Rules & Regulations of the State of Tennessee
Title 0720 - Health Facilities Commission
Chapter 0720-37 - Standards for Adult Care Homes - Level 2
Section 0720-37-.07 - ADMISSIONS, DISCHARGES, AND TRANSFERS
Universal Citation: TN Comp Rules and Regs 0720-37-.07
Current through April 3, 2024
(1) Admissions.
(a) An ACH may only admit and continue to
care for residents requiring specialized services.
(b) A Level 2 ACH may provide care to both
ventilator dependent patients and patient with traumatic brain injury. In the
event a resident with traumatic brain injury is also ventilator dependent, the
resident may only be served by a Level 2 ACH meeting the requirements for
ventilator dependent patients.
(c)
ACHs may serve up to five (5) elderly or disabled adults who are unrelated to
the adult care home provider by blood or marriage.
(d) An ACH provider may choose to serve one
(1) or more elderly or disabled adult members of their own family as long as
the adult care home provider serves at least two (2) additional elderly or
disabled adults unrelated to the adult care home provider by blood or marriage.
In no event shall an adult care home provider serve more than five (5) elderly
or disabled residents in the licensed ACH.
(e) An ACH provider may permit members of the
adult care home provider's or resident manager's family, who are not elderly or
disabled, to reside in the ACH as long as it does not interfere with the care
of the residents. For purposes of this rule, family member means spouse and
children.
(f) An ACH may not admit
or retain a resident who cannot be evacuated within five (5) minutes.
(g) An ACH shall upon admission of a
resident:
1. Be able to identify at the time
those residents whose needs for services are consistent with these rules and
regulations, and those residents who should be transferred to a more
appropriate level of care.
2.
Document plans and procedures to show evacuation of the resident within five
(5) minutes.
3. Provide to each
resident a written admission agreement signed and dated by the ACH provider and
the resident or the resident's family member or representative and presented
both verbally and in writing. The admission agreement shall be reviewed and
updated as necessary as a part of the residential plan of care review process
and contain the following:
(i) A copy of the
resident rights for the resident's review and signature;
(ii) A copy of house rules and the rate
schedules, including any resident liability for which the resident will be
responsible;
(iii) An accurate
written statement providing that the adult care home provider shall give thirty
(30) days written notice to the resident prior to making any changes in the
rates;
(iv) The consequences for
non-payment of resident liability which includes involuntary discharge from the
ACH;
(v) An accurate written
statement regarding services which will be provided residents upon
admission;
(vi) Procedures for
handling the transfer or discharge of residents that does not violate the
residents' rights under the law or these rules;
(vii) A copy of the medication disposal
policy, which shall be written in accordance with current FDA or current DEA
medication disposal guidelines, for resident's review and signature.
4. Disclose in writing to the
resident or to the resident's legal representative, the identity of the ACH's
primary liability insurance carrier. If the ACH is self-insured, its statement
shall reflect that fact and indicate the corporate entity responsible for
payment of any claims.
5. Document
evidence of annual vaccination against influenza for each resident, in
accordance with the recommendation of the Advisory Committee on Immunization
Practices of the Centers for Disease Control most recent to the time of
vaccine, unless such vaccination is medically contraindicated or the resident
has refused the vaccine. Influenza vaccination for all residents accepting the
vaccine shall be completed by November 30 of each year or within ten (10) days
of the vaccine becoming available. Residents admitted after this date during
the flu season and up to February 1, shall as medically appropriate, receive
influenza vaccination prior to or on admission unless refused by the
resident.
6. Document evidence of
vaccination against pneumococcal disease for all residents who are sixty-five
(65) years of age or older, in accordance with the recommendations of the
Advisory Committee on Immunization Practices of the Centers for Disease Control
at the time of vaccination, unless such vaccination is medically
contraindicated or the resident has refused the offer of vaccine. The facility
shall provide or arrange for the pneumococcal vaccination of residents who have
not received this immunization prior to or on admission unless the resident
refuses offer of the vaccine.
(2) Discharges and Transfers.
(a) Residents may only be moved, transferred
or discharged from an ACH for the following reasons:
1. Medical reasons. The resident has a
medical or nursing condition that exceeds the level of health services the
facility provides;
2. Welfare of
the resident or of other residents. This includes, but is not limited to the
following: The ACH is unable to accomplish timely evacuation of the resident in
the event of an emergency; the resident exhibits behavior that poses an
imminent danger to self or others; the resident engages in behavior or actions
that repeatedly and substantially interfere with the rights, health or safety
of residents or others; or the resident engages in illegal drug use, or commits
a criminal act that causes potential harm to the resident or others;
3. Nonpayment of patient liability;
or
4. Closing or selling the
facility.
(b) An ACH
resident shall be discharged and transferred to another appropriate setting
such as home, a hospital, or a nursing home when the resident, the resident's
legal representative, or the resident's treating physician determines that the
ACH cannot safely and effectively meet the resident's needs, including medical
services.
(c) The Board may require
that an ACH resident be discharged or transferred to another level of care if
it determines that the resident's needs, including medical services, cannot be
safely and effectively met in the ACH.
(d) In the event of a discharge or transfer
due to medical reasons, for the welfare of the resident or for the welfare of
other residents or due to nonpayment of patient liability, the adult care home
provider shall give the resident written notice at least thirty (30) days prior
to the proposed transfer or discharge.
(e) In the event of a discharge or transfer
due to medical reasons, the welfare of the resident, or for the welfare of
other residents, the ACH provider shall work with the Board, or for ACH
services reimbursed through the TennCare CHOICES program, the member's care
coordinator to develop a transition plan in order to maintain continuity of
care for the resident and to minimize the impact of the transition. The ACH
provider shall assist the resident in locating an alternate appropriate
setting.
(f) In the case of a
medical emergency that requires immediate action, the ACH provider shall give
the resident written notice as soon as possible under the
circumstances.
(g) In the event of
discharge or transfer due to selling the facility to another ACH provider, the
current ACH provider shall develop a transition plan for all residents to
facilitate the transition to a new ACH and shall maintain its license and
operation of the facility until the point in time the new ACH's license is
approved.
(h) In the event of
discharge or transfer due to the closing of the facility, the ACH provider
shall provide ninety (90) day advance notice to residents and shall work with
the board, or for ACH services reimbursed through the TennCare CHOICES program,
the MCO as appropriate, to develop a transition plan to maintain continuity of
care for the residents and to minimize the impact of transition. The ACH shall
assist each resident in locating an alternative placement.
Authority: T.C.A. §§ 68-11-201, 68-11-202, 68-11-206, 68-11-209, and 68-11-270.
Disclaimer: These regulations may not be the most recent version. Tennessee 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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