R9-10-808. Service Plans

A. Except as required in subsection (B), a manager shall ensure that a resident has a written service plan that:

1. Is completed no later than 14 calendar days after the resident’s date of acceptance;
2. Is developed with assistance and review from:
a. The resident or resident’s representative,
b. The manager, and
c. Any individual requested by the resident or the resident’s representative;
3. Includes the following:
a. A description of the resident’s medical or health problems, including physical,
behavioral, cognitive, or functional conditions or impairments;
b. The level of service the resident is expected to receive;
c. The amount, type, and frequency of assisted living services being provided to the
resident, including medication administration or assistance in the self-administration of medication;
d. For a resident who requires intermittent nursing services or medication
administration, review by a nurse or medical practitioner;
e. For a resident who requires behavioral care:
i. Any of the following that is necessary to provide assistance with the
resident’s psychosocial interactions to manage the resident’s behavior:
(1) The psychosocial interactions or behaviors for which the resident
requires assistance,
(2) Psychotropic medications ordered for the resident,
(3) Planned strategies and actions for changing the resident’s
psychosocial interactions or behaviors, and
(4) Goals for changes in the resident’s psychosocial interactions or
behaviors; and
ii. Review by a medical practitioner or behavioral health professional; and
f. For a resident who will be storing medication in the resident’s bedroom or
residential unit, how the medication will be stored and controlled;
4. Is reviewed and updated based on changes in the requirements in subsections (A)(3)(a)
through (f):
a. No later than 14 calendar days after a significant change in the resident’s
physical, cognitive, or functional condition; and
b. As follows:
i. At least once every 12 months for a resident receiving supervisory care
services,
ii. At least once every six months for a resident receiving personal care
services, and
iii. At least once every three months for a resident receiving directed care
services; and
5. When initially developed and when updated, is signed and dated by:
a. The resident or resident’s representative;
This document contains an unofficial version of the new rules in 9 A.A.C. 10, Article 1, effective November 5, 2019.
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b. The manager;
c. If a review is required in subsection (A)(3)(d), the nurse or medical practitioner
who reviewed the service plan; and
d. If a review is required in subsection (A)(3)(e)(ii), the medical practitioner or
behavioral health professional who reviewed the service plan.

B. For a resident receiving respite care services, a manager shall ensure that:

1. A written service plan is:
a. Based on a determination of the resident’s current needs and:
i. Is completed no later than three working days after the resident’s date of
acceptance; or
ii. If the resident has a service plan in the resident’s medical record that was
developed within the previous 12 months, is reviewed and updated based
on changes in the requirements in subsections (A)(3)(a) through (f)
within three working days after the resident’s date of acceptance; and
b. If a significant change in the resident’s physical, cognitive, or functional
condition occurs while the resident is receiving respite care services, updated
based on changes in the requirements in subsections (A)(3)(a) through (f) within
three working days after the significant change occurs; and
2. If the resident is not expected to be present in the assisted living facility for more than
seven calendar days, the resident is not required to comply with the requirements in R9-
10-807(A).

C. A manager shall ensure that:

1. A caregiver or an assistant caregiver:
a. Provides a resident with the assisted living services in the resident’s service plan;
b. Is only assigned to provide the assisted living services the caregiver or assistant
caregiver has the documented skills and knowledge to perform;
c. Provides assistance with activities of daily living according to the resident’s
service plan;
d. If applicable, suggests techniques a resident may use to maintain or improve the
resident’s independence in performing activities of daily living;
e. Provides assistance with, supervises, or directs a resident’s personal hygiene
according to the resident’s service plan;
f. Encourages a resident to participate in activities planned according to subsection(E), and
g. Documents the services provided in the resident’s medical record; and
2. A volunteer or an assistant caregiver who is 16 or 17 years of age does not provide:
a. Assistance to a resident for:
i. Bathing,
ii. Toileting, or
iii. Moving the resident’s body from one surface to another surface;
b. Assistance in the self-administration of medication;
c. Medication administration; or
d. Nursing services.

D. A manager of an assisted living facility that is authorized to provide adult day health services shall ensure that the adult day health care services are provided as specified in R9-10-1113.

E. A manager shall ensure that:

1. Daily social, recreational, or rehabilitative activities are planned according to residents’
preferences, needs, and abilities;
2. A calendar of planned activities is:
a. Prepared at least one week in advance of the date the activity is provided,
b. Posted in a location that is easily seen by residents,
c. Updated as necessary to reflect substitutions in the activities provided, and
d. Maintained for at least 12 months after the last scheduled activity;
3. Equipment and supplies are available and accessible to accommodate a resident who
chooses to participate in a planned activity; and
4. Multiple media sources, such as daily newspapers, current magazines, internet sources,
and a variety of reading materials, are available and accessible to a resident to maintain
the resident’s continued awareness of current news, social events, and other noteworthy
information.

F. If a resident is not receiving assistance with the resident’s psychosocial interactions under the
direction of a behavioral health professional or any other behavioral health services at an assisted
living facility, the resident is not considered to be receiving behavioral care or behavioral health
services from the assisted living facility if the resident:

1. Is prescribed psychotropic medication, or
2. Is receiving directed care services and has a primary diagnosis of:
a. Dementia,
b. Alzheimer’s disease-related dementia, or
c. Traumatic brain injury.