigation;
v. Criminal justice record;
vi. Family history;
vii. Behavioral health treatment history;
viii. Symptoms reported by the
resident; and
ix. Referrals needed
by the resident, if any;
b. Includes:
i. Recommendations for further assessment or
examination of the resident's needs,
ii. The physical health services or ancillary
services that will be provided to the resident until the resident's treatment
plan is completed, and
iii. The
signature and date signed of the personnel member conducting the behavioral
health assessment; and
c.
Is documented in resident's medical record;
12. A
resident is referred to a medical practitioner if a determination is made that
the resident requires immediate physical health services or the resident's
behavioral health issue may be related to the resident's medical condition; and
13. Except as provided
in subsection (E)(1)(d), a resident provides evidence of freedom from
infectious tuberculosis:
a. Before or within
seven calendar days after the resident's admission, and
b. As specified in
R9-10-113.
B. An
administrator shall ensure that:
1. A request
for participation in a resident's behavioral health assessment is made to the
resident or the resident's representative,
2. An opportunity for participation in the
resident's behavioral health assessment is provided to the resident or the
resident's representative, and
3.
The request in subsection (B)(1) and the opportunity in subsection (B)(2) are
documented in the resident's medical record.
C. An administrator shall ensure that a
resident's behavioral health assessment information is documented in the
medical record within 48 hours after completing the behavioral health
assessment.
D. If information in
subsection (A)(10) is obtained about a resident after the resident's behavioral
health assessment is completed, an administrator shall ensure that an interval
note, including the information, is documented in the resident's medical record
within 24 hours after the information is obtained.
E. If a behavioral health residential
facility is authorized to provide respite services, an administrator shall
ensure that:
1. Upon admission of a resident
for respite services:
a. Except as provided in
subsection (F), a medical history and physical examination of the resident:
i. Is performed; or
ii. If dated within the previous 12 months,
is available in the resident's medical record from a previous admission to the
behavioral health residential facility;
b. A treatment plan that meets the
requirements in
R9-10-708:
i. Is developed; or
ii. If dated within the previous 12 months,
is available in the resident's medical record from a previous admission to the
behavioral health residential facility;
c. If a treatment plan, dated within the
previous 12 months, is available, the treatment plan is reviewed, updated, and
documented in the resident's medical record; and
d. The resident is not required to comply
with the requirements in subsection (A)(13) if the resident is not expected to
be present in the behavioral health residential facility:
i. For more than seven consecutive days,
or
ii. For 10 days or more days in
a 90-consecutive-day period;
2. The common area required in
R9-10-722(B)(1)(b) provides at least 25 square feet for each resident,
including residents who do not stay overnight; and
3. In addition to the requirements in
R9-10-722(B)(3), toilets and hand-washing sinks are available to residents,
including residents who do not stay overnight, as follows:
a. There is at least one working toilet that
flushes and has a seat and one sink with running water for every 10
residents,
b. There are at least
two working toilets that flush and have seats and two sinks with running water
if there are 11 to 25 residents, and
c. There is at least one additional working
toilet that flushes and has a seat and one additional sink with running water
for each additional 20 residents.
F. A medical history and physical examination
is not required for a child who is admitted or expected to be admitted to a
residential behavioral health facility for less than 10 days in a
90-consecutive-day period.
The following Section was repealed and a new Article
adopted under an exemption from the provisions of the Administrative Procedure
Act which means these rules were not reviewed by the Governor's Regulatory
Review Council; the Department did not submit notice of proposed rulemaking to
the Secretary of State for publication in the Arizona Administrative Register;
and the Department was not required to hold public hearings on these rules
(Supp. 98-4).