Current through Register Vol. 46, No. 39, September 25, 2024
(a) An operator may 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 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 or 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 licensed or operated
pursuant to 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 treatment
facility licensed or operated pursuant to articles 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 social services agencies or
providers;
(4) causes, or is likely
to cause, 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
facility;
(6) has a medical
condition which requires continual skilled observation of symptoms or reactions
to medications or accurate recording of such skilled observations for the
purpose 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 refusal or inability causes, or, in the judgment
of a physician, is likely to cause life-threatening danger to the resident or
others;
(8) requires more than
supervision and assistance with self-administration of medications in order to
maintain a prescribed medication regimen;
(9) chronically requires physical assistance
with the personal activities of daily living, including grooming, bathing,
dressing, toileting, or eating;
(10)
is chronically bedfast;
(11) has
chronic unmanaged urinary or bowel incontinence;
(12) suffers from a communicable disease or
health condition which constitutes a danger to other residents and
staff;
(13) 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
facility;
(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, and such assistance is available from local social service
agencies or approved community resources; and
(v) each required medical evaluation attests
to the individual's ability to use and maintain the
equipment;
(14) engages in
alcohol or drug use which results in aggressive or destructive
behavior;
(15) is under 18 years of
age; or under 16 years of age if such person is to be admitted to a residence
for adults operated by a social services district.
(d) In accordance with a plan submitted by
the operator and approved by the department, persons who require physical
assistance with the personal care activities of daily living may remain in a
residence for adults if the facility was previously certified as an adult home,
and for so long as they remain appropriate for adult home care and the operator
can demonstrate continued provision of needed services.
(e) An operator may not admit or retain a
number of persons in excess of the capacity specified on the operating
certificate.
(f) An operator may
not admit an individual before a determination has been made that the facility
program can support the physical, supervisory, and psychosocial needs of the
individual. Such a determination must be based upon:
(1) receipt and consideration of a medical
evaluation;
(2) receipt and
consideration of a mental health evaluation;
(3) performance of a screening and an
assessment; and
(4) conduct of a
personal resident interview between the administrator or a designee responsible
for admission and retention decisions and the resident and the resident's
representative, if any.
(g) Each medical evaluation (DSS-3122 or an
approved substitute) must be a written and signed report from a physician which
includes:
(1) 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;
(2) a statement that
the resident is not medically or mentally unsuited for care in the
facility;
(3) a statement that the
resident does not require placement in a hospital, residential health care
facility, or an adult home; and
(4)
a statement that the physician has physically examined the resident within 30
days prior to the date of admission or, for a required annual evaluation,
within 30 days prior to the date of the report.
(h) Each mental health evaluation must
consist of a written report which includes:
(1) significant mental health history and
current conditions;
(2) the current
mental health services provided, if any;
(3) a statement that the resident is not
mentally unsuited for care in the facility;
(4) a statement that the resident does not
evidence need for placement in a residential treatment facility licensed or
operated pursuant to article 19, 23, 29 or 31 of the Mental Hygiene
Law;
(5) documentation that the
person responsible for providing the information is a psychiatrist, physician,
registered nurse, certified psychologist or certified social worker and has
conducted a face-to-face evaluation of the resident within 30 days prior to the
date of admission to the facility or, for required annual evaluations, within
30 days prior to the date of the report; and
(6) [Reserved]
(7) the name, signature, professional title,
and certification number of the person who conducted the mental health
evaluation.
(i) Each
resident screening and assessment must:
(1)
evaluate the supervisory, case management and other services which are
available in the facility and the community and how those services will be
utilized to meet the:
(i) supervision needs
of the resident;
(ii) physical
needs of the resident, including dietary needs occasioned by cultural or
religious practice or preference or medical prescription; and
(iii) socialization needs of the resident
through facility programs which foster and maintain family, facility, and
community ties and associations;
(2) be summarized in writing, including the
date of the screening and assessment, and a statement addressing whether the
resident was determined to be appropriate for admission and
retention.
