Section 0720-38-.07 - ADMISSIONS, DISCHARGES, AND TRANSFERS(1) Admissions. (a) A TBI residential home may only admit and continue to care for residents requiring specialized services, where assistance is provided with ADL's in a homelike environment.(b) A TBI residential home may not admit or serve a resident who is ventilator dependent.(c) A TBI residential home provider may choose to serve one (1) or more elderly adult members of their own family as long as the TBI residential home provider serves at least two (2) additional disabled adults unrelated to the TBI residential home provider by blood or marriage.(d) A TBI residential home may not admit or retain a resident who cannot be evacuated within five (5) minutes.(e) A TBI residential home shall upon admission of a resident:1. Be able to identify at the time those residents whose needs for services are consistent with these rules and regulations, and those residents who should be transferred to a more appropriate level of care;2. Document plans and procedures to show evacuation of the resident within five (5) minutes.3. Provide to each resident a written admission agreement signed and dated by the TBI residential home provider and the resident or the resident's family member or the resident's legal representative and presented both verbally and in writing. The admission agreement shall be reviewed and updated as necessary as a part of the residential plan of care review process and contain the following: (i) A copy of the resident rights for the resident's review and signature;(ii) A copy of house rules and the rate schedules, including any payment for services for which the resident will be responsible;(iii) An accurate written statement providing that the TBI residential home provider shall give thirty (30) days written notice to the resident prior to making any changes in the rates;(iv) The consequences for non-payment for services which includes involuntary discharge from the TBI residential home;(v) An accurate written statement regarding services which will be provided residents upon admission;(vi) Procedures for handling the transfer or discharge of residents that does not violate the residents' rights under the law or these rules;(vii) A copy of the medication disposal policy.4. Disclose in writing to the resident or to the resident's legal representative, the identity of the TBI residential home's primary liability insurance carrier. If the TBI residential home is self-insured, its statement shall reflect that fact and indicate the corporate entity responsible for payment of any claims;5. Document evidence of annual vaccination against influenza for each resident, in accordance with the recommendation of the Advisory Committee on Immunization Practices of the Centers for Disease Control most recent to the time of vaccine, unless such vaccination is medically contraindicated or the resident or the resident's legal representative has refused the vaccine. Influenza vaccination for all residents accepting the vaccine shall be completed by November 30 of each year or within ten (10) days of the vaccine becoming available. Residents admitted after this date during the flu season and up to February 1, shall, as medically appropriate, receive influenza vaccination prior to or on admission unless refused by the resident or the resident's legal representative; and6. Document evidence of vaccination against pneumococcal disease for all residents who are sixty-five (65) years of age or older, in accordance with the recommendations of the Advisory Committee on Immunization Practices of the Centers for Disease Control at the time of vaccination, unless such vaccination is medically contraindicated or the resident or the resident's legal representative has refused the offer of vaccine. The TBI residential home shall provide or arrange for the pneumococcal vaccination of residents who have not received this immunization prior to or on admission unless the resident or resident's legal representative refuses offer of the vaccine.(2) Discharges and Transfers. (a) Residents may only be moved, transferred or discharged from a TBI residential home for the following reasons: 1. Medical reasons. The resident has a medical or nursing condition that exceeds the level of health care services the home provides;2. Welfare of the resident or of other residents. This includes, but is not limited to the following: The TBI residential home is unable to accomplish timely evacuation of the resident in the event of an emergency; the resident exhibits behavior that poses an imminent danger to self or others; the resident engages in behavior or actions that repeatedly and substantially interfere with the rights, health or safety of residents or others; or the resident engages in illegal drug use, or commits a criminal act that causes potential harm to the resident or others;3. Nonpayment for services provided to the resident by the home; or4. Closing or selling the facility.(b) A TBI residential home resident shall be discharged and transferred to another appropriate setting such as home, a hospital, or a nursing home when the resident, the resident's legal representative, or the resident's treating physician determines that the TBI residential home cannot safely and effectively meet the resident's needs, including medical services.(c) The Board may require that a TBI residential home resident be discharged or transferred to another level of care if it determines that the resident's needs, including medical services, cannot be safely and effectively met in the TBI residential home.(d) In the event of a discharge or transfer due to medical reasons, for the welfare of the resident or for the welfare of other residents, or due to nonpayment for services provided to the resident by the home, the TBI residential home provider shall give the resident, the resident's family member, or the resident's legal representative written notice at least thirty (30) days prior to the proposed transfer or discharge.(e) In the event of a discharge or transfer due to medical reasons, the welfare of the resident, or for the welfare of other residents, the TBI residential home provider shall work with the Board to develop a transition plan in order to maintain continuity of care for the resident and to minimize the impact of the transition. The TBI residential home provider shall assist the resident in locating an alternate appropriate setting.(f) In the case of a medical emergency that requires immediate action, the TBI residential home provider shall give the resident, the resident's family member, or the resident's legal representative written notice as soon as possible under the circumstances.(g) In the event of discharge or transfer due to selling the home to another TBI residential home provider, the current TBI residential home provider shall develop a transition plan for all residents to facilitate the transition to a new TBI residential home and shall maintain its license and operation of the home until the point in time the new TBI residential home's license is approved.(h) In the event of discharge or transfer due to the closing of the home, the TBI residential home provider shall provide ninety (90) days advance notice to residents and shall work with the Board to develop a transition plan to maintain continuity of care for the residents and to minimize the impact of transition. The TBI residential home shall assist each resident in locating an alternative placement.Tenn. Comp. R. & Regs. 0720-38-.07
Original rule filed October 28, 2015; effective January 26, 2016. Amendments filed March 26, 2019; effective June 24, 2019. Transferred from chapter 1200-08-37 pursuant to Public Chapter 1119 of 2022 effective 7/1/2022.Authority: T.C.A. §§ 68-11-202, 68-11-206, 68-11-209, 68-11-270, and 68-11-273.