Hawaii Administrative Rules
Title 11 - DEPARTMENT OF HEALTH
Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS
Chapter 90 - ASSISTED LIVING FACILITY
Section 11-90-8 - Range of services
Universal Citation: HI Admin Rules 11-90-8
Current through February, 2024
(a) Service plan.
(1) The assisted living facility staff shall
conduct a comprehensive assessment of each resident's needs, plan and implement
responsive services, maintain and update resident records as needed, and
periodically evaluate results of the plan. The plan shall reflect the assessed
needs of the resident and resident choices, including resident's level of
involvement; support principles of dignity, privacy, choice, individuality,
independence, and home-like environment; and shall include significant others
who participate in the delivery of services;
(2) A service plan shall be developed and
followed for each resident consistent with the resident's unique physical,
psychological, and social needs, along with recognition of that resident's
capabilities and preferences. The plan shall include a written description of
what services will be provided, who will provide the services, when the
services will be provided, how often services will be provided, and the
expected outcome. Each resident shall actively participate in the development
of the service plan to the extent possible;
(3) The initial service plan shall be
developed prior to the time the resident moves into the facility and shall be
revised if needed within 30 days. The service plan shall be reviewed and
updated by the facility, the resident, and others as designated by the resident
at least annually or more often as needed; and
(4) The facility shall designate a staff
member to review, monitor, implement, and make appropriate modifications to the
service plan for each resident.
(b) Services.
(1) The assisted living facility shall
provide the following:
(A) Twenty-four hour
on-site direct staff to meet the needs of the residents;
(B) Three meals daily, seven days a week,
including modified diets and snacks which have been evaluated and approved by a
dietitian on a semi-annual basis and are appropriate to residents' needs and
choices;
(C) Laundry services to
the extent that the resident is unable to perform these tasks for himself or
herself;
(D) Opportunities for
individual and group socialization;
(E) Services to assist the resident in
performing all activities of daily living, including bathing, eating, dressing,
personal hygiene, grooming, toileting, and ambulation;
(F) Nursing assessment, health monitoring,
and routine nursing tasks, including those which may be delegated to unlicensed
assistive personnel by a currently licensed registered nurse under the
provisions of the state Board of Nursing; and
(G) Household services essential for the
health and comfort of the resident (e.g. floor cleaning, dusting, bed making,
etc.).
(2) The assisted
living facility shall also have the capability to provide or arrange access to
the following services:
(A) Transportation
for medical and social appointments;
(B) Ancillary services for medically related
care (e.g. physician, pharmacist, therapy, podiatry, etc.), barber or beauty
care services, social or recreational opportunities, and other services
necessary to support the resident;
(C) Services for residents who have behavior
problems requiring ongoing staff support, intervention, and
supervision;
(D) Social work
services; and
(E) Maintenance of a
personal fund account for residents showing deposits and withdrawals.
(3) The assisted living facility
shall have policies and procedures relating to medications to include but not
be limited to:
(A) Self-medication:
(i) Residents must have physician or
prescribing advanced practice registered nurse's written order of approval for
self-medication of prescription medications;
(ii) Residents able to handle their own
medication regimen may keep prescription medications in their unit;
(iii) Residents may keep and use
over-the-counter medications in their unit without a written order unless
otherwise indicated by a physician or prescribing advanced practice registered
nurse's written orders;
(iv) If
more than one resident resides in the unit, an assessment shall be made of each
person's ability to safely have medications in the unit. If safety is a factor,
the medication shall be kept in a locked container in the unit; and
(v) Residents who self-medicate with
prescription drugs or maintain over-the-counter drugs in their units shall have
all their medications reviewed by either a registered pharmacist, registered
nurse, or physician at least every 90 days.
(B) Administration of medication:
(i) Prescription and non-prescription
medications which the facility has responsibility for administering to a
resident must be identified in the resident's record and must be prescribed in
writing for the resident by a physician or prescribing advanced practice
registered nurse; and
(ii) The
facility shall provide and implement policies and procedures which assure that
all medications administered by the facility are reviewed at least once every
90 days by a registered nurse or physician, and is in compliance with
applicable state laws and administrative rules.
(4) Recreational or social activities are to
be made available to residents on a daily basis.
(c) Licensed nursing staff shall be available seven days a week to meet the care management and monitoring needs of the residents.
Disclaimer: These regulations may not be the most recent version. Hawaii 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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