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016.06.6-600. PARTICIPANTS' RIGHTS

AR ADC 016.06.6-600Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 6. Rules and Regulations for Licensing of Adult Day Health Care Providers
Ark. Admin. Code 016.06.6-600
016.06.6-600. PARTICIPANTS' RIGHTS
Currentness
The facility shall have written policies and procedures defining the rights and responsibilities of participants. The policies shall present a clear statement defining how participants are to be treated by the facility, its personnel, volunteers, and others involved in providing care.
601 A copy of the synopsis of the participant's bill of rights must be prominently displayed within the facility in a general use area.
602 Each participant admitted to the facility is to be fully informed of these rights and of all rules and regulations governing participant conduct and responsibilities.
602.1 Appropriate means shall be utilized to inform non-English speaking, deaf, or blind participants of their rights.
602.2 The ADHC shall communicate these expectations/rights during the period of not more than two weeks before or five working days after admission.
602.3 The ADHC shall obtain a signed and dated acknowledgement from the participants or his legal guardian that they have read and understand these rights.
602.3.1 The signed and dated acknowledgement shall be maintained in the participant's file.
603 Participants Rights shall be deemed appropriately signed if signed by:
• A participant capable of understanding: participant and one witness signs;
• A participant incapable because of illness: the attending physician documents the specific impairment that prevents the participant from understanding or signing their rights and the legal guardian and two witnesses sign;
• A participant is mentally retarded: Rights read and if understood by the participant, he/she and two witnesses sign. One witness shall be an outside disinterested party. If participant cannot understand Rights, legal guardian and one witness signs;
• A participant capable of understanding but signs with mark other than name: Participants signs with an Mark (i.e., “X”) and two witnesses sign.
604 ADHC employees shall be provided a copy of Participants Rights and complete a signed and dated acknowledgement stating they have received and read the Rights.
604.1 A copy of the acknowledgement shall be placed in the employee's personnel file.
605 SPECIFIC RIGHTS
Each participant shall be assured of the following rights:
605.1 To be treated as an adult, with respect and dignity regardless of race, color, sex, creed, or mental or physical disability;
605.2 To be fully informed prior, or at the time of admission and as need arises during participation in the program, of services available in the ADHC including any charges for services;
605.3 To be transferred or discharged only for:
• medical reasons
• his/her welfare or the welfare of other participants
• no longer needing the services provided by the facility
• non-payment
• facility ceasing operation;
605.4 To be given reasonable written notice to ensure orderly transfer or discharge;
605.4.1 The term “transfer” applies to the movement of a participant from one facility to another facility.
605.4.2 “Medical reasons” for transfer or discharge shall be based on the participant's needs and are to be determined and documented by a physician.
605.4.3 Documentation of “medical reasons” by a physician shall become a part of the participants permanent medical record.
605.4.4 “Reasonable notice of transfer or discharge” means the decision to transfer or discharge a participant shall be discused with the participant and/or their legal guardian. The participant/legal guardian shall be told the reason(s) and alternatives available.
605.4.5 A minimum of thirty (30) days written notice must be given.
605.4.6 A copy of the written notice shall be come a part of the participants permanent medical record.
605.4.7 Transfer for the welfare of the participant or other participants may be affected immediately if such action is documented in the medical record.
605.4.8 An appeals process for participants objecting to transfer or discharge shall be developed by the facility, in accordance with Ark Code Ann. 20-1--1005 amended. That process shall include:
• In the written notice of transfer or discharge, the notice shall inform the participant that they have the right to appeal the decision to the Director within seven (7) calendar days;
• The participant shall be assisted by the ADHC in filing the written objection to transfer or discharge;
• Within fourteen (14) days of filing of the written objections, a hearing will be scheduled;
• Final determination in the matter will be rendered within seven (7) days of the hearing;
605.5 To be encouraged and assisted to exercise all constitutional and legal rights including:
605.5.1 the right to vote;
605.5.2 the right to voice grievances or recommend changed in policies or services to ADHC staff or outside representatives of their choice;
605.5.3 freedom from restraint, coercion, discrimination or reprisal;
605.6 To have the right to free exercise of religion including the right to rely on spiritual means for treatment;
605.7 To have a response within ten (10) working days to complaints or suggestions made to the ADHC staff;
605.7.1 Documentations of such response will be maintained by the ADHC administrator or his designee.
605.8 To retain and use personal clothing and possessions as space and regulations permit;
605.9 To be free from mental and physical abuse, chemical and physical restraints (except in emergencies) unless authorized, in writing, by a physician, and only for such specified purpose and limited time as is reasonable necessary to protect the participant from injury to himself or others;
605.9.1 “Mental abuse” includes humiliation, harassment, and threats of punishment or deprivation.
605.9.2 “Physical abuse” refers to corporal punishment or the use of restraints as a punishment.
605.9.3 Drugs shall not be used to limit, control, or alter participant behavior for convenience of staff.
605.9.4 “Physical restraint” includes the use of devices designed or intended to limit participants total mobility.
605.9.5 Physical restraints are not to be used to limit participant mobility for the convenience of staff, as a means of punishment, or when not medically required to treat the participant's medical symptoms.
605.9.6 If a participant's behavior is such that it will result in injury to himself or others, any form of physical restraint utilized shall be in conjunction with a treatment procedure designed to modify the behavior problem for which the participant is restrained, and only after failure of therapy designed or intended to modify the threatening behavior.
605.10 To be assured confidential treatment of his/her personal and medical records;
605.11 To approve or refuse the release of such records to any individual except to authorized agents of DHS or their designee, in case of transfer to another health care institution, or as required by law or third party payment contract;
605.12 To be assured privacy in treatment and care for personal needs, including toileting and other activities of personal hygiene;
605.13 To be assured respect when spoken to, cared for, or talked about by ADHC staff;
605.14 To exercise choice in participation of ADHC daily activities, including individual preferences regarding such things as menus, clothing, religious activities, friendships, activity programs, and entertainment;
605.15 To associate or communicate privately with persons of their choice.
606 RESTRAINTS
The ADHC shall have written policy and procedures governing the use of restraints.
606.1 All physical restraints designed to limit participants' mobility or locking participants behind doors or other barriers are strictly prohibited.
606.2 Mechanical restraints used to achieve body position and balance must be designed and applied under the supervision of a qualified professional and in accordance with the principles of good body alignment, concern for circulation, and allowance for change of position.
606.3 The ADHC's written policy and procedures governing the use of mechanical supports shall specify which staff members may authorize the use of supports and must clearly specify the following:
A. Orders shall indicate the specific reason for the use of the supports.
B. Application of mechanical restraints shall not be allowed for longer than 12 hours during each application unless the participant's condition warrants and specified medical authorization is maintained in the participant's medical record.
C. A participant placed in mechanical restraints shall be checked at least every thirty (30) minutes by appropriately trained staff. A written record of this activity shall be maintained in the participant's medical record. The opportunity for motion and exercise shall be provided for a period of not less than ten (10) minutes during each two (2) hours in which supports are employed.
D. Reorder, extensions or reimposition of supports shall occur only upon review of the participant's condition by the physician, and must be documented in the physician's progress notes.
E. The use of supports shall not be employed as punishment for the convenience of staff, or as a substitute for supervision.
F. Mechanical supports must be employed in such manner as to avoid physical injury to the participant and provide a minimum of discomfort.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.6-600, AR ADC 016.06.6-600
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