Section R9-10-815. Directed Care Services

A.      A manager shall ensure that a resident’s representative is des- ignated for a resident who is unable to direct self-care.

B.       A manager of an assisted living facility authorized to provide directed care services shall not accept or retain a resident who, except as provided in R9-10-814(B)(2):

1.        Is confined to a bed or chair because of an inability to ambulate even with assistance; or

2.        Has a stage 3 or stage 4 pressure sore, as determined by a registered nurse or medical practitioner.

C.      In addition to the requirements in R9-10-808(A)(3), a manager shall ensure that the service plan for a resident receiving directed care services includes:

1.        The requirements in R9-10-814(F)(1) through (3);

2.        If applicable, the determination in R9-10-814(B)(2)(b);

3.        Cognitive stimulation and activities to maximize func- tioning;

4.        Strategies to ensure a resident’s personal safety;

5.        Encouragement to eat meals and snacks;

6.        Documentation:

a.         Of the resident’s weight, or

b.        From a medical practitioner stating that weighing the resident is contraindicated; and

7.        Coordination of communications with the resident’s rep- resentative, family members,  and, if applicable, other individuals identified in the resident's service plan.

D.      A manager shall ensure that an employee does not provide non-prescription medication to a resident receiving directed care services unless the resident has an order from a medical practitioner for the non-prescription medication.

E.       A manager shall ensure that:

1.        A bell, intercom,  or other mechanical means to alert employees to a resident’s needs or emergencies is avail- able in a bedroom being used by a resident receiving directed care services; or

2.        An assisted living facility has implemented another means to alert a caregiver or assistant caregiver to a resi- dent’s needs or emergencies.

F.       A manager of an assisted living facility authorized to provide directed care services shall ensure that:

1.        Policies and procedures are established, documented, and implemented that ensure the safety of a resident who may wander;

2.        There is a means of exiting the facility for a resident who does not have a key, special knowledge for egress, or the ability to expend increased physical effort that meets one of the following:

a.         Provides access to an outside area that:

i.         Allows the resident to be at least 30 feet away from the facility, and

ii.        Controls or alerts employees of the egress of a resident from the facility;

b.        Provides access to an outside area:

i.         From which a resident may exit to a location at least 30 feet away from the facility, and

ii.        Controls or alerts employees of the egress of a resident from the facility; or

c.         Uses a mechanism that meets the Special Egress- Control Devices provisions in the Uniform Building Code incorporated by reference in A.A.C. R9-1-412; and

3.        A caregiver or an assistant caregiver complies with the requirements for incidents in R9-10-804 when a resident who is unable to direct self-care wanders into an area not designated by the governing authority for use by the resi- dent.

Historical Note

New Section 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, pursuant to Laws 2013, Ch. 10, § 13; effective July 1, 2014 (Supp.

14-2).