Ariz. Admin. Code § R9-10-403 - Administration
A. A governing
authority shall:
1. Consist of one or more
individuals responsible for the organization, operation, and administration of
a nursing care institution;
2.
Establish, in writing, the nursing care institution's scope of
services;
3. Designate, in writing,
a nursing care institution administrator licensed according to A.R.S. Title 36,
Chapter 4, Article 6;
4. Adopt a
quality management program according to
R9-10-404;
5. Review and evaluate the effectiveness of
the quality management program at least once every 12 months;
6. Designate, in writing, an acting
administrator licensed according to A.R.S. § Title 36, Chapter 4, Article
6, if the administrator is:
a. Expected not to
be present on the nursing care institution's premises for more than 30 calendar
days, or
b. Not present on the
nursing care institution's premises for more than 30 calendar days;
and
7. Except as
permitted in subsection (A)(6), when there is a change of administrator, notify
the Department according to A.R.S. §
36-425(I)
and submit a copy of the new administrator's
license under A.R.S. Title 36, Chapter 4, Article 6 to the
Department.
B. An
administrator:
1. Is directly accountable to
the governing authority of a nursing care institution for the daily operation
of the nursing care institution and all services provided by or at the nursing
care institution;
2. Has the
authority and responsibility to manage the nursing care institution;
3. Except as provided in subsection (A)(6),
designates, in writing, an individual who is present on the nursing care
institution's premises and accountable for the nursing care institution when
the administrator is not present on the nursing care institution's
premises;
4. Ensures the nursing
care institution's compliance with A.R.S. §
36-411;
and
5. If the nursing care
institution provides feeding and nutrition assistant training, ensures the
nursing care institution complies with the requirements for the operation of a
feeding and nutrition assistant training program in
R9-10-116.
C. An administrator shall ensure
that:
1. Policies and procedures are
established, documented, and implemented to protect the health and safety of a
resident that:
a. Cover job descriptions,
duties, and qualifications, including required skills, knowledge, education,
and experience for personnel members, employees, volunteers, and
students;
b. Cover orientation and
in-service education for personnel members, employees, volunteers, and
students;
c. Include how a
personnel member may submit a complaint relating to resident care;
d. Cover the requirements in A.R.S. Title 36,
Chapter 4, Article 11;
e. Cover
cardiopulmonary resuscitation training including:
i. Which personnel members are required to
obtain cardiopulmonary resuscitation training,
ii. The method and content of cardiopulmonary
resuscitation training,
iii. The
qualifications for an individual to provide cardiopulmonary resuscitation
training,
iv. The time-frame for
renewal of cardiopulmonary resuscitation training, and
v. The documentation that verifies an
individual has received cardiopulmonary resuscitation training;
f. Cover first aid
training;
g. Include a method to
identify a resident to ensure the resident receives physical health services
and behavioral health services as ordered;
h. Cover resident rights, including assisting
a resident who does not speak English or who has a disability to become aware
of resident rights;
i. Cover
specific steps for:
i. A resident to file a
complaint, and
ii. The nursing care
institution to respond to a resident's complaint;
j. Cover health care directives;
k. Cover medical records, including
electronic medical records;
l.
Cover a quality management program, including incident reports and supporting
documentation;
m. Cover contracted
services;
n. Cover resident's
personal accounts;
o. Cover petty
cash funds;
p. Cover fees and
refund policies;
q. Cover
misappropriation of resident property; and
r. Cover when an individual may visit a
resident in a nursing care institution; and
2. Policies and procedures for physical
health services and behavioral health services are established, documented, and
implemented to protect the health and safety of a resident that:
a. Cover resident screening, admission,
transport, transfer, discharge planning, and discharge;
b. Cover the provision of physical health
services and behavioral health services;
c. Include when general consent and informed
consent are required;
d. Cover
storing, dispensing, administering, and disposing of medication;
e. Cover infection control;
f. Cover how personnel members will respond
to a resident's sudden, intense, or out-of-control behavior to prevent harm to
the resident or another individual;
g. Cover telemedicine, if applicable;
and
h. Cover environmental services
that affect resident care;
3. Policies and procedures are reviewed at
least once every three years and updated as needed;
4. Policies and procedures are available to
personnel members, employees, volunteers, and students; and
5. Unless otherwise stated:
a. Documentation required by this Article is
provided to the Department within two hours after a Department request;
and
b. When documentation or
information is required by this Chapter to be submitted on behalf of a nursing
care institution, the documentation or information is provided to the unit in
the Department that is responsible for licensing and monitoring the nursing
care institution.
