New York Codes, Rules and Regulations
Title 18 - DEPARTMENT OF SOCIAL SERVICES
Chapter II - Regulations of the Department of Social Services
Subchapter D - Adult-Care Facilities
Part 489 - Adult Care Facilities Standards for Family-type Homes
Section 489.10 - Resident services

Universal Citation: 18 NY Comp Codes Rules and Regs ยง 489.10

Current through Register Vol. 46, No. 39, September 25, 2024

(a) The operator shall provide a program of resident services which shall include room, board, supervision, personal care and social support.

(b) Supervision.

(1) Supervision services shall include, but are not limited to:
(i) maintaining knowledge of general whereabouts of each resident;

(ii) monitoring residents to identify abrupt or progressive changes in behavior or appearance which may signify the need for assessment and service;

(iii) monitoring and guidance to assist residents in performing basic activities of daily living, including:
(a) attendance at meals and maintenance of appropriate nutritional intake;

(b) performance of personal hygiene and grooming activities;

(c) participation in home and community programs; and

(d) performance of basic money management and fulfillment of service needs.

(iv) monitoring the property, the home and activities of residents to protect residents from harm to person and property;

(v) monitoring emergency call systems within the home;

(vi) handling individual emergencies, or need for assistance, including arranging for medical or other services;

(vii) conducting and supervising of evacuations and fire and evacuation drills;

(viii) implementing of the disaster and emergency plan; and

(ix) investigating of incidents involving resident endangerment, injury or death.

(2) All residents and other occupants of the home shall be trained in the means of rapidly evacuating the building.

(3) The operator shall conduct semi-annual evacuation drills at various times of the day and night for all occupants of the home, including participation by the designated substitute(s).

(4) The operator shall record the date and time of each drill, and how long it took to evacuate the home.

(5) The operator, together with the local department of social services, shall develop a plan to protect residents in a fire or other emergency. The plan shall include procedures for:
(i) evacuation of the home;

(ii) temporary provision of essential services;

(iii) relocation of residents;

(iv) coordination with community resources and local emergency planning organizations; and

(v) posting emergency telephone numbers by the telephone.

(6) In the event that a resident is absent from the home and the resident's whereabouts are unknown, the operator shall:
(i) initiate efforts to find the resident; and

(ii) if the absence exceeds eight hours:
(a) notify the resident's next of kin or representative;

(b) notify the appropriate law enforcement agency; and

(c) notify the local department of social services.

(7) In the event that a resident is unable or unwilling to consume regular meals for two consecutive days, the operator shall:
(i) immediately notify the resident's personal physician, act on the physician's instruction, and note the call and instructions in the resident's record; and

(ii) notify the local department of social services on the first available working day.

(8) In the event of illness or injury which requires immediate medical services which cannot be provided on an out-patient basis or which constitutes a danger to the resident or others, the operator shall:
(i) immediately obtain necessary assistance and services;

(ii) make arrangement for transfer of such resident to an appropriate medical facility;

(iii) notify the resident's representative, or next of kin, if known; and

(iv) notify the local department of social services on the first available working day.

(9) In the event that a resident exhibits behavior which constitutes a danger to self or others, the operator shall:
(i) arrange with the assistance of the local department of social services, if necessary, for appropriate professional evaluation of the resident's condition;

(ii) arrange with the assistance of the local department of social services, if necessary, for any needed transfer of the individual to a facility providing the proper level of care; and

(iii) notify the resident's representative, or next of kin, if known.

(10) In the event of the death of a resident, the operator shall:
(i) notify the resident's next of kin or representative;

(ii) notify the appropriate local authorities; and

(iii) notify the local department of social services.

(11) In the event of death by other than natural causes or in the case of a death by natural causes in which unusual circumstances exist, the operator shall telephone the local department of social services by the next working day.

(12) The operator, with the assistance of the local department of social services, if necessary, shall complete and maintain an Incident Report (DSS-3123) or an approved local equivalent whenever:
(i) a resident's whereabouts have been unknown for more than eight hours;

(ii) a resident assaults or injures or is assaulted or injured by another resident or others;

(iii) a resident attempts or commits suicide;

(iv) there is a complaint or evidence of resident abuse;

(v) a resident dies from other than natural causes; and

(vi) the home is evacuated or the emergency plan is implemented.

(13) The operator must include the resident's version of the events leading to an accident or incident involving such resident, unless the resident objects, on Incident Reports (DSS-3123) or local equivalents required by paragraph (12) of this subdivision.

(c) Personal/care.

(1) Each resident shall be provided such personal care as is necessary to enable the resident to maintain good personal hygiene and grooming, to carry out the activities of daily living, to maintain good health, and to participate in the on-going activities of the home.

