Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 25 - Division of Provider Services and Quality Assurance › Rule 016.25.19-006 - Rules for the Licensure of Residential Long-Term Care Facilities

Current through Register Vol. 49, No. 6, June, 2024
AUTHORITY
The following rules for the licensure of residential long term
				care facilities are duly adopted and promulgated by the Arkansas Department of
				Human Services, Division of Medical Services, Office of Long Term Care,
				pursuant to the authority expressly conferred by the laws of the State of
				Arkansas in Arkansas Code Annotated §
								20-76-201(b)(3),
				§
								20-10-203 and
				§
								20-10-224.
If any provisions of these rules, or the application thereof to
				any person or circumstances is held invalid, such invalidity shall not affect
				other provisions or applications, and to this end the provisions hereof are
				declared severable.
"The Arkansas Department of Human Services is in compliance
				with Titles VI and VII of the Civil Rights Act and operated, managed and
				delivers services without regard to age, religion, disability, political
				affiliation, veteran status, sex, race, color or national origin."
If you need this material in a different format, such as large
				print, contact our Americans with Disabilities Act Coordinator at (501)
				682-6240 (voice) or 682-8933 (TDD).
100 DEFINITIONS
As used in these rules the following definitions shall apply
				unless the context clearly states otherwise. Where these rules refer to an
				enactment of the General Assembly, such reference shall include subsequent
				enactments or amendments by the General Assembly on the same subject
				matter.
Note: Please refer to Appendix C of these rules for a listing
				of Arkansas Statutes as referenced in the following definitions.
Absence
- Circumstances where the resident
				cannot be located or has left a facility and there is sufficient question as to
				the whereabouts of the resident. Facilities must comply with all reporting
				requirements of any special programs in which they participate.
Abuse
- Shall have the same meaning as
				prescribed by Arkansas Code Annotated §
									5-28-101.
Administrator
- The person designated as being
				in charge of the daily operation of the facility. "Certified administrator"
				shall mean an administrator who has completed the certification course offered
				by the Arkansas Association of Residential Care Facilities.
Basic Charge
- The lowest rate charged by a
				facility to a client for specific services for a set period of time.
Boarding Home
- Any place, building or
				structure, other than a hotel, inn or transient lodging place, which is
				offered, used, maintained or advertised to the public as a place of residence
				which, incidental to occupancy, may also offer meals and housekeeping services
				to the residents, but may not offer or furnish to residents, either directly or
				in concert with any entities as defined in Arkansas Code Annotated §
									20-10-213
				- §
									20-10-228,
				oversight, supervision or care.
Caregiver
- Shall have the same meaning
				prescribed by Arkansas Code Annotated §
									5-28-101.
Department
- The Department of Human Services
				or its successor as created by Arkansas Code Annotated §
									25-10-101.
Direct Care Staff
- A caregiver acting on
				behalf of, employed by or under the control or supervision of a licensed
				facility.
Direct Threat
- A significant risk to the
				health or safety of others that cannot be eliminated by reasonable
				accommodation. This term as used in these rules is designed to assure
				conformity with the Americans with Disabilities Act (ADA) in determining
				whether an individual with a disability poses a "direct (health or safety)
				threat". This determination must be made on a case-by-case basis, through
				consideration of the following factors:
1. The duration of the risk;
2. The nature and severity of the potential
			 harm;
3. The likelihood that the
			 potential harm will occur; and
4.
			 The imminence of the potential harm.
			 29
			 CFR 1630.2(r)
This individualized inquiry must be based on the behavior of
				the particular disabled person, not merely on generalizations about the
				disability.
Division
- The Division of Medical Services
				within the Department of Human Services and prescribed by Arkansas Code
				Annotated §
										20-10-101.
Emergency Measures
- Those measures necessary
				to respond to a serious situation which may result in death or trauma.
Endangered Adult
- Shall have the same meaning
				as prescribed by Arkansas Code Annotated §
										5-28-101.
Exploitation
- Shall have the same meaning as
				prescribed by Arkansas Code Annotated §
										5-28-101.
First Aid Measures
- Temporary procedures
				necessary to relieve trauma or injury by applying dressing and/or
				band-aids.
Imminent Danger to Health and Safety
- Shall
				have the same meaning as prescribed by Arkansas Code Annotated §
										5-28-101.
Impaired Adult
- Shall have the same meaning
				as prescribed by Arkansas Code Annotated § 5- 28-101.
