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016.06.5-500. Admimstration , Plant, and Maintenance Requirements

AR ADC 016.06.5-500Arkansas Administrative CodeEffective: January 1, 2020

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 5. Rules Pertaining to Post-Acute Head Injury Retraining and Residential Adult Care Facilities (Refs & Annos)
Effective: January 1, 2020
Ark. Admin. Code 016.06.5-500
016.06.5-500. Admimstration [FN1], Plant, and Maintenance Requirements
Currentness
501. Administration: Each Facility shall have on the premises a manager or other individual delegated with supervisory authority. All communications between the Office of Long Term Care and the Facility will be through the manager. The manager or any supervisory employee must:
Be at least 21 years of age;
Be able to read or write;
Be able to understand and comply with these rules;
Be a full-time employee;
Have no prior criminal convictions under Act 28 of 1979, as amended; and
Have no prior history of abuse or neglect of others.
502. Staff. Sufficient staff shall be present at all times to meet the ordinary needs of the Residents.
503. Resident Records: Each Facility shall maintain individual records for each Resident.
The following information shall be contained in each Resident's record:
A. Resident's name and residential address prior to admission;
B. Resident's Sponsor's name, residential address, home telephone number, and business telephone.
C. Name and regular emergency telephone numbers of the Resident's attending physicians;
D. Reports of referring source;
E. Reports of outside service referrals;
F. Resident's Individual Service Plan;
G. Name and home telephone of the program manager for the Resident;
H. Evaluation reports from each service;
L. [FN1] Reports of staff conferences concerning the Resident;
J. The Resident's Home Health Care service plan;
K. A copy of the Resident's Rights Statement signed by the Resident or the Resident's Sponsor;
L. Written authorization from the Resident's attending physician for any medications being received by the Resident;
M. Any correspondence pertinent to the Resident;
N. A list of all insurance policies insuring the life of a Resident of which the Facility is a beneficiary; and
O. A signed copy of the Facility's admission/discharge and transfer agreement with the Resident.
The Facility shall maintain all Resident records as follows:
A. All information and documents shall be organized in a systematic fashion and affixed to the record binder.
B. All Resident records shall be maintained at a central location.
C. A designated staff member shall be responsible for the control of all Resident records.
D. An indexing and filing system shall be maintained for all Resident's records
E. Resident records shall be stored under lock with reasonable protection against fire, water, and other hazards.
The Facility shall protect the confidentiality of Resident records as follows:
A. Each Resident or the Resident's Sponsor shall have the right to inspect the Resident's records during normal business hours.
B. Provide access to the agents, representatives and employees of Office of Long Term Care in furtherance of the performance of official duties.
C. The Facility shall not disclose any Resident's records to any person or agency other than the Resident, the Resident's Sponsor, the personnel of the Facility or personnel of the Office of Long Term Care, except upon express written consent of the Resident, unless the disclosure is required by state or federal law.
D. Any inspection, investigative reports, or written complaints which are accessible to the public shall not disclose the identity of any Resident.
Upon discharge or death, a copy of the Resident's discharge report or death certificate shall be placed in the Resident's record. The records of discharged or deceased Residents must be retained for three years but may be stored separate from the records of present Residents.
504. Dietary Services: Each Facility shall provide to its Residents food and drink which furnishes sufficient nutrients and calories based on current recommendations of the Food and Nutrition Board of the National Academy of Sciences, National Research Council.
Each Facility shall provide three balanced meals per day and have available between meal snacks. The three meals, together, shall provide the following minimum dietary requirements:
A. Milk -- Two or more cups served as a beverage or used in cooking. Fortified whole, skim, low fat milk, flavored whole or fortified milk, buttermilk, or cheese may be used. Cheese may be used as a milk substitute or as a meat substitute, but nor both;
B. Meat Group -- Two or more servings of meat, fish, poultry, eggs, cheese, or equivalent; at least four or five ounces edible portions per day;
C. Vegetable and Fruit Group -- Four or more servings (two cups) which shall include citrus or other fruit, a vegetable for Vitamin C and a dark green or yellow vegetable for Vitamin A at least every other day;
D. Other vegetables and fruits, including potatoes; and
E. Bread and Cereal Group -- Four or more servings of whole grain or enriched bread.
The Facility in serving the three meals daily shall:
A. Serve the meals at approximately the same time each day;
B. Assist and supervise the Residents in consumption of the meals;
C. Serve food which is chopped, ground or pureed if necessary to meet the individual needs of a Resident.
If a Resident refuses to consume meals for more than two (2) days or shorter period, as the Resident's physician specifies, the Facility shall notify the Resident's attending physician and act on the physician's instructions.
