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Rule 3701-16-01 | Definitions.
As used in rules 3701-16-01 to 3701-16-18 of the
Administrative Code: (A) "Accommodations" means
housing, meals, laundry, housekeeping, transportation, social or recreational
activities, maintenance, security, or similar services that are not personal
care services or skilled nursing care. (B) "Activities of daily
living" means walking and moving, bathing, grooming, toileting, oral
hygiene, hair care, dressing, eating, and nail care. (C) "Administrator" means the
person responsible for the daily operation of the residential care facility.
The administrator and the operator may be the same person. (D) "Advanced Practice Nurse"
means a registered nurse authorized to practice as a certified nurse
specialist, certified registered nurse anesthetist, certified nurse midwife or
certified nurse practitioner in accordance with section 4723.41 of the Revised
Code. (E) "Bedroom" means a room used by a resident or
residents for sleeping purposes that is either a resident unit or a portion of
a resident unit. (F) "Complex therapeutic diets" has the same
meaning as "therapeutic diet" as that term is defined in paragraph
(QQ) of this rule (G) "County home" and "district home"
mean an entity operated under Chapter 5155. of the Revised Code. (H) "Department" means the department of
health. (I) "Developmental delay" means that a child has
not reached developmental milestones expected for their chronological age as
measured by qualified professionals using appropriate diagnostic instruments
and/or procedures. (1) Delay will be
demonstrated in one or more of the following developmental areas: adaptive
behavior, physical developmental or maturation (fine and gross motor skills;
growth) cognition; social or emotional development; and sensory development;
or (2) An established risk
involving early aberrant development related to diagnosed medical disorders,
such as infants and toddlers who are on a ventilator, are adversely affected by
drug exposure, or have a diagnosed medical disorder or physical or mental
condition known to result in developmental delay such as Down
syndrome. (J) "Developmental diagnosis" means a severe,
chronic disability that is characterized by the following: (1) It is attributable to
a mental or physical impairment or a combination of mental and physical
impairments, other than a mental impairment solely caused by mental illness as
that term is defined in division (A) of section 5122.01 of the Revised
Code. (2) It is manifested
before age twenty-two. (3) It is likely to
continue indefinitely. (4) It results in one of
the following: (a) In the case of a person under three years of age, at least
one developmental delay or an established risk; (b) In the case of a person at least three years of age but under
six years of age, at least two developmental delays or an established
risk. (c) In the case of a person six years of age or older, a
substantial functional limitation in at least three of the following areas of
major life activity, as appropriate for the person's age; self-care,
receptive and expressive language, learning, mobility, self-direction, capacity
for independent living, and if the person is at least sixteen years of age,
capacity for economic self-sufficiency. (5) It causes the person
to need a combination and sequence of special, interdisciplinary, or other type
of care, treatment, or provision of services for an extended period of time
that is individually planned and coordinated for the person. (K) "Director" means the director of health or
any office, bureau, agency, official or employee of the department to which the
director has delegated their authority or duties. (L) "Dietitian" means an individual licensed
under Chapter 4759. of the Revised Code to practice dietetics. (M) "Full-time" means an
individual works thirty hours or more per week. (N) "Home": (1) "Means both of
the following: (a) Any institution, residence, or facility that provides, for a
period of more than twenty-four hours, whether for a consideration or not,
accommodations to three or more unrelated individuals who are dependent upon
the services of others, including a nursing home, residential care facility,
and the Ohio veterans' home; (b) A county home or district home that is or has been licensed
as a residential care facility. (2) "Also means any
facility that a person, as defined in section 3702.51 of the Revised Code,
proposes for certification as a skilled nursing facility or nursing facility
under Title XVIII or XIX of the "Social Security Act," 49 Stat. 620
(1935), 42 U.S.C. 301, as amended , and for which a certificate of need, other
than a certificate to recategorize hospital beds as described in section
3702.521 of the Revised Code or under division (R)(7)(d) of the version of
section 3702.51 of the Revised Code in effect immediately prior to April 20,
1995, has been granted to the person under sections 3702.51 to 3702.594 of the
Revised Code after August 5, 1989. (3) "Does not mean
any of the following: (a) Except as provided in division (A)(1)(b) of section 3721.01
of the Revised Code, a public hospital or hospital as defined in section
3701.01 or 5122.01 of the Revised Code; (b) A residential facility for mentally ill persons as defined
under section 5119.34 of the Revised Code; (c) A residential facility as defined in section 5123.19 of the
Revised Code; (d) An alcohol or drug addiction program as defined in section
5119.01 of the Revised Code; (e) A facility licensed to provide methadone treatment under
section 5119.391 of the Revised Code; (f) A facility providing services under contract with the
department of mental retardation and developmental disabilities under section
5123.18 of the Revised Code; (g) A facility operated by a hospice care program licensed under
section 3712.04 of the Revised Code that is used exclusively for care of
hospice patients; (h) A facility operated by a pediatric respite care program
licensed under section 3712.041 of the Revised Code that is used exclusively
for care of pediatric respite care patients; (i) A facility, infirmary, or other entity that is operated by a
religious order, provides care exclusively to members of religious orders who
take vows of celibacy and live by virtue of their vows within the orders as if
related, and does not participate in the medicare program established under
Title XVIII of the "Social Security Act" or the medical assistance
program established under Chapter 5111. of the Revised Code and Title XIX of
the "Social Security Act," if on January 1, 1994, the facility,
infirmary, or entity was providing care exclusively to members of the religious
order; (j) A county home or district home that has never been licensed
as a residential care facility; or (k) A facility registered to provide a pediatric transition
care program under section 3712.042 of the Revised Code that is used
exclusively for pediatric transition care patients. (O) "Home health agency" means an entity licensed
under section 3740.04 of the Revised Code. (P) "Licensed practical nurse" means a person
licensed under Chapter 4723. of the Revised Code to practice nursing as a
licensed practical nurse. (Q) "Lot" means a plot or parcel of land
considered as a unit, devoted to a certain use, or occupied by a building or
group of buildings that are united by a common interest and use, and the
customary accessories and open spaces belonging to the same. (R) "Maximum licensed capacity" means the
authorized type and number of residents in a home as determined in paragraph
(S) of rule 3701-16-03 of the Administrative Code. (S) "Mechanically altered food" means that the
texture of food is altered altered by chopping, grinding, mashing, or pureeing
so that it can be successfully chewed and safely swallowed. (T) "Mental impairment" means a condition in
which a part of a person's brain has been damaged or is not working
properly. Mental impairment does not mean mental illness as that term is
defined in section 5122.01 of the Revised Code or intellectual disability as
that term is defined in section 5123.01 of the Revised Code. (U) "Nonambulatory" means not able to walk or not
physically able to leave the premises without assistance from another
individual. (V) "Nurse" means a registered nurse or licensed
practical nurse. (W) "Nursing home" means a home used for the
reception and care of individuals who by reason of illness or physical or
mental impairment is in need of skilled nursing care and of individuals who are
in need of personal care services but not skilled nursing care. A nursing home
is licensed to provide personal care services and skilled nursing
care. (X) "Ohio building code" means the building
standards, as adopted by the board of building standards pursuant to section
3781.10 of the Revised Code. (Y) "On call" means the person can be contacted
at all times and is immediately available to go on duty in the home upon short
notice. (Z) "On duty" means being in the home, awake, and
immediately available. (AA) "Operator" means the person, firm,
partnership, association, or corporation which is obligated by section 3721.05
of the Revised Code to obtain a license in order to open, maintain or operate a
home and the superintendent or administrator of a county home or district home
licensed or seeking to be licensed as a residential care facility. (BB) "Personal care services" means services
including, but not limited to, the following: (1) Assisting residents
with activities of daily living: (2) Assisting residents
with self-administration of medication, in accordance with rule 3701-16-09 of
the Administrative Code; (3) Preparing food for
special diets, other than therapeutic diets, for residents pursuant to the
instructions of a physician, a licensed health care professional acting within
their applicable scope of practice, or a licensed dietitian, in accordance with
rule 3701-16-10 of the Administrative Code. "Personal care services" does not
include "skilled nursing care." A facility need not provide more than
one of the services listed in this paragraph to be considered to be providing
personal care services. (CC) "Physician" means an individual licensed
under Chapter 4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery. (DD) "Registered nurse" means an individual
licensed to practice nursing as a registered nurse under Chapter 4723. of the
Revised Code. (EE) "Resident" means an unrelated individual to
whom a residential care facility provides accommodations. (FF) "Resident call system" means a set of devices
that are connected electrically, electronically, by radio frequency
transmission, or in a like manner, are resident activated, and effectively can
alert the staff member or members on duty of emergencies or resident
needs. (GG) "Resident unit" means the private room or
rooms occupied by a resident or residents. (HH) "Residents' rights" means the rights
enumerated in sections 3721.10 to 3721.17 of the Revised Code. (II) "Residential care facility" means a home that
provides either of the following: (1) Accommodations for
seventeen or more unrelated individuals and supervision and personal care
services for three or more of those individuals who are dependent on the
services of others by reason of age or physical or mental
impairment; (2) Accommodations for
three or more unrelated individuals, supervision and personal care services for
at least three of those individuals who are dependent on the services of others
by reason of age or physical or mental impairment, and to at least one of those
individuals, any of the skilled nursing care authorized by section 3721.011 of
the Revised Code. (JJ) "Serious mental illness" means an illness
classified in the "Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition (DSM-V)," that meets at least two of the three following
criteria of diagnosis, duration and disability: (1) Diagnosis: The
current primary diagnosis is: (a) Dissociative disorders (DSM-V F44.81); (b) Feeding and eating disorders (DSM-V F50.01, F50.02,
F50.2, F50.8, F 50.9); (c) Depressive disorders (DSM-V F32.8, F32.9, F34.8, F33,
F33.1, F33.2, F33.3, F 34, F34.1,); (d) Major neurocognitive disorders (DSM-V F01.50, F01.51, ,
F02.8x, F06.8); (e) Disruptive, impulsive-control, and conduct disorders
(DSM-V F21, F60, F60.1, F60.2, F60.3, , F60.5, F60.6, F60.7 F60.81,
F60.9); (f) Schizophrenia spectrum and other psychotic disorders
(DSM-V F20.81, F20.9, F22 , F23, F25x, F25.0, F25.1, F28, F29); (g) Somatoform disorder (DSM-V F45.1); (h) Other disorders (DSM-V F94.40, F91.3, F93.8);
or (i) Other specified. (2) Duration: the length
of the problem can be assessed by either inpatient or outpatient use of service
history, reported length of time of impairment, or some combination, including
at least two prior hospitalizations of more than twenty-one days or any number
of hospitalizations (more than one) totaling at least forty-two days prior to
the assessment, or ninety to three hundred sixty-five days in a hospital or
nursing home within three prior years, or major functional impairment lasting
more than two years, resulting in utilization of outpatient mental health
services on an intermittent basis, a continuous basis, or both. (3) Disability/functional
impairment: severity of disability can be established by disruption in two or
more life activities, including but not limited to: (a) Employment; (b) Contributing substantially to one's own financial
support (not to be entitlements); (c) Independent residence; (d) Self-care; (e) Perception and cognition; (f) Stress management or coping skills; or (g) Interpersonal and social relations. (KK) "Skilled nursing care" means procedures that
necessitate technical skills and knowledge beyond those the untrained person
possesses and that are commonly employed in providing for the physical, mental,
and emotional needs of the ill or otherwise incapacitated. "Skilled
nursing care" includes, but is not limited to, the following: (1) Irrigations,
catheterizations, application of dressings, and supervision of special
diets; (2) Objective observation
of changes in the resident's condition as a means of analyzing and
determining the nursing care necessary and the need for further medical
diagnosis and treatment; (3) Special procedures
contributing to rehabilitation; (4) Administration of
medication by any method ordered by a physician or other licensed health care
professional acting within their applicable scope of practice, such as
hypodermically, rectally, or orally, including observation of the resident
after receipt of the medication; or (5) Carrying out other
treatments prescribed by the physician or other licensed health care
professional acting within their applicable scope of practice, that involve a
similar level of complexity and skill in administration. (LL) "Special care unit" means a residential care
facility, or part thereof, that is dedicated to providing care to residents
with diagnoses, that include, but are not limited to, late-stage cognitive
impairment with significant ongoing daily living assistance needs, cognitive
impairments with increased emotional needs or presenting behaviors that cause
problems for the resident or other residents, or both; or, serious mental
illness. (MM) "Special diets" means a therapeutic diet
limited to: (1) Nutrient adjusted
diets, including high protein, no added salt, and no concentrated
sweets (2) Volume adjusted
diets, including small, medium and large portions; (3) The use of finger
foods or bite-sized pieces for a resident's physical needs;
or (4) Mechanically altered
food. (NN) "Staff member" or "staff" means an
individual working in a residential care facility including the owner; the
administrator; a full-time, part-time or temporary paid employee; or an
individual working on contract for the facility. (OO) "Supervision" means: (1) Watching over a
resident, when necessary, while the resident engages in activities of daily
living or other activities to ensure the resident's health, safety, and
welfare; (2) Reminding a resident
to do or complete such an activity, as by reminding them to engage in personal
hygiene or other self-care activity; or (3) Helping a resident to
schedule or keep an appointment, or both, including the arranging for
transportation. "Supervision" does not include
reminding a resident to take medication and watching the resident to ensure
that the resident follows the directions on the container, or supervision of
therapeutic diets as described in paragraph (J) of rule 3701-16-10 of the
Administrative Code. (PP) "Supervision of therapeutic diets" means
services, including, but not limited to, the following: (1) Monitoring a
resident's access to appropriate foods as obligated by a therapeutic
diet; (2) Monitoring a
resident's weight and acceptance of a therapeutic diet; (3) Providing assistance
to residents on therapeutic diets as needed or requested: and (4) Providing or
preparing therapeutic diets. (QQ) "Therapeutic diet" means a diet ordered by a
health care practitioner: (1) As part of the
treatment for a disease or clinical condition; (2) To eliminate,
decrease, or increase certain substances in the diet; or (3) To provide
mechanically altered food when indicated. (RR) "Unrelated individual" means one who is not
related to the owner or operator of the residential care facility or to their
spouse as a parent, grandparent, child, grandchild, brother, sister, niece,
nephew, aunt, uncle, or as the child of an aunt or uncle.
Last updated July 12, 2024 at 9:29 AM
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Rule 3701-16-02 | General provisions and prohibitions.
