Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-4 - ASSISTED LIVING FACILITIES › Section 420-5-4-.01 - General

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Legal
			 Authority for Adoption of Rules.
Under and by virtue of the authority
			 vested in it by the Legislature of Alabama,
Code of Ala.
			 1975
, Sections
			 22-21-20, et. seq., the Alabama
			 State Board of Health does hereby adopt and promulgate the following Rules
			 governing all assisted living facilities.
(2)
Definitions.
(a) "Advisory Board" means the Licensure
			 Advisory Board established by law to serve as consultants to the State Health
			 Officer and to assist in rule making necessary to carry out the provisions of
Code of Ala. 1975
, Section
			 22-21-20, et. seq.
(b) "Assisted Living Facility" means an
			 individual, individuals, corporation, partnership, limited partnership, limited
			 liability company or any other entity that provides, or offers to provide, any
			 combination of residence, health supervision, and personal care to three or
			 more individuals who are in need of assistance with activities of daily living
			 which include bathing, dressing, ambulation, feeding, toileting, grooming,
			 medication assistance, diet, and personal safety. Exceptions to this definition
			 are:
1. Individuals who provide residential
			 and personal care services solely to persons to whom they are personally
			 related, shall not be deemed to be an assisted living facility. "Personally
			 related" means that the person receiving the residential and personal care
			 services is the spouse, parent, sibling, adult child, adult grandchild,
			 grandparent, great-grandparent, adult niece, adult nephew, aunt, uncle, or
			 first cousin of the person providing such services, or stands in that relation
			 to the current spouse of the person providing the services. This exception is
			 only for individuals, and does not apply to corporations, partnerships, limited
			 partnerships, limited liability companies, or any other organized entity or
			 business.
2. Facilities whose
			 residents are under the care, oversight or protection of another governmental
			 agency shall not be deemed to be assisted living facilities and shall not be
			 subject to these rules, if both of the following conditions are satisfied:
(i) A federal, state, or other governmental
			 body, agency, or authority has a fiduciary relationship or some other legally
			 recognized and enforceable relationship to the residents of the facility which
			 carries an obligation to oversee the health, safety, and welfare of the
			 residents; and
(ii) The federal,
			 state, or other governmental body, agency, or authority licenses, certifies, or
			 otherwise legally authorizes the facility to provide accommodations and care
			 for the residents.
(c) "Abuse" means the willful infliction of
			 injury, unreasonable confinement, intimidation, or punishment with resulting
			 physical harm, pain, or mental anguish. Abuse shall also include mental abuse,
			 physical abuse, sexual abuse, and verbal abuse, as defined below.
(1) "Mental Abuse" means any willful act
			 directed at a resident that is intended to result in or that is likely to
			 result in mental distress or mental anguish. It includes humiliation,
			 harassment, threats of punishment, and threats of deprivation.
(2) "Physical Abuse" means any willful act
			 directed at a resident that is intended to result in or that is likely to
			 result in injury or pain. Physical abuse includes slapping, pinching, kicking,
			 shoving, and corporal punishment of any kind.
(3) "Sexual Abuse" means any sexually
			 oriented behavior directed at a resident by a staff member, any sexually
			 oriented behavior between residents that is not fully and freely consented to
			 by both residents involved, any sexually oriented behavior between residents
			 when either or both residents are incapable of consenting to the behavior, or
			 any sexually oriented behavior by a visitor directed at a resident incapable of
			 consenting to the behavior.
(4)
			 "Verbal Abuse" means the use of oral, written, or gestured language that
			 willfully includes disparaging or derogatory terms to residents or their
			 families, or that is used or uttered within the hearing distance of residents
			 or their families, regardless of their age, ability to comprehend, or
			 disability. Examples of verbal abuse include threats of harm, or saying things
			 to frighten a resident; such as telling a resident that the resident will never
			 see his or her family again.
(d) "Bed Capacity" means the maximum number
			 of beds which can be installed or set up in an assisted living facility at any
			 given time for use of residents. The bed capacity shall be based upon space
			 designed or specifically intended for such use, whether or not the beds are
			 actually installed.
(e) "Bed
			 Complement" means the number of beds normally installed in an assisted living
			 facility for use of the residents.
(f) "Board," or "State Board of Health,"
			 means the Alabama State Board of Health.
(g) "Bureau" means the Bureau of Health
			 Provider Standards, Alabama Department of Public Health.
(h) "Closure" means that the facility has no
			 current occupants which are classified as residents of the facility and is not
			 accepting and admitting new residents.
(i) "Congregate Assisted Living Facility"
			 means an assisted living facility authorized to care for 17 or more
			 adults.