Dining room space and furnishings shall be maintained in good repair. Dining room space and furnishings must be sufficient to serve the Residents in no more than two (2) seatings.
A supply of food must be maintained on the premises at all times. This shall include at least a 24-hour supply of perishable food and three-day supply of non-perishable. The food supply must come from sources approved by the State Department of Health.
Each Facility shall have adequate refrigeration and storage space. Refrigerator temperatures shall not exceed 45°F, and freezer temperatures shall not exceed 0°F. Thermometers shall be placed in each refrigerator and freezer. Left-over food placed in the refrigerator shall be sealed and dated and must be used within 48 hours.
All food shall be prepared, cooked, served, and stored in such manner that protects against contamination and spoilage.
The kitchen and dining area shall be cleaned after each meal.
An all purpose #5 ABC fire extinguisher shall be provided in the kitchen.
Food scraps shall be placed in garbage cans with tight fitting lids and bag liners. The liners must be sealed and the cans emptied after each meal.
All food service personnel shall have health cards and shall wear clean clothes.
505 Laundry and Linen Service:
Each Facility shall provide laundry services to its Residents. Laundry services may be provided by the Facility, by contract with an outside linen service, or by permitting Residents with supervision to do their own personal laundry.
In-house laundries shall be located in areas separate from kitchen, bathroom, and bedroom areas.
Facilities with in-house laundries shall have washers and dryers of adequate size to serve the needs of the Facility.
Laundry dryers shall be properly vented to the outside.
The laundry room shall be cleaned on a daily basis to prevent lint accumulation and to remove clutter.
Portable electric eaters or stove shall not be used in the laundry area.
The laundry room shall be well lighted and vented to the outside by either power vents, gravity vents, or by outside windows.
Resident's clothing and kitchen linens shall be washed separately from bed linens. Bed linens, including washable blankets, shall be washed at a minimum temperature of 150′F or with a disinfecting agent.
The following minimum amounts of linen shall be available in the Facility at all times:
A. Sheets -- Two (2) times the Facility's census.
B. Pillow Cases -- Two (2) times the Facility's census.
C. Bath Towels -- Two (2) times the Facility's census.
D. Hand Towels -- Two (2) times the Facility's census.
E. Washcloths -- Two (2) times the Facility's census.
F. One blanket and one pillow for each Resident.
Bed linens shall be changed at least once a week and more often as needed. Beds shall be straightened as necessary by the Resident or staff.
506. Housekeeping:
506.1 Each Facility shall keep all areas clean and free of insects, rodents, and trash. All equipment and furnishings shall be maintained in good operating condition.
506.2 Each Residential Area shall be cleaned before each used by another Resident. Resident should be encouraged to keep their own rooms clean and supervision from Facility staff.
506.3 Corridors shall not be sued for storage.
506.4 Attics, cellars, basements, below stairways, and similar areas shall be kept clean of accumulation of refuse, old newspapers, discarded furniture and other flammable or combustible materials.
506.5 Throw or scatter rugs must have non-skid backing.
506.6 Polish used on floors shall provide non-slip finish.
506.7 Flammable material, such as gasoline, kerosene, paint, and paint thinners, shall not be stored inside any building containing a Residential Area or in the attic of any building.
506.8 Metal or UL approved plastic wastepaper baskets shall be provided in Residential Areas and other areas in which Residents smoke.
506.9 Outside trash containers shall be equipped with covers.
506.10 There shall be an adequate and available supply of soap and toilet tissues for each Resident.
507. Space, Furnishings, and Equipment:
507.1 All rooms, including bedrooms, shall have light switches at the entrance to the room.
507.2 Windows shall be kept clean and in good repair and supplied with curtains, shades, or drapes. Each window shall have a screen which is clean and in good condition.
507.3 Light fixtures shall be equipped with covers to prevent glare and hazards to the Residents.
507.4 All fans located within seven (7) feet of the floor shall be protected by screen guards of not more than one-fourth inch mesh.
