Current through all regulations passed and filed through September 16, 2024
(A) A residential care facility
is
not allowed to admit an individual who
is in need
of services or accommodations beyond that which a residential care
facility is authorized to provide under paragraph (D) of rule
3701-16-02 of the Administrative
Code or beyond that which the specific facility provides.
(B) A residential care facility
is
not allowed to admit a resident prior to searching for the individual on
the Ohio sex offender registry as
obligated by section
3721.122 of the Revised
Code.
(C) Except for residents
receiving hospice care, no residential care facility is allowed to
admit or retain an individual who:
(1)
Needs skilled nursing care that is not authorized by
section 3721.011 of the Revised Code or
is beyond that which the specific facility can provide;
(2)
Needs
medical or skilled nursing care at least eight hours per day or forty hours per
week;
(3)
Needs chemical or physical restraints as defined in
paragraph (L) of rule
3701-16-09 of the Administrative
Code;
(4) Is bedridden with limited
potential for improvement;
(5) Has
stage III or IV pressure ulcers. For purposes of this rule, "pressure ulcers"
means any lesion caused by unrelieved pressure, or pressure in combination with
shear and/or friction, which results in damage to the underlying tissue.
Pressure ulcers
are to be staged in accordance with
current staging definitions issued by the "National
Pressure Ulcer Advisory Panel" ;
or
(6) Has a medical condition that
is so medically complex or changes so rapidly that it
necessitates constant monitoring and adjustment of
treatment regimen on an ongoing basis.
(D) A residential care facility is obligated
to enter into a written resident agreement with each prospective resident prior
to beginning residency in the residential care facility.
(1)
The agreement
needs be signed and dated by the operator, administrator, or acting
administrator and the prospective resident or, if the prospective resident is
physically or cognitively unable to sign and consents, another individual
designated by the prospective resident are obligated to sign the
agreement;
(2)
The facility is obligated to provide both the
prospective resident and any other individual signing on the resident's behalf
with a copy of the agreement and explain the agreement to them;
and
(3)
In the event that a durable power of attorney for
healthcare is enacted or when the physician determines that the resident is no
longer able to make reasoned decisions to the agreement, the facility is
obligated to provide a copy of the agreement to the individual designated by
the resident to make decisions and consent on the resident's behalf, if
any.
(E) The
agreement
obligated by paragraph (D) of this rule
is obligated
to include at least the following items:
(1) An explanation of all charges to the
resident including security deposits, if applicable;
(2) A statement that all charges, fines, or
penalties that
will be assessed against the resident are
included in the resident agreement;
(3) A statement that the basic rate
will not
be changed unless thirty days written notice is given to the resident or, if
the resident is unable to understand this information, to his or her
sponsor;
(4) An explanation of the
residential care facility's policy for refunding charges in the event of the
resident's absence, discharge, or transfer from the facility and the facility's
policy for refunding security deposits;
(5) An explanation of the services offered by
the facility, the types of skilled nursing care that the facility provides or
allows residents to receive in the facility, the providers that are authorized
to render that care, and the limitations of the type and duration of skilled
nursing care that is offered;
(6)
An explanation of the extent and types of services the facility will provide to
the resident and who is responsible for payment; and
(7) A statement that the facility
is obligated
to discharge or transfer a resident when a resident needs skilled nursing
care beyond the limitations identified in paragraph (E)(5) of this
rule.
(F) Prior to
admission or upon the request of a prospective resident or prospective
resident's sponsor, the residential care facility is obligated to
provide the resident or resident's sponsor with a copy and explain the contents
of the following policies:
(1) The facility's
residents' rights policy and procedures
mandated by
section 3721.12 of the Revised
Code;
(2) The facility's smoking
policy
mandated by paragraph (W) of rule
3701-16-13 of the Administrative
Code;
(3) The facility's
policies regarding advance directives
and do not resuscitate (DNR) orders, and an
explanation of the rights of the resident under state law concerning advance
directives and DNR orders. A residential care
facility
is barred from mandating the execution of an advance directive
or DNR order as a condition for
admission;
(4) The definition of
skilled nursing care from rule
3701-16-01 of the Administrative
Code;
(5) For individuals seeking
residency on a special care unit, the facility's policy on care for residents
in the special care unit. The policy is obligated to
include:
(a) A statement of mission or
philosophy that reflects the needs of the special population;
(b) Admission criteria to the special care
unit, including screening criteria, if applicable;
(c) Transfer and discharge criteria and
procedures;
(d) A weekly staffing
plan for the special care unit, if applicable, including:
(i) A statement of how this plan differs from
the staffing plan for the remainder of the facility; and
(ii) The necessary increase in supervision,
due to decreased safety awareness or other assessed condition, of residents
with cognitive impairments or serious mental illness in the special care
unit;
(e) A description
of activities offered, including frequency and type, and how the activities
meet the needs of the type of residents in that special care unit, including
how these activities differ from those offered in the remainder of the
facility, if applicable;
(f) A
listing of the costs of the services provided by the facility to the
resident;
(g) Specialized staff
training and continuing education practices;
(h) The process used for assessment and the
provision of services, including the method for altering services based on
changes in condition;
(i) If
necessary, how the facility addresses the behavioral healthcare needs of
residents;
(j) The physical
environment and design features to support the functioning of
residents;
(k) The involvement of
families and the availability of family support programs for residents;
and
(l) Any services or other
procedures that are over and above those provided in the remainder of the
facility, if applicable;
(6) An explanation of the facility's ability
to accommodate disabled residents or potentially disabled residents and the
facility's policy regarding transferring residents to units that accommodate
residents with disabilities; and
(7) Any other facility policies that
residents are
obligated to follow.
(G) A residential care facility may enter
into a risk agreement with a resident or the resident's sponsor with the
consent of the resident. Under a risk agreement, the resident or sponsor and
the facility agree to share responsibility for making and implementing
decisions affecting the scope and quantity of services provided by the facility
to the resident. The facility is obligated to identify the risks inherent in a
decision made by a resident or sponsor not to receive a service provided by the
facility. A risk agreement is valid only if it is made in writing. The
residential care facility is obligated to maintain a copy of any risk agreement
in the resident's record.
(H) Each
residential care facility that has a policy of entering into risk agreements
is obligated
to provide each prospective resident, or the prospective resident's
sponsor with the consent of the resident, a written explanation of the policy
and the provisions that may be contained in a risk agreement. At the time the
information is provided, the facility is obligated to
obtain a statement signed by the individual receiving the information
acknowledging that the individual received the information. The facility
is obligated
to maintain the signed statement on file. Any waiver of the resident's
rights under section 3721.13 of the Revised Code
contained in the risk agreement is void.
