Personal care homes 64 CSR 14 et seq.
Residential care homes 64 CSR 65 et seq.
Residential care communities §16-5N-1 et seq.
A new category of residential care communities was created by legislation in 1997. Rules implementing the law were to be proposed by July 1998.
Personal care homes "Any institution, residence or place or any part or unit thereof, however named, in this state which is advertised, offered, maintained or operated by the ownership or management, whether for a consideration or not, for the express or implied purpose of providing accommodations and personal assistance and supervision, for a period of more than twenty-four hours, to four or more persons who are dependent upon the services of others by reason of physical or mental impairment who may require limited and intermittent nursing care, including those individuals who qualify for and are receiving services coordinated by a licensed hospice."
Board and care homes "Any residence or any part or unit thereof, however named, in this state which is advertised, offered, maintained or operated by the ownership or management, whether for a consideration or not, for the express or implied purpose of providing accommodations and personal assistance and supervision, for a period of more than twenty-four hours, to four to 10 persons who are not related to the owner or managed by blood or marriage with in the degree of consanguinity of second cousin and are dependent upon the services of others by reason of physical or mental impairment or who may require limited and intermittent nursing care but are capable of self-preservation and are not bedfast, including those individuals who qualify for and are receiving services coordinated by a licensed hospice."
Residential care communities is a new category created by Chapter 163 (1997). A residential care community means any group of seventeen or more residential apartments, however named, which are part of a larger independent living community and which are advertised, offered, maintained or operated by an owner or manager, regardless of consideration or the absence thereof, for the express or implied purpose of providing residential accommodations, personal assistance and supervision on a monthly basis to seventeen or more persons who are or may be dependent upon the services of others by reason of physical or mental impairment or who may require limited and intermittent nursing care but who are capable of self-preservation and not bedfast.
There are 65 licensed personal care homes with 2,414 beds and 76 residential board and care homes with 641 beds.
Personal care homes Rooms must have 80 square feet for single occupancy and 60 square feet for multiple occupancy rooms. A maximum of two residents may share a room in newly constructed homes. Toilets are required for every five residents and bath/showers for every 10 residents.
Residential board and care homes Single rooms must have at least 80 square feet of floor space, and rooms with multiple beds must have at least 60 square feet per resident. There may not be more than three residents per bedroom. There must be at least one toilet and washroom per six people, including staff. There must be at least one bathing facility per 10 individuals residing in the home, and at least one per floor on which the resident rooms are located.
Residential care communities must offer apartment units with at least 300 square feet, with lockable doors, at least one bedroom, a kitchenette with a sink and refrigerator, and one full bathroom.
Personal care homes may not admit residents needing extensive or ongoing nursing care, or residents for whom the facility does not have appropriate staff to provide care.
Residential board and care homes Residents must be capable of self-preservation on admission and may need personal assistance in activities of daily living, supervision because of mental or physical impairment, or have limited and intermittent nursing care needs. Individuals with identified mental or developmental disabilities may be admitted if the home can provide evidence of continued professional follow-up to address the individual's mental health needs or the individual is a client of licensed behavioral health agency.
Facilities may not admit those who require the use of routine physical or chemical restraints, require ongoing or extensive nursing services, or require a level of service of which the home is not licensed or does not provide. Individuals who become bedfast subsequent to admission may remain in the home for 90 days during a temporary illness or recovery from surgery if the resident's care does not require nursing care in excess of limited and intermittent nursing care.
Personal care homes provide limited and intermittent nursing services (direct hands-on care for no more than two hours a day for not more than 90 consecutive days per episode), personal assistance, assistance with self-administration of medications, transportation for medical and social services, supervision, meals, dietary and general household services (housekeeping), making appointments for appropriate medical, dental, nursing or mental health services, and 11 hours of activities a week. Homes must have arrangements for a registered nurse to manage and oversee personal care and nursing services. Homes may administer medications according to physician orders.
Residential board and care homes provide treatment and care in accordance with the functional needs assessment and service plan to assist each resident to maintain the highest level of functioning possible. Services include making appointments for appropriate medical, dental, nursing or mental health services as needed by the resident; arranging for transportation, personal assistance, assistance with medication administration, and supervision.
The state does not currently reimburse residential care but is exploring a method to do so.
Personal care homes Administrators must be 21, have a high school diploma or GED. Awake staff are optional in homes of 10 beds or less if all residents are certified by a licensed health care professional not to need sleep time supervision and do need limited and intermittent nursing services. Larger facilities must have one awake staff per floor in multi-story buildings unless residents meet the requirements for smaller homes and there is an emergency call system.
Residential board and care homes The administrator must be at least 21 years old and have a high school diploma or GED. There must be awake staff during normal resident sleeping hours when residents require supervision during sleeping hours or are in need of limited and intermittent nursing services.
Personal care homes and residential board and care homes
Administrators must receive at least 10 hours of training related to the operation and administration of personal care homes each year.
Staff Employee orientation and training. Training shall be provided to new employees and new admissions within the first twenty four hours of association with the home in emergency procedures, evacuation of the home, procedures to report a missing resident, medical emergencies, accidents, fire, natural disasters or other emergencies.
The home shall maintain a written plan of orientation and training for employees. Such training will be provided within the first fifteen days of employment inclusive of the following:
Policies and procedures of the home;
The rights and responsibilities of residents including protection of resident privacy and confidentiality;
Complaint procedures of the home;
Procedures and agencies available in instances of abuse, neglect, and mistreatment ...;
The care of aged, infirm or disabled adults with consideration for individual capabilities and needs;
Personal assistance procedures as needed for resident care, including at a minimum, personal grooming care, personal hygiene care, nutritional services, and signs and symptoms of alteration of skin integrity;
Specific duties and responsibilities of the residential staff for assisting current residents of the home (i.e. a review of individualized service plans, the activities program and/or professionally-designed intervention strategies to help a resident with behavioral health needs to manage his or her behavior);
Cardiopulmonary resuscitation (CPR), as applicable, and first aid; and
Personal care homes and residential board and care homes shall provide ongoing in-service training annually in the areas of: resident rights and confidentiality; abuse, neglect, mistreatment and procedures to prevent the occurrence of such incidents; emergency care of residents (first aid and as applicable CPR), emergency plans for the home, including fire safety and evacuation plans; the responsibilities of the residential staff for assisting residents (i.e. individualized service plans, activity programs, etc.); and infection control.
Residential board and care homes Administrators must be free of evidence of fraud, abuse or substantial and repeated violations of applicable laws and conviction of crimes relevant for the provision of care to a dependent population.
Personal care homes Personnel records must contain documentation of a criminal record investigation covering convictions for abuse, mistreatment or neglect, and theft of property from the populations served.
The licensing agency makes on-site unannounced inspections are made as needed and investigates complaints.