507.5 All Resident bedrooms shall have a hinged door in working order.
507.6 All Facilities shall have at least one telephone available for outside calls for every forty (40) Residents.
507.7 All Residential Areas shall be decorated, painted, and appropriately furnished.
507.8 All furnishings and equipment shall be durable, clean, and appropriate to its functions.
507.9 All areas shall be well lighted to insure Residents safety.
508. Residential Areas.
508.1 Each Residential Areas shall have living room space meeting the following requirements:
A. At least 20 square feet of living room space must be provided for each licensed bed in the Residential Area.
B. The living room space shall be easily accessible to all Residents residing in the Residential area.
C. Living rooms shall not be used as bedrooms
D. Living rooms shall be available or use by Residents at appropriate times to provide periods of social diversion and individual or group activities.
508.2 Each Residential Area shall have dining room space meeting the following requirements:
A. Sufficient dining room space shall be provided to allow the serving of all Residents regularly utilizing it in not more than two seatings.
B. Each dining room shall be readily accessible to the Residents utilizing it.
C. Each dining room shall be furnished with sufficient dining tables and chairs to serve all Residents regularly utilizing it in not more than two seatings.
D. Dining room areas may serve more than one Residential Area may serve the entire Facility.
508.3 Dogs and cats may be permitted in Residential Areas if a pet therapy plan for the Facility has been approved by the Office of Long Term Care and the pets are maintained as part of a Resident's Individual Service Plan. Guide dogs for the visually impaired are permitted without approval of the Office of Long Term Care. Proper sanitary conditions must be maintained by the Facility.
509. Baths and Toilets:
509.1 In Residential Areas, there shall be a minimum of one toilet and one lavatory for each six Residents. A minimum of one tub or shower shall be provided for each ten Residents. In educational and administrative areas, the requirements of the Arkansas State Plumbing Code shall be satisfied.
509.2 Each bathroom shall have a door in working order.
509.3 If the Facility accepts Residents who must use wheelchairs of other assistive devices, the Facility shall insure that adequate accessible bath and toilet facilities are available to such Residents.
509.4 Hot water tanks serving bathroom fixtures shall be maintained on the lowest possible setting to avoid possible bums to Residents. No tank shall be located in a Residential Area. Each tank shall have a pressure release valve. In all Facilities which commence operation after adoption of these rules and in all future construction at all Facilities, an adjustable thermostatically controlled mixing valve shall be installed at the hot water tank on all hot water heaters.
509.5 Bathrooms shall provide privacy for each Resident.
509.6 Toilet and bathing facilities shall be vented to the outside.
510. Bedrooms:
510.1 No bedrooms shall be below ground level. If the floor level of a bedroom is above grade on one exterior wall, the bedroom shall not be considered to be below ground level. For natural ventilation each bedroom shall have an outside window with openings equal to one-eighth of the floor space. The opening of windows may be restricted if necessitated by a Resident's condition or behavior.
510.2 A bedroom occupied by a single Resident shall contain at least 80 square feet, exclusive of entrance way and closet space.
510.3 A bedroom occupied by more than one Resident shall provide at least 80 square feet for the first Resident and at least 60 spare feet for each additional Resident. The beds shall be at least three feet apart.
510.4 No more that three Residents shall share a bedroom.
510.5 Each Facility shall furnish every bedroom with the following equipment:
A. A standard or single bed in good repair for each Resident. Rollaway beds, cots, and folding beds shall not be used;
B. Each bed shall be equipped with well-constructed springs and mattresses in good repair, and a clean comfortable pillow;
C. Suitable furniture and storage facilities for personal articles for each Resident; and
D. At least three linear feet of closet or locker space shall be provided for each Resident.
510.6 Male and female Residents shall not have adjoining bedrooms which do not have full floor-to-ceilings partitions and closable solid core doors. Male and female Residents shall not be permitted to co-habitate outside the bounds of matrimony.
511. Other Plant Requirements:
511.1 An adequate supply of potable water, under pressure, shall be provided at all times. When public water systems is available, a connection to it shall be made. If water from a source other than public water supply is used, the supply shall meet the requirements set forth under Rules of the State Board of Health.
511.2 All sewage shall be disposed of by means of either:
A. A public system, if one is accessible within 300 feet, or
B. An approved sewage disposal system which is constructed and operated in conformance with the standards established for such systems by the Arkansas State Board of Health.
511.3 All plumbing shall be installed and maintained in accordance with the Arkansas State Plumbing and Gas Code.
511.4 Electrical wiring, fixtures, appliances, motors, and other electrical equipment shall be installed in accordance with the national electrical code NFPA Pamphlet #70 and shall comply with the local regulations and codes where they exist. The use of extension cords is strictly prohibited
511.5 All heating units or systems shall comply with the following requirements:
A. All liquefied petroleum gas systems must be installed and maintained in accordance with the State Code for liquefied Petroleum Gas Containers and Equipment, State of Arkansas.
