Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.06-059 - Rules for Adult Day Health Care (ADHC) Providers in Arkansas

Current through Register Vol. 49, No. 6, June, 2024
ADMINISTRATIVE RULES FOR PROVIDERS OF ADULT DAY HEALTH
				CARE
100
DEFINITIONS
As used in these rules and regulations, the following
				definitions shall apply unless the context clearly states otherwise. Where
				these rules and regulations refer to an enactment of the General Assembly, such
				referenced shall include subsequent enactment or amendments by the General
				Assembly on the same subject matter.
ABUSE
- Shall have the same meaning as
				prescribed by Ark. Code Ann. §
									12-12-1703. "Abuse"
				also includes sexual abuse as defined in Ark. Code Ann. §
									12-12-1703(18).
ACTIVITIES OF DAILY LIVING
- The tasks
				for self-care that are performed either independently, with supervision, with
				assistance, or by others. Activities of daily living include but are not
				limited to ambulating, transferring, grooming, bathing, dressing, eating and
				toileting.
ADA
- The Americans with Disabilities
				Act.
ADULT DAY HEALTH CARE PROGRAM
- Adult
				Day Health Care (ADHC) is a program which provides organized and continuing
				supportive health and social services and activities to meet the needs of four
				or more functionally impaired adults for periods of less than twenty-four, but
				more than two hours per day in a. place other than the adult's own home.
ADULT DAY HEALTH CARE PROVIDER
- The
				person, corporation, partnership, association or organization legally
				responsible for the overall operation of the ADHC Program and is licensed to
				operate as an ADHC by the Office of Long Term Care (OLTC).
APPLICANT
- The person, corporation,
				partnership, association or organization which has submitted an application to
				operate an ADHC but has not yet been approved and issued a license by the
				Office of Long Term Care.
CARE GIVER
- Shall have the same
				meaning prescribed by Ark. Code §
									12-12-1703.
CONTACT DAYS
- The number of days the
				client actually attended the Adult Day Health Care facility.
DEFICIENCY
- A facility's failure to
				meet program participation requirements as defined in these and other
				applicable regulations and laws.
DEPARTMENT
- The Department of Health
				and Human Services.
DIRECT CARE SERVICES
- Services that
				directly help a client with certain routines and activities of daily living
				such as assistance with mobility and transfers; assistance to consume a meal,
				grooming, shaving, trimming or shaping fingernails and toenails, bathing,
				dressing, personal hygiene, bladder and bowel requirements, including
				incontinence or assistance with medication only to the extent permitted by the
				state Nurse Practice Act and interpretations thereto by the Arkansas State
				Board of Nursing.
DIRECT CARE STAFF
- Any staff,
				compensated or volunteer, acting on behalf of, employed by, or contracted by
				the facility either directly or through an employment agency to provide
				services and who provides direct care services or assistance to clients,
				including activities of daily living and tasks related to medication
				administration or assistance.
DIRECT CONTACT
- The ability or
				opportunity of employees of the facility, or individuals with whom the facility
				contracts either directly or through an employment agency, to physically
				interact with or be in the presence of clients.
DIRECTOR
- The individual or entity
				that conducts the business of the facility and is in charge of the daily
				operations of the facility. The Director is the resource contact between the
				facility and OLTC.
DISCHARGE
- When a client leaves the
				facility and it is not anticipated that the client will return.
EMERGENCY MEASURES
- Those measures
				necessary to respond to a serious situation that threatens the health and
				safety of clients.
LONG-TERM CARE FACILITY RESIDENT
-
				Shall have the same meaning as prescribed by Ark. Code Ann. §
									12-12-1703
				and as amended.
EXPLOITATION
- Shall have the same
				meaning as prescribed by Ark. Code Ann. §
									12-12-1703
				and as amended.
FUNCTIONALLY FMPAIRED ADULT
- An
				individual, age eighteen (18) or older, who by reason of mental or physical
				disability, requires care and supervision.
