Ariz. Admin. Code § 9-10-514

Current through Register Vol. 30, No. 45, November 8, 2024

Section R9-10-514 - Individual Program Plan

A. An administrator shall ensure that:

1. A comprehensive assessment of a resident:

a. Is conducted or coordinated by a qualified intellectual disabilities professional, in collaboration with an interdisciplinary team that includes:

i. The resident's attending physician or designee;

ii. A registered nurse;

iii. If the resident is receiving medications as part of active treatment, a pharmacist; and

iv. Personnel members qualified to provide each type of rehabilitation services identified in a placement evaluation or the initial assessment required in R9-10-507(3);

b. Is completed for the resident within 30 calendar days after the resident's admission to an ICF/IID;

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 active treatment needed by the resident, including active treatment not provided by the ICF/IID;

xx. Identification of measurable goals and behavioral objective for the active treatment, 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 or seclusion is included in subsection (A)(1)(d)(xxiv), the specific restraints or conditions of seclusion 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 qualified intellectual disabilities professional who conducts or coordinates the comprehensive assessment or review; 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 an ICF/IID unless a physician, an individual designated by the physician, a qualified intellectual disabilities professional, 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. A qualified intellectual disabilities professional; and

b. If the resident has a nursing care plan or medical care plan, a registered nurse.

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 rehabilitation services and other physical health 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 § R9-10-514

Adopted as an emergency effective October 26, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-4). Emergency expired. Readopted without change as an emergency effective January 27, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-1). Emergency expired. Readopted without change as an emergency effective April 27, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-2). Emergency expired. Readopted without change as an emergency effective July 31, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-3). Permanent rules adopted with changes effective October 30, 1989 (Supp. 89-4). Section repealed, new Section adopted effective April 4, 1994 (Supp. 94-2). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Adopted by final rulemaking at 25 A.A.R. 1222, effective 4/25/2019. Amended by exempt rulemaking at 26 A.A.R. 72, effective 1/1/2020.