601 ADMISSIONS

601.1 Admission Criteria
The Level II licensed assisted living facility shall not admit any resident whose needs are greater than the facility is licensed to provide. The assisted living facility shall not provide services to residents who:
a. need 24-hour nursing services;
b. are bedridden;
c. have a temporary (more than fourteen (14) consecutive days) or terminal condition unless a physician or advance practice nurse certifies the resident’s needs may be safely met by a service agreement developed by the assisted living facility, the attending physician or advance practice nurse, a registered nurse, the resident or his or her responsible party if the resident is incapable of making decisions, and other appropriate health care professionals as determined by the resident’s needs;
d. have transfer assistance needs, including but not limited to assistance to evacuate the facility in case of emergency, that the facility cannot meet with current staffing;
e. present a danger to self or others or engage in criminal activities.

601.2 Pre-Admission Evaluation
Each applicant shall receive an initial evaluation completed by the facility prior to admission to determine whether the resident’s needs can be met by the assisted living facility, and the resident’s needs are not greater than the facility is licensed
to provide.

601.3 Occupancy Admission Agreement
Prior to or on the day of admission, the assisted living facility and the resident or his or her responsible party shall enter into an occupancy admission agreement. For admissions due to emergency circumstances, an individual shall enter into the
assisted living facility as a provisional placement with an occupancy admission agreement between the assisted living facility and the individual or his or her  responsible party in place within thirty (30) calendar days of admission if it is
determined the individual is appropriate for admission into the assisted living facility. The agreement shall be in writing and shall be signed by both parties. Each resident or his or her responsible party, prior to the execution of the occupancy admission agreement, shall have an opportunity to read the agreement.
In the event that a resident or his or her responsible party is unable to read the agreement, necessary steps shall be taken to ensure communication of its contents to the resident or his or her responsible party. The resident or his or her responsible party shall be given a signed copy of the agreement, and a copy signed by the resident or his or her responsible party, and assisted living facility
shall be retained in the resident’s record. The occupancy admission agreement shall include, at a minimum, the following:
a. Basic core services that the assisted living facility shall provide including, but not limited to:
1. 24-Hour Staff. The phrase 24-hour staff does not require continuous, uninterrupted visual monitoring, and does not place
any responsibility with the facility for the conduct of a resident who is away from the facility. This definition does not mean, and
is not intended to imply, that a facility is not responsible for any resident who has eloped, as that term is defined in these
regulations;
2. Assistance in obtaining emergency care 24-hours a day. This provision may be met with an agreement with an ambulance
service or hospital or emergency services through 911;
3. Assistance with social, recreational and other activities;
4. Assistance with transportation (this does not include the provision of transportation;
5. Linen service;
6. 3 meals a day;
b. Direct Care Services and Ancillary Services:
1. Services identified by the resident or his or her responsible party that are not included in the assisted living facility’s core services
(see Section 601.3(a) for basic core services) but are available in the facility on an additional fee basis (see Section 700.1.3, Section
700.2.3, Section 700.3.3 and Section 903(i) for examples of ancillary services on an additional fee basis) for which the resident
or his or her responsible party must sign a request that acknowledges the additional cost and the services provided in the
facility for that additional cost;
2. Arrangements for other services identified as needed by the resident or his or her responsible party but are not available in the
assisted living facility;
c. Health Care Services:
1. Health care services identified as needed by the resident or his or her responsible party that are not included in the assisted living
facility’s basic core services but are available in the facility on an additional fee basis, for which the resident or his or her responsible
party must sign a request that acknowledges the additional cost and the services provided in the facility for that additional cost;
2. Arrangements for other health care services identified as needed by the resident or his or her responsible party but are not available in the assisted living facility;
d. Parameters for pets to include behavior and health;
e. A current statement of all:
1. Fees,
2. Daily, weekly or monthly charges,
3. Any other services that are available on an additional fee basis for which the resident or his or her responsible party must sign a
request acknowledging the additional cost and the services provided for that charge;
All fees that a resident will be billed (basic core and other fees) shall be disclosed in writing to the resident and made a part of the occupancy admission agreement prior to the receipt of the services. If no prior agreement is obtained, the services may not be billed to the resident or the resident’s responsible party.
f. A statement that residents or their responsible parties shall be informed, in writing, at least thirty (30) days prior to general rate changes;
g. The refund policy that addresses refund of advance payment(s) in the event of transfer, death or voluntary or involuntary discharge. The facility shall ensure, and the policy shall include, as a minimum, the following:

1. For a fourteen-day (14) period beginning on the date of entry into a facility, the resident or his or her responsible party shall have the
right to rescind any contractual obligation into which he or she has entered and receive a full refund of any moneys transferred to the
facility. If the resident entered the facility and received some benefit, the charges of the services provided shall be prorated and
payment made only for the benefits conferred prior to the refund;
2. In the event of discharge for medical reasons, the refund policy must address the resident’s need to maintain on-going medical care
and services, and for that reason, refunds shall be on a pro-rata basis regardless of income source;
3. If, after the expiration of the fourteen-day (14) period referenced in Section 601.3(g)(1) above, the resident or his or her responsible
party provides a ten (10) day notice, any applicable refund shall be available the day the resident is discharged from the facility. If the
resident or his or her responsible party does not provide a ten (10) day notice, any applicable refund will be available within ten (10)
days of the resident’s departure;
h. Procedure for nonpayment of fees;
i. Whether the resident or his or her responsible party chooses to ask the facility to accept responsibility for the resident’s personal funds;
j. Whether the resident shall assume responsibility for his own medication;
k. The resident or his or her responsible party’s authorization and consent to release medical information as needed;
l. Provisions for the continuous assessment of the resident’s needs, referral for appropriate services as may be required if the resident’s condition changes and referral for transfer or discharge if required due to a change in the resident’s condition;
m. A statement that a resident may not be required to perform services for the assisted living facility except as provided for in the occupancy admission agreement or a subsequent written agreement. A resident and the assisted
living facility may agree in writing that a resident will perform certain activities or services in the facility if the resident volunteers or is
compensated at or above prevailing rates in the community. If a resident is compensated for performance of certain activities to which the resident and the facility agree, the resident shall have to undergo a criminal record check;
n. Conditions under which emergency transfers or discharges shall be made and procedures for handling such transfers or discharges;
o. Conditions or events resulting in termination of the occupancy admission agreement;
p. Resident’s or his or her responsible party’s responsibilities;
q. Written documentation of the resident’s or his or her responsible party’s preference regarding the formulation of an Advance Directive in accordance with Arkansas law. If applicable, a copy of the resident’s
Advance Directive shall be available;
r. Copy of Compliance Agreement (if applicable);
s. Evidence that the resident or responsible party was provided a copy of the facility Disclosure Statement, and annual updates upon revision of  Statement;
t. HIPAA authorization forms, if any;
u. Documentation of Options Counseling form;
s v. Other information as may be appropriate.

601.4 Retention Conditions
Pursuant to Act 1230 of 2001, Section 4 (c), no resident shall be permitted to remain in an assisted living facility if the resident’s condition requires twenty-four
(24) hour nursing care or other services that an assisted living facility is not authorized by law to provide, and the care is more than episodic as set forth in subsection (d) below. Further, this prohibition applies even if the resident is willing to execute an agreement relieving the facility of responsibility attendant to the resident’s continued placement.
A diagnosis of Alzheimer’s or related dementia, standing alone, shall not disqualify an individual from placement or residency in a Level II Assisted Living Facility. However, if the individual with a diagnosis of Alzheimer’s or related dementia requires twenty-four hour nursing care, and the period of twenty-four
(24) hour nursing care is more than episodic as set forth in subsection (d), below, the individual cannot be admitted to, or remain a resident of, a Level II Assisted Living Facility.
An assisted living facility may retain a resident whose condition requires episodic, twenty-four (24) hour nursing care, or who becomes incompetent or incapable of recognizing danger, summoning assistance, or expressing need provided that the 49

facility ensures all of the following:
a. That adequate oversight, protection and services are provided for the person;
b. That the resident has a guardian or has an agent with a current power of attorney, regardless of whether it is durable, for health care or both. The power of attorney for health care must substantially cover the person’s
areas of incapacity to meet the requirement of this subsection;
c. That both the service agreement and compliance agreement, if required, is signed by the guardian and the health care agent or the agent with power of attorney, if any; and
d. The retention is for a period of no more than ninety (90) days, with no more than a total of two (2) ninety (90) day periods for a single resident in any continuous twelve (12) month period.