HEALTH CARD
- A certificate issued by
				the Arkansas Department of Health and Human Services' Division of Health or any
				entity certified by the Arkansas Department of Health and Human Services'
				Division of Health, that states the person named on the card has been tested
				for tuberculosis.
HIPAA
- Health Insurance Portability
				Accountability Act required by federal law to "protect health information" of
				clients. See
www.dhhs.gov/ocr/hipaa
for specific
				details.
LICENSE
- A time-limited,
				non-transferable permit required by Ark. Code Ann. §
									20-10-224
				and issued for a maximum period of 12 months to a licensee who complies with
				the Office of Long Term Care rules and regulations. This document shall list
				the maximum number of slots for the facility.
MALTREATMENT
- Shall have the same
				meaning as prescribed in Ark. Code Ann. §
									12-12-1703.
MENTAL ABUSE
- Verbal, written, or
				gestured communications to a client, or to a visitor or staff, about a client
				within the client's presence or in a public forum, that a reasonable person
				finds to be a material endangerment to the mental health of a client.
NEGLECT
- Shall have the same meaning
				as prescribed by Ark. Code Ann. §
									12-12-1703.
NON-COMPLIANCE
- Any violation of
				these regulations, or of applicable law or regulations.
OFFICE OF LONG TERM CARE (OLTC)
- The
				Office in the Division of Medical Services of the Department of Health and
				Human Services that has the responsibility for the licensure, certification and
				regulation of long term care facilities, herein referred to as the Office or
				OLTC.
PERSON
- An individual, partnership,
				association, corporation, or other entity.
PERSONNEL/STAFF/EMPLOYEE
- Any person
				who, under the direction, control, or supervision of facility administration,
				provides services as defined in these regulations for compensation, or who
				provides services voluntarily, and may include the owner, professional,
				management and person, firms, or entities providing services pursuant to a
				contract or agreement.
PLAN OF CARE
- The Adult Day Health
				Care Provider's written description of the scope of services to be provided to
				each individual client.
PLAN OF CORRECTION (PoC)
- A plan
				developed by the facility and approved by OLTC that describes the actions the
				facility will take to correct deficiencies, specifies the date by which those
				deficiencies will be corrected, and sets forth the means and methods used to
				evaluate the efficacy of the corrections.
PRN
- A medication or treatment
				prescribed by a medical professional to a person, allowing the medication or
				treatment to be given "as needed".
PROGRAM REQUIREMENTS
- The
				requirements for participation and licensure under these and other applicable
				regulations and laws as an Adult Day Health Care Facility.
PROPRIETOR/LICENSEE
- Any person,
				firm, corporation, governmental agency or other legal entity issued an Adult
				Day Health Care license, and is responsible for maintaining approved
				standards.
SURVEY
- The process of inspection,
				interviews, or record reviews conducted by the Office of Long Term Care to
				determine an Adult Day Health Care facility's compliance with program
				requirements and with applicable regulations and laws.
200
LICENSURE
200.1 No Adult Day Health Care facility may
			 be established, conducted, or maintained in Arkansas without first obtaining a
			 long term care facility license as required by Ark. Code Ann. §
									20-10-201,
et seq.
and these licensing standards. All licenses issued
			 hereunder are non-transferable from one owner or proprietor to another or from
			 one site to another. Except when waived by the Office of Long Term Care in
			 times of emergency, no Adult Day Health Care facility may operate with more
			 slots than is stated in the license and no Adult Day Health Care facility may
			 accept more clients than the number of slots stated on the license.
200.2 The issuance of an Adult Day Health
			 Care facility license shall be a grant of authority to the facility to operate
			 an Adult Day Health Care facility. The initial license shall state the number
			 of slots. Subsequent licenses issued to the same owner will state the number of
			 slots for which the facility has been licensed at the time of the issuance of
			 the subsequent license. Licenses issued as a result of a change of ownership
			 shall state the number of slots for which the facility was licensed on the date
			 of sale of the facility or the date of sale of ownership of the
			 facility.