(A) Nothing contained in rules 3701-16-01
to 3701-16-18 of the Administrative Code should be construed as authorizing the
supervision, regulation, or control of the spiritual care or treatment of
residents who rely upon treatment by prayer or spiritual means in accordance
with the creed or tenets of any recognized church or religious
denomination. (B) For the purposes of rules 3701-16-01
to 3701-16-18 of the Administrative Code: (1) Any residence,
institution, hotel, assisted living facility, congregate housing project, or
similar facility that meets the definition of a residential care facility or a
home for the aging under section 3721.01 of the Revised Code is such a home
regardless of how the facility holds itself out to the public; (2) Any residence,
institution, hotel, assisted living facility, congregate housing project, or
similar facility that provides personal care services to fewer than three
residents or that provides for any number of residents, only housing,
housekeeping, laundry, meals, social or recreational activities, maintenance,
security, transportation, and similar services that are not personal care
services or skilled nursing care does not need to be licensed under Chapter
3721. of the Revised Code or rules 3701-16-01 to 3701-16-18 of the
Administrative Code; and (3) Personal care
services or skilled nursing care will be considered to be provided by a
residential care facility if they are provided by a person employed by or
associated with the facility or by another person pursuant to an agreement to
which neither the resident who receives the services nor their sponsor is a
party. (C) Nothing in paragraph (BB) of rule
3701-16-01 of the Administrative Code should be be construed to permit personal
care services to be imposed upon a resident who is capable of performing the
activity in question without assistance. Nothing in paragraph (KK) of rule
3701-16-01 of the Administrative Code should be be construed to permit skilled
nursing care to be imposed upon an individual who does not need skilled nursing
care. (D) In addition to providing
accommodations, supervision, and personal care services to its residents, a
residential care facility is licensed to provide skilled nursing care to its
residents as follows: (1) Supervision of
therapeutic diets; (2) Application of
dressings pursuant to division (A)(2) of section 3721.011 of the Revised Code
and paragraph (J) of rule 3701-16-09 of the Administrative Code; (3) Subject to division (B)(1) of section
3721.011 of the Revised Code, administration of medication; (4) Subject to division
(C) of section 3721.011 of the Revised Code, other skilled nursing care
provided on a part-time, intermittent basis for not more than a total of one
hundred twenty days in any twelve-month period; and (5) Subject to division
(D) of section 3721.011 of the Revised Code, skilled nursing care provided for
more than one hundred twenty days in any twelve-month period to a resident
whose physician has determined the skilled nursing care needed is routine, or
to a hospice patient as defined in section 3712.01 of the Revised
Code. (E) A residential care facility is not
allowed to admit or retain individuals requiring skilled nursing care or
provide skilled nursing care beyond the limits established under section
3721.011 of the Revised Code and rules 3701-16-07 and 3701-16-09.1 of the
Administrative Code. (F) Each residential care facility is
obligated to provide services as outlined in the resident agreement in
accordance with acceptable practices and the facility's policies and
procedures. (G) Each residential care facility is obligated to comply with
all the residents' rights provisions under Chapter 3721. of the Revised
Code. (H) A residential care facility is forbidden from using the word
"hospital" in its name, letterhead or advertising. (I) A residential care facility is forbidden from admitting
residents in excess of the maximum licensed bed capacity. (J) Notwithstanding section 3721.011 of the Revised Code, a
residential care facility in which residents receive skilled nursing care as
described in section 3721.011 of the Revised Code is not a nursing
home. (K) An applicant for a license to operate a residential care
facility will not accept more than two residents who need personal care
services, medication administration, supervision of therapeutic diets,
application of dressings or skilled nursing care before receiving a
license. (L) In addition to the provisions listed in this rule, no person,
firm, partnership, association, or corporation is obligated to: (1) Operate a residential
care facility as defined in section 3721.01 of the Revised Code and paragraph
(II) of rule 3701-16-01 of the Administrative Code without obtaining a license
from the director; (2) Violate any of the
conditions or qualifications necessary for licensing after the license has been
issued; (3) Operate a residential
care facility after the license for such has been revoked by the
director; (4) Interfere with the
inspection of a licensed residential care facility by any state or local
official when they are performing duties obligated by Chapter 3721. of the
Revised Code. All licensed residential care facilities are obligated to be open
for inspection; or (5) Violate any
applicable provision of Chapter 3721. of the Revised Code or rules 3701-16-01
to 3701-16-18 of the Administrative Code. (M) No county home or district home licensed under section
3721.07 of the Revised Code will do any of the following: (1) Violate any of the
conditions or qualifications necessary for licensing after the licensed has
been issued; (2) Continue operation
after its license has been revoked by the director of health; (3) Fail to be open for
an inspection, or interfere with an inspection, by a state or local official
performing inspection duties under Chapter 3721. of the Revised Code;
or (4) Violate any of the
provisions of this chapter or any rules adopted thereunder. (N) Nothing contained in rules 3701-16-01 to 3701-16-18 of the
Administrative Code should be be construed to permit any individual to engage
in the practice of nursing as a registered nurse or the practice of nursing as
a licensed practical nurse if the individual does not hold a valid license
issued under Chapter 4723. of the Revised Code.
Last updated July 12, 2024 at 9:29 AM
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Rule 3701-16-03 | Initial, renewal, and change of operator license applications; fees; issuance; revocation; notice.
(A) Not less than sixty days before the
proposed opening of a residential care facility, the operator of a residential
care facility will submit, on a form prescribed by the director, a completed
initial application, and pay the non-refundable application fee specified in
division (E) of section 3721.02 of the Revised Code, with the fee made payable
to the "treasurer, state of Ohio" in the form of a check or money
order to be deposited in the state treasury to the credit of the general
operations fund created by division (A) of section 3701.83 of the Revised Code.
A completed application includes: (1) A statement by the
applicant of the status of the proposed residential care facility under any
applicable zoning ordinances or rules, or a statement by the applicant that
there is no zoning authority where the proposed home is to be
located; (2) A statement of
financial solvency at the time of initial application, signed by a certified
public accountant, on a form provided by the director, showing that the
applicant has the financial ability to staff, equip, and operate the
residential care facility in accordance with Chapter 3721. of the Revised Code,
and rules 3701-16-01 to 3701-16-18 of the Administrative Code, and that the
applicant has sufficient capital or financial reserve to cover not less than
three months of operation; (3) A statement
containing the following information: (a) If the operator is an individual and owner of the
business, the individual's name, address, electronic mail address, and
telephone number. If the operator of the business is owned by an association,
corporation, or partnership, the business activity, address, and telephone
number of the entity and the name of every person who has an ownership interest
of five per cent or more in the entity; (b) If the operator does not own the building or buildings
or if the operator owns only part of the building or buildings in which the
residential care facility is housed, the name of each person who has an
ownership interest of five per cent or more in the buildings; (c) The name and address of any residential care facility
and any facility described in divisions (A)(1)(a) and (A)(1)(c) of section
3721.01 of the Revised Code in which the operator or administrator, or both,
have an ownership interest of five per cent or more or with which the operator
or administrator have been affiliated with through ownership or employment in
the five years prior to the date of the application; (d) The name, business address, electronic mail address,
and telephone number of the administrator of the residential care facility, if
different from the operator; (e) The name, business address, electronic mail address,
and telephone number of any management firm or business employed to manage the
residential care facility; and (f) The name, business address, and telephone number of the
statutory agent of the operator. (4) Copies of
the: (a) Floor plan for the building or area of a building to
be licensed as a residential care facility, including beds; (b) Certificate of occupancy obligated by paragraph (A) of
rule 3701-16-13 of the Administrative Code, showing a use group of R-4, I-1, or
I-2; (c) Inspection report of the state fire marshal or a
township, municipal, or other legally constituted fire department approved by
the state fire marshal obligated by paragraph (A) of rule 3701-16-13 of the
Administrative Code; and (d) Heating inspection report obligated by paragraph (A) of
rule 3701-16-15 of the Administrative Code. (B) The operator of a residential care
facility will submit, on a form prescribed by the director, a completed renewal
application, and pay the non-refundable application fee specified in division
(E) of section 3721.02 of the Revised Code, with the fee made payable to the
"treasurer, state of Ohio" to be deposited in the state treasury to
the credit of the general operations fund created by division (A) of section
3701.83 of the Revised Code. A completed renewal application
includes: (1) Include an update of
the information obligated by paragraphs (A)(2), (A)(3), and (A)(4)(c) of this
rule; and (2) Provide information
the director may require to assess whether the operator has violated section
3721.07 of the Revised Code. (C) Except as provided in paragraph (E)
of this rule, the operator or administrator will notify the director in writing
or electronically of any changes in the information contained in paragraph (A)
or (B) of this rule no later than ten days after the change
occurs. (D) The operator or administrator will
notify the residents and their sponsors or legal representatives and the
regional long-term care ombudsman program, designated under section 173.16 of
the Revised Code, serving the area where the home is located, in writing or
electronically of any changes in the information contained in paragraph
(A)(3)(a), (A)(3)(b), (A)(3)(d), or (A)(3)(e) of this rule no later than ten
days after the change occurs. (E) Subject to sections 3721.026, 3721.03, 3721.05, and
3701.07 of the Revised Code, at least sixty days before the proposed assignment
or transfer of the license, the operator of a residential care facility may,
with the approval of the director, assign or transfer the license to operate
the home after submitting, on a form prescribed by the director, a completed
change of operator application and paying the non-refundable application fee
specified in section 3721.02 of the Revised Code. The department will deposit
the fee in the state treasury to the credit of the general operations fund
created by section 3701.83 of the Revised Code. A completed change of operator
application includes: (1) A statement
containing the following information: (a) If the operator is an individual and owner of the
business, the individual's name, address, and telephone number. If the
operator of the business is owned by an association, corporation, or
partnership, the business activity, address, electronic mail address, and
telephone number of the entity and the name of every person who has an
ownership interest of five per cent or more in the entity; (b) If the operator does not own the building or buildings
or if the operator owns only part of the building or buildings in which the
residential care facility is housed, the name of each person who has an
ownership interest of five per cent or more in the buildings; (c) The name and address of any residential care facility
and any facility described in divisions (A)(1)(a) and (A)(1)(c) of section
3721.01 of the Revised Code in which the operator or administrator, or both,
have an ownership interest of five per cent or more or with which the operator
or administrator have been affiliated with through ownership or employment in
the five years prior to the date of the application; (d) The name, business address, electronic mail address,
and telephone number of the administrator of the residential care facility, if
different from the operator; (e) The name, business address, electronic mail address,
and telephone number of any management firm or business employed to manage the
residential care facility; and (f) The name, business address, and telephone number of the
statutory agent of the operator. (2) Copies of the
inspection report from the state fire marshal or a township, municipal, or
other legally constituted fire department approved by the marshal, performed
within the previous fifteen months, showing zero uncorrected
deficiencies. A change of the majority ownership of a
licensed operator is a change of operator for purposes of this
paragraph. (F) If the residential care facility alters its physical
facilities in a manner that affects bed capacity or proposes to relocate
existing beds to a unlicensed portion of the facility, the facility will
provide the director with written notice at least sixty days prior to the date
the facility wants to commence filling the new beds or relocating existing
beds. The residential care facility will not use the altered or unlicensed area
until the department notifies the facility, in writing, that the alteration or
move complies with the applicable provisions of Chapter 3721. of the Revised
Code and rules 3701-16-01 to 3701-16-18 of the Administrative Code. The written
notice from the facility will include: (1) A floor plan of the
area, including beds; (2) The results of the
inspection by the state fire marshal or a township, municipal, or other legally
constituted fire department approved by the state fire marshal for the area;
and (3) A certificate of
occupancy for the area. (G) The following persons will notify the director within
ten days of commencement of a suit against them, meaning a party suing has
filed a written complaint or petition with the clerk of the court, which could
result in the residential care facility being placed in a
receivership: (1) Operator; (2) Owner of the operator
or any person who has an ownership interest of five per cent or more in the
entity; (3) Owner of the
building(s) in which the residential care facility is housed or any person who
has an ownership interest of five per cent or more in the entity;
and (4) Management firm or
business employed to manage the residential care facility. (H) The director may request additional information at any
time which the director determines to be necessary to assess compliance with
the applicable criteria, standards, and requirements established by Chapter
3721. of the Revised Code and rules 3701-16-01 to 3701-16-18 of the
Administrative Code. The applicant will truthfully respond and submit any
additional information requested by the director within sixty days of the
director's request unless the director specifies otherwise. (I) If the license to operate a home is assigned or
transferred to a different person in accordance with paragraph (C) of this
rule, the new operator is responsible and liable for compliance with any notice
of proposed action or order issued under section 3721.08 of the Revised Code
prior to the effective date of the assignment or transfer. (J) An operator who operates one or more residential care
facilities in more than one building will obtain a separate license for each
building except if such buildings are on the same lot and constitute a single
residential care facility, such residential care facility may be operated under
a single license. However, no residential care facility will be licensed in the
same building as another residential care facility. On or after April 1, 2007,
an operator who operates one or more residential care facilities in more than
one building, where the buildings are intersected by a public roadway, will not
be granted a license to operate the buildings as a single residential care
facility, unless before April 1, 2007 the buildings were so
licensed. (K) The license will be posted in a conspicuous place in
the residential care facility. (L) If, under division (B)(5) of section 3721.03 of the
Revised Code, the license of a person has been revoked, the director of health
will not issue a license to the person or home at any time. A person whose
license is revoked for any reason other than nonpayment of the license renewal
fee or late fees is not allowed apply for a new license under Chapter 3721. of
the Revised Code until a period of one year following the date of revocation
has elapsed. (M) When closing a home, the operator will provide the
director written notification of closure at least ninety days or as soon as
practicable after determination is made, but no less than sixty days prior to
the proposed closing date and within twenty-four hours of an unplanned closure.
This notice will include: (1) An address where the
operator may be reached after the closing of the home; (2) A plan for the
transfer and adequate relocation of all residents; and (3) Assurances that the
residents will be transferred to the most integrated and appropriate facility
or other setting in terms of quality, services, and location, taking into
consideration the needs, choice, and best interests of each resident.
(N) While providing a written notification of closure under
paragraph (O) of this rule, the operator will, in accordance with Chapter
3701-61 of the Administrative Code, also provide written notice of the proposed
date of closing of the home to its residents and their sponsors or legal
representatives and the regional long-term care ombudsmen program, designated
under section 173.16 of the Revised Code, serving the area where the home is
located. (O) A license for a home that has closed are considered
surrendered to the department the three hundred sixty sixth day after the home
has closed. (P) The residential care facility will
include in all official correspondence with the department pertaining to the
home, its name, address and license number as it appears on the residential
care facility license. (Q) The director will determine the type and number of
residents a residential care facility can accommodate which will be the
authorized maximum licensed capacity of the facility. Such determination will
be made on the basis of the physical facilities, personnel of the facility and
the services and care needed by the residents to be admitted or retained in the
residential care facility, and the permitted occupancy approved by the
department of commerce. No operator, administrator, staff member or any other
person will set up beds for resident use in a residential care facility which
exceed the authorized maximum licensed capacity.
Last updated July 12, 2024 at 10:31 AM
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Rule 3701-16-03.1 | Expedited initial licensure inspections.
(A) An applicant for licensure as a
residential care facility may request an expedited initial licensure inspection
by providing the department of health with all of the following: (1) A complete initial
residential care facility application and fee obligated by paragraph (A) of
rule 3701-16-03 of the Administrative Code; (a) An application will be deemed complete when the department
verifies all information contained therein is complete and accurate and meets
the criteria of paragraph (B) of rule 3701-16-03 of the Administrative
Code; (b) An applicant may elect an expedited initial licensure
inspection on the initial residential care facility application and, if
electing such an inspection, provide a fee in addition to that obligated by
paragraph (A) of rule 3701-16-03 of the Administrative Code, in the amount of
two thousand two hundred fifty dollars; (c) A fee collected by the department will be deposited in the
state treasury to the credit of the general operations fund created by section
3701.83 of the Revised Code, and the fee shall not be refunded;
and (2) Notice of readiness
for inspection. (B) Upon receipt of a completed request
for expedited initial inspection made pursuant to paragraph (A) of this rule,
the department will commence an inspection of the residential care facility not
later than ten business days. Inspections under this rule will be scheduled in
the order in which the request for expedited initial licensure inspection is
determined to be complete. (C) If the residential care facility does
not meet the standards for licensure upon the initial licensure inspection
requested under paragraph (B) of this rule, the department of health may deny
the license. (D) This rule applies only to applicants
for licensure as a new residential care facility and does not apply to an
existing licensed residential care facility.
Last updated July 12, 2024 at 9:32 AM
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Rule 3701-16-04 | Inspections and investigations; correction.
(A) The director is obligated to inspect
each residential care facility at least once prior to the issuance of a
license, at least once every fifteen months and as the director considers
necessary. The inspections may be announced or unannounced except that one
unannounced inspection is obligated to be conducted at least every fifteen
months. The state fire marshal or a township, municipal, or other legally
constituted fire department approved by the fire marshal is also obligated to
inspect a residential care facility prior to issuance of a license, at least
once every fifteen months thereafter, and at any other time requested by the
director. A residential care facility does not have to be inspected prior to
issuance of a license by the director, state fire marshal, or a fire department
if ownership of the facility is assigned or transferred to a different person
and the facility was licensed under Chapter 3721. of the Revised Code as a
residential care facility immediately prior to the assignment or
transfer. (B) The director may investigate any
complaint concerning a facility in accordance with sections 3721.031 and
3721.17 of the Revised Code. (C) An operator, administrator, staff
member or any other person is forbidden from : (1) Refusing to permit
the director for the purpose of inspecting or investigating the operation of a
residential care facility, to enter and inspect at any time a building or
premise where a residential care facility is located, or to enter and inspect
records, including resident medical records, which are kept concerning the
operation of the residential care facility for information pertinent to the
legitimate interest of the department. (2) Using profane or
abusive language directed at or in the presence of residents or the
director. (D) When inspecting or investigating a
residential care facility, the director will respect the residents'
privacy and dignity, cooperate with the residents, behave in a congenial manner
toward the residents, protect the residents' rights, and behave in a
cooperative and professional manner toward individuals working in the facility.
The director or the director's designee will: (1) Refrain from using
language or behavior that is derogatory, insulting, intimidating, or
threatening; (2) Not harass or coerce
residents or otherwise attempt to influence residents' responses to
inquiries; (3) Not make remarks or
comparison, positive or negative, about another residential care facility or
other residents; (4) Not solicit, accept,
or agree to accept from the residential care facility or a resident of the
facility compensation, gratuities, gifts, or any other thing of value that is
of such character as to manifest a substantial and improper influence upon the
director or the director's designee with respect to their
duties; (5) Obtain the
resident's consent prior to conducting an evaluation of a resident unless
a court has issued a search warrant or other order authorizing such an
evaluation. When requesting the resident's consent to evaluate the
resident, the director or the director's designee will explain that the
resident: (a) Has the option to consent or not to consent to the
evaluation; (b) Will not be evaluated without the resident's
consent; (c) May have another individual of the resident's choice
present during the evaluation. If a resident requests that another individual
be present during the evaluation and that individual is not available, the
resident has not consented to the evaluation; and (d) Will not suffer any adverse consequences if the resident
refuses to consent. (E) The director may enter at any time,
for the purposes of investigation, any institution, residence, facility, or
other structure which has been reported to the director or that the director
has reasonable cause to believe is operating as a residential care facility
without a valid license or in the case of a county or district home, is
operating despite the revocation of its residential care facility
license. (F) If an inspection reveals a violation
or violations of Chapter 3721. of the Revised Code or of rules 3701-16-01 to
3701-16-18 of the Administrative Code, the director may provide the facility
with the opportunity to correct the violation or violations.
