Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 25 - Division of Provider Services and Quality Assurance › Rule 016.25.23-001 - Minimum Dementia Training Requirements pursuant to Act 335 of 2023

Current through Register Vol. 49, No. 6, June, 2024
300
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
				enactment or amendments by the General Assembly on the same subject
				matter.
Abuse
- Shall have the same meaning as
				prescribed by Ark. Code Ann. §
									5-28-101  and  42 CFR §
										488.301. "Abuse"
				also includes sexual abuse as defined in Ark. Code Ann. §
									5-28-101(12).
Activities of Daily Living
- The
				activities of daily living 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.
Administrator
- The person who has
				successfully completed a course of training or instruction certified by the
				Department as an assisted living facility administrator who is in charge of the
				daily operation of the facility. Until programs have been certified by the
				Department, Residential Care Facility Administrators or Nursing Home
				Administrators may be used.
Advertise
- To make publicly and
				generally known. For purposes of this definition,
advertise
includes, but is not limited to:
1.
			 Signs, billboards, or lettering;
2.
			 Electronic publishing or broadcasting, including the use of the Internet or
			 e-mail; and
3. Printed
			 material.
Alzheimer's Special Care Unit (ASCU)
-
				A separate and distinct unit within an Assisted Living or other Home and
				Community-Based Services _HCBS) facility that segregates and provides a special
				program for residents with a diagnosis of probable Alzheimer's disease or
				related dementia; that advertises, markets, or otherwise promotes the facility
				as providing specialized Alzheimer's or related dementia care services.
Assisted Living Facility (ALF)
- Any
				building or buildings, section or distinct part of a building, boarding home,
				home for the aged, or other residential facility whether operated for profit or
				not, that undertakes through its ownership or management to provide assisted
				living services for a period exceeding twenty-four (24) hours to more than
				three (3) adult residents of the facility who are not relatives of the owner or
				administrator. Assisted living facility means facilities in which assisted
				living services are provided either directly or through contractual
				arrangements or in which contracting in the name of residents is
				facilitated.
Assisted Living Program
- A program of
				assisted living services.
Assisted Living Services
- Housing,
				meals, laundry, social activities, assistance with transportation, direct care
				services, health care services, twenty-four (24) hour supervision and care,
				limited nursing services, for purposes of these rules,
assistance with
				transportation
means making arrangements for transportation.
Caregiver
- Shall have the same
				meaning prescribed by Ark. Code Ann. §
									5-28-101.
Choice
- Viable options available to a
				resident that enables the resident to exercise greater control over his or her
				life. Choice is supported by resident's self-directed care (including methods
				and scheduling) established through the care planning process, and the
				provision of sufficient private and common space within the facility to provide
				opportunities for residents to select when and how to spend time, and when and
				how to receive personal or assisted living services.
Common Areas (for Alzheimer's Special Care
				Units)
- Portions of the Alzheimer's Special Care Unit, exclusive
				of residents' rooms and bathrooms.
Common areas include any facility grounds accessible to
				residents of the Alzheimer's Special Care Unit.
Compliance Agreement
- If needed, the
				written formal plan developed in consideration of shared responsibility, choice
				and assisted living values and negotiated between the resident or his or her
				representative and the assisted living facility to avoid or reduce the risk of
				adverse outcomes that may occur in an assisted living environment.
Continuous
- Available at all times
				without cessation, break or interruption.
Covered direct service staff member - This definition is
				pertinent to dementia training requirements listed in sections 504.5 and 504.6.
				A covered staff member means a staff member whose work involves extensive
				contact with residents or program participants. Covered direct service staff
				members include certified nursing assistants, nurse aides, personal care
				assistants, personal care aides, licensed practical nurses, licensed vocational
				nurses, registered nurses, activity directors, and staff members who provide
				direct patient care to residents.
Deficiency
- A facility's failure to
				meet program participation requirements as defined in these and other
				applicable rules and laws.
Dementia
- A loss or decrease in
				intellectual ability that is of sufficient severity to interfere with social or
				occupational functioning; it describes a set of symptoms such as memory loss,
				personality change, poor reasoning or judgment, and language
				difficulties.
Department
- The Department of Human
				Services (DHS) and its divisions and offices.
Direct Care Services
- Services that
				directly help a resident with certain activities of daily living such as
				assistance with mobility and transfers; assistance provided to a resident 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 Service Plan
- A written
				plan for direct care services that is developed to meet the needs and
				preferences of the resident or his or her representative through a negotiated
				process that becomes a part of the resident's occupancy admission
				agreement.
Direct Care Staff
- Any licensed or
				certified staff acting on behalf of, employed by, or contracted by the
				facility, to provide services and who provides direct care services or
				assistance to residents, including activities of daily living and tasks related
				to medication administration or assistance.
Direct Care Staff (Alzheimer's Special Care
				Unit)
- An individual who is an employee of the facility, or an
				individual who is an employee of a temporary or employment agency assigned to
				work in the facility, who has received or will receive, in accordance with
				these rules, specialized training regarding Alzheimer's or related dementia,
				and who is responsible for providing direct, hands-on care or cuing services to
				residents of the ASCU.
