Ariz. Admin. Code § 9-10-2215

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

Section R9-10-2215 - Physical Health Services

A. An administrator shall ensure that:

1. A resident has a designated medical practitioner;

2. A physical examination is performed on a resident by the resident's designated medical practitioner or by a physician, physician assistant, or registered nurse practitioner designated by the resident's designated medical practitioner:

a. If indicated, based on the resident's placement evaluation or comprehensive assessment; and

b. At least once every 12 months after the date of admission, including an assessment of the acuity of the resident's medical condition;

3. The resident's designated medical practitioner, in conjunction with the director of nursing, develops a medical care plan of treatment for the resident, which is integrated into the resident's individual program plan; and

4. Vaccinations for influenza and pneumonia are available to each resident at least once every 12 months unless:

a. The resident's designated medical practitioner provides documentation that the vaccination is medically contraindicated;

b. The resident or the resident's representative refuses the vaccination or vaccinations and documentation is maintained in the resident's medical record that the resident or the resident's representative has been informed of the risks and benefits of a vaccination refused; or

c. The resident or the resident's representative provides documentation that the resident received a pneumonia vaccination within the last five years or the current recommendation from the U.S. Department of Health and Human Services, Center for Disease Control and Prevention.

B. A director of nursing shall ensure that:

1. A registered nurse participates in the development, review, and updating of a resident's nursing care plan or medical care plan;

2. Personnel members providing direct care to a resident with a nursing care plan or medical care plan receive direction from a nurse; and

3. Nursing personnel provide education and training to:

a. Residents on hygiene and other behaviors that promote health; and

b. Personnel members on:

i. Detecting signs of illness or injury or significant changes in condition,

ii. First aid, and

iii. Basic skills for caring for residents.

C. An administrator shall ensure that:

1. A resident's need for dental services is determined as part of the resident's initial assessment in R9-10-2207(3);

2. Unless a resident's eligibility for third-party payment for dental services is determined before the resident's initial comprehensive assessment in R9-10-2214(A)(1)(b) due to the resident's immediate need for dental services, the resident's eligibility for third-party payment for dental services is determined as part of the resident's comprehensive assessment;

3. Within one month after the initial comprehensive assessment in R9-10-2214(A)(1)(b), a personnel member coordinates for a resident the scheduling of a dental examination and, if needed, dental treatment:

a. If the resident is eligible for third-party payment for dental services, and

b. Unless the nursing-supported group home has documentation that the resident received a dental examination within 12 months before admission;

4. If a resident is eligible for third-party payment for dental services:

a. A dental examination is scheduled for the resident according to guidelines by the entity providing third-party payment for dental services and at least once every 12 months, and

b. Dental treatment is scheduled according to guidelines by the entity providing third-party payment for dental services and as needed;

5. Except as provided in subsection (C)(6), if a dental examination of a resident indicates a need for dental treatment, the resident's individual program plan includes the scheduling of dental treatment for the resident when the resident is eligible for third-party payment for dental services;

6. If needed, a resident is provided with emergency dental services;

7. A resident is provided with education and training in oral hygiene; and

8. A resident's medical record contains documentation of:

a. Each dental examination of the resident,

b. All dental treatment received by the resident, and

c. The resident's education and training in oral hygiene.

D. An administrator shall ensure that:

1. A resident's vision and hearing are assessed as part of the resident's comprehensive assessment in R9-10-2214(A)(1)(b) and, if applicable, as part of the update of the comprehensive assessment in R9-10-2214(A)(1)(c); and

2. If an issue is identified with the resident's vision or hearing:

a. The issue is included in the resident's individual program plan,

b. A personnel member contacts and coordinates with applicable entities to determine any vision or hearing benefits for which the resident may be eligible, and

c. The nursing-supported group home makes reasonable accommodations to address the issue in compliance with applicable federal and state disability laws.

Ariz. Admin. Code § R9-10-2215

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