Last updated July 12, 2024 at 9:32 AM
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Rule 3701-16-05 | Personnel requirements.
(A) Each residential care facility is
obligated to arrange for the services of an administrator who is obligated
to: (1) Meet the applicable
requirements of rule 3701-16-06 of the Administrative Code; (2) Be responsible for
the daily operation of the residential care facility including, but not limited
to, assuring that residents' ongoing or changing service needs, as
identified in the resident assessments, and services ordered by a licensed
health care professional are acted upon by the appropriate staff member. If the
facility does not provide for the needed service, the facility is obligated to
discuss the lack of the needed service with the resident as required by
paragraph (G) of rule 3701-16-08 of the Administrative Code; (3) Provide not less than
twenty hours of service in the facility during each calendar week during the
hours of eight a.m. and six p.m. If the administrator is unable to provide at
least twenty hours of service in the residential care facility in a given
calendar week because of a vacation, illness, or other temporary situation, the
administrator is obligated to designate a staff member, who is not allowed to
be less than twenty-one years of age and who meets the requirements of
paragraphs (D) and (H) of rule 3701-16-06 of the Administrative Code, to serve
as acting administrator; (4) The administrator or
acting administrator is obligated to be accessible at all other times when not
present at the residential care facility. A residential care facility located
in the same building as a nursing home, or on the same lot as a nursing home,
both of which are owned and operated by the same entity, will be considered to
have met this requirement if the nursing home has a full-time administrator
licensed under Chapter 4751. of the Revised Code who is responsible for both
the residential care facility and nursing home. For the purposes of this
paragraph, "full-time" means no less than thirty-two hours per
calendar week. (B) The residential care facility
administrator may provide services to residents if the administrator meets the
applicable qualifications of rule 3701-16-06 of the Administrative Code. An
administrator, providing personal care services, of a facility
with: (1) Sixteen or less beds
may be counted toward meeting the staffing requirements of paragraph (C) of
this rule; (2) Seventeen to
thirty-five beds is not allowed to be counted toward meeting the staffing
requirements of paragraph (C) of this rule until he or she has met the
requirements of paragraph (A)(3) of this rule; (3) More than thirty-five
beds is not allowed to be counted toward meeting the staffing requirements of
paragraph (C) of this rule. (C) Each residential care facility is
obligated to have the following staff members who are competent to perform the
duties they are assigned: (1) At least one staff
member on duty at all times who meets the qualifications of rule 3701-16-06 of
the Administrative Code for staff members providing personal care services.
During the night, the staff member who is physically present in the facility
may be on call if the facility meets the resident call system requirements of
paragraph (B)(5) of rule 3701-16-14 of the Administrative Code. When only one
staff person is on duty in the facility, the residential care facility is
obligated to designate another staff member who meets the same qualifications
to be on call; and (2) Sufficient additional
staff members who meet the applicable qualifications of rule 3701-16-06 of the
Administrative Code for the services they perform and appropriate scheduling of
sufficient staff time to adequately do all of the following: (a) Meet, in a timely manner, the residents' total care,
supervisory and emotional needs as determined by the resident assessment
required under rule 3701-16-08 of the Administrative Code and consistent with
the resident agreement required under rule 3701-16-07 of the Administrative
Code and reasonable and appropriate requests for services, including monitoring
in excess of supervision of residents with increased emotional needs or
presenting behaviors that cause problems for the resident or other residents,
or both; (b) Properly provide dietary, housekeeping, laundry, and facility
maintenance services and recreational activities for the residents in
accordance with the rules of this chapter; (c) Assist, when necessary, with prompt evacuation of
nonambulatory residents. The additional staff members needed to implement the
facility's evacuation plan required by paragraph (J) of rule 3701-16-13 of
the Administrative Code are obligated to be present in the facility at all
times; and (d) Provide or arrange for resident activities required under
rule 3701-16-11 of the Administrative Code. (3) Each residential care
facility is obligated to have at least one staff member capable of giving
personal care services who has successfully completed the first aid training
required by paragraph (E) of rule 3701-16-06 of the Administrative Code, if
applicable, present in the facility at all times. (4) In determining the staffing level for
the facility, the facility is not required to consider resident
needs: (a) That are being served through a contractual arrangement
between the resident and a third party provider; (b) That the resident chooses not to have met as documented in
the resident's record; or (c) That the resident has not contracted with the facility to
meet if the facility has complied with paragraph (G) of rule 3701-16-08 of the
Administrative Code. (5) Unless the
resident's needs are being met by a private psychologist or physician,
each residential care facility that admits or retains residents with a
diagnosis of late-stage cognitive impairment with significant ongoing daily
living assistance needs, cognitive impairments with increased emotional needs
or presenting behaviors that cause problems for the resident or other
residents, or both, or serious mental illness, is obligated to have a
psychologist or physician with experience in the diagnosis and treatment of the
applicable condition or conditions, either on staff or as a
consultant. (D) In addition to the requirements set
forth in this rule, each residential care facility that elects to admit or
retain residents for whom the facility provides skilled nursing care beyond the
supervision of special diets, application of dressings, or administration of
medication is obligated to do all of the following: (1) Employ or contract
with a registered nurse to provide onsite supervision of skilled nursing care
provided to residents. For purposes of this rule, "onsite
supervision" means that the registered nurse is obligated to spend
sufficient time each week in the facility to manage the provision of skilled
nursing care in accordance with accepted standards of practice; (2) Have a licensed nurse
on call when one is not present in the facility; and (3) Have sufficient
additional nursing staff to meet residents' needs. (E) The operator or administrator is obligated to establish a
schedule for staff coverage that includes coverage during vacations, emergency
situations, and long-term absences due to illness. The residential care
facility is not allowed to mandate, coerce or persuade a resident to supervise
other residents, provide personal care services, supervise special diets,
administer medications or manage the facility. Residents who voluntarily help
or receive assistance from one another are not allowed to be counted in
determining whether the residential care facility meets the staffing
requirements of this rule. (F) Each residential care facility which elects to administer
medication is obligated to have one of the following individuals on duty to
administer medications in accordance with paragraphs (G) and (H) of rule
3701-16-09 of the Administrative Code and remain on duty for a sufficient
amount of time to observe medication acceptance and reaction: (1) A registered
nurse; (2) A licensed practical
nurse holding proof of successful completion of a course in medication
administration approved by the Ohio board of nursing pursuant to Chapter 4723.
of the Revised Code who will administer medication only at the direction of a
registered nurse or physician; (3) A physician;
or (4) A person authorized
by law to administer medication. (G) Each residential care facility which elects to supervise
therapeutic diets is obligated to provide or arrange for a dietitian and comply
with the applicable requirements of rule 3701-16-10 of the Administrative
Code. (H) Each residential care facility which elects to provide for
the application of dressings in accordance with division (A)(2) of section
3721.011 of the Revised Code is obligated to have sufficient nursing staff to
provide the service and comply with the requirements of paragraph (J) of rule
3701-16-09 of the Administrative Code. (I) Each residential care facility that elects to provide skilled
nursing care using staff members, in accordance with division (C) of section
3721.011 of the Revised Code and paragraph (B) of rule 3701-16-09.1 of the
Administrative Code, is obligated to have sufficient nursing staff to provide
the skilled nursing care. If the residential care facility elects to provide
enteral tube feedings on a part-time intermittent basis the facility is
obligated to provide or arrange for a dietitian and provide sufficient nursing
staff with appropriate experience and training in enteral tube feedings.
Skilled nursing care may be delegated in accordance with Chapter 4723-13 of the
Administrative Code. (J) A residential care facility that is physically located in the
same building or on the same lot as a nursing home, or that provides an adult
day care program, or both, which are owned and operated by the same entity may
use staff from the residential care facility to provide services in the nursing
home or adult day care program, or use appropriate and qualified staff from the
nursing home or the adult day care program to meet part or all of the staffing
requirements of this rule, if all of the following criteria are
met: (1) The residential care
facility at all times meets the minimal staffing levels required by paragraph
(C) of this rule. The staff members, assigned to and responsible for meeting
the residential care facility residents' needs, may provide services to
nursing home residents if they meet the nurse aide qualifications of rule
3701-17-07.1 of the Administrative Code, but are not allowed to be counted
towards meeting the nursing home staffing levels of rule 3701-17-08 of the
Administrative Code; (2) The nursing home at
all times meets the staffing level requirements of rule 3701-17-08 of the
Administrative Code; (3) Separate staffing
schedules for the residential care facility, nursing home, and adult day care
program are maintained; (4) The residential care
facility has the resident call systems required by paragraph (B)(5) of rule
3701-16-14 of the Administrative Code, for residents to use in obtaining
unscheduled care or services, as needed, when unexpected care needs arise and
the monitoring of resident call systems in the residential care facility and
nursing home is not disrupted. The residential care facility is not allowed to
limit the use of the resident call systems to emergencies only; (5) Utilization of the
nurses or aides, or both, does not adversely affect the quality and timeliness
of meeting the care needs of the nursing home and residential care facility
residents; and (6) For a residential
care facility on the same lot as a nursing home, the homes are located within
two minutes or less response time from each other. A staff member simultaneously assigned to the
staffing schedule of the residential care facility and the nursing home is
allowed to be be counted in determining whether the residential care facility
meets the staffing requirements of paragraph (C) of this rule, unless over
fifty per cent of the staff member's assigned daily working hours are in
the residential care facility. (K) The operator or the administrator of each residential care
facility is obligated to maintain records, on forms provided by the director,
documenting compliance with the personnel requirements of this
rule. (L) Each residential care facility will
not admit residents in excess of the number for which it is able to provide
consistent nursing coverage and other appropriate staffing levels based on the
volume and needs of the residents.
Last updated July 12, 2024 at 9:33 AM
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Rule 3701-16-06 | Qualifications and health of personnel.
(A) No person with a disease which may be
transmitted in the performance of the person's job responsibilities is
allowed to work in a residential care facility during the stage of
communicability unless the person is given duties that minimize the likelihood
of transmission and follows infection control precautions and
procedures. (B) No person is allowed to work in a
residential care facility who uses alcohol or drugs to the extent that it
adversely affects the performance of the person's duties or the health or
safety of any resident. (C) No person is allowed to work in a
residential care facility in any capacity as a full-time, part-time or
temporary paid employee of the facility unless the person has been examined by
a physician or other health care professional acting within their applicable
scope of practice within thirty days before commencing work or on the first day
of work. No person is allowed to commence work in a residential care facility
in any capacity unless the person is medically capable of performing the
person's prescribed duties. Operators are obligated to retain copies of
the examinations obligated by this paragraph and are obligated to furnish them
to the director upon request. (1) Employees of temporary employment
services or, to the extent applicable, paid consultants working in a facility
are obligated to have medical examinations in accordance with paragraph (C) of
this rule, except that a new physical examination is not necessary for each new
assignment. Each facility in which such an individual works are obligated to
obtain verification of the physical examination, as applicable, from the
employment agency or consultant before the individual begins work and are
obligated to maintain this documentation on file. (2) Individuals used by an adult day care
program provided by and on the same site as the residential care facility are
obligated to have medical examinations in accordance with paragraph (C) of this
rule if the adult day care program is located or shares space within the same
building as the residential care facility or if there is a sharing of staff
between the residential care facility and adult day care program. (D) Each residential care facility staff
member and volunteer who: (1) Provides personal
care services will be at least sixteen years of age. Staff members or
volunteers who provide personal care services who are under the age of eighteen
are obligated to have on-site supervision by a staff member over the age of
eighteen. The administrator is obligated to be at least twenty-one years of
age; (2) Assists residents
with self-administration of medications is obligated to demonstrate an ability
to read, write and understand information and directions in English. All other
staff members and volunteers are obligated to demonstrate an ability to
understand and communicate job-related information and directions in English;
or (3) Plans activities for
residents with late-stage cognitive impairment with significant ongoing daily
living assistance needs, cognitive impairments with increased emotional needs
or presenting behaviors that cause problems for the resident or other
residents, or both; or, serious mental illness is obligated to have training in
appropriate activities for such residents. (E) Staff members who provide personal
care services in a residential care facility, except licensed health
professionals whose scope of practice include the provision of personal care
services, are obligated to complete the following training : (1) Within sixty days of
hire, have first-aid training evidenced by one of the following: (a) Currently valid documentation of successful completion,
online or in-person, of the "American Red Cross Standard First-Aid
Course", the "American Red Cross First-Aid Basics", or any other
American red cross course covering the training topics described in paragraph
(E)(1)(c) of this rule; (b) Currently valid documentation of successful completion,
online or in-person, of the "American Heart Association Heartsaver
First-Aid" course, or any other "American Heart Association"
course covering the training topics described in paragraph (E)(1)(c) of this
rule; or (c) Documentation of successful completion, within the past
three years, of first-aid training by a physician, registered nurse, a licensed
practical nurse under the direction of a registered nurse, an emergency medical
technician, or an instructor certified by the American red cross" or the
American heart association. Applicable first-aid training includes recognition
and emergency management of bleeding, burns, poisoning, respiratory distress
including choking, musculoskeletal injury, wounds including animal and insect
bites, sudden illness, shock, hypothermia, heat stroke and exhaustion, and
frost bite; (2) Have documentation
that, prior to providing personal care services without supervision in the
facility, the staff member met one of the following criteria: (a) Successfully completed training or continuing education
taught by a registered nurse or licensed practical nurse under the direction of
a registered nurse that covers, as is necessary to meet the needs of residents
in the facility, the following: (i) The correct
techniques of providing personal care services as obligated by the staff
member's job responsibilities; (ii) Observational skills
such as recognizing changes in residents' normal status and the
facility's procedures for reporting changes; and (iii) Communication and
interpersonal skills. The training or continuing education will
be sufficient to ensure that the staff member receiving the training can
demonstrate an ability to provide the personal care services. The facility may
utilize other health care professionals acting within the scope of the
professional's practice as part of the training or continuing
education; (b) Successfully completed the training and competency
evaluation program and competency evaluation program approved or conducted by
the director under section 3721.31 of the Revised Code; or (c) Successfully completed training or testing in
accordance with the medicare condition of participation of home health aide
services, 42 C.F.R. 484.4 (November 6, 2014) and 42 C.F.R. 484.36 (June 18,
2001); (3) Except as provided in
paragraph (E)(5) of this rule, staff members employed by a residential care
facility, or part thereof, that admits or retains residents with late-stage
cognitive impairment with significant ongoing daily living assistance needs, or
cognitive impairments with increased emotional needs or presenting behaviors
that cause problems for the resident or other residents, or both, are obligated
to have: (a) Two hours of initial training in the care of such
residents within fourteen days of the first day of work; and (b) Four hours of continuing education in the care of such
residents annually. The four hours of continuing education may count towards
the continuing education obligated by paragraph (E)(7) of this
rule. (4) Except as provided in
paragraph (E)(5) of this rule, staff members employed by a residential care
facility, or part thereof, that admits or retains residents with diagnoses of
serious mental illness are obligated to have: (a) Two hours of initial training in the care of such
residents within fourteen days of the first day of work; and (b) Four hours of continuing education in the care of such
residents annually. The four hours of continuing education may count towards
the continuing education obligated by paragraph (E)(7) of this
rule. (5) Staff members
employed by a residential care facility, or part thereof, that admits or
retains residents with late-stage cognitive impairment with significant ongoing
daily living assistance needs, or cognitive impairments with increased
emotional needs or presenting behaviors that cause problems for the resident or
other residents, or both, and that admits or retains residents with diagnoses
of serious mental illness, are obligated to have: (a) Four hours, divided in equal proportions for each
population, of initial training in the care of such residents within fourteen
days of the first day of work; and (b) Eight hours, divided in equal proportions for each
population, of continuing education in the care of such residents annually. The
eight hours of continuing education may count towards continuing education
obligated by paragraph (E)(7) of this rule (6) Staff members serving
special populations not identified in paragraphs (E)(3) and (E)(4) of this rule
are obligated to have: (a) Two hours of initial training in the care of such
residents within fourteen days of the first day of work; and (b) Four hours of continuing education in the care of such
residents annually. The four hours of continuing education may count towards
the continuing education obligated by paragraph (E)(7) of this
rule. (7) Successfully complete
at least eight hours of continuing education annually. (F) Staff members whose job
responsibilities will include providing therapeutic diets, other than special
diets, are obligated to be trained by a dietitian prior to performing this
responsibility. (G) The initial training obligated by
paragraphs (E)(3) to (E)(6) of this rule is to be conducted by a qualified
instructor for the topic covered. The annual continuing education obligated by
paragraphs (E)(3) to (E)(6) of this rule may be completed online or by other
media provided there is a qualified instructor present to answer questions and
to facilitate discussion about the topic at the end of the lesson. (H) The administrator is obligated to: (1) Be licensed as a
nursing home administrator under Chapter 4751. of the Revised Code;
or (2) Meet one of the
following criteria at the time of employment: (a) Has three thousand hours of direct operational
responsibility for a senior housing facility, health care facility, residential
care facility, adult care facility or any other group home licensed or approved
by the state; (b) Has successfully completed one hundred credit hours of
post high school education in the field of gerontology or health
care; (c) Holds a baccalaureate degree; or (d) Is a licensed health professional as that term is
defined in rule 3701-17-07.1 of the Administrative Code. (3) The administrator is
obligated to receive at least nine hours of continuing education annually in
the fields of gerontology, health care, business administration, or residential
care facility operation. Successful completion of course work at an accredited
college or university, or of courses approved by the following entities, may be
used to demonstrate compliance with this paragraph: (a) The Ohio state bar association; (b) The Ohio state board of executives of long-term
services and supports; (c) The Ohio state board of nursing; (d) The Ohio state board of pharmacy; (e) The Ohio state board of psychology; (f) The Ohio state medical board; or (g) Any other health-related state board organized pursuant
to Title 47 of the Revised Code. (I) The operator or administrator is obligated to ensure
that each staff member, other than a volunteer who does not provide personal
care services, receives and completes orientation and training applicable to
the staff member's job responsibilities within three working days after
beginning employment with the residential care facility. A staff member is not
allowed to stay alone in the residential care facility with residents until the
staff member has received the orientation and training obligated by this
paragraph and the general staff training in fire control and evacuation
procedures obligated by paragraph (P) of rule 3701-16-13 of the Administrative
Code. The orientation and training mandated by this paragraph will include at
least: (1) The physical layout
of the residential care facility; (2) The staff
member's job responsibilities; (3) The residential care
facility's policies and procedures; (4) How to secure
emergency assistance; and (5) Residents'
rights. (J) All individuals used by the
residential care facility who function in a professional capacity are obligated
to meet the standards applicable to that profession, including but not limited
to, possessing a current Ohio license, registration, or certification, if
obligated by law. (K) Each residential care facility is obligated to provide
appropriate staff training to implement each resident right under division (A)
of section 3721.13 of the Revised Code on an annual basis and additionally as
needed. The training obligated by this rule will include, but not be limited
to, an explanation of: (1) The residents'
rights and the staff's responsibility in implementation of the rights;
and (2) The staff's
obligation to provide all residents who have similar needs with comparable
service. (L) No residential care facility is allowed to employ a
person for a position that involves the provision of direct care to an older
adult, if the person: (1) Has been convicted of
or pleaded guilty to an offense listed in division (C)(1) of section 3721.121
of the Revised Code, unless the individual is hired under the personal
character standards set forth in rule 3701-13-06 of the Administrative Code;
(2) Fails to complete the
form(s) or provide fingerprint impressions as obligated by division (B)(2) of
section 3721.121 of the Revised Code; (3) Is the subject of a
finding of abuse or neglect of a resident or misappropriation of the property
of a resident on the nurse aide registry, established pursuant to section
3721.32 of the Revised Code; (4) Is the subject of a
finding of abuse or neglect of a resident or misappropriation of the property
of a resident on the nurse aide registry established by another state where the
home believes or has reason to believe the person resides or resided;
or (5) Have had a
disciplinary action taken against a professional license by a state licensure
body as a result of a finding of abuse, neglect, mistreatment of residents or
misappropriation of resident property. (M) For purposes of this rule,
"annual" means a calendar year. The training hours obligated by this
rule may be pro-rated from the employee's date of hire.