Direct Contact
- The ability or
				opportunity of employees of the facility, or individuals with whom the facility
				contracts, to physically interact with or be in the presence of
				residents.
Direct Threat
- A significant risk to
				the health or safety of self or others that cannot be eliminated by reasonable
				accommodation. This term as used in these rules is designed to ensure
				conformity with the Americans with Disabilities Act (ADA) in determining
				whether a person with a disability poses a "direct (health or safety)
				threat".
Directed Plan of Correction
- A plan
				developed by the Department that describes the actions the facility will take
				to correct deficiencies and specifies the date by which those deficiencies will
				be corrected.
Discharge
- When a resident leaves the
				facility, and it is not anticipated that the resident will return. A discharge
				occurs when a return to the facility by the resident requires that admission
				procedures set forth in these rules be followed.
Disclosure Statement (Alzheimer's Special Care
				Unit)
- A written statement prepared by the facility and provided
				to individuals or their representatives, and to individual's families, prior to
				admission to the ASCU, disclosing the form of care, treatment, and related
				services especially applicable to, or suitable for residents of, the
				ASCU.
Elopement
- Circumstances where a
				resident, who has been identified as being cognitively impaired, has left a
				facility without staff knowledge. Facilities must comply with all reporting
				requirements of any special programs in which they participate.
Emergency Measures
- Those measures
				are necessary to respond to a serious situation that threatens the health and
				safety of residents.
Endangered Adult
- Shall have the same
				meaning as prescribed by Ark. Code Ann. § 5- 28-101 and as amended.
Exploitation
- Shall have the same
				meaning as prescribed by Ark. Code Ann. §
									5-28-101.
First Aid Measures
- Temporary
				interventions necessary to treat trauma or injury.
Health Care Service Plan
- A written
				plan for health care services that is developed to meet the needs and
				preferences of the resident or his or her representative through a negotiated
				process that becomes a part of the resident's occupancy admission
				agreement.
Health Care Services
- The provision
				of services in an assisted living facility that assists the resident in
				achieving and maintaining well-being (e.g., psychological, social, physical,
				and spiritual) and functional status. This may include nursing assessments and
				the monitoring and delegation of nursing tasks by registered nurses pursuant to
				the Nurse Practice Act and interpretations thereto by the Arkansas State Board
				of Nursing, care management, records management and coordinating basic health
				care and social services in such settings. Health care services may not be
				provided in a Level I Assisted Living Facility except as provided in Section
				702 of these rules.
Home Health Services
- Home health
				aide services, medical supplies suitable for use in the resident's assisted
				living facility apartment, and nursing services as defined in the state Nurse
				Practice Act and interpretations thereto by the Arkansas State Board of
				Nursing.
IDR
- The informal dispute resolution
				process as described in these rules.
Imminent Danger to Health and Safety
-
				Shall have the same meaning as prescribed by Ark. Code Ann. §
									5-28-101.
Impaired Adult
- Shall have the same
				meaning as prescribed by Ark. Code Ann. §
									5-28-101.
Independence
- The maintenance and
				promotion of resident capabilities to enhance the resident's preferences and
				choices within a barrier-free environment.
Individual Assessment Team (IAT)
- A
				group of individuals possessing the knowledge and skills to identify the
				medical, behavioral, and social needs of residents of the Alzheimer's Special
				Care Unit (ASCU), and to develop services designed to meet those needs.
Individual Support Plan
- A written
				plan developed by an Individual Assessment Team (IAT) that identifies services
				to a resident of the Alzheimer's Special Care Unit (ASCU).
Limited Nursing Services
- Acts that
				may be performed by licensed personnel while carrying out their professional
				duties, but limited to those acts that the department specified by rule. Acts
				that may be specified by rule as allowable limited nursing services shall be
				for persons who meet the admission criteria established by the Department for
				facilities offering assisted living services, shall not be complex enough to
				require twenty-four (24) hour nursing supervision and may include such services
				as application and care of routine dressings, and care of casts, braces, and
				splints.
Assisted Living I License
- A
				time-limited, non-transferable, permit required by Ark. Code Ann. §
									20-10-224  and issued for a maximum period of twelve (12) months to a licensee
				who complies with the Department rules. This document must list the maximum
				number of beds for the facility.
Medication Assistance and Monitoring
-
				Services provided by the facility, either directly or through contract, in
				accordance with the Nurse Practices Act and interpretations thereto by the
				Arkansas State Board of Nursing, designed to ensure that residents receive
				necessary or prescribed medication, and to prevent wastage of
				medication.
Mental Abuse
- Verbal, written, or
				gestured communication, to a resident, or to a visitor or staff, about a
				resident within the resident's presence, or in a public forum, that a
				reasonable person finds to be a material endangerment to the mental health of a
				resident.
Neglect
- Shall have the same meaning
				as prescribed by Ark. Code Ann. §
									5-28-101  and  42 C.F.R. §
										488.301.
New Admission
- An individual who is
				being admitted to the facility for the first time, or who is returning after a
				formal discharge.
Non-Compliance
- Any violation of
				these rules, or of applicable law or rules.
