(1) An individual resident file shall be maintained by the administrator or on-site manager for each
resident in the home. Personal information shall be treated as confidential and shall not be disclosed
except to the resident and his or her representative or legal surrogate, if any, an authorized agent of the
Department, and others to whom written authorization is given by the resident or his representative or
legal surrogate, if any. The resident file shall be made available for inspection and/or copy to the resident
or the resident’s representative or legal surrogate, if any, upon request.

(2) Each resident file shall include the following information:
(a) identifying information including name, social security number, veteran status and number, age, sex
and previous address;
(b) name, address and telephone number of next of kin, legal guardian and/ or representative or legal
surrogate, if any, or representative payee and any court order or written document designating the
resident’s representative or legal surrogate, if any;
(c) name, address and telephone number of any person or agency providing additional services to the
resident. This information shall include the name of the agency personnel primarily responsible, (i.e., the
caseworker, case manager, or therapist);
(d) date of admission, prior residence of resident, referral source, agency contact and telephone
number of referral source;
(e) date of discharge, facility or residence discharged to and telephone number;
(f) the name, address and telephone number of a physician, hospital and pharmacy of the resident’s
choice;
(g) a record of all monetary transactions conducted on behalf of the resident with itemized receipts of all
disbursements and deposits;
(h) a record of all monies and other valuables entrusted to the home for safekeeping; a receipt for same
shall be provided to the resident or representative or legal surrogate, if any, at the time of admission and
at anytime thereafter when the resident acquires additional property and wishes to entrust such property
to the home for safekeeping;
(i) health information including all health appraisals, diagnoses, prescribed diets, medications, and
physician’s instructions;
(j) an inventory of all personal items brought to the home by the resident to be updated at anytime after
admission if a resident or representative or legal surrogate, if any, submits to the home a new inventory of
the resident’s personal items;
(k) a signed copy of the Resident’s Rights form;
(l) a signed copy of the admission agreement;
(m) any power of attorney or document issued by a court or by the Social Security Administration or any
other governmental authority which designates another person as responsible for management of the
resident’s finances;
(n) a copy of a living will and/or durable power of attorney for health care if executed prior to 2007 or a
copy of the Georgia advance directive for health care, if any, the forms for which shall be made available
at the time of admission and shall remain available to the resident;
(o) a copy of the resident’s written waiver of the personal needs allowance charge pursuant to the
provisions of Rule 111-8-62-.26(p)1.; and
(p) a copy of the physician’s statement certifying which staff person or persons have been trained and
are qualified to administer insulin to the resident pursuant to the provisions of Rule 111-8-62-.21(1)(b).

(3) The following information may be given voluntarily by the resident, guardian, or representative or
legal surrogate, if any, but may not be required:
(a) religious preference, church membership, name and telephone number of minister, priest or rabbi;
and
(b) information about insurance policies and prearranged funeral and burial provisions, if any.

(4) Resident files shall be maintained by the home for a period of three years after a resident’s
discharge.