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Rule 3701-16-07 | Resident agreement; other information to be provided upon admission; risk agreements.
(A) A residential care facility is not
allowed to admit an individual who is in need of services or accommodations
beyond that which a residential care facility is authorized to provide under
paragraph (D) of rule 3701-16-02 of the Administrative Code or beyond that
which the specific facility provides. (B) A residential care facility is not
allowed to admit a resident prior to searching for the individual on the Ohio
sex offender registry as obligated by section 3721.122 of the Revised
Code. (C) Except for residents receiving
hospice care, no residential care facility is allowed to admit or retain an
individual who: (1) Needs skilled nursing
care that is not authorized by section 3721.011 of the Revised Code or is
beyond that which the specific facility can provide; (2) Needs medical or
skilled nursing care at least eight hours per day or forty hours per
week; (3) Needs chemical or
physical restraints as defined in paragraph (L) of rule 3701-16-09 of the
Administrative Code; (4) Is bedridden with
limited potential for improvement; (5) Has stage III or IV
pressure ulcers. For purposes of this rule, "pressure ulcers" means
any lesion caused by unrelieved pressure, or pressure in combination with shear
and/or friction, which results in damage to the underlying tissue. Pressure
ulcers are to be staged in accordance with current staging definitions issued
by the "National Pressure Ulcer Advisory Panel" ; or (6) Has a medical
condition that is so medically complex or changes so rapidly that it
necessitates constant monitoring and adjustment of treatment regimen on an
ongoing basis. (D) A residential care facility is obligated to enter into a
written resident agreement with each prospective resident prior to beginning
residency in the residential care. (1) The agreement needs
be signed and dated by the operator, administrator, or acting administrator and
the prospective resident or, if the prospective resident is physically or
cognitively unable to sign and consents, another individual designated by the
prospective resident are obligated to sign the agreement; (2) The facility is
obligated to provide both the prospective resident and any other individual
signing on the resident's behalf with a copy of the agreement and explain
the agreement to them; and (3) In the event that a
durable power of attorney for healthcare is enacted or when the physician
determines that the resident is no longer able to make reasoned decisions to
the agreement, the facility is obligated to provide a copy of the agreement to
the individual designated by the resident to make decisions and consent on the
resident's behalf, if any. (E) The agreement obligated by paragraph (D) of this rule is
obligated to include at least the following items: (1) An explanation of all
charges to the resident including security deposits, if
applicable; (2) A statement that all
charges, fines, or penalties that will be assessed against the resident are
included in the resident agreement; (3) A statement that the
basic rate will not be changed unless thirty days written notice is given to
the resident or, if the resident is unable to understand this information, to
his or her sponsor; (4) An explanation of the
residential care facility's policy for refunding charges in the event of
the resident's absence, discharge, or transfer from the facility and the
facility's policy for refunding security deposits; (5) An explanation of the
services offered by the facility, the types of skilled nursing care that the
facility provides or allows residents to receive in the facility, the providers
that are authorized to render that care, and the limitations of the type and
duration of skilled nursing care that is offered; (6) An explanation of the
extent and types of services the facility will provide to the resident and who
is responsible for payment; and (7) A statement that the
facility is obligated to discharge or transfer a resident when a resident needs
skilled nursing care beyond the limitations identified in paragraph (E)(5) of
this rule. (F) Prior to admission or upon the request of a prospective
resident or prospective resident's sponsor, the residential care facility
is obligated to provide the resident or resident's sponsor with a copy and
explain the contents of the following policies: (1) The facility's
residents' rights policy and procedures mandated by section 3721.12 of the
Revised Code; (2) The facility's
smoking policy mandated by paragraph (W) of rule 3701-16-13 of the
Administrative Code; (3) The facility's
policies regarding advance directives and do not resuscitate (DNR) orders, and
an explanation of the rights of the resident under state law concerning advance
directives and DNR orders. A residential care facility is barred from mandating
the execution of an advance directive or DNR order as a condition for
admission; (4) The definition of
skilled nursing care from rule 3701-16-01 of the Administrative
Code; (5) For individuals
seeking residency on a special care unit, the facility's policy on care
for residents in the special care unit. The policy is obligated to
include: (a) A statement of mission or philosophy that reflects the needs
of the special population; (b) Admission criteria to the special care unit, including
screening criteria, if applicable; (c) Transfer and discharge criteria and procedures; (d) A weekly staffing plan for the special care unit, if
applicable, including: (i) A statement of how
this plan differs from the staffing plan for the remainder of the facility;
and (ii) The necessary
increase in supervision, due to decreased safety awareness or other assessed
condition, of residents with cognitive impairments or serious mental illness in
the special care unit; (e) A description of activities offered, including frequency and
type, and how the activities meet the needs of the type of residents in that
special care unit, including how these activities differ from those offered in
the remainder of the facility, if applicable; (f) A listing of the costs of the services provided by the
facility to the resident; (g) Specialized staff training and continuing education
practices; (h) The process used for assessment and the provision of
services, including the method for altering services based on changes in
condition; (i) If necessary, how the facility addresses the behavioral
healthcare needs of residents; (j) The physical environment and design features to support the
functioning of residents; (k) The involvement of families and the availability of family
support programs for residents; and (l) Any services or other procedures that are over and above
those provided in the remainder of the facility, if applicable; (6) An explanation of the
facility's ability to accommodate disabled residents or potentially
disabled residents and the facility's policy regarding transferring
residents to units that accommodate residents with disabilities;
and (7) Any other facility
policies that residents are obligated to follow. (G) A residential care facility may enter into a risk agreement
with a resident or the resident's sponsor with the consent of the
resident. Under a risk agreement, the resident or sponsor and the facility
agree to share responsibility for making and implementing decisions affecting
the scope and quantity of services provided by the facility to the resident.
The facility is obligated to identify the risks inherent in a decision made by
a resident or sponsor not to receive a service provided by the facility. A risk
agreement is valid only if it is made in writing. The residential care facility
is obligated to maintain a copy of any risk agreement in the resident's
record. (H) Each residential care facility that has a policy of entering
into risk agreements is obligated to provide each prospective resident, or the
prospective resident's sponsor with the consent of the resident, a written
explanation of the policy and the provisions that may be contained in a risk
agreement. At the time the information is provided, the facility is obligated
to obtain a statement signed by the individual receiving the information
acknowledging that the individual received the information. The facility is
obligated to maintain the signed statement on file. Any waiver of the
resident's rights under section 3721.13 of the Revised Code contained in
the risk agreement is void.
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Rule 3701-16-08 | Resident health assessments.
(A) The residential care facility, in
accordance with this rule, will ensure that written initial and periodic health
assessments of prospective and current residents are conducted. The different
components of the health assessment may be performed by different licensed
health professionals, consistent with the type of information bring collected
and the professional's scope of practice, as defined by applicable law. In
conducting the assessment, the licensed health professional may use resident
information obtained by or from unlicensed staff as long as the licensed health
professional evaluates such information in accordance with their applicable
scope of practice. The residential care facility is obligated to ensure that
all components of the assessments obligated by this rule are completed and that
residents do not need accommodations or services beyond those that the
residential care facility provides. Each residential care facility is obligated
to, on an annual basis, offer to each resident a vaccination against influenza
and a vaccination against pneumococcal pneumonia as obligated by section
3721.041 of the Revised Code. (B) Each resident is obligated to be
initially assessed within forty-eight hours of admission, except that
paragraphs (C)(11) and (C)(12) of this rule are obligated to be performed
within fourteen days after admission. If the resident had an assessment meeting
the criteria set forth in paragraph (C) of this rule performed no more than
ninety days before beginning to reside in the residential care facility, the
resident does not need to obtain another initial assessment. (C) The initial health assessment is
obligated to include documentation of the following: (1) Preferences of the
resident including hobbies, usual activities, bathing, sleeping patterns,
socialization and religious; (2) Medical diagnoses, if
applicable; (3) Psychological,
intellectual disabilities, and developmental diagnoses history, if
applicable; (4) Health history and
physical, including cognitive functioning and sensory and physical impairments,
and the risk of falls; (5) Prescription
medications, over-the-counter medications, and dietary
supplements; (6) Nutrition and dietary
needs, including any food allergies and intolerances, food preferences, and
need for any adaptive equipment, and needs for assistance and supervision of
meals; (7) Height, weight, and
history of weight changes; (8) A functional
assessment which evaluates how the resident performs activities of daily living
and instrumental activities of daily living. For the purposes of this
paragraph, "instrumental activities of daily living" means using the
telephone, acquiring and using public and private transportation, shopping,
preparing meals, performing housework, laundering, and managing financial
affairs; (9) Type of care or
services, including the amount, frequency, and duration of skilled nursing care
the resident needs as determined by a licensed health professional in
accordance with the resident's assessment under paragraph (C) of this
rule; (10) A determination by a
physician or other licensed healthcare professional working within their scope
of practice, as to whether or not the resident is capable of self-administering
medications. The documentation will specify what assistance with
self-administration, as authorized by paragraph (F) of rule 3701-16-09 of the
Administrative Code, if any, is needed or if the resident needs to have
medications administered in accordance with paragraphs (G) and (H) of rule
3701-16-09 of the Administrative Code; (11) If skilled care is
provided to the resident by staff members, a determination by a physician or
other licensed healthcare professional working within their scope of practice
of: (a) Whether the resident's personal care needs have been
affected by the skilled nursing care needs, other than the administration of
medication or supervision of special diets; and (b) Whether any changes are necessary in the manner personal care
services are provided. The individual conducting the assessment is obligated to
establish the extent, if any, of the changes necessary. (12) If skilled nursing
care is provided to the resident by staff members, the resident's
attending physician or other licensed healthcare professional working within
their scope of practice, will sign orders documenting the need for skilled
nursing care, including the specific procedures and modalities to be used and
the amount, frequency, and duration. This care is obligated to be provided and
reviewed pursuant to paragraph (B) of rule 3701-16-09.1 of the Administrative
Code. (13) If the resident has
been determined to have medical, psychological, or developmental or
intellectual impairment, the assessment is obligated to include: (a) A plan for addressing the resident's assessed
needs; (b) The need for physical environment and design features to
support the functioning of the resident; and (c) The need for increased supervision, due to decreased safety
awareness or other assessed condition. (D) Subsequent to the initial health
assessment, the residential care facility will assess each resident's
health at least annually unless medically indicated sooner. The annual health
assessment is obligated to be performed within thirty days of the anniversary
date of the resident's last health assessment and include documentation of
at least the following: (1) Changes in medical
diagnoses, if any; (2) Updated nutritional
needs, including any food allergies and intolerances; (3) Height, weight and
history of weight changes; (4) Prescription
medications, over-the-counter medications, and dietary
supplements; (5) A functional
assessment as described in paragraph (C)(8) of this rule; (6) If the resident has
been determined to have medical, psychological, or developmental or
intellectual impairment, an assessment as described in paragraph (C)(13) of
this rule; (7) Type of care or services, including
the amount, frequency, and duration of skilled nursing care, the resident needs
as determined by a licensed health professional in accordance with paragraph
(D) of this rule; (8) A determination by a physician or
other licensed healthcare professional working within their scope of practice,
as to whether or not the resident is capable of self-administering medications.
The documentation will specify what assistance with self-administration, as
authorized by paragraph (F) of rule 3701-16-09 of the Administrative Code, if
any, is needed or if the resident needs to have medications administered in
accordance with paragraphs (G) and (H) of rule 3701-16-09 of the Administrative
Code; and (9) If skilled care is provided to the
resident by staff members, a determination by a physician or other licensed
healthcare professional working within their scope of practice,
of: (a) Whether the resident's personal care needs have been
affected by the skilled nursing care needs, other than the administration of
medication or supervision of special diets; and (b) Whether any changes are necessary in the manner personal care
services are provided. The individual conducting the assessment will establish
the extent, if any, of the changes necessary. (E) The residential care facility will
ensure that each resident's health is assessed if a change in condition or
functional abilities warrants a change in services or equipment. The assessment
is obligated to include, as applicable, documentation of paragraphs (D)(1) to
(D)(9) of this rule. The facility is obligated to make a good faith effort to
obtain information from residents about assessments independently obtained
outside the facility. (F) Prior to admitting or transferring a
resident to a special care unit that restricts the resident's freedom of
movement, the residential care facility is obligated to ensure that a physician
or other licensed healthcare professional working within their scope of
practice, has made a determination that the admission or transfer to the
special care unit is needed. The facility is obligated to update this
determination to include both improvement and decline, during the periodic
reassessment obligated by paragraph (D) of this rule. Prior to admission to the
special care unit, the residential care facility is obligated to provide the
resident with an updated resident agreement obligated by rule 3701-16-07 of the
Administrative Code and with the facility's policy on care of residents
by means of a special care unit obligated by paragraph (E)(5) of that rule. No
resident is allowed to be admitted to a secured special care unit based solely
on his or her diagnosis. (G) If a resident needs services or accommodations beyond that
which a residential care facility is authorized to provide or beyond that which
the specific facility provides, refuses needed services, or fails to obtain
needed services for which the resident agreed to be responsible under the
resident agreement obligated by rule 3701-16-07 of the Administrative Code, the
residential care facility is obligated to take the following
action: (1) Except in emergency
situations, the residential care facility is obligated to meet with the
resident, and, if applicable, the resident's sponsor and discuss the
resident's condition, the options available to the resident including
whether the needed services may be provided through a medicaid waiver program,
and the consequences of each option; (2) If the lack of needed
services has resulted in a significant adverse change in the resident, the
residential care facility is obligated to seek appropriate intervention in
accordance with paragraph (A) of rule 3701-16-12 of the Administrative Code. If
an emergency does not exist the facility is obligated to provide or arrange for
the provision of any needed services that the resident has not refused until
the resident is discharged or transferred or the resident and the facility have
mutually resolved the issue in a manner that does not jeopardize the
resident's health or the health, safety or welfare of the other residents.
