It is always an exciting time when a new resident chooses to move into your community! Many hours of work from your team have paid off and now you welcome a new member to the “family”- but it’s not done yet! The state of Arizona requires a written admission agreement for every new person moving into an Assisted Living Facility. Agreements should always be signed prior to the resident moving in or taking possession of the apartment. Check out the regulations below as to what needs to be included in the written admission agreement as well as general residency guidelines:
R9-10-807. Residency and Residency Agreements
- Except as provided in R9-10-808(B)(2), a manager shall ensure that a resident provides evidence of freedom from infectious tuberculosis:
- Before or within seven calendar days after the resident’s date of occupancy, and
- As specified in R9-10-113.
- A manager shall ensure that before or at the time of acceptance of an individual, the individual submits documentation that is dated within 90 calendar days before the individual is accepted by an assisted living facility and:
- If an individual is requesting or is expected to receive supervisory care services, personal care services, or directed care services:
- Includes whether the individual requires:
- Continuous medical services,
- Continuous or intermittent nursing services, or
iii. Restraints; and
- Is dated and signed by a:
- Physician,
- Registered nurse practitioner,
iii. Registered nurse, or
- Physician assistant; and
- If an individual is requesting or is expected to receive behavioral health services, other than behavioral care, in addition to supervisory care services, personal care services, or directed care services from an assisted living facility:
- Includes whether the individual requires continuous behavioral health services, and
- Is signed and dated by a behavioral health professional.
- A manager shall not accept or retain an individual if:
- The individual requires continuous:
- Medical services;
- Nursing services, unless the assisted living facility complies with A.R.S. § 36- 401(C); or
- Behavioral health services;
- The primary condition for which the individual needs assisted living services is a behavioral health issue;
- The services needed by the individual are not within the assisted living facility’s scope of services and a home health agency or hospice service agency is not involved in the care of the individual;
- The assisted living facility does not have the ability to provide the assisted living services needed by the individual; or
- The individual requires restraints, including the use of bedrails.
- Before or at the time of an individual’s acceptance by an assisted living facility, a manager ensure that there is a documented residency agreement with the assisted living facility that includes:
- The individual’s name;
- Terms of occupancy, including:
- Date of occupancy or expected date of occupancy,
- Resident responsibilities, and
- Responsibilities of the assisted living facility;
- A list of the services to be provided by the assisted living facility to the resident;
- A list of the services available from the assisted living facility at an additional fee or charge;
- For an assisted living home, whether the manager or a caregiver is awake during nighttime hours;
- The policy for refunding fees, charges, or deposits;
- The policy and procedure for a resident to terminate residency, including terminating residency because services were not provided to the resident according to the resident’s service plan;
- The policy and procedure for an assisted living facility to terminate residency;
- The complaint process; and
- The manager’s signature and date signed.
- Before or within five working days after a resident’s acceptance by an assisted living facility, a manager shall obtain on the documented agreement, required in subsection (D), the signature of one of the following individuals:
- The resident,
- The resident’s representative,
- The resident’s legal guardian, or
- Another individual who has been designated by the individual under A.R.S. § 36-3221 to make health care decisions on the individual’s behalf.
- A manager shall:
- Before or at the time of an individual’s acceptance by an assisted living facility, provide to the resident or resident’s representative a copy of:
- The residency agreement in subsection (D),
- Resident’s rights, and
- The policy and procedure on health care directives; and
- Maintain the original of the residency agreement in subsection (D) in the resident’s This document contains an unofficial version of the new rules in 9 A.A.C. 10, Article 1, effective November 5, 2019. 16 medical record
Top Takeaway:
- A manager shall ensure that before or at the time of acceptance of an individual, the individual submits documentation that is dated within 90 calendar days before the individual is accepted by an assisted living facility and:
- If an individual is requesting or is expected to receive supervisory care services, personal care services, or directed care services:
- Includes whether the individual requires:
- Continuous medical services,
- Continuous or intermittent nursing services, or
iii. Restraints; and
- Is dated and signed by a:
- Physician,
- Registered nurse practitioner,
iii. Registered nurse, or
- Physician assistant; and
This is a point where there is no grey area. The Bureau of Residential Facilities Licensing survey team will inspect this area to ensure the resident is ALF appropriate as determined by a medical professional. This is an area where many facilities are often tagged as being deficient.
Pro Tip:
- Often times a facility will be cited during an unexpected visit for not keeping proper record of the written admission agreement. Ensure that your community has a policy in place for 1. Identifying WHEN the contract will be signed and WHO will be present for the signing. 2. Tracking system for resident written admission agreement after completion. (It is recommended to keep a binder or folder for each resident with any documents pertinent to their residency just as you would with a clinical chart).