N.H. Admin. Code § He-P 813.08

Current through Register No. 50, December 12, 2024

Section He-P 813.08 - Certification Process

(a) An applicant shall apply to be certified via an application form obtained from the health facilities administration entitled "Application for Family Care Certification" (December 1, 2010) .

(b) An applicant shall request certification for any of the following reasons:

(1) Certification of a new AFCR; or

(2) For an existing AFCR:

a. A change in the oversight agency;

b. A change in physical location; or

c. A request for an increase from one to 2 certified beds.

(c) The applicant shall provide the following with the application:

(1) Results of a physical examination or a health screening completed within the past 12 months by a licensed practitioner;

(2) Results of a 2 step tuberculosis (TB) test, Mantoux method, conducted no more than 12 months prior to filing the application;

(3) The full name, date of birth and relationship to the applicant of all household members;

(4) Documentation that all family pets have current vaccinations and are licensed, if required;

(5) Verification from the department or local fire official that the applicant complies with all applicable state and local fire ordinances for a single or two family dwelling, including verification that the AFCR:

a. Has smoke detectors that are:

1. Placed on every level of the AFCR;

2. Placed in every bedroom;

3. Interconnected and hardwired or a wireless system approved by the New Hampshire state fire marshal's office; and

4. Powered by the AFCR's electrical service;

b. Has at least one ABC type fire extinguisher on every level of the AFCR;

c. Is free from fire hazards; and

d. Has at least one functioning carbon monoxide detector on every inhabited level of the home and in the basement;

(6) An approval from the local fire official signed and dated with the following information:

a. Date indicates that approval was obtained more than 90 days prior to the submission of the application;

b. Verifies the street address of the proposed or existing AFCR;

c. Verifies that the home complies with all state and local fire codes;

d. Includes the date of the life safety inspection; and

e. States the specific the number of beds for safe occupancy by AFC residents living in the proposed of existing AFCR; and

(7) For AFCRs not served by a public water system, an analysis report completed within the previous 12 months by a certified laboratory that verifies the water supplied to or used in the prospective home is suitable for human consumption and in compliance with Env-Dws 704 through Env-Dws 706;

(8) The results of criminal record checks, motor vehicle records, and BEAS adult registry checks for the applicant, family provider and all household members age 17 years or older as completed by the oversight agency, pursuant to He-P 813.05; and

(9) A written disclosure from the applicant, caregivers and all household members containing a list of any:

a. Misdemeanor or felony convictions, in this or any other state;

b. Adjudications of juvenile delinquency;

c. Permanent restraining or protective orders;

d. Evidence of any conduct that could endanger the well-being of the individual receiving care;

e. Findings by the department or any administrative agency in this or any other state for assault, fraud, abuse, neglect or exploitation;

f. Current investigations by any law enforcement agency;

g. Current investigations by the department for abuse, neglect or exploitation; or

h. An explanation of the circumstances surrounding disclosure of matters described in a. through g. above.

(d) The applicant shall provide to the department a written agreement, signed by the oversight agency's executive director, or his or her designee, that indicates that the oversight agency agrees to monitor the residence.

(e) The applicant and all household members living within the home shall authorize a registry check in the BEAS adult registry to verify that the applicant and other adult household members do not have a non-criminal finding of abuse neglect and exploitation of an incapacitated adult.

(f) Information disclosed regarding adjudication of juvenile delinquency, as required by (c) (10) b. above, shall be confidential and shall not be released except in a proceeding involving the question of certification or revocation of a license, or pursuant to court order.

(g) The applicant shall mail or hand-deliver the documents to:

Department of Health and Human Services

Health Facilities Administration

129 Pleasant Street

Concord, NH 03301

(h) The department shall process applications in accordance with RSA 541-A:29.

(i) An application for an initial certification shall be deemed to be complete when the department determines that all items required in (a), and (c) -(f) above have been received.

(j) If an application does not contain all of the items required by (a), and (c) -(f) above the department shall notify the applicant in writing of the items required before the application can be processed.

(k) All certifications issued in accordance with RSA 151 shall be non-transferable by person or location.

(l) An inspection shall be completed by the department in accordance with He-P 813.09 prior to the issuance of the certification.

(m) An applicant for temporary certification shall apply via the application form incorporated by reference in (a) above and provide all of the information required in (c) -(f) above.

(n) If the AFCR is not in compliance with these rules, the AFCR shall submit a plan of correction in accordance with applicable sections of He-P 813.

(o) A temporary certification shall be granted for a period of 90 days if the applicant:

(1) Has submitted all of the information required in this section; and

(2) Is in compliance with these rules.

(p) Within 90 days of the receipt of the application for temporary certification, the health facilities administration shall complete an inspection for the purposes of determining whether the AFCR is in compliance with these rules.

N.H. Admin. Code § He-P 813.08

#8595, eff 4-1-06; amd by #9899-A, eff 3-29-11, (paras (b)-(p)); amd by #9899-B, eff 3-29-11 (para (a))

Amended by Volume XXXIX Number 16, Filed April 18, 2019, Proposed by #12740, Effective 3/20/2019, Expires 9/16/2019.