Ariz. Admin. Code § 9-10-803

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

Section R9-10-803 - Administration

A. A governing authority shall:

1. Consist of one or more individuals responsible for the organization, operation, and administration of an assisted living facility;

2. Establish, in writing, an assisted living facility's scope of services;

3. Designate, in writing, a manager who:

a. Is 21 years of age or older; and

b. Except for the manager of an adult foster care home, has either a:

i. Certificate as an assisted living facility manager issued under A.R.S. § 36-446.04(C), or

ii. A temporary certificate as an assisted living facility manager issued under A.R.S. § 36-446.06;

4. Adopt a quality management program that complies with R9-10-804;

5. Review and evaluate the effectiveness of the quality management program at least once every 12 months;

6. Designate, in writing, an acting manager who has the qualifications established in subsection (A)(3), if the manager is:

a. Expected not to be present on the assisted living facility's premises for more than 30 calendar days, or

b. Not present on the assisted living facility's premises for more than 30 calendar days;

7. Except as provided in subsection (A)(6), notify the Department according to A.R.S. § 36-425(I) when there is a change in the manager and identify the name and qualifications of the new manager;

8. Ensure that a manager or caregiver who is able to read, write, understand, and communicate in English is on an assisted living facility's premises; and

9. Ensure compliance with A.R.S. § 36-411.

B. A manager:

1. Is directly accountable to the governing authority of an assisted living facility for the daily operation of the assisted living facility and all services provided by or at the assisted living facility;

2. Has the authority and responsibility to manage the assisted living facility; and

3. Except as provided in subsection (A)(6), designates, in writing, a caregiver who is:

a. At least 21 years of age, and

b. Present on the assisted living facility's premises and accountable for the assisted living facility when the manager is not present on the assisted living facility premises.

C. A manager shall ensure that policies and procedures are:

1. Established, documented, and implemented to protect the health and safety of a resident that:

a. Cover job descriptions, duties, and qualifications, including required skills and knowledge, education, and experience for employees and volunteers;

b. Cover orientation and in-service education for employees and volunteers;

c. Include how an employee may submit a complaint related to resident care;

d. Cover the requirements in A.R.S. Title 36, Chapter 4, Article 11;

e. Except as provided in subsection (M), cover cardiopulmonary resuscitation training for applicable employees and volunteers, including:

i. The method and content of cardiopulmonary resuscitation training, which includes a demonstration of the employee's or volunteer's ability to perform cardiopulmonary resuscitation;

ii. The qualifications for an individual to provide cardiopulmonary resuscitation training;

iii. The time-frame for renewal of cardiopulmonary resuscitation training; and

iv. The documentation that verifies that the employee or volunteer has received cardiopulmonary resuscitation training;

f. Cover first aid training;

g. Cover how a caregiver will respond to a resident's sudden, intense, or out-of-control behavior to prevent harm to the resident or another individual;

h. Cover staffing and recordkeeping;

i. Cover resident acceptance and resident rights;

j. Cover termination of residency, including:

i. Termination initiated by the manager of an assisted living facility, and

ii. Termination initiated by a resident or the resident's representative;

k. Cover the provision of assisted living services, including:

i. Coordinating the provision of assisted living services,

ii. Making vaccination for influenza and pneumonia available to residents according to A.R.S. § 36-406(1)(d), and

iii. Obtaining resident preferences for food and the provision of assisted living services;

l. Cover the provision of respite services or adult day health services, if applicable;

m. Cover methods by which the assisted living facility is aware of the general or specific whereabouts of a resident, based on the level of assisted living services provided to the resident and the assisted living services the assisted living facility is authorized to provide;

n. Cover resident medical records, including electronic medical records;

o. Cover personal funds accounts, if applicable;

p. Cover specific steps for:

i. A resident to file a complaint, and

ii. The assisted living facility to respond to a resident's complaint;

q. Cover health care directives;

r. Cover assistance in the self-administration of medication, and medication administration;

s. Cover food services;

t. Cover contracted services;

u. Cover equipment inspection and maintenance, if applicable;

v. Cover infection control; and

w. Cover a quality management program, including incident report and supporting documentation;

2. Available to employees and volunteers of the assisted living facility; and

3. Reviewed at least once every three years and updated as needed.

D. A manager shall ensure that the following are conspicuously posted:

1. A list of resident rights;

2. The assisted living facility's license;

3. Current phone numbers of:

a. The unit in the Department responsible for licensing and monitoring the assisted living facility,

b. Adult Protective Services in the Department of Economic Security,

c. The State Long-Term Care Ombudsman, and

d. The Arizona Center for Disability Law; and

4. The location at which a copy of the most recent Department inspection report and any plan of correction resulting from the Department inspection may be viewed.

E. A manager shall ensure that, unless otherwise stated:

1. Documentation required by this Article is provided to the Department within two hours after a Department request; and

2. When documentation or information is required by this Chapter to be submitted on behalf of an assisted living facility, the documentation or information is provided to the unit in the Department that is responsible for licensing and monitoring the assisted living facility.

