Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 25 - Division of Provider Services and Quality Assurance › Rule 016.25.21-002 - Direct Care Staffing Requirements update pursuant to ACT 715 of 2021

Current through Register Vol. 49, No. 6, June, 2024
520
DIRECT
			 CARE STAFFING REQUIREMENTS AND FLEXIBILITIES FOR NURSING FACILITIES
520.1
Definitions
For purposes of this section, the following definitions
				apply:
a. "Average direct care hours
			 per resident day" means the total number of hours of direct care services
			 provided by direct care staff in a month, divided by the number of calendar
			 days in that month, and the facility's average daily resident census for that
			 month.
b. "Certified nursing
			 facility" means a nursing facility licensed by the Department of Human Services
			 that is certified to participate in the federal Medicare program as a skilled
			 nursing facility, or in the Arkansas Medicaid Program as a nursing facility, or
			 both.
c. "Direct care services"
			 means nursing and nursing-related services; clinical, diagnostic, therapeutic,
			 and rehabilitative services; physical, occupational, respiratory, and speech
			 therapy services; delegated physician tasks; behavioral health services; care
			 management, care coordination, and care transition activities; medication
			 administration; assistance with activities of daily living; assessment,
			 evaluation, planning, and implementation of care plans; coordination and
			 consultation with residents' physicians and other healthcare providers; and
			 other services and supports provided for nursing facility residents in response
			 to individual resident needs. However, the meaning of "direct care services"
			 does not include food preparation, laundry, housekeeping, or other maintenance
			 of a nursing facility's physical environment.
d. "Direct care staff" means a person who
			 provides any direct care services to a nursing facility resident through
			 interpersonal contact with residents or resident care management, including
			 without limitation a licensed nurse; nurse aide; medication assistant;
			 physician; physician assistant; licensed physical or occupational therapist or
			 licensed therapy assistant; registered respiratory therapist; licensed
			 speech-language pathologist; infection preventionist; and other healthcare
			 professionals licensed or certified in the state of Arkansas.
e. "Division" means the Division of Provider
			 Services and Quality Assurance.
f.
			 "Federal direct care data system" means the national online data reporting
			 system operated by the Centers for Medicare and Medicaid Services and used by
			 nursing facilities participating in the federal Medicare program, or the
			 Arkansas Medicaid Program, or both to electronically report detailed and
			 standardized direct care and other staffing information.
g. "Licensed nurse" means any registered
			 nurse, licensed practical nurse, advanced practice registered nurse, or
			 registered nurse practitioner licensed in the state of Arkansas.
h. "Medicare and Medicaid requirements of
			 participation" means the federal requirements established by the Centers for
			 Medicare and Medicaid Services under
			 42 U.S.C.
			 1320a-7j, 42 U.S.C. 1395i-3, and
			 42 U.S.C.
			 1396r, that a licensed nursing facility is
			 required to follow to be certified as compliant with and participate in the
			 federal Medicare program as a skilled nursing facility, or the Medicaid program
			 as a nursing facility, or both, as existing on January 1, 2021.
i. "Medication assistant" means a medication
			 assistive person who is qualified and certified under Arkansas Code §
										17-87-701
			 et. seq. Alternatively referred to as medication assistant-certified in rules
			 of the Arkansas Board of Nursing.
j. "Private pay-only nursing facility" means
			 a licensed nursing facility that is not certified to participate in the federal
			 Medicare program as a skilled nursing facility or in the Arkansas Medicaid
			 Program as a nursing facility.
k.
			 "Universal worker" means a certified nurse aide (CNA) who is designated by a
			 skilled nursing facility as a universal worker and who performs both CNA direct
			 care service duties and non-direct care tasks such as food service, laundry,
			 and housekeeping, and other non-direct care services to meet the needs of
			 residents.
l. "Variance" means
			 granting an alternate requirement or modifying a requirement in place of a
			 requirement established in rule.
m.
			 "Waiver" means the grant of an exemption from a requirement established in
			 rule.