201
LICENSING
			 INFORMATION
201.1 Licenses to operate
			 an Adult Day Health Care facility are effective beginning July
			 1st and expiring on the following June
			 30th.
201.2 Licenses shall be issued only for the
			 premises and persons specified in the application and shall not be
			 transferable.
201.3 Licenses shall
			 be posted in a conspicuous place on the licensed premises.
201.4 Separate licenses are required for
			 Adult Day Health Care facilities maintained on separate premises, even though
			 they are operated under the same management.
Multiple buildings on contiguous land that serve clients shall
				require and shall be licensed under a single license.
201.5 Every Adult Day Health Care facility
			 owner shall designate a distinctive name for the facility which shall be
			 included on the application for a license. The name of the facility shall not
			 be changed without prior written notification to and approval from the Office
			 of Long Term Care.
202
			 INITIAL LICENSE
202.1 Initial licensure shall
			 apply to:
(a) Newly constructed facilities
			 designed to operate as Adult Day Health Care facilities;
(b) Existing structures not already licensed
			 as Adult Day Health Care facilities on the effective date of these regulations;
			 and
(c) Facilities that change
			 ownership.
202.2 The
			 initial licensure application shall be accompanied by:
(a) Building plans showing a detailed floor
			 plan of the facility. Floor plans must contain exact measurements and identify
			 each room, hallway, window, exit, etc.
(b) A letter from the City or County Zoning
			 Commission stating that the facility meets zoning requirements.
(c) A letter from a licensed electrician and
			 licensed plumber, with their name and license number included, stating that the
			 facility complies with State Codes.
(d) A letter from the County or State
			 Division of Health Department stating approval for facilities with wells and
			 septic tanks, if applicable.
203 COMPLIANCE
An initial license will not be issued until the Department
				verifies that the facility is in compliance with, and able to meet, the
				licensing standards and program requirements set forth in these
				regulations.
An initial license will be effective on the date specified by
				the Office of Long Term Care once the Office of Long Term Care determines the
				facility to be in compliance with these licensing standards and applicable laws
				and regulations. The license will expire on June
				30th following the issuance of the license.
204 APPLICATION, EXPIRATION AND
			 RENEWAL OF LICENSE
204.1 Applicants for
			 licensure or renewal of Adult Day Health Care facility licensure shall obtain
			 the necessary forms for initial or renewal licensure or re-licensure of the
			 facility after a change of ownership (see Section 205) from the Office of Long
Term Care. The issuance of an application form is not a
				guarantee that the completed application will be acceptable or that the
				Department will issue a license.
204.2 The facility shall not admit any
			 clients until a license to operate an Adult Day Health Care facility has been
			 issued.
204.3 Applicants for
			 initial licensure, renewal, or re-licensure after a change in ownership shall
			 pay in advance a license fee of $5.00 per slot to the Department. Such fee
			 shall be refunded to the applicant in the event a license is not
			 issued.
204.4 Annual renewal is
			 required for all Adult Day Health Care facility licenses. Licenses are
			 effective beginning July 1 and shall expire on June
			 30th of the following year. In the event that a
			 facility's license is not renewed by June 30th, the
			 license will be void.
204.5
			 Applications for annual license renewal shall be delivered or, if mailed,
			 postmarked to the Office of Long Term Care no later than June
			 1st before the June 30th
			 expiration of the license. Any license fee received by the Department after
			 June 1 is subject to a ten percent (10%) penalty.
204.6 The Director of the facility shall sign
			 applications and must successfully complete a criminal background check
			 pursuant to Ark. Code Ann. § 20-33-201,
et seq.,
and in
			 accordance with the Rules and Regulations for Conducting Criminal Record Checks
			 for Employees of Long Term Care Facilities.
204.7 When a change in ownership or
			 controlling interest in the facility is sold by person or persons named in the
			 license to any other person or persons, the new owner shall, at least 30 days
			 prior to completion of the sale, submit a new application and license fee,
			 request to be inspected and meet the applicable standards and regulations,
			 including but not limited to, life safety codes, at the time of inspection. The
			 seller, in writing, shall report such change in ownership to the Office of Long
			 Term Care at least thirty (30) days before the change is to be implemented.