F. If a requirement in this Article states that a manager shall ensure an action or condition or sign a document:

1. A governing authority or licensee may ensure the action or condition or sign the document and retain the responsibility to ensure compliance with the requirement in this Article;

2. The manager may delegate ensuring the action or condition or signing the document to another individual, but the manager retains the responsibility to ensure compliance with the requirement in the Article; and

3. If the manager delegates ensuring an action or condition or signing a document, the delegation is documented and the documentation includes the name of the individual to whom the action, condition, or signing is delegated and the effective date of the delegation.

G. A manager shall:

1. Not act as a resident's representative and not allow an employee or a family member of an employee to act as a resident's representative for a resident who is not a family member of the employee;

2. If the assisted living facility administers personal funds accounts for residents and is authorized in writing by a resident or the resident's representative to administer a personal funds account for the resident:

a. Ensure that the resident's personal funds account does not exceed $2,000;

b. Maintain a separate record for each resident's personal funds account, including receipts and expenditures;

c. Maintain the resident's personal funds account separate from any account of the assisted living facility; and

d. Provide a copy of the record of the resident's personal funds account to the resident or the resident's representative at least once every three months;

3. Notify the resident's representative, family member, public fiduciary, or trust officer if the manager determines that a resident is incapable of handling financial affairs; and

4. Except when a resident's need for assisted living services changes, as documented in the resident's service plan, ensure that a resident receives at least 30 calendar days written notice before any increase in a fee or charge.

H. A manager shall permit the Department to interview an employee, a volunteer, or a resident as part of a compliance survey or a complaint investigation.

I. If abuse, neglect, or exploitation of a resident is alleged or suspected to have occurred before the resident was accepted or while the resident is not on the premises and not receiving services from an assisted living facility's manager, caregiver, or assistant caregiver, the manager shall report the alleged or suspected abuse, neglect, or exploitation of the resident according to A.R.S. § 46-454.

J. If a manager has a reasonable basis, according to A.R.S. § 46-454, to believe abuse, neglect or exploitation has occurred on the premises or while a resident is receiving services from an assisted living facility's manager, caregiver, or assistant caregiver, the manager shall:

1. If applicable, take immediate action to stop the suspected abuse, neglect, or exploitation;

2. Report the suspected abuse, neglect, or exploitation of the resident according to A.R.S. § 46-454;

3. Document:

a. The suspected abuse, neglect, or exploitation;

b. Any action taken according to subsection (J)(1); and

c. The report in subsection (J)(2);

4. Maintain the documentation in subsection (J)(3) for at least 12 months after the date of the report in subsection(J)(2);

5. Initiate an investigation of the suspected abuse, neglect, or exploitation and document the following information within five working days after the report required in subsection (J)(2):

a. The dates, times, and description of the suspected abuse, neglect, or exploitation;

b. A description of any injury to the resident related to the suspected abuse or neglect and any change to the resident's physical, cognitive, functional, or emotional condition;

c. The names of witnesses to the suspected abuse, neglect, or exploitation; and

d. The actions taken by the manager to prevent the suspected abuse, neglect, or exploitation from occurring in the future; and

6. Maintain a copy of the documented information required in subsection (J)(5) for at least 12 months after the date the investigation was initiated.

K. A manager shall provide written notification to the Department of a resident's:

1. Death, if the resident's death is required to be reported according to A.R.S. § 11-593, within one working day after the resident's death; and

2. Self-injury, within two working days after the resident inflicts a self-injury that requires immediate intervention by an emergency services provider.

L. If a resident is receiving services from a home health agency or hospice service agency, a manager shall ensure that:

1. The resident's medical record contains:

a. The name, address, and contact individual, including contact information, of the home health agency or hospice service agency;

b. Any information provided by the home health agency or hospice service agency; and

c. A copy of resident follow-up instructions provided to the resident by the home health agency or hospice service agency; and

2. Any care instructions for a resident provided to the assisted living facility by the home health agency or hospice service agency are:

a. Within the assisted living facility's scope of services,

b. Communicated to a caregiver, and

c. Documented in the resident's service plan.

M. A manager of an assisted living home may establish, in policies and procedures, requirements that a caregiver obtains and provides documentation of cardiopulmonary resuscitation training specific to adults, which includes a demonstration of the caregiver's ability to perform cardiopulmonary resuscitation, from one of the following organizations:

1. American Red Cross,

2. American Heart Association, or

3. National Safety Council.

Ariz. Admin. Code § R9-10-803

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). Former Section R9-10-803 renumbered to R9-10-804; new Section R9-10-803 made by final rulemaking at 9 A.A.R. 319, effective March 14, 2003 (Supp. 03-1). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014. Amended by final rulemaking at 25 A.A.R. 1583, effective 10/1/2019.