Ariz. Admin. Code § 9-10-2214

Current through Register Vol. 30, No. 50, December 13, 2024

Section R9-10-2214 - Individual Program Plan

A. An administrator shall ensure that:

1. A comprehensive assessment of a resident:

a. Is conducted or coordinated by the director of nursing, in collaboration with an interdisciplinary team that includes:

i. The resident's designated medical practitioner or designee;

ii. A registered nurse;

iii. If the resident is receiving medications as part of physical health services or behavioral care, a pharmacist; and iv. Personnel members qualified to provide each type of habilitation services or rehabilitation services identified in a placement evaluation in R9-10-2207(1)(a) or the initial assessment required in R9-10-2207(3);

b. Is completed for the resident within 30 calendar days after the resident's admission to a nursing-supported group home;

c. Is updated:

i. No later than 12 months after the date of the resident's last comprehensive assessment, and

ii. When the resident experiences a significant change;

d. Includes the following information for the resident:

i. Identifying information;

ii. An evaluation of the resident's hearing, speech, and vision;

iii. An evaluation of the resident's ability to understand and recall information;

iv. An evaluation of the resident's mental status;

v. Whether the resident demonstrates inappropriate behavior;

vi. Preferences for customary routine and activities;

vii. An evaluation of the resident's ability to perform activities of daily living;

viii. Need for a mobility device;

ix. An evaluation of the resident's ability to control the resident's bladder and bowels;

x. Any diagnosis that impacts rehabilitation services or other physical health services or behavioral care that the resident may require;

xi. Any medical conditions that impact the resident's functional status, quality of life, or need for nursing services;

xii. An evaluation of the resident's ability to maintain adequate nutrition and hydration;

xiii. An evaluation of the resident's oral and dental status;

xiv. An evaluation of the condition of the resident's skin;

xv. Identification of any medication or treatment administered to the resident during a seven-day calendar period that includes the time the comprehensive assessment was conducted;

xvi. Identification of any treatment or medication ordered for the resident;

xvii. Identification of interventions that may support the resident towards independence;

xviii. Identification of any assistive devices needed by the resident;

xix. Identification of the physical health services needed by the resident, including physical health services not provided by the nursing-supported group home;

xx. Identification of measurable goals and behavioral objective for the physical health services, habilitation services, and behavioral care, in priority order, with time limits for attainment;

xxi. Identification of the methods, schedule, and strategies to accomplish the goals in subsection (A)(1)(d)(xviii), including the personnel member responsible;

xxii. Evaluation procedures for determining if the methods and strategies in subsection (A)(1)(d)(xix) are working, including the type of data required and frequency of collection;

xxiii. Whether any restraints have been used for the resident during a seven-day calendar period that includes the time the comprehensive assessment was conducted;

xxiv. If the resident demonstrates inappropriate behavior, as reported according to subsection (A)(1)(d)(v), identification of the methods, schedule, and strategies for replacement of the inappropriate behavior with appropriate behavioral expressions, including the hierarchy for use;

xxv. If restraint is included in subsection (A)(1)(d)(xxiv), the specific restraints that may be used because of the resident's inappropriate behavior;

xxvi. A description of the resident or resident's representative's participation in the comprehensive assessment;

xxvii. The name and title of the interdisciplinary team members who participated in the resident's comprehensive assessment;

xxviii. Potential for rehabilitation, including the resident's strengths and specific developmental or behavioral health needs; and

xxix. Potential for discharge;

e. Is signed and dated by the director of nursing; and

f. Is used to determine or update the resident's acuity;

2. If any of the conditions in subsection (A)(1)(d)(v) are answered in the affirmative during the comprehensive assessment or review, a behavioral health professional reviews a resident's comprehensive assessment or review and individual program plan to ensure that the resident's needs for behavioral care are being met;

3. A new comprehensive assessment is not required for a resident who is hospitalized and readmitted to a nursing-supported group home unless a physician, an individual designated by the physician, or a registered nurse determines the resident has a significant change in condition; and

4. A resident's comprehensive assessment is reviewed at least once every three months after the date of the current comprehensive assessment and if there is a significant change in the resident's condition by:

a. The director of nursing;

b. A registered nurse providing nursing services to the resident; and

c. If there is a significant change in the resident's ability to maintain adequate nutrition and hydration, a registered dietitian.

B. An administrator shall ensure that an individual program plan for a resident:

1. Is developed, documented, and implemented for the resident within seven calendar days after completing the resident's comprehensive assessment required in subsection (A)(1);

2. Includes the acuity of the resident;

3. Is reviewed at least annually by the interdisciplinary team required in subsection (A)(1)(a) and revised based on any change to the resident's comprehensive assessment; and

4. Ensures that a resident is provided physical health services, rehabilitation services, habilitation services, and other services or behavioral care that:

a. Address any medical condition or behavioral care issue identified in the resident's comprehensive assessment, and

b. Assist the resident in maintaining the resident's highest practicable well-being according to the resident's comprehensive assessment.

Ariz. Admin. Code § R9-10-2214

New Section made by final exempt rulemaking at 28 A.A.R. 927, effective 4/15/2022.