 

602 INVOLUNTARY TRANSFER OR DISCHARGE OF RESIDENT

Except in cases of provisional placements, in the event of involuntary transfer or discharge of a resident, the assisted living facility shall:
a. Discuss with the resident the decision to transfer or discharge the resident;
b. Inform the resident of the reason for the transfer or discharge;
c. Inform the resident of any available alternative to the transfer or discharge;
d. Provide a thirty (30) day written notice of transfer or discharge, unless an immediate discharge is required to ensure the welfare of the resident or the welfare of other residents may be immediately affected or the conditions
found in Ark. Code Ann. § 20-10-1005(a)(1) exist. The written notice shall contain, at a minimum:
1. The reason or reasons for the transfer or discharge;
2. Except for a transfer pursuant to Section 404.9, a statement of the resident’s right of appeal;
3. Except for a transfer pursuant to Section 404.9, a statement that an appeal must be made to the Office of Long Term Care;
4. Except for a transfer pursuant to Section 404.9, a statement that the notice of appeal must be made within seven (7) calendar days of
the written notice of transfer or discharge to the resident.
e. In the event an immediate transfer or discharge is required pursuant to the conditions set forth in Section 602(d), the assisted living facility shall advise the resident or his or her responsible party, and immediate arrangements shall be made based on the written occupancy admission agreement to transfer or discharge such resident to an appropriate facility.
f. Where there is no responsible party or the responsible party is unwilling to act, the assisted living facility shall notify the Department of Human Services’ Adult Protective Services for the county in which the assistedbliving facility is located and other appropriate agencies when transfer assistance is needed.
g. Provide a copy of pertinent information that must include:
1. Identifying information including social security number and Medicaid number if there is one, and birth date;
2. Responsible party contact information;
3. Summary of needs/problems including medications, treatments and diagnosis;
4. Social history, if available;
h. Refund to the resident or his or her responsible party any security deposit, less appropriate deductions for damage or specific charges made to the assisted living facility by or on behalf of the resident.
i. Document in the resident’s file the reasons for the transfer or discharge.
Prior to making such transfer or discharge, the assisted living facility shall:
1. Develop a transfer or discharge plan consistent with the occupancy admission agreement;
2. Document in the resident’s file the following:
A. The reason for the transfer or discharge;
B. The strategies used, if any, to prevent involuntary transfer or discharge;
C. The fact that the resident or his or her responsible party was
informed and the manner in which they were informed;
D. The name, address, and telephone number of the individual or location to which the resident is to be transferred or
discharged.
j. If it is determined that there is a medical need for a transfer to another health care facility because the assisted living facility cannot meet the resident’s needs, such transfers shall be initiated promptly. The registered
nurse shall be notified and shall ensure:
1. That the resident is receiving appropriate care prior to transfer or discharge;
2. That discharge or transfer occurs in a manner consistent with the medical needs of the resident including arrangements for
appropriate transportation.
602.1 Conditions of Termination of the Occupancy Admission Agreement Pursuant to Act 1230 of 2001, Section 4 (c), no resident shall be permitted to remain in an assisted living facility if the resident’s condition requires twenty-four
(24) hour nursing care or other services that an assisted living facility is not authorized by law to provide. See also Section 601.1. Further, this prohibition applies even if the resident is willing to execute an agreement relieving the facility of responsibility attendant to the resident’s continued placement. Subject to the foregoing, supplemental services may be provided as an alternative to
termination. In no event shall an assisted living facility terminate an occupancy admission agreement if the resident or his or her responsible party arranges for the needed services and any unmet needs. Supplemental services may be provided by
the resident’s family, facility staff or private duty staff as agreed between the resident and the facility. The occupancy admission agreement shall not be terminated except under one of the following conditions:
a. By written notification by either party giving the other party thirty (30) calendar days written notice, provided, however, that if an emergency condition exists whereby the continued residency of the resident will constitute immediate jeopardy, a direct threat or the substantial risk of serious harm, serious injury, impairment or death to other residents, the facility may immediately discharge the resident. In such cases, the facility shall document the nature of the emergency and the reasons why it could
not permit the continued residency of a resident, and shall provide a written statement of discharge containing the reason for the discharge, and stating the right and method to appeal the discharge;
b. The resident’s mental or physical condition deteriorates to a level requiring services that cannot be provided in a Level II assisted living
facility
c. The resident’s condition requires twenty-four (24) hour nursing care as defined in Section 300;
d. The resident’s behavior or condition poses an immediate threat to the health or safety of self or others;
e. The resident or his or her responsible party refuses to cooperate in an examination by a physician or advance practice nurse or licensed
psychologist of his or her own choosing to determine the resident’s health or mental status for the purpose of establishing appropriateness for retention or termination;
f. The resident’s fees have not been paid, provided the resident or his or her responsible party was notified and given thirty (30) days to pay any deficiency;
g. The resident or his or her responsible party refuses to enter into a negotiated compliance agreement, refuses to revise the compliance
agreement when there is a documented medical reason for the need of a negotiated compliance agreement or revision thereto, or refuses to comply with the terms of the compliance agreement (See Section 704, Compliance Agreements);
h. Other written conditions as may be mutually established between the resident or his or her responsible party and the assisted living facility at the time of admission or any time thereafter.

