A. Admission Criteria. Residents considered for admission may include those who need or wish to have available for themselves or their spouse, room, board, personal care, and supervision due to age, infirmity, physical disability, or social dependency. Residents with advanced or higher care needs may be accepted or retained under the circumstances set forth in 8823.A.2.
1. The facility shall have a clear and specific written description of admission policies and procedures. This written description shall include, but is not limited
to the following:
a. the application process and the possible reasons for the rejection of an application;
b. types of residents suitable to the facility;
c. services offered and allowed in the facility; and,
d. facility’s house rules.
2. A facility may accept or retain residents in need of additional care beyond routine personal care provided that:
a. the resident, the representative, if applicable, and the Provider agree that
acceptance or retention of the resident is appropriate;
b. the resident can provide or arrange for his or her own care and this care
can be provided through appropriate private duty personnel;
c. the level of care required in order to accommodate the resident’s
additional needs do not amount to continuous nursing care except as
follows:
i. the reason for the need for continuous nursing care is temporary (not to exceed ninety (90) days) and the Provider has the the capability of meeting the needs of the resident; or,
ii. the resident or the legal representative of the resident provides for private duty care, or other health-related home and community-based services and assumes, in writing, the full legal responsibility for the manner in which care is provided to the resident. In
addition, this care, and responsibility shall be in compliance with
the facility rules for private duty caregivers; and,
iii. the care is given, as allowed under this section shall not interfere with facility operations or create a danger to others in the facility.
3. A Provider shall not enter into contracts with outside providers to give health-related services to individual residents. All such services shall be arranged for by
the individual resident, the resident’s family, or the resident’s representative.
4. The Provider shall encourage residents with impairments that impact their decision-making to arrange to have a representative.
5. A resident shall have the opportunity to request and consent to sharing a living unit with another resident. A facility shall not force any resident to share a living
unit.
B. Pre-Admission Appraisal
1. The Provider shall complete and maintain a pre-admission appraisal on each applicant. This initial screening shall assess the applicant’s needs and
appropriateness for admissions and shall include the following:
a. the resident’s physical and mental status;
b. the resident’s need for personal services and for assistance with instrumental activities of daily living; and,
c. the resident’s ability to evacuate the facility in the event of an emergency.
2. The pre-admission appraisal shall be completed and dated before the contract/admissions agreement is signed.
C. Admissions Agreement
1. The Provider shall complete and maintain individual written admission agreements with all persons admitted to the facility or with their legally
responsible person or persons. The facility contract/admissions agreement shall specify the following:
a. clear and specific occupancy criteria and procedures (admission, transfer,
and discharge);
b. basic services to be made available;
c. optional services which are available;
d. payment provisions, including the following:
i. covered and non-covered services;
ii. service packages and “a’ la carte” services;
iii. regular and extra fees;
iv. payor;
v. due date; and,
vi. the funding source provided that the resident may refuse to disclose sources.
e. modification conditions, including the provision of at least 30 days prior
written notice to the resident of any basic rate change, or for SSI/SSP rate
changes, as soon as the Provider is notified. Agreements involving
persons whose care is funded at government-prescribed rates may specify
that operative dates of government modifications shall be considered
operative dates for basic service rate modification;
f. refund conditions;
g. that the Bureau of Licensing has the authority to examine residents’ records as part of the evaluation of the facility;
h. general facility policies which are for the purpose of making it possible
for residents to live together, including policies and rules regarding third-party providers arranged by the resident (the use of private duty nurses or assistants);
i. division of responsibility between the facility, the resident, family, or others (e.g., arranging for or overseeing medical care, purchase of
essential or desired supplies, emergencies, monitoring of health, handling of finances);
j. residents’ rights;
k. explanation of the grievance procedure and appeals process, including information on outside agencies to which appeals may be made; and,
l. The availability of a service plan specific to the individual resident.
2. The Provider shall allow the review of the contract/admissions agreement by an attorney or other representative is chosen by the resident.
3. The admissions agreement shall be signed by the Director and by the resident and
the representative, if applicable.
4. The admissions agreement shall conform to all relevant federal, state, and local laws and requirements.
D. Other Admission Criteria. At the time of admission the Provider shall:
1. obtain from the resident or the resident’s family or representative, their plan for both routine and emergency medical care to include the name of the physician(s) and
provisions and authorization for emergency medical care;
2. document that the resident was informed of the Facility’s emergency and evacuation procedures;
3. provide the resident with a copy of the house rules; and
4. obtain a copy of health power of attorney and living will if the resident or the
resident’s representative wants the facility to keep it on file.