16 Del. Admin. Code § 3225-5.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 3225-5.0 - General Requirements

5.1 All written information provided by the assisted living facility including the written application process shall be accurate, precise, easily understood and readable by a resident, and in compliance with all applicable laws. If an applicant is rejected the facility shall provide clear reasons for the rejection in writing upon request.

5.2 All records maintained by the assisted living facility shall at all times be open to inspection and copying by the authorized representatives of the Department, as well as other agencies as required by state and federal laws and regulations. Such records shall be made available in accordance with 16Del.C.Ch. 11, Subchapter I., Licensing by the State.

5.3 The assisted living facility shall adopt internal written policies and procedures pursuant to these regulations. No policies shall be adopted by the assisted living facility which are in conflict with these regulations.

5.4 The assisted living facility shall establish and adhere to written policies and procedures regarding the rights and responsibilities of residents, and these policies and procedures shall be made available to authorized representatives of the Department, facility staff, and residents.

5.5 The assisted living facility shall develop and adhere to policies and procedures to prevent residents with diagnosed memory impairment from wandering away from safe areas. However, residents may be permitted to wander safely within the perimeter of a secured unit.

5.6 The assisted living facility shall arrange for emergency transportation and care.

5.7 Inspection summaries and compliance history information shall be posted by the facility in accordance with 16Del.C.Ch. 11, Subchapter I., Licensing by the State.

5.8 An assisted living facility shall recognize the authority of a representative acting on the resident's behalf pursuant to Delaware law, as long as such representative does not exceed his/her authority. The facility shall request and keep on file any documents such as an advance directive, living will, do not resuscitate, and power(s) of attorney.

5.9 An assisted living facility shall not admit, provide services to, or permit the provision of services to individuals who, as established by the resident assessment:

5.9.1 Require care by a nurse that is more than intermittent or for more than a limited period of time;

5.9.2 Require skilled monitoring, testing, and aggressive adjustment of medications and treatments where there is the presence of, or reasonable potential of, an acute episode unless there is an RN to provide appropriate care;

5.9.3 Require monitoring of a chronic medical condition that is not essentially stabilized through available medications and treatments;

5.9.4 Are bedridden for more than 14 days;

5.9.5 Have developed stage three or four skin ulcers;

5.9.6 Require a ventilator;

5.9.7 Require treatment for a disease or condition which requires more than contact isolation;

5.9.8 Have an unstable tracheostomy or have a stable tracheostomy of less than 6 months' duration;

5.9.9 Have an unstable peg tube;

5.9.10 Require an IV or central line with an exception for a completely covered subcutaneously implanted venous port provided the assisted living facility meets the following standards:

5.9.10.1 Facility records shall include the type, purpose and site of the port, the insertion date, and the last date medication was administered or the port flushed.

5.9.10.2 The facility shall document the presence of the port on the Uniform Assessment Instrument, the service plan, interagency referrals and any facility reports,

5.9.10.3 The facility shall not permit the provision of care to the port or surrounding area, the administration of medication or the flushing of the port or the surgical removal of the port within the facility by facility staff, physicians or third party providers;

5.9.11 Wander such that the assisted living facility would be unable to provide adequate supervision and/or security arrangements;

5.9.12 Exhibit behaviors that present a threat to the health or safety of themselves or others, such that the assisted living facility would be unable to eliminate the threat either through immediate discharge or use of immediate appropriate treatment modalities with measurable documented progress within 45 days; and

5.9.13 Are socially inappropriate as determined by the assisted living facility such that the facility would be unable to manage the behavior after documented, reasonable efforts such as clinical assessments and counseling for a period of no more than 60 days.

5.10 The provisions of section 5.9 above do not apply to residents under the care of a Hospice program licensed by the Department as long as the Hospice program provides written assurance that, in conjunction with care provided by the assisted living facility, all of the resident's needs will be met without placing other residents at risk.

5.11 The Assisted Living facility shall cooperate fully with the state protection and advocacy agency, as defined in 16Del.C.§ 1102(7), in fulfilling functions authorized by Title 16, Chapter 11.

5.12 An assisted living facility that provides direct healthcare services to persons diagnosed as having Alzheimer's disease or other forms of dementia shall provide dementia specific training each year to those healthcare providers who must participate in continuing education programs. The mandatory training must include: communicating with persons diagnosed as having Alzheimer's disease or other forms of dementia; the psychological, social, and physical needs of those persons; and safety measures which need to be taken with those persons. This paragraph shall not apply to persons certified to practice medicine under the Medical Practice Act, Chapter 17 of Title 24 of the Delaware Code.

16 Del. Admin. Code § 3225-5.0

8 DE Reg. 85 (7/1/04)
13 DE Reg. 1328 (04/01/10)
14 DE Reg. 1360 (06/01/11)
15 DE Reg. 192 (08/01/11)