A. A manager shall ensure that a resident’s representative is designated for a resident who is unable
to direct self-care.
B. A manager of an assisted living facility authorized to provide directed care services shall not
accept or retain a resident who, except as provided in R9-10-814(B)(2):
1. Is confined to a bed or chair because of an inability to ambulate even with assistance; or
2. Has a stage 3 or stage 4 pressure sore, as determined by a registered nurse or medical
practitioner.
C. In addition to the requirements in R9-10-808(A)(3), a manager shall ensure that the service plan
for a resident receiving directed care services includes:
1. The requirements in R9-10-814(F)(1) through (3);
2. If applicable, the determination in R9-10-814(B)(2)(b) R9-10-814(B)(2)(b)(iii);
3. Cognitive stimulation and activities to maximize functioning;
4. Strategies to ensure a resident’s personal safety;
5. Encouragement to eat meals and snacks;
6. Documentation:
a. Of the resident’s weight, or
b. From a medical practitioner stating that weighing the resident is contraindicated;
and
7. Coordination of communications with the resident’s representative, family members, and,
if applicable, other individuals identified in the resident’s service plan.
D. A manager shall ensure that an employee does not provide non-prescription medication to a
resident receiving directed care services unless the resident has an order from a medical
practitioner for the non-prescription medication.
E. A manager shall ensure that:
1. A bell, intercom, or other mechanical means to alert employees to a resident’s needs or
emergencies is available in a bedroom being used by a resident receiving directed care
services; or
2. An assisted living facility has implemented another means to alert a caregiver or assistant
caregiver to a resident’s needs or emergencies.
F. A manager of an assisted living facility authorized to provide directed care services shall ensure
that:
1. Policies and procedures are established, documented, and implemented that ensure the
safety of a resident who may wander;
2. There is a means of exiting the facility for a resident who does not have a key, special
knowledge for egress, or the ability to expend the increased physical effort that meets one of
the following:
a. Provides access to an outside area that:
i. Allows the resident to be at least 30 feet away from the facility, and
ii. Controls or alerts employees of the egress of a resident from the facility;
b. Provides access to an outside area:
i. From which, a resident may exit to a location at least 30 feet away from
the facility, and
ii. Controls or alerts employees of the egress of a resident from the facility; or
c. Uses a mechanism that meets the Special Egress-Control Devices provisions in
the International Building Code incorporated by reference R9-10-104.01; and
3. A caregiver or an assistant caregiver complies with the requirements for incidents in R9-
10-804 when a resident who is unable to direct self-care wanders into an area not
designated by the governing authority for use by the resident.