(j) "Department" means the
			 Alabama Department of Public Health.
(k) "Elopement" means a resident who is
			 incapable of protecting himself or herself from harm is able to successfully
			 leave a safe area or safe premises.
(l) "Exploitation" means the deliberate
			 misplacement or wrongful temporary or permanent use of a resident's belongings,
			 money, or property without the resident's consent.
(m) "Family Assisted Living Facility" means
			 an assisted living facility authorized to care for two or three adults, which
			 was licensed prior to October 1, 2015. Family assisted living facilities
			 currently licensed may renew their license yearly but if closed for any reason,
			 may not be relicensed as a family assisted living facility. No new license will
			 be granted for assisted living facilities of fewer than three beds.
(n) "Group Assisted Living Facility" means an
			 assisted living facility authorized to care for 3 to 16 adults.
(o) "License" means the legal authority
			 granted by the State Board of Health to operate a facility.
(p) "License Certificate" means the document
			 issued by the State Board of Health and signed by the State Health Officer that
			 constitutes rebuttable evidence of the facility's legal authority to
			 operate.
(q) "Licensed Bed
			 Capacity" means the number of beds for which the facility has been issued a
			 certificate of licensure by the Department. The Licensed Bed Capacity is also
			 the maximum daily census that an assisted living facility may have in its
			 capacity.
(r) "Licensed Practical
			 Nurse" (LPN) means a person currently licensed as a Licensed Practical Nurse by
			 the State of Alabama Board of Nursing in accordance with
Code of Ala. 1975
, Sections
			 34-21-1, et. seq.
(s) "Mechanical Restraint" means any manual
			 method or physical or mechanical device, material, or equipment that the
			 resident cannot remove which restricts freedom of movement or normal access to
			 one's body (e.g. leg restraints, arm restraints, hand mitts, soft ties or
			 vests, lap cushions, and lap trays). Facility practices that meet the
			 definition of a restraint include, but are not limited to: using side rails
			 that keep a resident from voluntarily getting out of bed; tucking in, tying, or
			 using devices or materials to hold a sheet, fabric, or clothing tightly so that
			 a resident's movement is restricted; using devices in conjunction with a chair,
			 such as trays, tables, bars, or belts that the resident cannot remove, that
			 prevent the resident from rising; placing a resident in a chair that prevents
			 the resident from rising; and placing a chair or bed so close to a structure
			 that the structure prevents the resident from rising out of the chair or
			 voluntarily getting out of bed.
(t)
			 "Medication" means all substances having medicinal properties intended for
			 external and/or internal use for the treatment, prevention, diagnosing, or
			 curing of any disease, illness, malady, etc., in humans. The term "medication"
			 as defined in the Pharmacological Basis of Therapeutics shall encompass all
			 other synonymous terms such as drugs, biologicals, chemicals, potions,
			 remedies, or poisons.
(u)
			 "Medication Administration" means the act of giving medications to residents by
			 a nurse or physician as defined in these rules.
(v) "Medication Error" means any preventable
			 event that causes or leads to inappropriate medication use or harm while
			 medication is in the control of the assisted living facility staff or
			 resident."
(w) "Neglect" means the
			 failure to provide goods and services necessary to avoid physical harm or
			 mental distress or anguish.
(x)
			 "Pharmacist" means a person currently licensed to practice pharmacy in Alabama
			 under the provisions of
Code of Ala.
			 1975
, Sections
			 34-23-1, et. seq.
(y) "Physician" means a person currently
			 licensed by the Medical Licensure Commission of Alabama to practice medicine
			 and surgery in Alabama. The use of the word, "physician" in these rules shall
			 not be deemed to preclude a properly licensed nurse practitioner or a physician
			 assistant from performing any function in an assisted living facility that is
			 within that individual's scope of practice.
(z) "Qualified Dietitian" means a person who
			 is currently licensed in the State of Alabama in accordance with the provisions
			 contained in current state statutes as governed by the Board of Examiners for
			 Dietetic/Nutrition Practice.
(aa)
			 "Registered Professional Nurse" (RN) means a person currently licensed as a
			 Registered Professional Nurse by the State of Alabama Board of Nursing in
			 accordance with
Code of Ala. 1975
,
			 Section 34-21-21.
(bb) "Resident" means any individual in need
			 of assistance with activities of daily living that receives residence, health
			 supervision, or personal care in an assisted living facility.
(cc) "Specialty Care Assisted Living
			 Facility" means a facility that meets the definition of an assisted living
			 facility but which is specially licensed and staffed to permit it to care for
			 residents with a degree of cognitive impairment that would ordinarily make them
			 ineligible for admission or continued stay in an assisted living
			 facility.