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Title: Section 492.5 - Admission and discharge policies.

492.5 Admission and discharge policies. (a) The operator must admit to the program only those persons 18 years of age and older who are not residents of an adult home, residence for adults or enriched housing program who, by reason of social, physical and/or mental dependencies require the services provided by a nonresident services program in order to remain in or return to the community.

(b) The operator must give admission priority to persons who:

(1) require supervision in order to live in the community; or

(2) need assistance with activities of daily living in order to remain in the community; or

(3) are socially isolated or disoriented and need opportunities for social interaction to prevent deterioration that would lead to placement in congregate facilities; or

(4) are in transition from a higher level of care; or

(5) are in danger of being neglected or abused by a caregiver or have needs which the caregiver is unable to meet; or

(6) are receiving services as part of a protective services for adults program.

(c) The operator of an adult home, residence for adults or enriched housing program must not admit or retain in the nonresident services program any person who would be inappropriate for admission to the facility.

(d) Prior to admission, the program director must interview the applicant and the applicant's caregiver or representative, if any. The interview must provide the director with information on the general health characteristics, psychosocial condition, and nutritional habits of the applicant, and his/her home support system and care needs. The interview must acquaint the applicant and caregiver or representative with the services and activities offered by the facility.

(e) At admission, the participant must obtain and provide to the operator a written, dated and signed report from the participant's physician, stating:

(1) that the physician has physically examined the participant within the last 30 days;

(2) a current list of medications and treatments provided to the participant by community providers;

(3) the needs of the participant for assistance with self-administration of medication;

(4) the dietary needs of the participant;

(5) the assistance needed in the activities of daily living;

(6) any contraindications or limitations to the individual's participation in program activities.

(f) Every six months, beginning on the date of admission to the program, the participant must obtain and provide to the operator a written, dated and signed statement from the participant's physician indicating changes in the participant's needs for assistance with self-administration of medication. If there are no changes in such needs, the statement required by this subdivision must so indicate.

(g) The operator must enter into a written agreement with the participant. The agreement must specify the basic services to be provided to the individual by the operator, the charges for these services, and the obligations of the participant, the participant's representative and the caregiver. The agreement must also contain a statement of the operator's refund policies.

(h) The participant and caregiver or representative must receive a copy of the written agreement.

(i) When a participant is involuntarily discharged from the program, the operator must provide at least 72 hours prior written notification to the participant and caregiver or representative. The notification must state the date of the notice, the date of discharge and the reason(s) for discharge.

(j) The notice required by subdivision (i) of this section may be disregarded when a participant develops a serious physical or mental dysfunction which constitutes an immediate and present danger to himself/herself or others.



VOLUME B-1 (Title 18)