			 With the exception of civil money penalties imposed for violations or
			 deficiencies that occurred prior to the sale of ownership or control, when a
			 license is granted pursuant to a change of ownership the buyer shall be
			 responsible for implementation or performance of any remedy listed in Section
			 802 imposed against the facility for violations or deficiencies that occurred
			 prior to the sale of ownership or control. The seller shall remain liable for
			 all civil money penalties assessed against the facility that are imposed for
			 violations or deficiencies occurring prior to the sale of ownership or
			 operational control. The Department shall consider and may deny a license based
			 upon any criteria provided for at Ark. Code Ann. §
										20-10-224(f)
			 (1),
et seq.
Failure to
			 comply with the provisions of this section will result in the denial of
			 licensure to the new owner.
204.8
			 The applicant/licensee must furnish the following information:
(a) The identity of each person having
			 (directly or indirectly) an ownership interest of five percent (5%) or more in
			 the facility;
(b) The complete name
			 and address of the Adult Day Health Care facility for which licensure is
			 requested and such additional information as the Department may require
			 including, but not limited to, affirmative evidence of ability to comply with
			 standards, rules and regulations as are lawfully prescribed
			 hereunder;
(c) In case such
			 facility is organized as a corporation, the identity of each officer and
			 Director of the corporation, together with a certificate of good standing from
			 the Arkansas Secretary of State;
(d) In case such facility is organized as a
			 partnership, the identity of each partner and a copy of the partnership
			 agreement.
204.9
Procedure for Licensure
The procedure for obtaining an Adult Day Health Care License
				shall be:
(a) The individual or entity
			 seeking licensure shall request and obtain all forms for licensure from the
			 Office of Long Term Care.
(b) The
			 individual or applicant shall fully complete all forms for licensure and submit
			 same to the Office of Long Term Care, along with all licensure fees. As
			 applicable and required by law or regulation, the individual or entity seeking
			 licensure shall submit drawings or plans for the facility to the Office of Long
			 Term Care at the time of application.
(c) For a new facility, the Office of Long
			 Term Care will conduct a Life-Safety code survey to determine compliance with
			 applicable building code requirements.
(d) For a new facility, upon being informed
			 that the facility meets all requirements for all applicable building codes the
			 facility may admit clients.
(e) For
			 a new facility, upon successful completion of the initial survey the facility
			 shall be granted a license to operate as an Adult Day Health Care.
(f) The Office of Long Term Care may elect,
			 for any renewal application, to perform a survey prior to the issuance of the
			 license, and issuance of the license is contingent upon the facility being
			 found in compliance with all program requirements.
(g) The Office of Long Term Care may elect,
			 for any renewal application, to deny re-licensure if the facility has unpaid
			 civil money penalties imposed by the Office of Long Term Care; and,
* The time for an appeal has passed with no appeal being filed
				or all appeals have been exhausted and the imposition of the CMPs was
				upheld.
(h) The Office of
			 Long Term Care shall deny renewal of any license when a facility is unable to
			 meet program requirements at the time of renewal.
205
CHANGE IN
			 OWNERSHIP
205.1 Transactions
			 constituting a change in ownership include, but are not limited to, the
			 following:
(a) A sole proprietor becomes a
			 member of a partnership or corporation, succeeding him as the new
			 operator;
(b) A partnership
			 dissolves;
(c) One partnership is
			 replaced by another through the removal, addition or substitution of a
			 partner;
(d) The corporate owner
			 merges with, or is purchased by, another corporation or legal entity;
(e) A not-for-profit corporation becomes a
			 general corporation, or a for-profit corporation becomes
			 not-for-profit.
205.2
			 Transactions that do not constitute a change of ownership include, but are not
			 limited to, the following:
(a) Changes in the
			 membership of a corporate board of Directors or board of trustees,
			 or;
(b) Changes in the membership
			 of a not-for-profit corporation.