This paragraph does not authorize a facility to provide skilled nursing care
beyond the limits established in section 3721.011 of the Revised Code;
and (3) The residential care
facility is obligated to transfer or discharge the resident in accordance with
section 3721.16 of the Revised Code and Chapter 3701-61 of the Administrative
Code if the resident needs skilled nursing care or services beyond what the
facility provides and the residential care facility, based on the meeting with
the resident obligated by paragraph (G)(1) of this rule, determines that such
action is necessary to assure the health, safety and welfare of the resident or
the other residents of the facility. The residential care facility may retain a
resident who refuses available services if doing so does not endanger the
health, safety, and welfare of other residents and the resident does not need
services beyond that which a facility is authorized to provide under Chapter
3721. of the Revised Code and rules 3701-16-01 to 3701-16-18 of the
Administrative Code.
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Rule 3701-16-09 | Personal care services; medication administration; resident medications; application of dressings; supervision of therapeutic diets.
(A) For the purposes of this
rule; (1) Personal care
services or skilled nursing care are provided by a residential care facility
when: (a) They are provided by
a person: (i) Employed by the facility; (ii) Associated with the facility; or (iii) Who is a related party to the facility; (b) By another person
pursuant to an agreement to which neither the resident nor their sponsor is a
party; (c) By another person
pursuant to an agreement the facility requires a resident or their sponsor to
contract with a person to receive services; or (d) The resident does not
have free choice of service provider. For purposes of this rule "related
party" means an individual or organization that, to a significant extent,
has common ownership with, is associated or affiliated with, has control of, or
is controlled by, the owner or operator of the residential care
facility. (2) A residential care
facility may provide the skilled nursing care authorized by paragraphs (J) and
(K) of this rule through the following arrangements as long as the residential
care facility complies with the applicable provisions of this
rule: (a) Qualified staff members of the residential care facility;
or (b) Through agreements or contractual arrangements, including but
not limited to, contracts with a home health agency certified under Title XVIII
of "the Social Security Act", 42 U.S.C. 301, as amended (1981), or a
licensed hospice care program, licensed under Chapter 3712. of the Revised
Code. (B) Each residential care facility is
obligated to: (1) Specify in its
policies and the resident agreements, obligated by rule 3701-16-07 of the
Administrative Code, the extent and types of personal care services it
provides; and (2) Provide personal care
services to its residents who are in need of those services, unless the
resident and the facility have entered into a risk agreement under rule
3701-16-07 of the Administrative Code or the resident has refused services, and
may provide personal care services to other residents upon
request. Nothing in this paragraph is to be construed as
permitting personal care services to be imposed upon a resident who is capable
of performing the activity in question without assistance unless
requested. (C) If a resident requires certain
personal care services that the residential care facility does not
offer: (1) The facility is
obligated to comply with paragraph (G) of rule 3701-16-08 of the Administrative
Code; and (a) Arrange for or allow the resident to arrange for the services
to be provided; or (b) Transfer the resident to an appropriate setting or discharge
the resident in accordance with section 3721.16 of the Revised Code and Chapter
3701-61 of the Administrative Code; or (2) The facility and the
resident may enter into a risk agreement in accordance with paragraphs (F) and
(G) of rule 3701-16-07 of the Administrative Code, if the facility has a policy
of entering into such agreements. (D) Each residential care facility is
obligated to ensure that personal care services are provided to
residents: (1) In accordance with
acceptable standards of care; (2) By staff members
meeting the training standards of rule 3701-16-06 of the Administrative Code;
and (3) That meet the needs
of residents as determined in the resident assessments obligated by rule
3701-16-08 of the Administrative Code and consistent with the resident
agreements under rule 3701-16-07 of the Administrative Code. (E) A residential care facility may
provide for the administration of medication to residents in accordance with
division (B) of section 3721.011 of the Revised Code and this
rule. (1) All medication taken
by residents of residential care facilities will be self-administered, and
members of the staff of a residential care facility are barred from
administering medication to residents, except that medication may be
administered in accordance with division (B) of section 3721.011 of the Revised
Code and paragraphs (G) and (H) of this rule. (2) A residential care
facility may admit or retain an individual requiring medication only if the
individual is capable of taking their own medication and biologicals, as
determined in writing by the person's attending physician or other
licensed healthcare professional working within their scope of practice, or if
the facility provides for the administration of medication by: (a) A home health agency certified under Title XVIII of the
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C. 301, as amended
(1981); (b) A hospice care program licensed under Chapter 3712. of the
Revised Code; or (c) A member of the staff of the residential care facility who is
qualified to perform medication administration. (F) Staff members may assist with
self-administration of medication by doing any of the following once they have
received training in providing the services, as obligated by paragraph (E) of
rule 3701-16-06 of the Administrative Code: (1) Remind a resident
when to take medication, and watch to ensure that the resident follows the
directions on the container; (2) Assist a resident in
self-administration of medication by taking the medication from the locked area
where it is stored and handing it to the resident. If the resident is
physically unable to open a container, a staff member may open the container
for the resident. The staff member is obligated to check the name on the
prescription label and verify that the resident's name on the prescription
label corresponds to the resident requesting the medication before handing it
to the resident. The staff member may read the label and directions on the
medication container to the resident upon request. The staff member also may
remind the resident and any other individual designated by the resident when
prescribed medication needs to be refilled. Staff members are not allowed to
assist a resident with self-administration of a prescription medication that
belongs to another resident; (3) Assist a physically
impaired but mentally alert resident such as, but not limited to, a resident
with arthritis, cerebral palsy, or Parkinson's disease, upon that
resident's request, in removing oral or topical medication from containers
and in consuming or applying the medication upon request by or with the consent
of the resident. If the resident is physically unable to place a dose of
medicine to their mouth without spilling it, a staff member may place the dose
in a container and place the container to the mouth of the resident. As used in
this paragraph, "topical medication" means: (a) Eye, nose, or ear drops excluding irrigations;
and (b) Medication used in the treatment of a skin condition or minor
abrasion, excluding debriding agents; and (4) Assist a resident
with organizing the resident's medications in a weekly pill organizer if
the resident is able to differentiate between pills and actively participates
in the organization. Nothing in this rule is to be construed as allowing staff
members to fill a weekly pill organizer for a resident. (G) Medication are obligated to be
administered in accordance with accepted standards of practice to a resident in
a residential care facility only by the following persons authorized by law to
administer medication: (1) A registered
nurse; (2) A licensed practical
nurse holding proof of successful completion of a course in medication
administration approved by the Ohio board of nursing pursuant to Chapter 4723.
of the Revised Code who is allowed to administer medication only at the
direction of a registered nurse or physician; (3) A physician;
or (4) A person authorized
by law to administer medication. (H) Residential care facilities that
administer medication are obligated to comply with all of the
following: (1) No medication is
allowed to be given to any resident unless ordered by a physician or individual
authorized under state law to prescribe medications. Ordered medications are
obligated to be administered unless the resident refuses or the resident
exhibits symptoms that contraindicate medication administration. If a
medication is not administered, the staff member responsible for administering
the medication is obligated to document in the resident's record why the
medication was not administered. Telephone orders are not allowed to be
accepted by a person other than a licensed nurse, another physician or a
pharmacist except that a licensed health professional may receive, document and
date medication orders concerning their specific discipline, to the extent
permitted by applicable licensing laws. If orders are given by telephone, they
are obligated to be recorded with the prescriber's name and the date, and
the order signed by the person who accepted the order. All telephone orders are
obligated to be signed by the physician who gave the order or other licensed
health professional with prescriptive authority working under the supervision
of or in collaboration with the physician within fourteen days after the order
was given. The residential care facility may accept facsimile and electronic
documentation of orders in accordance with paragraph (B)(4) of rule
3701-16-09.1 of the Administrative Code; (2) All medications are
obligated to be given only to the individual resident for whom they are
prescribed, given in accordance with the directions on the prescription or the
physician's or other authorized prescriber's orders, and recorded on
the resident's medication record obligated by paragraph (I)(7) of this
rule; (3) The person who
administers the medication is obligated to observe the resident for adverse
effects, contraindications, and medication effectiveness. Such person is
obligated to notify the resident's attending physician or other licensed
healthcare professional working within their scope of practice, of any
undesirable effects and document these effects and the date and time of such
notification in the resident's medication record; (4) Only administer drugs
bearing the American hospital formulary service therapeutic class 4:00,
28:16:08, 28:24:08, or 28:24:92 with the authorization of the attending
physician, after personal examination of the resident and documentation of the
medical condition being treated and reasons for use of the drug and when
necessary to treat a resident's medical condition and to assist the
resident to attain their highest practicable physical, mental, and psychosocial
well-being. Drugs used for this purpose are not considered chemical restraints
as defined in paragraph (L) of this rule; and (5) Ohio board of
pharmacy and United States drug enforcement administration
regulations. (I) Residential care facilities that
handle residents' medication are obligated to: (1) Not stock or dispense
medicines or drugs which may be sold only by prescription unless the facility
has in its employ, on either a full-time or part-time supervisory and
consulting basis, a pharmacist registered under Chapter 4729. of the Revised
Code, who will be in complete control of such stock and the dispensing
thereof; (2) Keep all prescription
medications in locked storage areas, including drugs requiring refrigeration,
except medications of residents living in individual units who self-administer
their own medications may be stored in the resident's unit if the resident
and residential care facility take reasonable precautions to prevent access to
the medications by other residents; (3) Assure that the
labeling of prescription medicine and drugs meet the following
criteria: (a) Every container of medicine and drugs prescribed for a
resident for self-administration or assistance by non-licensed health care
personnel, will be clearly labeled with the resident's name, the
proprietary or generic name of the medication dispensed and its strength, the
name and address of the dispensing pharmacy, the name or initials of the
dispensing pharmacist, the prescription number, the date dispensed, the name of
the prescribing physician or individual authorized under state law to prescribe
medications, and the instructions for use including any cautions which may be
obligated by federal or state law. Containers too small to bear a complete
prescription label will be labeled with at least the prescription number and
the dispensing date and will be dispensed in a container bearing a complete
prescription label; (b) Medicines and drugs dispensed by a health care facility
pharmacy for administration by a licensed nurse or physician to residents
whereby the medicines and drugs are not in the possession of the resident prior
to administration will be clearly labeled in accordance with rule 4729-17-10 of
the Administrative Code; (c) Not repackage or relabel resident medications;
and (d) Ensure over-the-counter medications that are either
administered by an individual acting within their scope of practice and based
on a prescriber's order, or given to residents capable of
self-administration of medication, contain a United States food and drug
administration label indicating, in part, the medication's: (i) Name; (ii) Strength; (iii) Quantity; (iv) Accessory
instructions; (v) Lot number;
and (vi) Expiration
date; Over-the-counter medications kept by
residents capable of self-administration do not need to meet the criteria of
this rule. (4) Send a
resident's medication with him or her upon permanent transfer or discharge
or destroy or dispose them with the consent of the resident in accordance with
any applicable state or federal laws and regulations; (5) If controlled
substances are used, order, dispense, administer, and dispose of controlled
substances in accordance with state and federal laws and regulations and ensure
policies and procedures are in place to prevent the misappropriation or theft
of controlled substances; (6) Keep a written list
of all medications prescribed for each resident and are obligated to make a
good-faith effort to keep the list current; and (7) Maintain an
individual medication record for each resident to whom the residential care
facility administers medications in which: (a) Medication orders, including telephone, electronic, and
facsimile orders, are recorded and signed by the prescriber; and (b) All medications are recorded as given, documenting the name
of the medication, date and time given, route of administration, and signed by
the individual administering the medication. (J) Each residential care facility that
provides for the application of dressings in accordance with division (A) of
section 3721.011 of the Revised Code is obligated to: (1) Establish in writing
the services pertaining to the application of dressings that are routinely
managed by the facility. The determination of the type of applications of
dressings that are managed by the facility are based on staff education, staff
competence, the amount of staff experience with the listed types of
applications of dressings, and support services available in the
facility; (2) Develop and follow
policies and procedures which assure that the application of dressings are
provided in accordance with acceptable standards of practice; (3) Ensure that the
application of dressings are provided only by individuals authorized under
state law to provide the application of the dressing. Skilled nursing care may
be delegated in accordance with Chapter 4723-13 of the Administrative
Code; (4) Evaluate each
resident at least once every seven days to determine whether the resident
should be transferred to a nursing home or other appropriate health care
setting. The evaluation and determination is obligated to be performed by the
appropriate health care professional and documented in the resident's
record; (5) Document all
applications of dressings that are provided by the residential care facility in
the resident's record. Such documentation is obligated to include, but not
be limited to, treatment and medication orders issued by appropriate licensed
health care professionals when needed to authorize provision of a service and
nurse's notes indicating the nature of the service provided and the
resident's status. The residential care facility may accept facsimile and
electronic orders in accordance with paragraph (B)(4) of rule 3701-16-09.1 of
the Administrative Code; and (6) Ensure that a nurse
coordinates the overall nursing care of each resident who receives applications
of dressings. (K) Each residential care facility that
provides supervision of therapeutic diets is obligated to comply with the
applicable provisions of rule 3701-16-10 of the Administrative Code. The
residential care facility may accept facsimile and electronic documentation of
therapeutic diet orders in accordance with paragraph (B)(4) of rule
3701-16-09.1 of the Administrative Code; (L) The residential care facility is
forbidden from physically, chemically, or through isolation, restraining
residents. (1) For the purposes of
this paragraph: (a) "Physical restraint" means, but is not limited to,
any article, device, or garment that interferes with the free movement of the
resident and that the resident is unable to remove easily, a geriatric chair,
or a locked room door; (b) "Chemical restraint" means any drug that is used
for discipline or staff convenience and not prescribed to treat medical
symptoms; and (c) "Freedom of movement" means the ability of the
resident to move around within the context of the resident's functional
capacity as assessed by the facility. (2) A residential care
facility's use of the following items for the purposes stated in this
paragraph will not be construed as physically or chemically restraining a
resident or subjecting a resident to prolonged isolation: (a) Devices that assist a resident in the improvement of the
resident's mental and physical functional status and that do not restrict
freedom of movement or normal access to one's body; (b) Medications that are standard treatment or a documented
exception to standard treatment for the resident's medical or psychiatric
condition which assist a resident in attaining or maintaining the
resident's highest practicable physical, mental, and psycho-social
well-being; (c) Residency in a secured special care unit that restricts a
resident's freedom of movement throughout the facility if; (i) Care and services are
provided in accordance with each resident's individual needs and
preferences, not for staff convenience; (ii) The need for
continued residency in the secured special care unit is reviewed during each
periodic assessment obligated by rule 3701-16-08 of the Administrative
Code; (iii) The secured special
care unit meets state building and fire code standards; and (iv) Residency on the
secured special care unit is not based solely on the resident's
diagnosis. (d) Not withstanding paragraph (L)(2)(c) of this rule, a resident
may choose to reside in the secured special care unit based upon their specific
circumstances, such as if their spouse is a resident of the secured special
care unit, or if the only room available in the facility is on the secured
special care unit. A resident who chooses to reside in the secured special care
unit needs to be able to enter and exit the unit without
assistance.
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Rule 3701-16-09.1 | Skilled nursing care.
(A) Except as provided for in division
(D) of section 3721.011 of the Revised Code, a residential care facility may
admit or retain individuals who are in need of skilled nursing care beyond the
supervision of special diets, application of dressings, or administration of
medication only if the skilled nursing care will be provided on a part-time,
intermittent basis for not more than a total of one hundred twenty days in any
twelve-month period regardless of any transfer or discharge and readmission to
the facility. A part-time, intermittent basis means that skilled nursing care
is rendered for less than eight hours a day or less than forty hours a week.
