Ariz. Admin. Code § 9-10-808

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

Section R9-10-808 - Service Plans

A. Except as required in subsection (B), a manager shall ensure that a resident has a written service plan that:

1. Is completed no later than 14 calendar days after the resident's date of acceptance;

2. Is developed with assistance and review from:

a. The resident or resident's representative,

b. The manager, and

c. Any individual requested by the resident or the resident's representative;

3. Includes the following:

a. A description of the resident's medical or health problems, including physical, behavioral, cognitive, or functional conditions or impairments;

b. The level of service the resident is expected to receive;

c. The amount, type, and frequency of assisted living services being provided to the resident, including medication administration or assistance in the self-administration of medication;

d. For a resident who requires intermittent nursing services or medication administration, review by a nurse or medical practitioner;

e. For a resident who requires behavioral care:

i. Any of the following that is necessary to provide assistance with the resident's psychosocial interactions to manage the resident's behavior:

(1) The psychosocial interactions or behaviors for which the resident requires assistance,

(2) Psychotropic medications ordered for the resident,

(3) Planned strategies and actions for changing the resident's psychosocial interactions or behaviors, and

(4) Goals for changes in the resident's psychosocial interactions or behaviors; and

ii. Review by a medical practitioner or behavioral health professional; and

f. For a resident who will be storing medication in the resident's bedroom or residential unit, how the medication will be stored and controlled;

4. Is reviewed and updated based on changes in the requirements in subsections (A)(3)(a) through (f):

a. No later than 14 calendar days after a significant change in the resident's physical, cognitive, or functional condition; and

b. As follows:

i. At least once every 12 months for a resident receiving supervisory care services,

ii. At least once every six months for a resident receiving personal care services, and

iii. At least once every three months for a resident receiving directed care services; and

5. When initially developed and when updated, is signed and dated by:

a. The resident or resident's representative;

b. The manager;

c. If a review is required in subsection (A)(3)(d), the nurse or medical practitioner who reviewed the service plan; and

d. If a review is required in subsection (A)(3)(e)(ii), the medical practitioner or behavioral health professional who reviewed the service plan.

B. For a resident receiving respite care services, a manager shall ensure that:

1. A written service plan is:

a. Based on a determination of the resident's current needs and:

i. Is completed no later than three working days after the resident's date of acceptance; or

ii. If the resident has a service plan in the resident's medical record that was developed within the previous 12 months, is reviewed and updated based on changes in the requirements in subsections (A)(3)(a) through (f) within three working days after the resident's date of acceptance; and

b. If a significant change in the resident's physical, cognitive, or functional condition occurs while the resident is receiving respite care services, updated based on changes in the requirements in subsections (A)(3)(a) through (f) within three working days after the significant change occurs; and

2. If the resident is not expected to be present in the assisted living facility for more than seven calendar days, the resident is not required to comply with the requirements in R9-10-807(A).

C. A manager shall ensure that:

1. A caregiver or an assistant caregiver:

a. Provides a resident with the assisted living services in the resident's service plan;

b. Is only assigned to provide the assisted living services the caregiver or assistant caregiver has the documented skills and knowledge to perform;

c. Provides assistance with activities of daily living according to the resident's service plan;

d. If applicable, suggests techniques a resident may use to maintain or improve the resident's independence in performing activities of daily living;

e. Provides assistance with, supervises, or directs a resident's personal hygiene according to the resident's service plan;

f. Encourages a resident to participate in activities planned according to subsection (E); and

g. Documents the services provided in the resident's medical record; and

2. A volunteer or an assistant caregiver who is 16 or 17 years of age does not provide:

a. Assistance to a resident for:

i. Bathing,

ii. Toileting, or

iii. Moving the resident's body from one surface to another surface;

b. Assistance in the self-administration of medication;

c. Medication administration; or

d. Nursing services.

D. A manager of an assisted living facility that is authorized to provide adult day health services shall ensure that the adult day health care services are provided as specified in R9-10-1113.

E. A manager shall ensure that:

1. Daily social, recreational, or rehabilitative activities are planned according to residents' preferences, needs, and abilities;

2. A calendar of planned activities is:

a. Prepared at least one week in advance of the date the activity is provided,

b. Posted in a location that is easily seen by residents,

c. Updated as necessary to reflect substitutions in the activities provided, and

d. Maintained for at least 12 months after the last scheduled activity;

3. Equipment and supplies are available and accessible to accommodate a resident who chooses to participate in a planned activity; and

4. Multiple media sources, such as daily newspapers, current magazines, internet sources, and a variety of reading materials, are available and accessible to a resident to maintain the resident's continued awareness of current news, social events, and other noteworthy information.

F. If a resident is not receiving assistance with the resident's psychosocial interactions under the direction of a behavioral health professional or any other behavioral health services at an assisted living facility, the resident is not considered to be receiving behavioral care or behavioral health services from the assisted living facility if the resident:

1. Is prescribed a psychotropic medication, or

2. Is receiving directed care services and has a primary diagnosis of:

a. Dementia,

b. Alzheimer's disease-related dementia, or

c. Traumatic brain injury.

Ariz. Admin. Code § R9-10-808

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). Amended 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.