B. All gas heating units shall bear the stamp of approval of the American Gas Association Testing Laboratories, Inc., or other nationally recognized testing agency for enclosed, vented heaters for the type of fuel used.
C. All gas heating units and water heaters shall be vented adequately to care the by-products of combustion to the outside atmosphere. Vents shall be constructed and maintained to provide a continuous draft to the outside atmosphere in accordance with the American Gas Association Recommended Procedures.
D. All heating units shall be provided with a sufficient supply of outside air so as to support combustion without depletion of the air in the occupied room.
E. All heating and cooling units must be installed and maintained in a manner which will provide for the safety and comfort of the occupants.
F. Wood heaters may be used if UL approved and installed per UL instructions.
511.6 Facilities must be operated in areas permitted by local zoning codes. Each Facility shall provide the Office of Long Term Care with documentation that the Facility is in compliance with zoning Requirements.
511.7 Conditions of soil, groundwater level, drainage and topography shall not create hazards to the property or to the health and safety of the occupants. The site shall not be subject to unpredictable flooding and shall be large enough to provide an exercise area for Residents.
512. Safety Standards:
512.1 Life Safety Code 1985, Chapters I through 7 shall apply to all buildings containing Residential Areas. Chapters 16, 18, 20, and 2 1, as appropriate, shall apply to buildings containing Residential Areas, depending on the living and structural arrangement of each building.
512.2 Tornado drills shall be conducted annually and documented. Fire drills shall be conducted quarterly and documented. Smoke detectors checked monthly and documented. Fire extinguishers 5 #ABC shall be located in bedroom areas.
512.3 Steam pipes and heating pipes with which Residents may come in contact shall be covered to prevent injury or burns.
512.4 Grab bars shall be provided in Resident bathrooms for toilets, tubs, and showers. Bathtubs shall be equipped with non-slip surfaces.
512.5 Bedrooms must access directly to an exit corridor. Access to toilet and bathing areas shall not be through another Resident's bedroom. Access to bedroom areas shall not be through toilet or bathing areas.
512.6 Any practices which create a fire hazard are prohibited, including but not limited to:
A. Portable electric space heaters or self-contained, fuel-burning space heaters, unless specifically authorized by the Office of Long Term Care in writing;
B. Use of electrical cooking appliances or mini-kitchens in Resident's bedrooms;
C. Combustible containers for smoking material or ashes;
D. The accumulation of combustible material, such as rags, paper items, and general trash, and
E. Unsafe storage of oil-based paints, varnishes or other flammables.
512.7 Doors in Resident bedrooms may be secured by the Resident provided such doors can be unlocked from the outside and keys are available to staff at all times.
512.8 Chain locks, clasps, bars, padlocks, and similar devices on doors shall not be used in any area of the Facility intended for use by Residents.
512.9 A diagram of the building shall be posted in each building showing exits and fire extinguishers.
512.10 Emergency telephone numbers shall be posted in large print in each building. The list shall include fire department, police department, physician, ambulance service, poison control center, emergency services, and the Office of Long Term Care.
513. Maintenance:
513.1 Each Facility shall establish and conduct a maintenance program to insure the continued maintenance of the Facility's plant, to promote good housekeeping procedures, and to insure sanitary practices.
513.2 Each Facility shall:
A. Maintain the building and grounds in a clean, orderly condition in good repair;
B. Maintain draperies and furniture in good and safe repair;
C. Promptly replace or repair cracks in plaster, peeling wallpaper or paint, missing or damaged tiles, and tears or splits in floor coverings;
D. Maintain the electrical systems, including appliances, cords, and switches, in compliance with the state and local codes;
E. Maintain plumbing and plumbing fixtures in compliance with Arkansas Plumbing and Gas Codes;
F. Maintain ventilation, heating, air conditioning, and air changing systems. Gas systems shall e inspected at least every 12 months to assure safe operation. Inspection certificates, where applicable, shall be maintained for review;
G. Maintain the building, grounds and other buildings free of breeding areas for flies, other insects, and rodents;
H. Maintain entrances, exits, steps, and outside walkways free from ice, snow, and other hazards; and
L. [FN1] Repairs or additions must meet then-existing building codes.

Credits

Amended Jan. 1, 2020.
[FN1]
So in original.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.5-500, AR ADC 016.06.5-500
End of Document