For the purposes of this provision: (1) The residential care
facility is obligated to use the following criteria in tracking the one hundred
and twenty days of part-time, intermittent skilled nursing care permitted under
this paragraph: (a) Self-care does not count toward the allowable one hundred
twenty days; (b) Services provided by physical and occupational therapists and
assistants licensed under Chapter 4755. of the Revised Code and speech-language
pathologists licensed under Chapter 4753. of the Revised Code do not constitute
skilled nursing care and are not to be counted; (c) Only days on which skilled nursing care is performed are to
be counted toward the allowable one hundred and twenty days; and (d) Medication administration, supervision of therapeutic diets
or application of dressings will be counted toward the allowable one hundred
and twenty days, if the residential care facility does not provide for these
services, pursuant to rule 3701-16-09 of the Administrative Code. (2) Skilled nursing care
may be provided by one or more of the following: (a) A home health agency certified under Title XVIII of the
"Social Security Act," 49 Stat. 620 (1935), 42 U.S.C.A. 301, as
amended (1981); (b) A hospice care program licensed under Chapter 3712. of the
Revised Code; (c) A member of the staff who is authorized under state law to
provide skilled nursing care. If a resident's condition is in need of
more skilled nursing care than permitted under this paragraph, the residential
care facility is obligated to transfer or discharge the resident in accordance
with section 3721.16 of the Revised Code and Chapter 3701-61 of the
Administrative Code. (B) Each residential care facility that
provides skilled nursing care using staff members is obligated to: (1) Develop and follow
policies and procedures which assure that the skilled nursing care is provided
in accordance with acceptable standards of practice; (2) Ensure that the
skilled nursing care is provided in accordance with accepted standards of
practice only by individuals authorized under state law to provide skilled
nursing care. Skilled nursing care may be delegated in accordance with Chapter
4723-13 of the Administrative Code; (3) Except for residents
receiving medication administration, supervision of special diets, the
application of dressings, or skilled nursing care permitted by paragraph (D) of
this rule, evaluate each resident receiving skilled nursing care at least once
every seven days to determine whether the resident should be transferred to a
nursing home or other appropriate health care setting. The evaluation and
determination is obligated to be performed by the appropriate licensed health
care professional and documented in the resident's record; (4) Document all skilled
nursing care provided by the residential care facility in the resident's
record. Such documentation is obligated to include, but not be limited to,
medication and treatment orders when needed to authorize provision of a service
and nurse's notes indicating the nature of the service provided and the
resident's status. All orders are obligated to be signed and dated by the
licensed health professional who gave the order within fourteen days after the
order was given; (a) Telephone orders are not allowed to be accepted by a person
other than a licensed nurse on duty, another physician or a pharmacist, except
that a licensed health professional may receive, document and date medication
and treatment orders concerning their specific discipline for residents under
their care, to the extent permitted by applicable licensing laws. (b) The residential care facility may accept signed treatment and
medication orders issued by a licensed health professional by facsimile
transmission if the facility has instituted procedural safeguards for
authentication and maintaining confidentiality of the facsimile order, and for
handling the order in an expedient and priority manner. (c) An entry that is an electronic record as defined in section
3701.75 of the Revised Code may be authenticated by an electronic signature in
accordance with section 3701.75 of the Revised Code. (5) Meet the skilled
nursing care needs of each resident receiving care as determined by the
assessment obligated by rule 3701-16-08 of the Administrative Code and
consistent with the resident agreement obligated by rule 3701-16-07 of the
Administrative Code; and (6) Ensure that a nurse
coordinates the overall nursing care of each resident who receives skilled
nursing care from facility staff. (C) In addition to paragraphs (A) and (B)
of this rule, each residential care facility that provides enteral tube
feedings on a part-time intermittent basis is obligated: (1) Establish in writing
the types of enteral tube feedings that are routinely managed by the facility.
The determination of the types of enteral tube feedings that are provided by
the facility are to be based on staff education, staff competence, the amount
of staff experience with the listed types of enteral tube feedings, and support
services available in the facility; (2) Develop and follow
policies and procedures which assure that enteral tube feedings are prepared
and offered as ordered and that sanitary conditions are maintained in
procurement, storage, preparation, and the administration of the enteral tube
feedings; (3) Document the weight
of the resident and the resident's acceptance and tolerance of the enteral
tube feedings in accordance with policies and procedures developed by the
dietitian and the nurse responsible for the overall nursing care of the
resident; and (4) Provide or arrange
for a dietitian. (D) A residential care facility may admit
or retain an individual who is in need of skilled nursing care for more than
one hundred twenty days in any twelve-month period only if: (1) The facility has
entered into a written agreement with each of the following: (a) The individual, the individual's sponsor, or
both; (b) The individual's personal physician or other licensed
health professional acting within their applicable scope of practice, unless
either of the following apply: (i) If the provision of
the skilled nursing care is not overseen by the individual's personal
physician, the provider of the skilled nursing care may enter into the
agreement; or (ii) If the individual is
a hospice patient as defined in section 3712.01 of the Revised Code, a hospice
care program licensed under Chapter 3712. of the Revised Code may enter into
the agreement. (2) The written agreement
obligated by this paragraph includes a statement signed by all parties
acknowledging that they understand the agreement and that the individual's
needs can be met at the facility. The agreement is not considered complete
without this signed statement and includes all of the following
provisions: (a) That the individual will be provided skilled nursing care in
the facility only if a determination has been made that the individual's
needs can be met at the facility. This determination is obligated to be made by
the residential care facility, the individual's attending physician, and,
if applicable, the provider of the skilled nursing care; (b) That the individual will be retained in the facility only if
periodic re-determinations are made that the individual's needs can be met
at the facility; (c) That the re-determinations will be made according to a
schedule specified in the agreement and as the resident's condition
necessitates , but no less frequently than every thirty days, except for
hospice patients whose re-determinations are to be made be no less frequently
than every fifteen days; (d) Unless the individual is a hospice patient, the
individual's personal physician has determined that the skilled nursing
care the resident or prospective resident needs is routine. For purposes of
this rule, "routine" does not include those conditions listed in
paragraph (B) of rule 3701-16-07 of the Administrative Code; and (e) If the individual is a hospice patient, that the individual
has been given an opportunity to choose the hospice care program that best
meets the individual's needs.
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Rule 3701-16-10 | Dietary services; supervision of therapeutic diets.
(A) Each residential care facility is
obligated to specify in its residential care facility policies and the resident
agreements, established by rule 3701-16-07 of the Administrative Code, the
amount and types of dietary services it provides. The facility is obligated to
elect to provide any of the following: (1) No
meals; (2) One, two, or three
daily meals; (3) Preparation of
special diets other than therapeutic diets; one, two, or three daily meals;
or (4) Preparation and supervision of
therapeutic diets. Each facility that elects to supervise therapeutic diets is
obligated to provide three daily meals and meet the criteria of this chapter of
the Administrative Code for the supervision of therapeutic diets; Each residential care facility that provides
meals is obligated to include a variety of food accommodating religious
restrictions and ethnic and cultural preferences of residents in accordance
with the residential care facility's policy (B) Each residential care facility that
agrees to provide three daily meals for a resident is obligated to make
available at least three nourishing, palatable, attractive and appetizing meals
at regular hours comparable to normal mealtimes in the community. The meals
will provide the dietary referenced intake of the "Food and Nutrition
Board" of the "National Academy of Science", be based on a
standard meal planning guide from a diet manual published by a dietitian,
approved by a dietitian, or both. Food will be prepared and served in a form
that meets the resident's individual needs based on the assessment
conducted pursuant to rule 3701-16-08 of the Administrative Code. There will be
no more than sixteen hours between the evening meal and breakfast. Each
residential care facility that provides meals is obligated to offer a
nourishing snack, consisting of a choice of beverages and a food item from a
basic food group, after the evening meal. Food substitutes of similar nutritive
value will be offered to residents who refuse the food served and serving size
may be adjusted according to resident preference. The residential care facility
is obligated to accommodate a resident's preference or medical need to eat
at different intervals. (C) All residential care facilities are
obligated to provide safe drinking water that is accessible to residents at all
times. (D) Each residential care facility that
does not provide any meals is obligated to ensure that each resident unit is
appropriately and safely equipped with food storage and preparation appliances
which the facility maintains in safe operating condition or that each resident
has access to an appropriately and safely equipped food storage and preparation
area. Each residential care facility that does not provide any meals is
obligated to permit residents to store and prepare food in a safe manner in
their resident units or in a resident food storage and preparation
area. (E) Each residential care facility that
provides one or more meals and that does not permit residents to have food in
their resident units is obligated to make snacks available twenty-four hours a
day. (F) Each residential care facility is
obligated to have a kitchen and other food service facilities that are adequate
for preparing and serving the amount and types of meals the facility agrees to
provide. (G) If applicable, the residential care
facility is obligated to have a food service operation license issued under
Chapter 3701-21 of the Administrative Code. (H) Each residential care facility that
provides meals is obligated to: (1) Procure, store,
prepare, distribute, and serve all food in a manner that protects it against
contamination and spoilage; (2) Maintain at least a
week supply of staple foods and a two-day supply of perishable foods for
residents at all times and the amount of such supplies is to be based on the
number of residents and meals the facility provides daily; (3) Plan all menus for
meals at least one week in advance, provided food that varies in texture, color
and include seasonal foods. Records of dated menus, including therapeutic
diets, as served, are to be maintained for at least three months and make the
records available to the director upon request and indicate any food
substitutions from the menu; (4) Observe, supervise,
and assist a resident in consuming meals if the resident needs observation,
supervision, or assistance; (5) Ensure that food
texture is appropriate to the individual needs of each resident, except that
residential care facility staff are not allowed to perform syringe
feedings; (6) Ensure that the kitchen and dining
areas are cleaned after each meal and : (a) Transport meals in a sanitary manner to prevent
contamination; (b) Provide handwashing facilities, including hot and cold water,
soap and individual paper towels in the food preparation and service
area; (c) Provide and maintain clean and sanitary kitchen and dining
areas and a clean, sanitary and adequate supply of eating and drinking
utensils, pots, and pans for use in preparing, serving, and eating appetizing
meals and snacks; and (d) Place food scraps and trash in garbage cans with tightfitting
lids and bag liners and empty garbage cans daily, or more often if needed.
Nondisposable containers are to be cleaned frequently enough to maintain
sanitary conditions. Disposable bags of garbage may be stored outside only in a
non-absorbent container with a close-fitting cover. Liquid wastes resulting
from compacting are to be disposed of as sewage; (7) Provide any format of meal service,
which otherwise meets the criteria established by this rule, with input from
residents; and (8) Provide a dining environment as
natural and independent as possible, comparable with eating at home, with
choices from a wide variety of food items tailored to the residents' wants
and needs, which otherwise meet the criteria established by this
rule. (I) Each residential care facility that elects to prepare special
diets other than therapeutic diets is obligated to: (1) Prepare and provide
the special diets in accordance with the orders of a physician or other
licensed health professional acting within their scope of practice, or a
dietitian; and (2) Adjust special diet
menus as ordered by the resident's attending physician or other licensed
health professional acting within their scope of practice, or a
dietitian. (J) Each residential care facility which elects to supervise
therapeutic diets is obligated to make available three daily meals in
accordance with paragraph (B) of this rule and provide or arrange for a
dietitian to plan, direct and implement dietary services that meet the
residents' nutritional needs and comply with the criteria established by
this rule and for residents on therapeutic diets on an ongoing
basis: (1) Determine that the
diet ordered is appropriate according to the resident's individual
nutritional assessment; (2) Monitor the
resident's nutritional intake and acceptance of the diet; (3) Evaluate the
home's compliance in the provision of the diet; and (4) Adjust nutritional
assessments and diets as needed. (K) If obligated by paragraph (J) of this rules, the dietitian is
obligated to oversee, monitor and assist in the training of food service staff
in the preparation and serving of foods for therapeutic diets and consult
quarterly with the food service staff. Trained unlicensed staff, including the
dietary manager, may perform routine tasks that: (1) May be assigned
pursuant to Chapter 4759. of the Revised Code and this rule; and (2) Do not necessitate
professional judgment or knowledge. (L) Residential care facilities are barred from administering
parenteral nutrition and a residential care facility may administer enteral
tube feedings on a part-time intermittent basis in accordance with rule
3701-16-09.1 of the Administrative Code. (M) A hospice patient's diet is obligated to be planned by a
dietitian, the hospice program, or both, as appropriate for that
individual.
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Rule 3701-16-11 | Resident life enrichment; finances; pets; laundry.
(A) Each residential care facility is
obligated to encourage residents to participate in social, recreational, and
leisure activities. The residential care facility is obligated to, with
consideration given to resident preferences, provide or arrange for varied
activities of sufficient quantity so that residents' lives may be more
meaningful, to stimulate physical and mental capabilities and to assist
residents in attaining their optimal social, physical, and emotional
well-being. The residential care facility is obligated to provide, at minimum,
all of the following: (1) One local daily
newspaper either in digital or paper format, or current community activity
brochures and advertisements; (2) Information about
activities in the community and the availability of transportation to community
activities; and (3) An opportunity for
residents to engage in a variety of activities which may include, but are not
limited to, internet, television, crafts, reading, or games. (B) A residential care facility is not
allowed to coerce, induce, or prompt a resident to assign, transfer, give, or
sign over to the facility money, valuables, insurance benefits, property, or
anything of value other than payment for services rendered by the facility. A
residential care facility is not allowed to manage a resident's financial
affairs unless authorized by the resident or a sponsor with power of attorney.
Such authorization is obligated to be in writing and attested to by a witness
who is not connected in any manner whatsoever with the residential care
facility or its administrator. A facility that manages a resident's
financial affairs is obligated to: (1) Maintain accounts
pursuant to division (A)(27)(b) of section 3721.13 of the Revised Code of
resident funds and personal property or possessions deposited for safekeeping
with the facility for use by the resident or resident's sponsor. The
resident has the right to receive, upon written or oral request, an accounting
statement of financial transactions made on the resident's behalf. This
statement is obligated to include a: (a) Complete record of all funds, personal property, or
possessions from any source whatsoever, that have been deposited for
safekeeping with the facility for use by the resident or resident's
sponsor; and (b) Listing of all deposits and withdrawals transacted,
substantiated by receipts that are available for inspection and copying by the
resident or sponsor. (2) Deposit the
resident's funds in excess of one thousand dollars, and may deposit the
resident's funds that are one thousand dollars or less, in an
interest-bearing account separate from any of the facility's operating
accounts. Interest earned on the resident's funds is obligated to be
credited to the resident's account. A resident's funds that are one
thousand dollars or less and have not been deposited in an interest-bearing
account may be deposited in a noninterest-bearing account or petty cash
fund. (3) Purchase a surety
bond or otherwise provide assurance satisfactory to the director to assure the
security of all residents' funds managed by the facility. (4) Upon the
resident's transfer, discharge, or death, close all resident accounts,
make a final accounting, and make provisions for the conveyance of any
remaining funds to the resident or the resident's estate. (5) Allow the resident
access to their funds during normal bank business hours within the
community. (6) Not mandate that a
resident allow the facility to manage the resident's financial affairs as
a condition of admission to the facility. (C) Neither the administrator of a
residential care facility nor facility staff may serve as the guardian or
attorney-in-fact of a resident unless related by blood, marriage, or adoption
to that resident. (D) Residents may keep pets if allowed
by facility policy. If a residential care facility allows residents to keep
animals or pets, or has facility pets, the facility is obligated to consult
with a veterinarian licensed to practice veterinary medicine under Chapter
4741. of the Revised Code, establish and implement a written protocol regarding
animals and pets that protects the health and safety of residents and staff
members. At minimum, the written protocol is obligated to include: (1) An annual physical
examination, including an examination for internal and external
parasites; (2) Vaccinations for
common infectious agents, including rabies; (3) Any other preventive
care necessary to protect the health, safety and rights of
residents; (4) Procedure to follow
if an animal: (a) Bites a person; or (b) Becomes ill or injured; (5) For resident pets, if
the resident is transfered, discharged or otherwise unable to care for the pet,
responsibilities for care of the pet until a family member or sponsor can
retrieve the pet; (6) In the case of a
facility pet, the name of the designated member or members of the staff
responsible for the care of the animal and for maintaining the protocol,
including medical records for the animal; and (7) An evaluation of the
medical needs of residents. (E) The residential care facility is
obligated to specify in the resident agreements established by rule 3701-16-07
of the Administrative Code what laundry services it provides. The residential
care facility is obligated to launder or assist in arranging for the laundering
of all clothing and bed and bath linen for residents who are in need of laundry
services as described in the resident agreement. The facility may provide a
washer and dryer in the home for residents' use or may provide residents
with transportation to and from a laundromat.
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Rule 3701-16-12 | Changes in residents' health status; incidents; infection control; tuberculosis control plan.
