Current through Register Vol. 35, No. 6, March 26, 2024
The facility shall complete an admission agreement for each
resident. The administrator of the facility or a designee responsible for
admission decisions shall meet with the resident or the resident's surrogate
decision maker prior to admission. No resident shall be admitted who is below
the age of eighteen (18) or for whom the facility is unable to provide
appropriate care.
A.
Admission
agreement. The admission agreement shall include the following
information:
(1) the parties to the
agreement;
(2) the program
narrative;
(3) the facility's
rules;
(4) the cost of services and
the method of payment;
(5) the
refund provision in case of death, transfer, voluntary or involuntary
discharge;
(6) information to
formulate advance directives;
(7) a
written description of the legal rights of the residents translated into
another language, if necessary;
(8)
the facility's staffing ratio;
(9)
written authorization for staff to assist with medications;
(10) notification of rights and
responsibilities pursuant to the Incident Reporting Intake, Processing and
Training Requirements, 7.1.13 NMAC;
(11) the facility's bed hold policy;
and
(12) the admission agreement
may be terminated if an appropriate placement is found for the resident, under
the following circumstances:
(a) there shall
be a fifteen (15) day written notice of termination given to the resident or
his or her surrogate decision maker, unless the resident requests the
termination;
(b) the resident has
failed to pay for a stay at the facility as defined in the admission
agreement;
(c) the facility ceases
to operate or is no longer able to provide services to the resident;
(d) the resident's health has improved
sufficiently and therefore no longer requires the services of the
facility;
(e) termination without
prior notice is permitted in emergency situations for the following reasons:
(i) the transfer or discharge is necessary
for the resident's safety and welfare;
(ii) the resident's needs cannot safely be
met in the facility; or
(iii) the
safety and health of other residents and staff in the facility are
endangered;
(13) the facility shall provide a thirty (30)
day written notice to residents regarding any changes in the cost or the
material services provided; a new or amended admission agreement must be
executed whenever services, costs or other material terms are changed;
and
(14) facilities representing
their services as "specialized" must disclose evidence of staff specialty
training to prospective residents.
B.
Restrictions in admission.
The facility shall not admit or retain individuals that require twenty-four
(24) hour continuous nursing care, refer to Subsection U of 7.8.2.7 NMAC
Definitions. This rule does not apply to hospice residents who have elected to
receive the hospice benefit. Conditions or circumstances that usually require
continuous nursing care may include but are not limited to the following:
(1) ventilator dependency;
(2) pressure sores and decubitus ulcers
(stage III or IV);
(3) intravenous
therapy or injections;
(4) any
condition requiring either physical or chemical restraints;
(5) nasogastric tubes;
(6) tracheostomy care;
(7) residents that present an imminent
physical threat or danger to self or others;
(8) residents whose psychological or physical
condition has declined and placement in the current facility is no longer
appropriate as determined by the PCP;
(9) residents with a diagnosis that requires
isolation techniques;
(10)
residents that require the use of a Hoyer lift; and
(11) ostomy (unless resident is able to
provide self care).
C.
Exceptions to admission, readmission and retention. If a resident
requires a greater degree of care than the facility would normally provide or
is permitted to provide and the resident wishes to be re-admitted or remain in
the facility and the facility wishes to re-admit or retain the resident. The
facility shall comply with the following requirements.
(1) Convene a team, comprised of:
(a) the facility administrator and a facility
health care professional if desired;
(b) the resident or resident's surrogate
decision maker; and
(c) the hospice
or home health clinician.
(2) The team shall jointly determine if the
resident should be admitted, readmitted or allowed to remain in the facility.
Team approval shall be in writing, signed and dated by all team members and the
approval shall be maintained in the resident's record and shall:
(a) be based upon an individual service plan
(ISP) which identifies the resident's specific needs and addresses the manner
that such needs will be met;
(b)
ensure that if the facility is licensed for more than eight (8) residents and
does not have complete fire sprinkler coverage, the facility shall maintain an
evacuation rating score of prompt as determined by the fire safety equivalency
system (FSES);
(c) evaluate and
outline how meeting the specific needs of the resident will impact the staff
and the other residents; and
(d)
include an independent advocate such as a certified ombudsman if requested by
the resident, the family or the facility.
(3) The team recommendation shall be
maintained on site in the resident's file.
(4) When a resident is discharged, the
facility shall record where the resident was discharged to and what medications
were released with the resident.
D.
Coordination of care.
(1) Assisted living facilities shall have
evidence of care coordination on an ISP for all services that are provided in
the facility by an outside health care provider, such as hospice or home health
providers.
(2) Residents shall be
given a list of providers, including hospice and home health if applicable, and
have the right to choose their provider. If applicable, the referring party
shall disclose any ownership interest in a recommended or listed
provider.