603 BILL OF RIGHTS

603.1 Residents’ Bill of Rights
1. Each assisted living facility must post the Residents’ Bill of Rights, as provided by the Department, in a prominent place in the facility. The Residents’ Bill of Rights must prominently display the toll-free number for contacting the Office of Long Term Care and filing a complaint, or the facility must post the number and its purpose beside the Residents’ Bill of Rights. Further, the facility shall prominently display the contact information for the State Ombudsman’s office. A copy of the Residents’ Bill of Rights must be given to each resident in a manner and form comprehendible to the resident or his or her responsible party.
2. A resident has all the rights, benefits, responsibilities, and privileges granted by the constitution and laws and regulations of this state and the United States except where lawfully restricted. The resident has the right to be free of interference, coercion, discrimination, or reprisal in exercising these civil rights.
3. In addition to the provisions of Section 603.1(1)(2), each resident in the assisted living facility has the right to, and the facility shall ensure that residents shall:
A. Be free from physical or mental abuse, including corporal punishment;
B. Be permitted to participate in activities of social, religious, or community groups unless the participation interferes with the
rights of others;
C. Be provided a schedule of individual and group activities appropriate to individual resident needs, interests and wishes;
D. Be, at a minimum, provided:
(i.) In-house activities and programs, the character and scope of which shall be disclosed to potential residents or their
responsible parties in writing as part of the application process;
(ii.) Group recreation and socialization;
E. Not be prevented in any way from the practice of the religion of the resident’s choice. The assisted living facility shall not be
expected to participate or facilitate the practice of religion beyond arranging or coordinating transportation to the extent possible;
F. Be treated with respect, kindness, consideration, and recognition of his or her dignity and individuality, without regard to race,
religion, national origin, sex, age, disability, marital status, sexual orientation or source of payment. This means that the resident:
(i.) has the right to make his or her own choices regarding personal affairs, care, benefits, and services,
(ii.) has the right to be free from abuse, neglect, and exploitation, and
(iii.) if protective measures are required, has the right to designate a guardian or representative to ensure the right to
quality stewardship of his or her affairs to the extent permitted by law;
G. Be provided a safe and appropriate living environment;
H. Not be confined to his or her apartment or bed;
I. Not be prohibited from communicating in his or her native language with other residents or personnel/staff/employees;
J. Be permitted to complain about the resident’s care or treatment. The complaint may be made anonymously or communicated by a
person designated by the resident. The provider must promptly respond to resolve the complaint. The provider must not
discriminate or take any punitive, retaliatory, or adverse action whatsoever against a resident who makes a complaint or causes a
complaint to be made;
K. Be allowed to receive and send unopened mail, and the provider must ensure that the resident’s mail is sent and delivered promptly;
L. Be allowed communication, including personal visitation with any person of the resident’s choice, including family members,
representatives of advocacy groups, and community service organizations;
M. Be allowed to make contacts with the community and to achieve the highest level of independence, autonomy, and interaction with
the community of which the resident is capable;
N. Be allowed to manage his or her financial affairs. The resident may authorize in writing another person to manage his or her
money. The resident may choose the manner in which his or her money is managed, including a money management program, a
representative payee program, a financial power of attorney, a trust, or a similar method, as desired by the resident. The resident