(A) In the event of a significant adverse
change in residents' health status, the residential care facility is
obligated to do all of the following: (1) Take immediate and
proper steps to see that the resident receives necessary intervention
including, if needed, medical attention or transfer to an appropriate medical
facility; (2) Make a notation of
the change in health status and any intervention taken in the resident's
record; (3) Provide pertinent
resident information to the person providing the intervention as soon as
possible; and (4) Notify the sponsor
unless the resident refuses or requests otherwise. (B) As used in this paragraph,
"incident" means any accident or episode involving a resident, staff
member, or other individual in a residential care facility which presents a
risk to the health, safety, or well-being of a resident. In the event of an
incident, the facility is obligated to do both of the following: (1) Take immediate and
proper steps to see that the resident or residents involved receive necessary
intervention including, if needed, medical attention or transfer to an
appropriate medical facility; (2) Investigate the
incident and document the incident and the investigation and include
information that will enable staff to identify to the director upon request,
the resident involved in an incident. The facility is obligated to maintain an
incident log separate from the resident record which is accessible to the
director and contains the time, place, and date of the occurrence; a general
description of the incident; and the care provided or action taken. The
facility is obligated to document the incident in the resident's
record. (C) Each residential care facility will
establish and implement appropriate written policies and procedures to assure a
safe, sanitary, and comfortable environment for the residents and to control
the development and transmission of infections and diseases. Each residential
care facility is obligated to establish an infection prevention and control
program to monitor compliance with the home's infection prevention and
control policies and procedures, to prevent, investigate, and control
infections in the home, to institute appropriate interventions, and ensure all
staff are appropriately trained on the home's infection prevention and
control protocol. An effective infection control program includes: (1) Each residential care
facility is obligated to designate one or more individuals as the infection
prevention and control designee and provide that individuals name and contact
information, including an electronic mail address, on an electronic system
prescribed by the director no later than ten days after hiring or appointing
the individual and no later than ten days after the individual's contact
information changes or the designated individual is replaced. The infection
control designee is responsible for the facility's infection prevention
and control program. The infection prevention and control designee will have:
(a) Completed post-secondary education in a health-related
field including but not limited to medicine, nursing, medical technology,
laboratory technology, public health, epidemiology, or biology; (b) Have education, training, or experience in infection
control; and (c) Work at least part-time at the facility or hold a
contract to provide infection prevention and control at least part-time at the
facility. A residential care facility located in the
same building as a nursing home, or on the same lot as a nursing home, both of
which are owned and operated by the same entity, will be considered to have met
this requirement if the nursing home has an infection prevention and control
designee who is responsible for both the residential care facility and nursing
home. (2) A tuberculosis control plan that
meets the standards set forth in rule 3701-15-03 of the Administrative
Code. (3) A written surveillance plan outlining
the activities for monitoring/tracking infections based on
nationally-recognized surveillance criteria such as McGeer criteria
and: (a) Includes a surveillance system that includes a data
collection tool; (b) Uses surveillance data to: (i) Implement timely
corrective action when a greater than expected number healthcare-associated
infections are detected; and (ii) Implement timely
corrective actions when transmission of targeted MDROs (e.g., CRE, Candida
auris) are detected. (4) Written standards,
policies, and procedures for the program, which must include, but are not
limited to: (a) Standard and transmission-based precautions to be
followed to prevent spread of infections; (b) When and to whom possible incidents of communicable
disease or infections should be reported; (c) When and how isolation should be used for a resident;
including but not limited to: (i) The type and duration
of the isolation, depending upon the infectious agent or organism involved; and
(ii) A requirement that
the isolation should be the least restrictive possible for the resident under
the circumstances. (5) Written standards,
policies, and procedures under which the facility will prohibit employees with
a communicable disease or infected skin lesions from direct contact with
residents or their food, if direct contact will transmit the disease;
(6) The hand hygiene
procedures to be followed by staff involved in direct resident contact,
including, but not limited to: (a) Washing hands for twenty seconds with soap and water;
or (b) Cleaning of hands with an alcohol-based product used
according to manufacturer's directions or other alternative methods
accepted by the United States centers for disease control and prevention or US
food and drug administration, as being an effective alternative, or handwashing
with soap and water. (7) Written standards,
policies, and procedures for laundry to ensure personnel handle, store,
process, and transport linens so as to prevent the spread of infection
including: (a) Handling soiled laundry as little as
possible; (b) Placing of laundry that is wet or soiled with body
substances in impervious bags that are secured to prevent spillage;
and (c) Wearing of impervious gloves and impervious gowns by
individuals performing laundry services, and, if handling soiled or wet laundry
on the unit, the wearing of gloves and, if appropriate, other personal
protective equipment. (D) Each residential care facility will
establish and implement an effective water management program to identify
hazardous conditions, and take steps to manage the risk of occurrence and
transmission of waterborne pathogens, including but not limited to legionella,
in building water systems in accordance with guidance from the United States
centers for disease control and prevention (available at
https://www.cdc.gov/legionella/wmp/overview.html) and recommendations of the
United States centers for disease control and prevention healthcare infection
control practices advisory committee, "Environmental Infection Control
Guidelines" (2019) or its successors. (E) If the residential care facility provides an adult day
care program which is located, or shares space, within the same building as the
residential care facility, shares staff between the program and the facility,
or where the day care participants at any time intermingle with residents of
the facility, the requirements of this rule are also applicable to participants
of the adult day care program.
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Rule 3701-16-13 | Building, plumbing, fire and carbon monoxide safety requirements.
(A) The building or buildings in which a
residential care facility is located are obligated to be approved by and have a
certificate of occupancy for the appropriate use group designation issued by
the local certified building department with jurisdiction over the area in
which the building or buildings are located, or by the department of commerce
if there is no local certified building department. In the case of a license
renewal, if any alterations to the buildings have been made since the original
license was issued or the license was last renewed, whichever is later, the
residential care facility is obligated to have a certificate of occupancy for
the residential care facility issued by the department of commerce or a local
certified building department. (B) The plumbing fixtures in a
residential care facility are obligated to conform to the applicable provisions
of the Ohio plumbing code. (C) All plumbing is to be installed in
accordance with the Ohio plumbing code and maintained free of leakage and odors
and have adequate water pressure to reasonably ensure resident health and
safety protection. This includes, but is not limited to, plumbing
in: (1) Water
closets; (2) Service
sinks; (3) Kitchens; (4) Utility
closets; (5) Public and resident
bathrooms; (6) Shower and bathing
areas; and (7) Drinking
fountains. (D) Lavatories, bathing facilities, and
shower facilities are to be provided with pressure balancing thermostatic
mixing devices in accordance with the Ohio plumbing code to prevent
unanticipated changes in hot water temperatures. (E) The water supply for a residential
care facility is to be taken from a public supply, if available. Each
residential care facility using a water source other than a public water system
is obligated to comply with all applicable local and state regulations
regarding the construction, development, installation, alteration, and use of
private water systems. (F) Each residential care facility not
using a public sewage disposal system is obligated to comply with all
applicable local and state regulations regarding the construction, development,
installation, alteration, and use of household sewage disposal
systems. (G) Each residential care facility is
obligated to comply with all the applicable state fire code standards of
Chapter 1301:7-7 of the Administrative Code. (H) Each residential care facility is
obligated to be inspected for fire safety in accordance with paragraph (A) of
rule 3701-16-04 of the Administrative Code. (I) Each residential care facility is
obligated to provide paths of clear and unobstructed access to egress exits.
Additionally, the propping open of a door through the use of door stops,
wedges, or other devices is only permitted with approved hold-open devices that
release with the loss of facility power and/or with the engagement of the fire
alarm or sprinkler system. (J) Each residential care facility is obligated to develop and
maintain a written disaster preparedness plan to be followed in case of
emergency or disaster. A copy of the plan is obligated to be readily available
at all times within the residential care facility and a copy of the disaster
preparedness plan is to be maintained electronically to ensure off-site access
in the event of emergency. The plan is obligated to include the
following: (1) Procedures for
evacuating all individuals in the residential care facility, which include the
following: (a) Provisions for evacuating residents with impaired mobility;
and (b) Provisions for transporting all of the residents of the
residential care facility to a predetermined appropriate facility or facilities
that will accommodate all the residents of the residential care facility in
case of a disaster requiring evacuation of the residential care
facility. (2) A plan for protection
of all persons in the event of fire and procedures for fire control and
evacuation, including a fire watch and the prompt notification of the local
fire authority and state fire marshal's office when a fire detection, fire
alarm, or sprinkler system is impaired or inoperable. For purposes of this
rule, "fire watch" means the process set forth in the Ohio fire code
for detecting and immediately alerting residents, staff, and the responding
fire department of a fire or other emergency while the building's fire
alarm or sprinkler system is impaired, inoperable or undergoing
testing; (3) Procedures for
locating missing residents, including notification of local law
enforcement; (4) Procedures for
ensuring the health and safety of residents during severe weather situations,
such as tornadoes and floods, and designation of tornado shelter areas in the
facility; (5) Procedures, as
appropriate, for ensuring the health and safety of residents in residential
care facilities located in close proximity to areas known to have specific
disaster potential, such as airports, chemical processing plants, and railroad
tracks; and (6) Each residential care
facility will notify the director by electronic mail or telephone when there is
an interruption of normal business services due to an emergency or a disaster
involving the facility. (K) Each residential care facility is obligated to conduct the
following drills unless the state fire marshal allows a home to vary from this
obligation and the residential care facility has written documentation to this
effect from the state fire marshal: (1) Twelve fire exit
drills, one conducted on each shift at least every three months to familiarize
staff members and residents with signals, evacuation procedures and emergency
actions that may be necessary under varied times and conditions. Fire exit
drills will include the transmission of a fire alarm signal to the appropriate
fire department or monitoring station, verification of receipt of that signal,
and simulation of emergency fire conditions except that the movement of infirm
and bedridden residents to safe areas or to the exterior of the structure is
not necessary for these drills. Drills conducted between nine p.m. and six a.m.
may use a coded announcement instead of an audible alarm. Residential care
facilities that have an alarm system that is not capable of sending a fire
alarm signal if an audible alarm is not used are obligated to transmit a fire
alarm signal and verify receipt of that signal no more than twelve hours after
the coded announcement. Fire drills will meet the following
standards. (a) Each staff member is obligated to participate in at least one
fire drill annually. (b) One staff member with knowledge of the disaster preparedness
plan and the fire evacuation routes is obligated to be designated to observe
and evaluate each drill and not participate in that drill. (c) Residents capable of self-evacuation are to be actually
evacuated to safe areas or to the exterior of the residential care facility in
at least two fire drills a year on each shift. Movement of non-ambulatory
residents to safe areas or to the exterior of the facility is not necessary for
these drills. (2) At least two disaster
preparedness drills per year, one of which is a tornado drill which is
conducted during the months of March through July. (3) The residential care
facility will reset the alarms after each drill. (L) Each residential care facility is obligated to investigate
and take corrective action for all problems encountered in the drills obligated
under paragraph (K) of this rule. (M) Each residential care facility is obligated to keep a written
record and evaluation of each fire drill which includes the date, time, staff
member attendance, method of activation, effectiveness of the drill procedures,
number of individuals evacuated, total time for evacuation, and the weather
conditions during the evacuation, and of each tornado drill. Any problems
encountered and the corrective actions taken are to be included in the written
record. This record is to be maintained in the facility for three
years. (N) Each residential care facility is obligated to post in a
conspicuous place in each section or floor of the residential care facility a
correctly oriented wall-specific floor plan designating room use, locations of
alarm sending stations, evacuation routes and exits, fire alarms and fire
extinguishers, and flow of resident evacuation. (O) The buildings in which a residential care facility is housed
are obligated to be equipped with both an automatic fire extinguishing system
and fire alarm system that conform to standards set forth in rules 4101:1-1 to
4101:1-35 and rules 1301:7-7-01 to 1301:1-7-47 of the Administrative Code.
Records of the installation, testing and maintenance of both systems are to be
maintained at the facility and produced for inspection upon
request. (P) All staff members in each residential
care facility are to be trained in fire control and evacuation procedures
within three working days of beginning employment. A staff member is not
allowed to stay alone in the residential care facility with residents until the
staff member has received the training in fire control and evacuation
procedures established by this rule. (Q) Each residential care facility is obligated to provide for
annual training in fire prevention for regularly scheduled staff members on all
shifts to be conducted by the state fire marshal or township, municipal or
local legally constituted fire department. Records of this training are to be
maintained at the facility. (R) Each residential care facility is obligated to train all
residents in the proper actions to take in the event of fire, tornado,
disaster, or other emergency. (S) Each residential care facility is obligated to conduct at
least monthly a fire safety inspection which is recorded on forms provided by
the department and kept on file in the facility for three years. (T) Each residential care facility is
obligated to install carbon monoxide detectors in accordance with section 915.
of the Ohio Fire Code. (U) Smoking, as defined in rule 3701-52-01 of the
Administrative Code, which includes the use of an electronic smoking device and
a vapor product, are permitted only in properly designated areas which may
include resident units with the approval of the administrator. No staff member,
resident of a residential care facility or other persons in the facility is
permitted to smoke, carry a lighted cigarette, cigar, or pipe or use any spark
or flame producing device in any room or area in the facility where oxygen is
stored or in use. Approved terminals of a piped oxygen supply does not
constitute storage. "No smoking" signs are to be posted in areas and
on doors of rooms where oxygen is stored or in use. Each residential care
facility is obligated to take reasonable precautions to ensure the safety of
all residents when permitting residents to smoke. Ash trays, wastebaskets or
containers into which burnable materials are placed cannot be made of materials
which are flammable, combustible, or capable of generating quantities of smoke
or toxic gases and shall be used solely for that purpose. Such containers are
to be made readily available in all areas where smoking is permitted.
Residential care facilities that allow outdoor resident smoking are obligated
to make accommodations for residents during adverse weather
conditions. (V) Each residential care facility is obligated to maintain
all electrical systems including, but not limited to, cords, switches, lighting
fixtures, and lamps in good, safe operating condition and ensure that
appliances are in good, safe operating condition; (W) Each residential care facility is obligated to report
any incident of fire, damage due to fire and any incidence of illness, injury
or death due to fire or smoke inhalation of a resident within twenty-four hours
to the office of the state fire marshal and the department on forms provided by
these entities. (X) Each residential care facility is obligated to maintain
written transfer agreements with other facilities that can meet the needs of
residents who are in need of transfer because their health and safety is or
potentially is adversely affected by conditions in the facility.
Last updated July 12, 2024 at 9:35 AM
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Rule 3701-16-14 | Space requirements.
