Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 82 - General Licensure Requirements › Section 19 CSR 30-82.070 - Alzheimer's Demonstration Projects

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule is being promulgated to describe
				  the general requirements and process by which project participants will be
				  selected in order to implement Alzheimer's Demonstration Projects in accordance
				  with section
				  198.086, RSMo Supp.
				  1999.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. Therefore, the material which is so incorporated is on file with
				  the agency who filed this rule, and with the Office of the Secretary of State.
				  Any interested person may view this material at either agency's headquarters or
				  the same will be made available at the Office of the Secretary of State at a
				  cost not to exceed actual cost of copy reproduction. The entire text of the
				  rule is printed here. This note refers only to the incorporated by reference
				  material.
(1) For the
				purposes of this rule, "Health care facilities for persons with Alzheimer's
				disease or Alzheimer's related dementia" means facilities that are specifically
				designed and operated to provide elderly individuals who have chronic confusion
				or dementia illness, or both, with a safe, structured but flexible environment
				that encourages physical activity through a well-developed recreational and
				aging-in-place activity program.
(2) Participation in the Alzheimer's
				Demonstration Projects will be solicited by the Division of Aging by letter to
				all providers currently licensed by the division and to all interested parties
				who have advised the division of their interest. The solicitation letter will
				advise all recipients of the criteria to be used in making the selection and
				will be sent in advance of the selection with sufficient mailing time allowed
				for the submission of proposals by the date specified.
(3) Potential project participants must
				respond to the solicitation letter within thirty (30) days of the date
				received. The division must receive proposals by the date specified in the
				solicitation letter in order for the proposals to be considered. Proposals must
				address the criteria contained in the letter.
(4) The criteria utilized to select
				Alzheimer's Demonstration Project participants will be developed by a committee
				appointed by the director of the Division of Aging consisting of
				representatives of providers, consumers and professionals in the long-term care
				industry who possess knowledge of the provision of treatment to individuals
				with Alzheimer's disease or other related dementias.
(5) Proposals submitted will be screened
				initially for the ability of project applicants to comply with the minimum
				requirements set forth in section
				198.086, RSMo Supp.
				1999. Such applicants must provide supported assurances of their ability to
				achieve initial and continued compliance with all such requirements in order to
				be included in the final selection. Proposals from project applicants which are
				determined to not meet the minimum requirements shall be removed from
				consideration.
(6) The proposals
				submitted by applicants which remain after the initial screening shall be
				reviewed to determine whether all required components, as set forth in this
				rule, are addressed. Proposals which are determined to have not addressed all
				required components shall be removed from consideration.
(7) Proposals remaining shall be reviewed by
				the director of the Division of Aging and initial selections made. Selections
				for participants will be finalized only after the applicant reasonably
				demonstrates the financial capacity necessary to effectively implement and
				maintain the facility and program described in the proposal.
(8) Project participants selected for the
				demonstration projects shall be notified by the division within sixty (60) days
				from the date by which proposals shall be submitted to the division.
(9) All facilities selected to participate in
				the demonstration projects shall demonstrate the ability to comply with the
				following minimum requirements set forth in section
				198.086, RSMo Supp.
				1999:
(A) Each health care facility for
				persons with Alzheimer's disease or other related dementias shall maintain
				substantial compliance with all regulations under which they are licensed or
				certified. A facility may request an exception to a state licensure regulation
				in accordance with 13 CSR 15-10.010(4);
(B) Facilities shall design and implement
				self-care, productive and leisure activity programs for individuals with
				Alzheimer's or other related dementias. These programs shall continually strive
				to promote the highest practicable physical and mental abilities and
				functioning of each resident;
(C)
				The facility may admit to the demonstration project facility only persons who
				have been diagnosed with Alzheimer's disease or other related dementia and for
				whom it has been determined that the facility is able to meet their needs. The
				determination of whether a facility is able to meet a resident's needs shall be
				made in consultation between the resident's physician, family members or health
				care advocates;
(D) Facilities
				shall designate a contiguous portion of the facility as the demonstration
				project site, unless such facility exclusively admits individuals with
				Alzheimer's or other related dementias as part of the demonstration project.
				All designated demonstration project beds shall be located within this
				designated contiguous portion of the facility;
(E) Facilities shall design and implement a
				resident environment which promotes the maintenance of the residents' social
				abilities through daily and frequent opportunities for socialization and
				appropriate activities. The residential environment shall be designed and
				utilized in such a way as to reflect the individual preferences of residents
				and to provide as much independence and opportunities for choices throughout a
				day as possible;
(F) A Minimum Data
				Set (MDS) assessment shall be completed for any resident who occupies a bed
				designated for demonstration project participants. The MDS must be completed
				within fourteen (14) days of admission and an MDS quarterly review assessment
				must be completed every ninety (90) days thereafter. The MDS must also be
				completed whenever a significant change in condition occurs. For the purposes
				of this rule, "significant change" means a change in medical condition or in
				cognitive or psychosocial functioning which requires a change or modification
				in services or treatments provided in order to maintain the individual at the
				highest practicable level of functioning.
(G) Facilities shall be staffed twenty-four
				(24) hours a day by the number and type of licensed and unlicensed personnel
				sufficient to insure that all the needs of residents are met throughout the
				day. Facilities must remain in compliance with the staffing regulations in
				effect for the licensure category of the facility and as established by statute
				and must provide any additional staffing required to insure that residents'
				needs are met. Facilities shall determine appropriate staffing levels by
				utilizing current and updated Minimum Data Set information to identify
				residents' needs and shall make a determination on a daily and as-needed basis
				regarding the number of staff required to meet these needs;
(H) Facilities shall conduct a total of at
				least twenty-four (24) hours of staff training for all employees providing
				direct care to demonstration project residents within the first thirty (30)
				days of employment. This training shall consist of at least six (6) hours of
				classroom training and two (2) hours of on-the-job training in the special
				needs, care and safety of individuals with Alzheimer's disease or related
				dementias;
(I) Additional training
				provided shall address the needs, preferences and choices of the individual
				demonstration project residents, the degree of and the provision of assistance
				required with activities of daily living, the initiation of appropriate
				activities for residents and the promotion of each resident's rights, dignity
				and independence;
(J) Facilities
				shall utilize personal electronic monitoring devices for any resident whose
				physician recommends and orders the use of the device. Such orders shall be
				documented in the resident's health care record;
(K) The facility shall be equipped with a
				complete automated sprinkler system installed and maintained in accordance with
				the 1996 edition of the National Fire Protection Association (NFPA) 13,
Standard for the Installation of Sprinkler Systems,
or the
				1996 edition of NFPA 13R,
Sprinkler Systems in Residential Occupancies
				Up to and Including Four Stories in Height
, which are hereby
				incorporated by reference in this rule. The facility shall also be equipped
				with a complete electrically supervised fire alarm system and smoke barriers in
				accordance with the provisions of the 1997
Life Safety Code for
				Existing Health Care Occupancy
, which code is hereby incorporated by
				reference in this rule; and
(L)
				Buildings and furnishings shall be designed to provide for residents' safety.
				Facilities shall have indoor and outdoor activity areas, and electronically
				controlled exits from the buildings and grounds to allow residents the ability
				to explore while preventing them from exiting the facility's grounds
				unattended.