Current through Register Vol. 50, No. 9, September 20, 2024
A. Information to prospective residents. The
ARCP shall provide to prospective residents written information regarding
conditions for residency, services, costs, fees and policies/procedures. This
written information shall include, but is not limited to the following:
1. the application process and the possible
reasons for rejection of an application;
2. types of residents suitable to the
ARCP;
3. services offered and
allowed in the ARCP;
4. residents
responsibilities;
5. policy
regarding smoking;
6. policy
regarding pets;
7. fee structure,
including but not limited to any additional costs for providing services to
residents during natural disasters (e.g. tropical storms, hurricanes, floods,
etc.):
a. the ARCP shall develop and provide a
formula with cost parameters for any additional charges incurred due to
disasters; and
8.
criteria for termination of residency agreement.
B. The ARCP shall complete and maintain a
preresidency screening of the prospective resident to assess the applicant's
needs and appropriateness for residency.
1.
The pre-residency screening shall include:
a.
the resident's physical and mental status, including but not limited to, fall
risk assessment;
b. the residents
need for personal assistance;
c.
the residents need for assistance with activities of daily living and
instrumental activities of daily living; and
d. the residents ability to evacuate the ARCP
in the event of an emergency.
2. The pre-residency screening shall be
completed and dated before the residency agreement is signed.
C. Prohibited Health Conditions.
There are individuals who are not eligible for residency in ARCPs because their
conditions and care needs are beyond the scope of the ARCP's capacity to
deliver services and ensure residents' health, safety, and welfare. ARCPs may
not enter into agreements with residents with such conditions. These prohibited
health conditions include:
1. unstageable,
stage 3, or stage 4 pressure ulcers;
2. use of feeding tubes, including but not
limited to, nasogastric or gastrostomy tubes;
3. ventilator dependency;
4. dependency on BiPap, CPAP or other
positive airway pressure device without the ability to self-administer at all
times:
a. exception. The resident may remain
in the ARCP when a third party is available at all times to administer the
positive airway pressure device during the hours of use;
5. coma;
6. continuous IV/TPN therapy (TPN3/4total
parental nutrition, intravenous form of complete nutritional
sustenance);
7. wound vac therapy
(a system that uses controlled negative pressure, vacuum therapy, to help
promote wound healing);
8. active
communicable tuberculosis; and
9.
any condition requiring chemical or physical restraints.
D. ARCP residents with a prohibited condition
may remain in residence on a time limited basis provided that the conditions
listed below are met. Time limited is defined as 90 days.
1. The resident, the residents
representative, if applicable, the residents physician and the provider shall
agree that the residents continued residency is appropriate.
2. The residents physician has certified that
the condition is time limited and not permanent.
3. The ARCP is prepared to coordinate with
providers who may enter the ARCP to meet time limited needs. Level 4 ARCPs may
deliver or contract for the additional services to meet time limited needs
pursuant to this Section.
4. In
accordance with the terms of the residency agreement, the resident or the
residents representative, if applicable, shall provide for or contract with a
third party provider for the delivery of services necessary to meet the
residents increased health and service needs which are beyond the scope of the
services of the ARCP.
a. It is the
responsibility of the ARCP to assure that needed services are provided, even if
those services are provided by the residents family or by a third party or
contracted provider. A copy of such third party contract shall be verifiable,
in writing, and retained in the residents record. The ARCP retains
responsibility for notifying the resident or the resident's representative, if
applicable, if services are not delivered or if the residents condition
changes.
5. The ARCP or
an affiliated business owned in full or in part by the owner or any member of
the board of directors shall not be the third party providing the
services.
6. The care provided, as
allowed under this section, shall not interfere with ARCP operations or create
a danger to others in the ARCP.
E. In level 4 ARCPs, residents whose health
needs increase may continue to reside in the ARCP and receive intermittent
nursing services from the ARCP in accordance with the PCSP if the services are
within the scope provided for in these regulations.
F. In accordance with the terms of the
residency agreement, residents who are receiving hospice services may continue
to reside in all levels of the ARCP as long as the residents physician, the
ARCP, the resident and/or residents legal representative, if applicable, deem
that the residents needs can be met.
G. Residency Agreement. The ARCP shall
complete and maintain individual residency agreements with all persons who move
into the ARCP or with the residents representative where appropriate.
1. The ARCP residency agreement shall specify
the following:
a. clear and specific criteria
for residency, continued residency and termination of residency agreements and
procedures for termination of residency agreements;
b. basic services provided;
c. optional services;
d. payment provisions for both basic and
optional services, including the following:
i.
service packages and any additional charges for services;
ii. regular/ordinary and extra
fees;
iii. payer source;
iv. due dates; and
v. deposits;
e. procedures for the modification of the
residency agreement, including provision of at least 30 days prior written
notice to the resident of any rate change;
f. requirements around notice before
voluntarily terminating the residency agreement;
g. refund policy;
h. the delineation of responsibility among
the following parties: the ARCP, the resident, the family, the residents
representative and/or others;
i.
residents rights; and
j. grievance
procedures.
2. The ARCP
shall allow review of the residency agreement by an attorney or other
representative chosen by the resident.
3. The residency agreement shall be signed by
the director, or designee, and by the resident or the residents representative
if applicable.
4. The residency
agreement shall conform to all relevant federal, state and local laws and
requirements.
5. The residency
agreement shall provide a process for involuntary termination of the residency
agreement that includes, at a minimum, the following:
a. written notice of any adverse action for
violation(s) of the terms of the residency agreement that includes the
following:
i. notice shall allow the resident
a minimum of 30 calendar days from date of delivery of written notice to vacate
the ARCP premises; however, the advance notice period may be shortened to 15
calendar days for nonpayment of a bill for a stay at the ARCP; and
ii. the notice shall allow a minimum of 10
calendar days for residents corrective action.
6. The residency agreement shall include
provisions for the opportunity for a formal appeal to the DAL for any
involuntary termination of the residency agreement in accordance with
§6837. B 2-4, including
but not limited to, contact information for the DAL.
7. A request for appeal shall be made within
30 calendar days of receipt of the written notice and the hearing shall be
conducted by the DAL in accordance with the Administrative Procedure
Act.
H. When the
resident moves in, the ARCP shall:
1. obtain
from the resident or if appropriate, the residents representative, the
residents plan for both routine and emergency medical care which shall include:
a. the name of physician(s); and
b. provisions and authorization for emergency
medical care;
2. provide
the resident with a copy of the ARCPs emergency and evacuation
procedures.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and
R.S.
40:2166.1-2166.8.
