Tenn. Comp. R. & Regs. 0720-38-.07 - ADMISSIONS, DISCHARGES, AND TRANSFERS
(1) Admissions.
(a) A TBI residential home may only admit and
continue to care for residents requiring specialized services, where assistance
is provided with ADL's in a homelike environment.
(b) A TBI residential home may not admit or
serve a resident who is ventilator dependent.
(c) A TBI residential home provider may
choose to serve one (1) or more elderly adult members of their own family as
long as the TBI residential home provider serves at least two (2) additional
disabled adults unrelated to the TBI residential home provider by blood or
marriage.
(d) A TBI residential
home may not admit or retain a resident who cannot be evacuated within five (5)
minutes.
(e) A TBI residential home
shall upon admission of a resident:
1. Be able
to identify at the time those residents whose needs for services are consistent
with these rules and regulations, and those residents who should be transferred
to a more appropriate level of care;
2. Document plans and procedures to show
evacuation of the resident within five (5) minutes.
3. Provide to each resident a written
admission agreement signed and dated by the TBI residential home provider and
the resident or the resident's family member or the resident's legal
representative and presented both verbally and in writing. The admission
agreement shall be reviewed and updated as necessary as a part of the
residential plan of care review process and contain the following:
(i) A copy of the resident rights for the
resident's review and signature;
(ii) A copy of house rules and the rate
schedules, including any payment for services for which the resident will be
responsible;
(iii) An accurate
written statement providing that the TBI residential home provider shall give
thirty (30) days written notice to the resident prior to making any changes in
the rates;
(iv) The consequences
for non-payment for services which includes involuntary discharge from the TBI
residential home;
(v) An accurate
written statement regarding services which will be provided residents upon
admission;
(vi) Procedures for
handling the transfer or discharge of residents that does not violate the
residents' rights under the law or these rules;
(vii) A copy of the medication disposal
policy.
4. Disclose in
writing to the resident or to the resident's legal representative, the identity
of the TBI residential home's primary liability insurance carrier. If the TBI
residential home is self-insured, its statement shall reflect that fact and
indicate the corporate entity responsible for payment of any claims;
5. Document evidence of annual vaccination
against influenza for each resident, in accordance with the recommendation of
the Advisory Committee on Immunization Practices of the Centers for Disease
Control most recent to the time of vaccine, unless such vaccination is
medically contraindicated or the resident or the resident's legal
representative has refused the vaccine. Influenza vaccination for all residents
accepting the vaccine shall be completed by November 30 of each year or within
ten (10) days of the vaccine becoming available. Residents admitted after this
date during the flu season and up to February 1, shall, as medically
appropriate, receive influenza vaccination prior to or on admission unless
refused by the resident or the resident's legal representative; and
6. Document evidence of vaccination against
pneumococcal disease for all residents who are sixty-five (65) years of age or
older, in accordance with the recommendations of the Advisory Committee on
Immunization Practices of the Centers for Disease Control at the time of
vaccination, unless such vaccination is medically contraindicated or the
resident or the resident's legal representative has refused the offer of
vaccine. The TBI residential home shall provide or arrange for the pneumococcal
vaccination of residents who have not received this immunization prior to or on
admission unless the resident or resident's legal representative refuses offer
of the vaccine.
(2) Discharges and Transfers.
(a) Residents may only be moved, transferred
or discharged from a TBI residential home for the following reasons:
1. Medical reasons. The resident has a
medical or nursing condition that exceeds the level of health care services the
home provides;
2. Welfare of the
resident or of other residents. This includes, but is not limited to the
following: The TBI residential home is unable to accomplish timely evacuation
of the resident in the event of an emergency; the resident exhibits behavior
that poses an imminent danger to self or others; the resident engages in
behavior or actions that repeatedly and substantially interfere with the
rights, health or safety of residents or others; or the resident engages in
illegal drug use, or commits a criminal act that causes potential harm to the
resident or others;
3. Nonpayment
for services provided to the resident by the home; or
4. Closing or selling the facility.
(b) A TBI residential home
resident shall be discharged and transferred to another appropriate setting
such as home, a hospital, or a nursing home when the resident, the resident's
legal representative, or the resident's treating physician determines that the
TBI residential home cannot safely and effectively meet the resident's needs,
including medical services.
(c) The
Board may require that a TBI residential home resident be discharged or
transferred to another level of care if it determines that the resident's
needs, including medical services, cannot be safely and effectively met in the
TBI residential home.
(d) In the
event of a discharge or transfer due to medical reasons, for the welfare of the
resident or for the welfare of other residents, or due to nonpayment for
services provided to the resident by the home, the TBI residential home
provider shall give the resident, the resident's family member, or the
resident's legal representative written notice at least thirty (30) days prior
to the proposed transfer or discharge.
(e) In the event of a discharge or transfer
due to medical reasons, the welfare of the resident, or for the welfare of
other residents, the TBI residential home provider shall work with the Board to
develop a transition plan in order to maintain continuity of care for the
resident and to minimize the impact of the transition. The TBI residential home
provider shall assist the resident in locating an alternate appropriate
setting.
(f) In the case of a
medical emergency that requires immediate action, the TBI residential home
provider shall give the resident, the resident's family member, or the
resident's legal representative written notice as soon as possible under the
circumstances.
(g) In the event of
discharge or transfer due to selling the home to another TBI residential home
provider, the current TBI residential home provider shall develop a transition
plan for all residents to facilitate the transition to a new TBI residential
home and shall maintain its license and operation of the home until the point
in time the new TBI residential home's license is approved.
(h) In the event of discharge or transfer due
to the closing of the home, the TBI residential home provider shall provide
ninety (90) days advance notice to residents and shall work with the Board to
develop a transition plan to maintain continuity of care for the residents and
to minimize the impact of transition. The TBI residential home shall assist
each resident in locating an alternative placement.
Notes
Authority: T.C.A. ยงยง 68-11-202, 68-11-206, 68-11-209, 68-11-270, and 68-11-273.
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