(j) Each
resident interview must:
(1) be conducted
within 30 days prior to admission to the facility;
(2) include an explanation of the admission
agreement, resident rights and responsibilities, facility rules and regulations
and the personal allowance protections available to Supplemental Security
Income (SSI) or Home Relief (HR) recipients; and
(3) be summarized in writing, including the
date of the resident interview and identification of those present.
(k) Resident screenings and
assessments, resident interviews, medical evaluations and mental health
evaluations, if required, must be conducted:
(1) within 30 days prior to the date of
admission to the facility; and
(2)
whenever a change in a resident's condition warrants but no less than once
every 12 months.
(l) The
operator must assist a resident to obtain any required evaluations.
(m) For any resident who cannot be retained
under the conditions set forth in subdivision (c) of this section:
(1) the operator must make persistent efforts
to secure appropriate alternative placements and must document such
efforts;
(2) persistent efforts are
defined as:
(i) assisting the resident or
resident's representative with filing five applications for each such resident
with appropriate facilities;
(ii)
following up by telephone every two weeks on the status of the
applications;
(iii) if an
application in rejected the operator shall assist the resident or resident's
representative in filing an application to another facility within five working
days of the date of rejection; and
(iv) if the resident is not placed, the
operator must notify the regional office in writing, every 90 days from the
filing of the first application, of the name of the resident and any pending
and rejected applications.
(n) Notwithstanding subdivisions (f), (g) and
(k) of this section, medical evaluations are not 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 bona fide adherent. In such cases the operator must:
(1) obtain 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.
(o) An
individual service plan must be completed for each resident within 30 days of
admission to the facility, and must be reviewed and revised as necessary
thereafter, but no less frequently than every 12 months. Each individual
service plan must:
(1) be a written report
prepared, signed, and dated by the facility's administrator or case
manager;
(2) evaluate the
resident's ability to function in the facility and need for supervision and
services to:
(i) perform the personal
activities of daily living, including personal hygiene, bathing, dressing,
grooming, and toileting;
(ii)
perform activities of daily living, including self-administration of
medication, care of personal effects and clothing, light housekeeping, meal
preparation, shopping, and use of available transportation;
(iii) manage personal, financial and legal
affairs;
(iv) engage in social and
interpersonal activities;
(v) use
community services and resources; and
(vi) find and keep employment or participate
in training or education.
(3) specify resident goals;
(4) specify the supervisory, case management
and other services which are available in the facility and the community, how
these services will be utilized to assist the resident in attaining the
resident's goals, and how the facility will:
(i) meet the supervision needs of the
resident;
(ii) meet the physical
needs of the resident, including dietary needs occasioned by cultural or
religious practice or preference or medical prescription; and
(iii) meet the socialization needs of the
resident through facility programs which foster and maintain family, facility,
and community ties and associations.
(p) The operator may not admit or accept for
return an individual 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 regimens and such psychosocial
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 or mental
health evaluation required by this Part if the requirements of subdivision (g)
or (h) of this section are met.
(q)
In a facility with a significant number of mentally disabled persons, the
mental health organization or agency with which the operator has executed the
agreement required by section
490.7(b)
of this Part must be afforded reasonable opportunity to participate in the
admission or retention assessment of persons who require a mental health
evaluation or who would be eligible for the mental health organization's
services by reason of residency in the residence for adults. Such participation
must be solely for the purpose of assisting the operator to determine if the
operator and available mental health services can meet the needs of the
resident.
(r) An applicant must
receive at or prior to the admission interview:
(1) a copy of the admission
agreement;
(2) a copy of the
statement of resident rights;
(3) a
copy of any facility regulations relating to resident activities, office and
visiting hours and like information; and
(4) a listing of legal services or advocacy
agencies made available by the department, and as described in section
490.5(f)(7)
of this Part.
(s) Each
applicant for admission must have the opportunity to review a copy of the most
recent inspection report issued by the department to the facility.
(t) 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 conducting the interview and
transmitting the contents of the admission agreement, the statement of rights
and responsibilities and facility information in a manner comprehensible to the
applicant.