or his or her responsible party must be given, upon request of the resident or his or her responsible party, but at least quarterly, an
accounting of financial transactions made on his or her behalf by the facility should the facility accept his or her written delegation
of this responsibility to the facility in conformance with state law. Further, if a facility agrees to manage residents’ funds, the facility
shall indemnify and hold harmless the resident from any loss of or theft of funds;
O. Be allowed access to the resident’s records. Resident records are confidential and may not be released without the resident’s or his
or her responsible party’s consent unless the release without consent is required by law;
P. Have the right and be allowed to choose and retain a personal physician or advance practice nurse;
Q. Participate in the development of the individual direct care services and health care services plan portions of his or her occupancy
admission agreement that describes the resident’s direct care services and how the needs will be met;
R. Be given the opportunity to refuse medical treatment or services after the resident or his or her responsible party:
(i.) is advised by the person providing services of the possible consequences of refusing treatment or services, and
(ii.) acknowledges that he or she understands the consequences
of refusing treatment or services;
S. Be allowed unaccompanied access to a telephone;
T. Have privacy while attending to personal needs, and a private place for receiving visitors or associating with other residents,
unless providing privacy would infringe on the rights of other residents. The right applies to medical treatment, written
communications, telephone conversations, meeting with family, and access to resident councils;
U. If married, have the right to share an apartment or unit with his or her spouse even if the spouse is not receiving services through the
assisted living facility. In the case of two consenting adults, if one or both is receiving services through the assisted living facility, the
couple shall have the right to share an apartment or unit;
V. Be allowed to retain and use personal possessions, including, but not limited to, clothing and furnishings, as space permits. The
number of personal possessions may be limited for the health and safety of other residents;
W. Be allowed to determine his or her dress, hairstyle, or other personal effects according to individual preference, except the
resident has the responsibility to maintain personal hygiene;
X. Be allowed to retain and use personal property in his or her immediate living quarters and shall have a lockable apartment or
unit door;
Y. Be allowed to refuse to perform services for the facility;
Z. Be informed by the assisted living facility no later than the 30th day after admission:
(i.) whether the resident is entitled to benefits under Medicare or Medicaid, and
(ii.) which items and services are covered by these benefits, including items or services for which the resident may not
be separately charged;
AA. Residents are discharged or transferred in conformity with Ark.
Code Ann. § 20-10-1005 and the provisions governing transfer and discharge in these regulations.
BB. Be allowed to immediately leave the assisted living facility, either temporarily or permanently, subject to contractual or financial
obligations as specified in Section 601.3(g);
CC. Have access to the services of a representative of the State Long Term Care Ombudsman Program, Arkansas Department of Human
Services, Division of Aging and Adult Services;
DD. Be allowed to execute an advance directive or designate a guardian bin advance of need to make decisions regarding the resident’s
health care should the resident become incapacitated. EE. Receive reimbursement from the facility for any lost,
misappropriated, or destroyed property or funds, when the loss, misappropriation, or destruction, occurs at a time in which the
facility was exercising care or control over the funds or properties, including loss or destruction of residents’ property that occurs
during laundering or cleaning of the facility, the resident’s room, or the resident’s property, excluding normal wear and tear.