(2) Personal care functions shall include direction and some assistance with:
(i) grooming, including care of hair, shaving and ordinary care of nails, teeth and mouth;

(ii) dressing;

(iii) bathing;

(iv) toileting;

(v) walking and ordinary movement from bed to chair or wheelchair;

(vi) eating;

(vii) taking and recording weights; and

(viii) assisting with the self-administration of medications, as defined in subdivision (d) of this section.

(3) Personal care functions to participate in the ongoing activities of the home shall include assistance to:
(i) use the dining area;

(ii) consume meals; and

(iii) participate in activities.

(4) Residents shall not be permitted, except as may be necessary for the treatment of a short-term illness to be confined to their room or bed.

(5) Commodes shall not be permitted except as may be necessary for a short-term illness or for night use as a safety measure as confirmed by the written order of a physician.

(6) Residents shall not be provided in-room tray services except as may be necessary for a short-term illness. The operator shall notify the resident's physician and the local department of social services if the need for in-room tray service extends beyond five days.

(7) Physical restraints, i.e., any apparatus which prevents the free movement of a resident's arms or legs, or which immobilizes a resident and which the resident is unable to remove, shall not be used.

(d) Medication management.

(1) Each resident capable of self-administration of medication shall be permitted to retain and self-administer medications provided that:
(i) the resident's physician attests, in writing, that the resident is capable of self-administration; and

(ii) the resident keeps the operator informed of all medications being taken, including name, route, dosage, frequency, times and any instructions, including any contraindications, indicated by the physician.

(2) Residents capable of self-administration are those who are able to:
(i) correctly read the label on the medication container;

(ii) correctly interpret the label;

(iii) correctly ingest, inject or apply the medication;

(iv) correctly follow instructions as to the route, time, dosage and frequency;

(v) open the container;

(vi) measure or prepare medications, including mixing, shaking, and filling syringes; and

(vii) safely store the medication.

(3) For each resident who self-administers medication, the operator shall periodically verify the resident's continuing ability to do so.

(4) A resident needing assistance with self-administration is one who needs assistance to properly carry out one or more of the activities listed in paragraph (2) of this subdivision.

(5) Assistance with self-administration shall include assistance with any activity which the resident would ordinarily be capable of carrying out, pursuant to paragraph (2) of this subdivision.

(6) The operator shall maintain a system to ensure that residents in need of self-administration with supervision or assistance are taking the prescribed dosage at the correct time.

(7) If a resident refuses to take medications, or appears unable to independently administer medications, the operator shall notify the prescribing physician, and if different, the primary physician.

(8) Under no circumstances shall the operator make a change in the dosage or schedule of administration of medication without the prior written authorization of a physician or, in the case of an emergency, by telephone with written confirmation from the physician within seven days.

(9) If medication is prescribed by other than the resident's primary physician, the operator shall notify the primary physician, advise him or her of the medication and dosage prescribed and note the call or retain a copy of the correspondence in the resident's record.

(10) The operator or substitute caretaker shall not be permitted to administer injectable medications to a resident; unless he or she holds a valid license from the New York State Education Department to administer injectable medications, provided that the injectable medication is one which licensed health care providers would customarily train a patient or his family to administer.

(11) Medication shall be kept in a secure storage area at all times whether kept by a resident or kept by the operator for the resident, except when required to be kept by the resident on his person for frequent or emergency use.

(12) Medications shall not be emptied from one container into another, except when necessary to enable a resident to take medications during temporary absences from the home.

(13) Labels of medication containers shall not be modified or remarked in any way except by a physician or pharmacist. When a change in dosage or schedule has been made, the container must be tagged until the label is corrected.

(14) Stock supplies of prescription medications are prohibited.

(15) Drugs for external use shall be stored separately from internal and injectable medications.

(16) Any medication which has been prescribed but is no longer in use by a resident shall be properly disposed of.

(17) Pharmaceuticals stored in the refrigerator shall be kept in a separate container.

(18) The operator shall maintain a record for each resident on all medications currently being taken. The record shall include: the person's name; a list of each medication and the current dosage, frequency, time and route of each medication; the prescribing physician; the dates of each prescription change; any contraindications noted by the physician; the type of supervision or assistance, if any, needed by the resident and record of such assistance.

(e) Social support.

(1) The operator shall maintain a program of social support which shall include:
(i) assisting the resident to: attend to personal financial matters; establish and maintain ties with family, friends and other occupants of the home; participate in the daily routine of the home, including orientation and adjustment to the placement; and participate in and assist in arranging transportation to community activities;

(ii) providing opportunities to participate in individual or family activities within or outside of the home;

(iii) establishing, with local department of social services assistance, linkages with community service providers;

(iv) identifying residents in need of services and assisting service providers in working with residents;

(v) providing the opportunity for residents to meet in private with service providers; and

(vi) in no way inhibiting access to residents who need and desire services.

Disclaimer: These regulations may not be the most recent version. New York 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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