Nurse Practice Act
- As used in these
				rules, the term
Nurse Practice Act
refers to Ark. Code Ann.
				§
									17-87-101
et seq.
and interpretations thereto by the
				Arkansas State Board of Nursing.
Operator
- The individual or entity
				that conducts the business of the facility. The individual or individuals
				executing the licensure application form shall be deemed an operator.
Office of Community Services (OCS)- The Office within the
				Division of Provider Services and Quality Assurance of the Department of Human
				Services (DHS) that has the responsibility for the licensure, certification,
				and rules, of (HCBS) facilities, herein referred to as the Department or
				OCS.
Person
- An individual, partnership,
				association, corporation, or other entity.
Personnel, Staff, or Employee
- Any
				person who, under the direction, control, or supervision of facility
				administration, provides services as defined in these rules for compensation,
				or who provides services voluntarily, and may include the owner, operator,
				professional, management and persons, firms, or entities providing services
				pursuant to a contract or agreement.
Plan of Correction (P-o-C)
- A plan
				developed by the facility and approved by the Department that describes the
				actions the facility will take to correct deficiencies, and which specifies the
				date by which those deficiencies will be corrected.
PRN
- A medication or treatment
				prescribed by a medical professional to a person, allowing the medication or
				ointment to be given "as needed".
Program Requirements
- The
				requirements for participation and licensure under these and other applicable
				rules and laws as an assisted living facility.
Proprietor or Licensee
- Any person,
				firm, corporation, governmental agency, or other legal entity, issued an
				assisted living facility license, and who is responsible for maintaining
				approved standards.
Protective Services
- Shall have the
				same meaning as prescribed by Ark. Code Ann. §
									5-28-101.
Provisional Licensure
is a temporary
				grant of authority to the purchaser to operate an existing facility upon
				application for licensure to the Department.
Provisional Placement
- Placement in
				an assisted living facility made for the purposes of assessment to determine
				appropriateness of admission or emergency, such as placement by law enforcement
				or Adult Protective Services. A provisional placement shall be permitted for no
				longer than thirty (30) days, at which time the resident must either be
				discharged or admitted to the facility in conformity with these rules. A
				provisional placement shall not be an admission pursuant to these rules, and
				any individual in an assisted living facility pursuant to a provisional
				placement shall not be deemed a resident of the facility.
Representative or Responsible Party
-
				An individual, who, at the request of the applicant or resident, or by
				appointment by a court of competent jurisdiction, agrees to act on behalf of a
				resident or applicant for the purposes of making decisions regarding the needs
				and welfare of the resident or applicant. These rules, and this definition,
				does not grant or permit, and should not be construed as granting or
				permitting, any individual authority or permission to act for or on behalf of a
				resident or applicant in excess of any authority or permission granted by law.
				A competent resident may select a representative or may choose not to select a
				representative. In no event may an individual act for, or on behalf of, a
				resident or applicant when the resident or applicant has a legal guardian,
				attorney-in-fact, or other legal representative. For purposes of these rules
				only, representatives will also refer to the terms,
responsible party,
				guardian, power of attorney
or similar phrase
.
Separate Premises
- Buildings housing
				Assisted Living Facility operations that are located on non-contiguous
				land.
Significant Change
- Any improvement
				or decline in a resident's medical, physiological, psychological, or social
				condition, in which:
a. The decline
			 cannot be reasonably expected to resolve itself; or,
b. In which the decline may cause a worsening
			 of another or preexisting medical, physiological, psychological, or social
			 condition.
Substandard Quality of Care
- One (1)
				or more deficiencies related to participation requirements, as set forth in
				these or other applicable rules or laws, that constitute either immediate
				jeopardy to resident health or safety; a pattern of, or widespread actual harm,
				that is not immediate jeopardy; or a widespread potential for more than minimal
				harm, but less than immediate jeopardy, with no actual harm.
Survey
- The process of inspection,
				interviews, or record reviews, conducted by the Department.
Standard Survey
- A comprehensive
				survey conducted by the Department on an average of every eighteen (18) months
				for each facility.
Transfer
- The temporary or permanent
				relocation of a resident from one living unit within the facility to another
				living unit within the facility, or the temporary relocation of a resident to a
				location outside the facility.
Twenty-Four (24) Hour Nursing
-
				Services that are ordered by a physician or advance practice nurse for a
				resident whose condition requires the supervision of a physician or advance
				practice nurse and continued monitoring of vital signs and physical status and
				whose condition is medically complex enough to require onsite nursing
				supervision on a twenty-four (24) hour per day basis.
Visually and Functionally Distinct
				Area
- A space that can be distinguished from other areas within
				the apartment by sight. A visually and functionally distinct area need not be a
				separate room. To create a visually distinct area, one or more of the following
				methods must be employed: change in ceiling height, separation by ceiling
				soffit(s) or wall returns, change in flooring color, partial height partitions
				or counters, use of alcoves, use of permanent screening devices such as columns
				or fixed screens. In the case of an "L" shaped studio apartment or unit,
				kitchenettes and living areas may be combined and bedroom areas may be in a leg
				of an "L" shaped plan and qualify without additional separation
				methods.