Current through Register Vol. 46, No. 39, September 25, 2024
(a) An operator may admit, retain and care
for only those individuals who require the services the operator is certified
to provide.
(b) An operator shall
not exclude an individual on the basis of an individual's mobility impairment,
and shall make reasonable accommodations to the extent necessary to admit such
individuals, consistent with federal, state and local laws.
(c) An operator must not accept nor retain
any person who:
(1) needs continual medical
or nursing care or supervision as provided by an acute care facility or a
residential health care facility certified by the Department of
Health;
(2) suffers from a serious
and persistent mental disability sufficient to warrant placement in an acute
care or residential treatment facility operated or certified by an office of
the Department of Mental Hygiene;
(3) requires health, mental health, or other
services which cannot be provided by local service agencies;
(4) causes, or is likely to cause, a danger
to himself/herself or others;
(5)
repeatedly behaves in a manner which directly impairs the wellbeing, care, or
safety of the resident or other residents or which substantially interferes
with the orderly operation of the enriched housing program;
(6) requires continual skilled observation of
symptoms and reactions or accurate recording of such skilled observations for
the purpose of reporting on a medical condition to the resident's
physician;
(7) refuses or is unable
to comply with a prescribed treatment program, including but not limited to a
prescribed medications regimen when such refusal or inability causes, or is
likely to cause, in the judgment of a physician, life-threatening danger to the
resident or others;
(8) is
chronically bedfast;
(9) has chronic
unmanaged urinary or bowel incontinence;
(10) suffers from a communicable disease or
health condition which constitutes a danger to other residents and
staff;
(11) is dependent on medical
equipment unless it has been demonstrated that:
(i) the equipment presents no safety
hazard;
(ii) use of the equipment
does not restrict the individual to his/her room, impede the individual in the
event of evacuation, or inhibit participation in the routine activities of the
home;
(iii) use of the equipment
does not restrict or impede the activities of other residents;
(iv) the individual is able to use and
maintain the equipment with only intermittent or occasional assistance from
medical personnel;
(v) assistance in
the use or maintenance of the equipment, if needed, is available from local
social services agencies or approved community resources;
(vi) each required medical evaluation attests
to the individual's ability to use and maintain the
equipment;
(12) has
chronic personal care needs which cannot be met by enriched housing staff or
approved community providers;
(13)
is not self-directing; i.e., requires continuous supervision and is not capable
of making choices about his/her activities of daily living; or
(14) engages in alcohol or drug use which
results in aggressive or destructive behavior.
(d) An operator must not admit nor retain
persons in excess of the capacity specified on the operating
certificate.
(e) An operator must
not admit nor retain an individual without a determination being made that the
enriched housing program can support the physical and social needs of the
resident. Such determination must be based upon:
(1) a medical evaluation (DSS-3122 or an
approved substitute) written and signed by a physician, physician assistant or
nurse practitioner, which includes:
(i) the
date of examination, significant medical history and current conditions, known
allergies, the prescribed medication regimen, including information on the
applicant's ability to self-administer medications, recommendations for diet,
exercise, recreation, frequency of medical examinations and assistance needed
in the activities of daily living;
(ii) a statement that a resident is medically
or mentally suited for care in the enriched housing program;
(iii) a statement that the resident does not
require placement in a hospital or residential health care facility;
and
(iv) a dated statement
indicating that the physician, physician assistant or nurse practitioner has
physically examined the resident within 30 days prior to the date of admission,
or for required annual evaluations within 30 days prior to the date of the
report.
(2) an interview
between the enriched housing program coordinator, or a designee responsible for
admission and retention decisions and the resident and his/her
representative(s), if any. Each applicant interview must:
(i) include an explanation of the conditions
of residency including, but not limited to, the admission agreement, resident
rights and responsibilities, enriched housing program rules and regulations and
the personal allowance protections available to Supplemental Security Income or
Home Relief recipients;
(ii)
ascertain that the enriched housing program can:
(a) meet the physical needs and personal care
needs of the resident, including dietary needs occasioned by cultural or
religious practice or preference or medical prescription; and
(b) meet the psycho-social needs of the
resident.
(iii) be
summarized in writing, including the date of the interview and identification
of those present.
(3) a
mental health evaluation if a proposed resident has a known history of chronic
mental disability, or the medical evaluation or resident interview suggests the
existence of such a disability. Such evaluation must be a written and signed
report from a psychiatrist, physician, registered nurse, certified psychologist
or certified social worker who has experience in the assessment and treatment
of mental illness. Such report shall be documented on a form prescribed by the
Department and developed in consultation with the Office of Mental Health and
shall include:
(i) a significant mental
health history and current conditions;
(ii) a statement that the resident or
prospective resident is mentally suited for care in the enriched housing
program;
(iii) a statement that the
resident or prospective resident does not evidence need for placement in a
hospital or residential treatment facility; and
(iv) a dated statement indicating that the
person signing the report has conducted a face-to-face examination of the
resident or prospective resident which, for prospective residents, shall be
dated within 30 days prior to admission.
(4) a functional assessment completed on a
form prescribed or approved by the department. Each functional assessment must
be a written report prepared by the program coordinator, case manager, or
consultant registered nurse and must address:
(i) personal activities of daily
living;
(ii) instrumental
activities of daily living;
(iii)
sensory impairments;
(iv)
behavioral characteristics;
(v)
personality characteristics; and
(vi) daily habits.
(f) The following assessments must
be conducted whenever a change in a resident's condition warrants and no less
than once every 12 months:
(1) a medical
assessment;
(2) a mental health
evaluation, if needed; and
(3) a
functional assessment.
(g) The operator must assist an applicant in
obtaining any required evaluations.
(h) The operator must assist a resident who
cannot be retained because of the presence of one or more of the conditions set
forth in subdivision (c) of this section to find an alternative placement and
must document such assistance.
(i)
Notwithstanding subdivision (e) of this section, medical evaluations need not
be required of a competent adult who relies upon or is being furnished
treatment by spiritual means through prayer, in lieu of medical treatment, in
accordance with the tenets and practices of a recognized church or religious
denomination of which the resident is a member or a bona fide adherent. In such
cases the operator must:
(1) require
documentation of the resident's standing as a member; and
(2) adhere to the admission and retention
standards set forth in subdivision (c) of this section.
(j) The operator must not admit nor accept
for return an individual directly from a general or special hospital,
psychiatric center, developmental center, skilled nursing or health-related
facility without a signed statement from the referral source which details
significant medical conditions, prescribed health or mental health regimens and
such psycho-social information as may be available to help the operator plan an
adequate level of care for the resident. This statement may substitute for the
medical and mental health evaluations or functional assessment if the
requirements of subdivision (e)(1), (3) and (4) of this section are
met.
(k) The operator must give
each applicant at or prior to the admissions interview copies of:
(1) the admission agreement;
(2) the statement of resident
rights;
(3) the enriched housing
program rules, if any, relating to resident activities, office and visiting
hours and other pertinent information concerning the operation of the
program;
(4) a fact sheet about the
Long-Term Ombudsman Program, if made available by the program; and
(5) the listing of legal services or advocacy
agencies made available to the program by the department.
(l) The operator must provide to each
applicant for admission and to the applicant's representative, if any, an
opportunity to review the most recent inspection report issued by the
department to the enriched housing program.
(m) If the applicant or resident is
sight-impaired or hearing-impaired or otherwise unable to comprehend English or
printed matter, the operator must arrange for the conduct of the required
admission interview and transmission of the contents of the admission
agreement, the statement of rights and responsibilities and enriched housing
information in a manner comprehensible to the applicant.
