Current through Register Vol. 46, No. 39, September 25, 2024
(a) An operator
shall admit, retain and care for only those individuals who do not require
services beyond those the operator is permitted by law and regulation to
provide.
(b) An operator shall not
accept nor retain any person who:
(1) is in
need of continual medical or nursing care or supervision as provided by
facilities licensed pursuant to article 28 of the Public Health Law or articles
19, 23, 29 and 31 of the Mental Hygiene Law;
(2) suffers from a serious and persistent
mental disability sufficient to warrant placement in a residential facility
licensed pursuant to article 19, 23, 29 or 31 of the Mental Hygiene
Law;
(3) requires health or mental
health services which are not available or cannot be provided safely and
effectively by local service agencies or providers;
(4) causes, or is likely to cause, danger to
himself or others;
(5) repeatedly
behaves in a manner which directly impairs the well-being, care or safety of
the resident or other residents or which substantially interferes with the
orderly operation of the home;
(6)
has a medical condition which is unstable, and which requires continuous
skilled observation of symptoms and reactions or accurate recording of such
skilled observations for the purposes of reporting 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 failure 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) is chronically
chairfast and unable to transfer or chronically requires the physical
assistance of another person to transfer;
(10) chronically requires the physical
assistance of another person in order to walk;
(11) chronically requires the physical
assistance of another person to climb or descend stairs, unless assignment on a
floor with ground-level egress can be made;
(12) has chronic unmanaged urinary or bowel
incontinence;
(13) suffers from a
communicable disease or health condition which constitutes a danger to other
residents and staff;
(14) 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 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) such
assistance, if needed, is available from approved community resources;
and
(vi) each required medical
evaluation attests to the individual's ability to use and maintain the
equipment;
(15) is under
18 years of age;
(16) does not
provide the operator with the required medical evaluations;
(17) refuses or fails to inform the operator
on an on-going basis of changes in medications or other elements of the medical
evaluation as they occur;
(18)
engages in alcohol or drug use which results in aggressive or destructive
behavior; or
(19) is unable to
communicate with the operator in a common language.
(c) An operator must not admit or retain a
number of persons in excess of the capacity specified on the operating
certificate. In a certified family-type home, relatives not specified in
section
489.2(b)
of this Part who require personal care and supervision and who reside in the
home must be included as part of the certified capacity of the home. If
relatives not specified in section
489.2(b)
of this Part require a higher level of care than may be provided in a
family-type home, they may not be cared for in the home, unless the operator
moves the other residents to other appropriate locations and surrenders the
operating certificate or unless the social services district grants prior
approval to an operator to continue to care for a relative who requires a
higher level of care. In determining whether to grant such approval, the social
services district must consider the potential impact on the other family-type
home residents and the ability of the operator to provide the required
care.
(d) An operator shall not
admit an individual before a determination that the home can support the
physical and psycho-social needs of the resident has been made.
(e) Such a determination shall be based upon:
(1) receipt and consideration of a medical
evaluation; and
(2) conduct of an
interview between the operator and the resident and the resident's
representative(s), if any.
(f) The medical evaluation shall be a
written, and signed report on a Medical Evaluation (DSS-3122) or approved local
equivalent, from the resident's physician which includes:
(1) significant medical history and current
conditions, 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;
(2) a statement that the resident is not
medically or mentally unsuited for care in a family-type home;
(3) a statement that the resident does not
require placement in a hospital or residential health care facility;
and
(4) a statement that the
physician has physically examined the resident within 30 days prior to the date
of admission.
(g) In the
event the resident is transferred from another family-type home with a medical
evaluation completed within six months prior to transfer, the local department
of social services may approve the use of that evaluation to satisfy
requirements of subdivision (f) of this section, provided there has been no
substantial change in the resident's condition, medication and diet regimen, or
other needs to be provided or supervised by the operator.
(h) During the resident interview the
operator shall:
(1) explain and discuss the
conditions of residency, including but not limited to the admission agreement,
resident rights, house rules, and to all who receive Supplemental Security
Income or Home Relief, the personal allowance; and
(2) ascertain that the home can:
(i) 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
(ii) meet the psycho-social needs of the
resident through the fostering and maintenance of family and community ties and
associations;
(i) A resident shall receive, at or prior to
the interview:
(1) a copy of the admission
agreement; and
(2) a copy of the
statement of resident rights.
(j) Medical and social evaluations must be
conducted whenever a change in the resident's condition warrants, but at least
once every 12 months.
(k)
Notwithstanding subdivisions (f) and (g) of this section, physical examinations
shall not be required for a resident who relies upon or is being furnished
treatment by spiritual means through prayer in lieu of medical treatment in
accordance with the teachings and practices of a recognized church or religious
denomination of which the resident is a member or bona fide adherent. In such
cases the operator shall:
(1) require
documentation of the resident's standing as a member; and
(2) adhere to the admission and retention
standards set forth in subdivision (b) of this section.
(l) An individual shall not be admitted
directly from a general or special hospital, psychiatric center, developmental
center, skilled nursing or health-related facility without a statement from the
referral source which details significant medical conditions, prescribed health
or mental health regimen, and such psycho-social information as may be
available to help plan an adequate level of care for the resident. This
statement shall not substitute for either the medical evaluation or the
resident interview, if requirements of subdivisions (f) and (g) of this section
are met.
(m) Each applicant for
admission shall have the opportunity to review a copy of most recent report of
inspection issued to the home.
(n)
The operator and resident or resident's representative, if any, shall execute
an admissions agreement which conforms with the requirements of section
487.5(d)
of this Title, with the exception of subparagraph (xvi) of paragraph
(6).
(o) The operator shall
complete upon admission and maintain for each resident a Personal Data Sheet
(DSS-2949) or an approved local equivalent, including persons to be contacted
in an emergency and next-of-kin.
(p) The operator shall maintain a record of
persons admitted and discharged from the home, and the dates of admission and
discharge. This record may be maintained on a Chronological Admission and
Discharge Register (DSS-3026) or an approved local equivalent.
(q) For any residents who cannot be retained
in the home due to the conditions set forth in subdivision (b) of this section:
(1) the operator must immediately notify the
social services district that there is a resident who cannot be retained in a
family-type home; and
(2) the
operator must make persistent efforts to secure an appropriate alternative
placement. The social services district must document such efforts in the case
record; and
(3) when an appropriate
alternative placement is not immediately available for a resident who cannot be
retained in a family-type home in accordance with subdivision (b) of this
section, the operator must arrange for other appropriate services when
necessary to assure that the health and safety of the resident are maintained
until placement is secured. The social services district must document such
efforts in the case record.