Independently Mobile
- An individual who is
				physically and mentally capable of vacating the residential care facility in
				case of emergency, including the capability to ascend or descend stairs that
				are present in the exit path. Residents who can use canes, wheelchairs or
				walkers are considered independently mobile as long as they do not require more
				than verbal or minimum assistance from another person to vacate and can do so
				in three (3) minutes or as required by local fire code.
Initial Licensure
- License that applies to
				newly constructed residential care facilities and to all facilities not already
				licensed as residential care facilities.
Long Term Care Facility
- Shall have the same
				meaning as prescribed by Arkansas Code Annotated §
										20-10-213.
Long Term Care Facility License
- A
				time-limited non-transferrable permit required by Arkansas Code Annotated
				§
										20-10-224
				issued for a maximum period of twelve (12) months to a licensee who complies
				with Office of Long Term Care rules. This documentation must list the maximum
				number of beds for the facility and any limitations thereto.
Mental Illness
- A primary impairment of brain
				function such as psychosis, neurosis or behavior reaction resulting in
				difficulty in adapting to the environment.
Mental Retardation
- Subnormal intellectual
				functioning often present since birth or apparent in early life, the degree of
				which may be indicated by the IQ of 70 (+ or - 5) or below.
Neglect
- Shall have the same meaning as
				prescribed by Arkansas Code Annotated §
										5-28-101.
Office of Long Term Care
- The Office in the
				Division of Medical Services of the Department of Human Services that has
				responsibility for the licensure, certification and regulation of long term
				care facilities, herein referred to as the Office.
Personnel
- Any person who, under the
				direction, control or supervision of facility administration, provides services
				for compensation or who provides services voluntarily, and includes the owner,
				operator, professional, management and individuals, firms or entities providing
				goods or services pursuant to a contract or agreement.
Proprietor/Licensee
- Any person, firm,
				corporation, governmental agency or other legal entity issued a residential
				care facility license and who is responsible for maintaining approved
				standards. Facilities owned and operated by entities exempted from state
				licensure by state or federal law shall be excluded from these rules.
Protective Services
- Shall have the same
				meaning as prescribed by Arkansas Code Annotated §
										5-28-101.
Provisional Licensure
is a temporary grant of
				authority to the purchaser to operate an existing long-term care facility upon
				application for licensure to the Office of Long Term Care.
Residential and Adult Day Care Section
- The
				unit within the Office of Long Term Care charged with survey, licensure and
				complaint investigations for residential care facilities and adult day care
				facilities.
Residential Care Facility (RCF)
- Shall have
				the same meaning as prescribed by Arkansas Code Annotated §
										20-10-101(14).
Residential Care Facility Services
- Services
				provided, in accordance with these rules, to independently mobile adult
				residents whose functional capabilities may have been impaired but who do not
				require hospital or nursing home care on a daily basis but could require other
				assistance in activities of daily living. A residential care facility does not
				provide nursing or medical services and shall not offer, attempt to provide or
				provide services to an individual in need of hospitalization, substance abuse
				treatment, or nursing services. Residential care facility personnel may not
				administer or attempt to administer medications.
Supportive Services
- Occasional or
				intermittent direction or monitoring of an individual resident as he/she
				carries out activities of daily living and social activities. Supportive
				services do not include continuous monitoring or delivery of actual hands-on or
				physical assistance to a resident in the performance of the activities of daily
				living.
Transfer
- The movement of a resident from one
				facility to another facility. Transfer does not include room changes within the
				same facility.
Undue Burden
- This term as used in these
				rules is designed to assure conformity with the Americans with Disabilities Act
				(ADA) in a determination that an individual's service needs are greater than
				what the facility is licensed to provide and to that end shall be liberally
				construed to effectuate the intent of the ADA. Before a facility may deny
				admission or discontinue care based on a disability, meeting the individual's
				needs must be shown to place an undue burden on the facility or to
				fundamentally alter the program to the point where residential services are no
				longer being provided.
In order to determine if an alteration would be an undue
				burden, the following factors are to be considered:
1. The nature and cost of the action
			 needed;
2. The overall financial
			 resources of the site or sites involved in the action; the number of persons
			 employed at the site; the effect on expenses and resources; legitimate safety
			 requirements that are necessary for safe operation;
3. The geographic separateness, and the
			 administrative or fiscal relationship of the site or sites in question to any
			 parent corporation or entity;
4.
			 The overall financial resources of any parent corporation or entity; the
			 overall size of the parent corporation with respect to the number of its
			 employees; the number, type, and location of its facilities; and
5. The type of operation or operations of any
			 parent corporation or entity, including the composition, structure, and
			 functions of the workforce of the parent corporation or entity.
			 28
			 CFR 36.104