3701-16-17 Resident assessments.

(A) In accordance with this rule, a community alternative home shall require written initial and periodic health assessments of prospective and current residents. Health assessments shall be conducted by physicians, or other licensed health professionals acting within their scope of practice, including assessment of the residents’ capacity to self-administer prescribed medications with or without assistance. The purpose of the assessments shall be to ensure that the residents do not require a level of care beyond that which is provided by the community alternative home.

(B) The initial health assessment shall include documentation of the following:

(1) Health history and physical;

(2) TB testing and results in accordance with paragraph (C) of this rule;

(3) Prescription medications;

(4) Dietary requirements;

(5) Height and weight;

(6) Medical diagnosis;

(7) Psychiatric or psychological diagnosis, if applicable;

(8) Type of care or services required; and

(9) The resident’s capability, as determined by his or her personal physician, to self-administer medications. The documentation shall specify what assistance with self-administration, as authorized by paragraph (D) of rule 3701-16-16 of the Administrative Code, if any, is needed.

(C) In addition to the requirements of paragraphs (A) and (B) of this rule, within forty-eight hours after admission, residents who have not had previously documented significant Mantoux tests and who do not have A record of a two-step Mantoux testing within the year preceding admission shall have a two-step Mantoux test using five tuberculin units of purified protein derivative. If nonsignificant, the second step shall be performed no less than seven or more than twenty-one days from the date of the first step. If a resident has had a two-step Mantoux test followed by uninterrupted annual single Mantoux tests, the most recent single Mantoux test having been obtained within one year of admission, the resident shall have at least a single Mantoux test within forty-eight hours of admission.

(1) The community alternative home shall assure that residents with documented significant Mantoux tests are reviewed for history and symptoms by a physician and that they have had a chest x-ray within ninety days before admission or within forty-eight hours of notification of significant test results. If appropriate, the physician shall order a repeat x-ray.

(2) Residents with nonsignificant Mantoux tests shall receive a single Mantoux test if they are exposed to a known case of tuberculosis and another single Mantoux test shall be performed no less than ninety days after exposure. If the test reveals evidence of conversion, the resident shall have a chest x-ray

(a) If the chest x-ray does not reveal active pulmonary tuberculosis, the home shall document that the resident is receiving appropriate preventive treatment or shall obtain a written statement from a licensed physician that treatment is medically contraindicated.

(b) If the chest x-ray reveals active pulmonary tuberculosis, the community alternative home shall, in accordance with rule 3701-16-23 of the Administrative Code. Immediately transfer the resident to a facility capable of appropriately caring for a resident with active pulmonary tuberculosis. The resident shall not be transferred back to a community alternative home until the pulmonary tuberculosis is no longer infectious.

Each resident with a nonsignificant Mantoux test shall have a single Mantoux test repeated annually within thirty days of the anniversary date of initial testing. Residents with a documented significant Mantoux test shall be monitored for signs and symptoms of tuberculosis but shall not be required to have an annual chest x-ray. If a resident shows signs and symptoms of tuberculosis, a chest x-ray of the resident shall be required at that time.

(D) A quarterly health assessment shall be performed within three months of the resident’s last health assessment. This health assessment shall include documentation of at least the following:

(1) Prescription medications;

(2) Updated dietary requirements;

(3) Weight;

(4) Updated medical diagnosis;

(5) For residents with significant Mantoux tests, assessment for signs and symptoms of tuberculosis;

(6) Type of care or services required; and

(7) The resident’s capability, as determined by his or her personal physician, to self-administer medications. The documentation also shall specify what type of assistance with self-administration, as authorized by paragraph (D) of rule 3701-16-16 of the Administrative Code, if any, is needed.

(E) If a resident’s condition requires care beyond that which a community alternative home is licensed to provide or beyond that which the specific home provides, the home shall transfer or discharge the resident in accordance with section 3724.10 of the Revised Code and rule 3701-16-23 of the Administrative Code.

R.C. 119.032 review dates: 01/09/2009 and 01/01/2014

Promulgated Under: 119.03

Statutory Authority: 3724.05

Rule Amplifies: 3724.02, 3724.05

Prior Effective Dates: 8/29/1988 (Emer.), 11/27/94, 2/13/99