D. Except for health screening services, an
administrator shall ensure that medical services, nursing services,
health-related services, behavioral health services, or ancillary services
provided by a nursing care institution are only provided to a
resident.
E. If abuse, neglect, or
exploitation of a resident is alleged or suspected to have occurred before the
resident was admitted or while the resident is not on the premises and not
receiving services from a nursing care institution's employee or personnel
member, an administrator shall report the alleged or suspected abuse, neglect,
or exploitation of the resident as follows:
1.
For a resident 18 years of age or older, according to A.R.S. §
46-454;
or
2. For a resident under 18 years
of age, according to A.R.S. §
13-3620.
F. If an administrator has a
reasonable basis, according to A.R.S. §
13-3620
or
46-454,
to believe that abuse, neglect, or exploitation has occurred on the premises or
while a resident is receiving services from a nursing care institution's
employee or personnel member, an administrator shall:
1. If applicable, take immediate action to
stop the suspected abuse, neglect, or exploitation;
2. Report the suspected abuse, neglect, or
exploitation of the resident as follows:
a.
For a resident 18 years of age or older, according to A.R.S. §
46-454;
or
b. For a resident under 18 years
of age, according to A.R.S. §
13-3620;
3. Document:
a. The suspected abuse, neglect, or
exploitation;
b. Any action taken
according to subsection (F)(1); and
c. The report in subsection (F)(2);
4. Maintain the documentation in
subsection (F)(3) for at least 12 months after the date of the report in
subsection (F)(2);
5. Initiate an
investigation of the suspected abuse, neglect, or exploitation and document the
following information within five working days after the report required in
subsection (F)(2):
a. The dates, times, and
description of the suspected abuse, neglect, or exploitation;
b. A description of any injury to the
resident related to the suspected abuse or neglect and any change to the
resident's physical, cognitive, functional, or emotional condition;
c. The names of witnesses to the suspected
abuse, neglect, or exploitation; and
d. The actions taken by the administrator to
prevent the suspected abuse, neglect, or exploitation from occurring in the
future; and
6. Maintain
a copy of the documented information required in subsection (F)(5) and any
other information obtained during the investigation for at least 12 months
after the date the investigation was initiated.
G. An administrator shall:
1. Allow a resident advocate to assist a
resident, the resident's representative, or a resident group with a request or
recommendation, and document in writing any complaint submitted to the nursing
care institution;
2. Ensure that a
monthly schedule of recreational activities for residents is developed,
documented, and implemented; and
3.
Ensure that the following are conspicuously posted on the premises:
a. The current nursing care institution
license and quality rating issued by the Department;
b. The name, address, and telephone number
of:
i. The Department's Office of Long Term
Care,
ii. The State Long-Term Care
Ombudsman Program, and
iii. Adult
Protective Services of the Department of Economic Security;
c. A notice that a resident may
file a complaint with the Department concerning the nursing care
institution;
d. The monthly
schedule of recreational activities; and
e. One of the following:
i. A copy of the current license survey
report with information identifying residents redacted, any subsequent reports
issued by the Department, and any plan of correction that is in effect;
or
ii. A notice that the current
license survey report with information identifying residents redacted, any
subsequent reports issued by the Department, and any plan of correction that is
in effect are available for review upon request.
H. An administrator
shall provide written notification to the Department of a resident's:
1. Death, if the resident's death is required
to be reported according to A.R.S. §
11-593,
within one working day after the resident's death; and
2. Self-injury, within two working days after
the resident inflicts a self-injury that requires immediate intervention by an
emergency medical services provider.
I. If an administrator administers a
resident's personal account at the request of the resident or the resident's
representative, the administrator shall:
1.
Comply with policies and procedures established according to subsection
(C)(1)(n);
2. Designate a personnel
member who is responsible for the personal accounts;
3. Maintain a complete and separate
accounting of each personal account;
4. Obtain written authorization from the
resident or the resident's representative for a personal account
transaction;
5. Document an account
transaction and provide a copy of the documentation to the resident or the
resident's representative upon request and at least every three
months;
6. Transfer all money from
the resident's personal account in excess of $50.00 to an interest-bearing
account and credit the interest to the resident's personal account;
and
7. Within 30 calendar days
after the resident's death, transfer, or discharge, return all money in the
resident's personal account and a final accounting to the resident, the
resident's representative, or the probate jurisdiction administering the
resident's estate.
J. If
a petty cash fund is established for use by residents, the administrator shall
ensure that:
1. The policies and procedures
established according to subsection (C)(1)(o) include:
a. A prescribed cash limit of the petty cash
fund, and
b. The hours of the day a
resident may access the petty cash fund; and
2. A resident's written acknowledgment is
obtained for a petty cash transaction.
Notes
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