R 325.1921 Governing bodies, administrators, and supervisors.
Rule 21. (1) The owner, operator, and governing body of a home shall do all of the following:
(a) Assume full legal responsibility for the overall conduct and operation of the home.
(b) Assure that the home maintains an organized program to provide room and board,
protection, supervision, assistance, and supervised personal care for its residents.
(c) Assure the availability of emergency medical care required by a resident.
(d) Appoint a competent administrator who is responsible for operating the home in
accordance with the established policies of the home.
(2) An administrator shall meet all of the following requirements:
(a) Be at least 18 years old.
(b) Have education, training, and/or experience related to the population served by
the home.
(c) Be capable of assuring program planning, development, and implementation of
services to residents consistent with the home’s program statement and in accordance
with the resident’s service plan and agreements.
(3) A licensee who meets the qualifications of an administrator may serve as an
administrator.
R 325.1922 Admission and retention of residents.
Rule 22. (1) A home shall have a written resident admission contract, program statement,
admission and discharge policy and a resident’s service plan for each resident.
(2) The admission policy shall specify all of the following:
(a) That at the time of admission, the home shall document the needs of each individual
seeking admission. The documented needs shall be used to develop the resident’s service plan.
(b) That a home shall not accept an individual seeking admission unless the individual’s
needs can be adequately and appropriately met within the scope of the home’s program statement.
(c) That the individual seeking admission and his or her authorized representative, if
any shall participate in the development of the individual’s service plan.
(d) The home’s policy governing the annual screening of residents for tuberculosis.
(3) At the time of an individual’s admission, home or the home’s designee shall
complete a written resident admission contract between the resident and/or the
resident’s authorized representative, if any, and the home. The resident admission
contract shall, at a minimum, specify all of the following:
(a) That the home shall provide room, board, protection, supervision, assistance, and
supervised personal care consistent with the resident’s service plan.
(b) The services to be provided and the fees for the services.
(c) The notice to be provided by the home to the resident and/or the resident’s
the authorized representative, if any, upon any change in fees.
(d) The transportation services that are provided, if any, and the fees for those services.
(e) The home’s admission and discharge policy.
(f) The home’s refund policy.
(g) The resident’s rights and responsibilities, which shall include those rights and
responsibilities specified in MCL 333.20201(2) and (3) and MCL 333.20202.
(4) If there is a change in a term or condition in the written resident admission contract,
then the home or home’s designee shall review the change with the resident and the
resident’s authorized representative if any.
(5) A home shall update each resident’s service plan at least annually or if there is a
significant change in the resident’s care needs. Changes shall be communicated to the
resident and his or her authorized representative if any.
(6) A home shall require an individual who, at the time of admission, is under the
care of licensed health care professional for ongoing treatments or prescription
medications that require the home’s intervention or oversight, to provide a written
statement from that licensed health care professional completed within the 90-day
period before the individual’s admission to the home. The statement shall list those
treatments or medications for the purpose of developing and implementing the
resident’s service plan. If this statement is not available at the time of an emergency
admission, then the home shall require that the statement be obtained not later than 30
days after admission.
(7) An individual admitted to a residence in the home shall have evidence of
tuberculosis screening on record in the home which consists of an intradermal skin test,
chest x-ray or other methods recommended by the local health authority performed
within 12 months before admission.
(8) A home shall not retain a resident if the resident has harmed himself or herself
or others, or has demonstrated behaviors that pose a risk of serious harm to himself or
herself or others, unless the home has the capacity to manage the resident’s behavior.
(9) A home shall not admit a resident who requires continuous nursing care services
of the kind normally provided in a nursing home as specified in MCL 333.21711(3) and
MCL 333.21715(2).
(10) A home shall not retain a resident who requires continuous nursing care services
of any kind normally provided in a nursing home as specified in MCL 333.21711(3) and
MCL 333.21715(2) unless the home meets the provisions of MCL 333.21325 or the
the individual is enrolled in and receiving services from a licensed hospice program or a
home health agency.
(11) In accordance with MCL 333.20201(3)(e), a home’s discharge policy shall specify
that a home for the aged resident may be transferred or discharged for any of the following
reasons:
(a) Medical reasons.
(b) His or her welfare or that of other residents.
(c) For nonpayment of his or her stay.
(d) Transfer or discharge sought by the resident or authorized representative.
(12) The reason for transfer or discharge shall be documented in the resident record.
(13) A home shall provide a resident and his or her authorized representative if any,
and the agency responsible for the resident’s placement, if any, with a 30-day written
notice before discharge from the home. The written notice shall consist of all of the
following:
(a) The reasons for discharge.
(b) The effective date of the discharge.
(c) A statement notifying the resident of the right to file a complaint with the
department. The provisions of this subrule do not preclude a home from providing other
legal notice as required by law.
(14) If the department finds that the resident was discharged in violation of these
rules or the home’s discharge policy, then the resident may return to the fi rst available
bed in the home that can meet the resident’s needs as identifi ed in the resident’s
service plan.
(15) A home may discharge a resident before the 30-day notice if the home has
determined and documented that either, or both, of the following, exist:
(a) Substantial risk to the resident due to the inability of the home to meet the resident’s needs or due to the inability of the home to assure the safety and well-being of
the resident, other residents, visitors, or staff of the home.
(b) A substantial risk or an occurrence of the destruction of property.
(16) A home that proposes to discharge a resident for any of the reasons listed
in subrule (15) of this rule shall take all of the following steps before discharging the
resident:
(a) The home shall notify the resident, the resident’s authorized representative, if
any, and the agency responsible for the resident’s placement, if any, not less than 24
hours before discharge. The notice shall be verbal and issued in writing. The notice of
discharge shall include all of the following information:
(i) The reason for the proposed discharge, including the specifi c nature of the
substantial risk.
(ii) The alternatives to discharge that have been attempted by the home, if any.
(iii) The location to which the resident will be discharged.
(iv) The right of the resident to fi le a complaint with the department.
(b) The department and adult protective services shall be notifi ed not less than 24
hours before discharge in the event of either of the following:
(i) A resident does not have an authorized representative or an agency responsible
for the resident’s placement.
(ii) The resident does not have a subsequent placement.
(c) The notice to the department and adult protective services shall include all of the
following information:
(i) The reason for the proposed discharge, including the specific nature of the
substantial risk.
(ii) The alternatives to discharge that have been attempted by the home if any.
(iii) The location to which the resident will be discharged if known.
(d) If the department finds that the resident was improperly discharged, then the
the resident may return to the first available bed in the home that can meet the resident’s
needs as identified in the resident’s service plan.
(e) The resident shall not be discharged until a subsequent setting that meets the
resident’s immediate needs is located.