(A) For purposes of this rule,
"habitable floor area" means the clear floor area of a bedroom or
resident unit and the floor area occupied by the usual room furniture, such as
beds, chairs, sofas, dressers, and tables and does not include areas
partitioned off in the bedroom or resident unit such as closets and toilet
rooms. (B) Each residential care facility is
obligated to provide resident unit space for each resident which meets the
following criteria: (1) Except as provided
for in paragraphs (B)(1)(a) and (B)(1)(b) of this rule, in facilities which
were licensed prior to December 22, 1964, and in continuous operation since
that date, every single-occupancy bedroom is obligated to have a habitable
floor area of not less than eighty square feet and every multi-occupancy
bedroom is obligated to have a habitable floor area of not less than seventy
square feet per person. (a) Resident units added after December 22, 1964, are obligated
to comply with paragraph (B)(2) of this rule; and (b) Any building licensed as a facility on or before December 22,
1964, that discontinued operating as a facility and later resumed facility
operation is obligated to comply with paragraph (B)(2) of this
rule; (2) For every building or
addition to a building erected or converted to use or initially licensed as a
facility after December 22, 1964, every single-occupancy resident unit is
obligated to have a habitable floor area of not less than one hundred square
feet and every multi-occupancy resident unit is obligated to have a habitable
floor area of not less than eighty square feet per person; (3) No resident unit,
bedroom, or similar division used for sleeping purposes by residents is allowed
to be occupied by more than four residents; (4) A resident unit is
not allowed to be used as a passageway to other areas of the residential care
facility; (5) Each resident will
have a resident-activated resident call system as defined by paragraph (FF) of
rule 3701-16-01 of the Administrative Code, in good working order that, at
minimum, provides for the transmission of calls from resident rooms and toilet
and bathing facilities and cannot be deactivated from any location except from
where the resident initiated the call, unless the staff is able to communicate
with the resident; (6) Resident units are
obligated to be separated from halls, corridors, and other rooms by permanent
floor-to-ceiling walls. Temporary partitions are not allowed to be used to
separate resident units; (7) Each resident bedroom
is obligated to have a minimum of one window opening to the outside or to an
atrium with a curtain, shade, or other appropriate covering to assure privacy
and a screen if the window is operable; (8) Each residential care
facility is obligated to ensure that each resident unit is equipped with the
furnishings and supplies specified in paragraph (C) of rule 3701-16-15 of the
Administrative Code; and (9) Each residential care
facility is obligated to assign non-ambulatory residents to resident units on a
floor that exits to ground level unless there is an elevator to accommodate
movement of such residents to other floors of the facility. (C) Each residential care facility that
provides meals is obligated to have at least one room or suitable area with
comfortable, safe, and functional furniture to be used by residents for dining
purposes that comfortably accommodates the number of residents to whom the
residential care facility provides meals. (D) As used in this rule,
"bathroom" means a room or rooms including at least one toilet, one
shower or bathtub, and one sink. Each residential care facility is obligated to
provide at least one toilet, one shower or bathtub, and one sink for every
eight residents living in the residential care facility. Each residential care
facility is obligated to meet the following standards regarding bathroom
facilities: (1) The bathrooms and all
the facilities therein are to be in good repair, in a clean and sanitary
condition, free from filth and accumulation of waste; (2) Bathrooms and all
fixtures therein ensure resident privacy and dignity. Where there are more than
one toilet or more than one bathtub or shower in a bathroom, each toilet and
each bathtub or shower is to be enclosed in such a way as to maintain the
privacy of each resident; (3) Bathrooms are obligated to conform to
the Ohio building code; (4) At all times, bathrooms and all the
facilities therein are to be kept in good repair, in a clean and sanitary
condition, and free from filth and accumulated waste, and be provided with a
supply of toilet tissue, unless provided by the resident as specified in the
resident agreement. Each hand washing basin will be provided soap and a
self-draining device or other appropriate dispenser unless provided by the
resident as specified in the resident agreement; (5) Each bathtub and shower will have a
nonskid surfacing and handrails or grab bars. Each residential care facility is
obligated to provide handrails or grab bars near each toilet in resident units
occupied by individuals who need assistance with activities of daily living or,
if resident units do not have toilets, near a sufficient number of toilets on
each floor of the facility to accommodate such individuals; and (6) Each bathtub, shower, and sink will
have hot and cold running water. If the residential care facility is in control
of the hot water temperature, the hot water is to be at least one hundred five
degrees fahrenheit and no more than one hundred twenty degrees fahrenheit at
the point of use. If a resident is in control of the hot water temperature in
their resident unit, the residential care facility is obligated to ensure that
the hot water is at a safe temperature sufficient to meet the preferences of
the resident. (E) As used in this paragraph,
"toilet room" means a room or rooms conforming to the Ohio building
code, and including a water closet and a lavatory which is located in or
adjacent to the room in which the water closet is located. The residential care
facility is obligated to provide toilet tissue, soap in a self-draining device
or other appropriate dispenser, and individual paper towels or a hand dryer for
all toilet rooms or bathrooms open to staff, visitors, or both.
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Rule 3701-16-15 | Building maintenance, equipment and supplies.
(A) Each residential care facility is
obligated to maintain heating, electrical, and other building service equipment
in good working and safe condition and have its central heating system checked
every two years by a heating contractor. (B) Each residential care facility is
obligated to maintain a clean, healthy environment by at minimum: (1) Establishing and
implementing housekeeping and maintenance procedures to assure a clean, safe,
sanitary environment; (2) Providing durable
garbage and refuse receptacles to accommodate waste. The residential care
facility is obligated to store all garbage and other refuse in leakproof
containers with tight fitting covers until time of disposal, and dispose all
waste in a satisfactory manner; and (3) Eliminating any
existing insects and rodents and taking effective measures to prevent the
presence of insects and rodents in or around any building used for a
residential care facility or part thereof. The extermination of insects and
rodents is to be done in such a manner as not to create a fire or health
hazard. (C) Unless the resident chooses to bring
their own or as specified in the resident agreement, the residential care
facility is obligated to provide each resident with the following bedroom
furnishings and supplies: (1) An individual bed
equipped with springs that is sturdy, safe, and in good condition as well as a
clean comfortable flame resistant mattress or a clean comfortable mattress with
a flame resistant mattress cover. Rollaway beds and cots, double deck beds,
stacked bunk beds, hide-a-bed couches, or studio couches do not meet the
standards of this rule. If the resident chooses to sleep on an alternate piece
of furniture, such as a reclining chair, the facility is obligated to ensure
that a bed meeting the standards of this rule remains available to the
resident; (2) Bed linen which
includes at least two sheets, a pillow and pillow case, a bedspread, and one
blanket that fit properly and are free of tears, holes, and excessive fraying
or wear. The residential care facility is obligated to: (a) Ensure that the mattresses of incontinent residents are
protected with an intact waterproof material unless contraindicated or
otherwise ordered by a physician or other licensed healthcare professional
working within their scope of practice; and (b) Provide each resident with additional blankets and pillows
upon request and ensure that two sets of bed linens are available for each bed
at all times. Residential care facilities are obligated to ensure that bed
linen is changed weekly and more often if soiled or requested by the
resident; (3) Closet or wardrobe
space with a minimum width of twenty-two inches of hanging space sufficient in
height and equipped for hanging full length garments and at least one shelf of
adequate size within reach of the resident; (4) A bedside table,
personal reading lamp, adequate bureau, dresser or equivalent space, a mirror
appropriate for grooming, a waste basket with liners, and a chair with a padded
back and seat, with arms for lateral support. If a resident has a wheelchair,
the wheelchair may meet this standard unless the resident indicates he or she
wants a comfortable chair in addition to the wheelchair; (5) Bath linen that
includes at least two full towels, two face towels, and two
washcloths; (6) A shower curtain and
appropriate hanging devices; and (7) Basic toiletry items
and paper products. (D) In meeting the criteria set forth in
paragraph (C) of this rule, residential care facilities may allow residents to
provide all or part of the bedroom furnishings and supplies listed under
paragraphs (C)(1) to (C)(7) of this rule if the bedroom furnishings and
supplies meet the criteria set forth in paragraphs (C)(1) to (C)(7) of this
rule and there is sufficient space in the residential care facility. Residents
who smoke are obligated to provide documentation that the mattress they bring
to the residential care facility is flame resistant. Residents are to be
permitted to bring personal furnishings and items in addition to the bedroom
furnishings and supplies listed under paragraphs (C)(1) to (C)(7) of this rule
if the personal furnishings and items do not create a safety hazard or infringe
upon the rights of other residents. (E) A residential care facility is obligated to arrange for the
provision of at least a double size bed, upon request of a married couple or
other consenting adult residents sharing a room in accordance with the
residential care facility's policy, unless there is an overriding
documented medical reason that puts one of the consenting parties at risk of
health and safety or there is a risk to other residents. (F) All residential care facilities are obligated to have the
supplies and equipment necessary to provide the services needed by the
residents admitted to or retained in the facility. The residential care
facility is obligated to keep all equipment and supplies in the facility clean
and usable and store them satisfactorily and safely when not in
use. (G) Waste baskets or containers in common areas where burnable
materials may be placed are forbidden from being made of materials which are
flammable, combustible or capable of generating quantities of smoke or toxic
gases. (H) Each residential care facility is obligated to provide at
least one non-pay telephone to which residents have reasonable access at all
times for making local calls in a location or manner which affords privacy. The
residential care facility is obligated to arrange for a method by which
residents can make long-distance calls from the residential care facility at
the residents' expense. (I) Each residential care facility is obligated to meet the
following safety and maintenance standards: (1) The residential care
facility is obligated to keep floors in good repair and ensure that rugs used
in the facility are secured in a manner that does not create a safety
hazard; (2) The residential care
facility is obligated to keep corridors, entrances, exits, fire escape routes
and outside pathways in good repair, free of obstacles, and ice and snow.
Buildings that are constructed or converted for use as residential care
facilities after April 1, 2007, are obligated to have accessible means of
egress that open to a hard surface leading to a public way; (3) Common areas and
exits will be well-lighted; (4) The residential care
facility is obligated to store poisonous and hazardous materials in clearly
labeled containers, away from foodstuffs and medication and poisonous and
hazardous materials shall be stored in accordance with the manufacturer's
instructions and applicable provisions of the Ohio fire code; (5) If resident units
have locks, the residential care facility is obligated to have duplicate keys
or a master key available and readily accessible at all times to the staff
members on duty or present in the facility for use in case of
emergency; (6) The residential care
facility is obligated to maintain first-aid supplies in a closed but unlocked
container which is easily accessible to the administrator and
staff; (7) The residential care
facility is obligated to maintain its buildings and grounds in a clean and
orderly manner; and (8) Residential care
facilities is not allowed to mandate that residents or staff members to obtain
approval from the operator, administrator or staff member prior to telephoning
for assistance in the event of an emergency. Each residential care facility is
obligated to prominently display emergency telephone numbers, such as the fire
and police department numbers, at each telephone maintained by the residential
care facility.
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Rule 3701-16-16 | Temperature regulation in residential care facilities.
(A) For the purposes of this
rule: (1) "Resident
area" means any area within a residential care facility that is occupied
at any time by a resident. (2) "Temperature
range" means between seventy-one degrees Fahrenheit and eighty-one degrees
Fahrenheit. (B) Each residential care facility is
obligated to maintain the temperature range and humidity in resident areas at a
safe and comfortable level and have a device, such as a hand held hygrometer or
infrared thermometer, to check the ambient temperature of the
rooms. (C) Residents in rooms containing
separate heating and cooling systems who are capable of controlling them may
maintain the temperature of their rooms at any level they desire except the
residential care facility is obligated to take appropriate intervention if a
resident's desired temperature level adversely affects or has potential
for adversely affecting the health and safety of the resident or the health,
safety and comfort of any other resident sharing the resident
room. (D) Each residential care facility, in
consultation with a physician or an appropriate health care professional acting
within the professional's scope of practice, is obligated to develop
written policies and procedures for responding to temperatures in resident
areas that are outside the temperature range as defined in paragraph (A) of
this rule. The policies and procedures will include at least the following
items: (1) An identification of
available sites within or outside the residential care facility to which
residents can be relocated temporarily and of other suitable health care
facilities or facilities that provide personal care services that will be
available to receive transfers of residents if the temperature level adversely
affects or has potential for adversely affecting the health and safety of
residents; (2) Measures to be taken
to assure the health, safety and comfort of residents who remain in the
facility when temperatures are outside the temperature range as defined in
paragraph (A) of this rule; and (3) Identification of the
circumstances that necessitate notification of the resident's attending
physician or other licensed healthcare professional working within their scope
of practice, or that necessitate medical examinations or other medical
intervention and appropriate time frames for these actions. (E) Whenever the temperature in any
resident area is outside the temperature range as defined in paragraph (A) of
this rule, the residential care facility immediately is obligated to evaluate
the situation, monitor residents, and take appropriate action to ensure the
health, safety and comfort of its residents, including but not limited to
implementation of the policies and procedures developed under paragraph (D) of
this rule. The residential care facility is obligated to document all action
taken under this paragraph and maintain, on site, documentation of action taken
during the current calendar year and during the preceding calendar
year. (F) Each residential care facility is
obligated to maintain appropriate arrangements with qualified persons that
provide for emergency service in the event of an electrical, heating,
ventilation or air conditioning failure or malfunction and maintain
documentation of the arrangements such as employment or other written
agreements. The residential care facility is obligated to ensure that all
necessary repairs are completed within forty-eight hours or less. If, for
reasons beyond the facility's control, repairs cannot be completed timely,
the residential care facility is obligated to take any necessary action, as
specified in paragraph (E) of this rule, and provide for the repairs to be
completed as soon as possible.
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Rule 3701-16-17 | Records and reports.
(A) Each residential care facility is
obligated to maintain records which are able to be made available for
inspection at all times when requested by the director, including: (1) An individual record
for each resident that is stored in a manner that protects and ensures
confidentiality, except that information is immediately accessible for an
emergency; (a) Each resident record will be started immediately upon
admission to the residential care facility and include the
following: (i) The resident's
name, previous address, date of birth, gender, race, religion; the date the
resident began living at the residential care facility; the names, addresses,
and telephone numbers of the resident's attending physician, nearest
relative, current guardian, if any, and any other individuals the resident
designates to be contacted, including individuals to be notified in the event
of an emergency. If applicable, the contact information of the nearest relative
or guardian is obligated to be reviewed and updated every six months to ensure
appropriate notification in the event of an emergency, quarantine, or closure
.The residential care facility is not allowed to coerce a resident to provide
any of this information; (ii) Copies of the health
assessments in accordance with rule 3701-16-08 of the Administrative
Code; (iii) Notations about
incidents and adverse changes in health status in accordance with rule
3701-16-12 of the Administrative Code; (iv) A medication record
in accordance with paragraph (I)(7) of rule 3701-16-09 of the Administrative
Code as well as any medicare-D plan, if any, in which the resident is enrolled
and receives prescription medication; (v) Documentation in
accordance with paragraph (J) of rule 3701-16-10 of the Administrative Code for
residents on therapeutic diets; (vi) A written resident
agreement in accordance with rule 3701-16-07 of the Administrative
Code; (vii) Documentation in
accordance with paragraphs (J)(5) of rule 3701-16-09 and (B)(4) and (C)(3) of
rule 3701-16-09.1 of the Administrative Code for residents receiving skilled
nursing care provided by the residential care facility; and (viii) A copy of risk
agreements entered into under paragraph (G) of rule 3701-16-07 of the
Administrative Code and the signed statement in accordance with paragraph (H)
of rule 3701-16-07 of the Administrative Code, if applicable; (2) An incident log in
accordance with paragraph (B)(2) of rule 3701-16-12 of the Administrative
Code; (3) Copies of all current
licenses, approvals and inspections in accordance with rules 3701-16-01 to
3701-16-18 of the Administrative Code; (4) A record of the name,
address, working hours, medical statements, and training for staff
members; (5) Documentation of
compliance with rule 3701-16-16 of the Administrative Code; (6) Fire and evacuation
procedures and records of fire drills in accordance with rule 3701-16-13 of the
Administrative Code; (7) Records of heating
system checks in accordance with paragraph (A) of rule 3701-16-15 of the
Administrative Code and fire extinguishing system checks; (8) Records in accordance
with state and federal laws and regulations as to the purchase, dispensing,
administering, and disposition of prescription medications including unused
portions; (9) The residents'
rights policies, procedures and records; and (10) Other records in
accordance with Chapter 3721. of the Revised Code and rules 3701-16-01 to
3701-16-18 of the Administrative Code. (B) All records and reports maintained in accordance Chapter
3701-13 of the Administrative Code are to be maintained and made available in
accordance with that chapter. (C) The residential care facility is obligated to: (1) Maintain records kept
in accordance with paragraphs (A)(1) and (A)(2) of this rule, for seven years
following the date of the resident's discharge except if the resident is a
minor, such records are to be maintained for three years past the age of
majority but not less than seven years; and (2) Maintain records kept
in accordance with paragraphs (A)(3) to (A)(10) of this rule, for three years
unless otherwise required by law.
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Rule 3701-16-18 | Variances.
(A) The director may grant a variance
from the requirements of rules 3701-16-01 to 3701-16-18 of the Administrative
Code unless required by statute if the operator or administrator shows that
granting the variance will not jeopardize the health or safety of any resident
and that: (1) Because of practical
difficulties or other special conditions, strict application of the licensure
requirement will cause unusual and unnecessary hardship; or (2) An alternative to the
licensure requirement, including new concepts, methods, procedures, techniques,
or the conducting of pilot projects is in the interest of better health care or
management. No variance will be granted that will defeat
the spirit and general intent of these rules or otherwise not be in the public
interest. (B) A request for a variance from the
requirements of the residential care facility licensure rules is obligated to
be made in writing to the director, specifying the following: (1) The rule requirement
for which the variance is requested; (2) The time period for
which the variance is requested; (3) The specific
alternative action which the residential care facility proposes; (4) The reasons for the
request; and (5) An explanation of the
anticipated affect granting of the variance will have on
residents; The director may request additional information
from the residential care facility prior to making a determination regarding
the request. (C) The director is obligated to notify
the operator, in writing, of the director's determination regarding a
variance request. The director may establish conditions that the residential
care facility is obligated to meet for a variance to be operative, a time frame
for which the variance will be effective, or both. (D) The director is obligated to notify
the operator, in writing, of the director's determination to revoke a
granted variance. The director may revoke a variance if the director determines
that: (1) The variance is
adversely affecting the health and safety of the residents; (2) The residential care
facility has failed to comply with the variance as granted; (3) The operator or
administrator notified the department that the owner or administrator wishes to
relinquish the variance; or (4) The variance
conflicts with a statutory change thus rendering the variance
invalid. (E) The refusal of the director to grant
or revoke a variance or waiver, in whole or in part, will be final and will not
be construed as creating any rights to a hearing under Chapter 119. of the
Revised Code.
Last updated July 12, 2024 at 9:36 AM
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