Part 400. Rules for Nursing Homes

20 CAR § 400-2203. Treatment philosophy. Each Alzheimer’s special care unit shall develop a mission statement that reflects the ASCU’s treatment philosophy for those residents diagnosed with Alzheimer’s or related dementia.

20 CAR § 400-2204. Assessments. (a) Psychosocial and physical assessments. (1) Each resident shall receive a psychosocial and physical assessment which: (A) Includes the resident’s: (i) Degree or level of family support; (ii) Level of activities of daily living functioning; (iii)…

20 CAR § 400-2205. Admissions, discharges, transfers. (a) Criteria for services. (1) Each Alzheimer’s special care unit shall have written policies setting forth preadmission screening, admission, and discharge procedures. (2) Admission criteria shall require: (A) A physician’s d…

20 CAR § 400-2206. Staffing. (a)(1) Alzheimer’s special care units shall staff according to this part. (2) Furthermore, the following staffing requirements are established for Alzheimer's special care units. (b) Professional program services. A social worker or other professional…

20 CAR § 400-2207. Physical environment, design, and safety. (a) Physical design. In addition to the physical design standards required for the facility’s license, an Alzheimer’s special care unit shall include the following: (1) A floor plan design that does not require visitors…

20 CAR § 400-2208. Therapeutic activities. (a) Intent and general requirements. (1) Therapeutic activities can: (A) Improve a resident’s eating or sleeping patterns; (B) Lessen wandering, restlessness, or anxiety; (C) Improve socialization or cooperation; (D) Delay deterioration …

20 CAR § 400-2209. Penalties. (a) If a facility having an Alzheimer's special care unit does not meet the specific standards established herein, the Office of Long-Term Care shall instruct the facility to immediately cease advertising or holding itself out as having one (1) or mo…

20 CAR § 400-2301. Definitions. As used in this subpart: (1) “Administrator” means a long-term facility administrator as defined in Arkansas Code § 20-10-101; (2) “Department” means the Department of Human Services; (3) “Director of the Office of Long-Term Care” means the Assista…

20 CAR § 400-2302. Purpose. (a)(1) Arkansas Code § 20-10-902 describes the purpose for development of a mechanism for the concept of receivership to protect resident in long-term care facilities. (2) Utilization of the receivership mechanism shall be a remedy of last resort and s…

20 CAR § 400-2303. Appointment and supervision of a monitor or monitors. (a) The Secretary of the Department of Human Services, pursuant to Arkansas Code § 20-10-915, may in his or her discretion place a designated employee in the facility in lieu of a receiver. (b) The monitor o…

20 CAR § 400-2304. Determination of need for receivership. Prepetition activities. Prior to the filing of a petition of receivership (Arkansas Code § 20-10-905), the Department of Human Services shall be notified and: (1) Coordinate the preparation and collection of documentation…

20 CAR § 400-2305. Petition for notice of receivership. (a) The Department of Human Services, Attorney General, or prosecuting attorney or duly appointed deputy prosecuting attorney of the district in which the facility is located may file in circuit court of the county in which …

20 CAR § 400-2306. Postpetition activities. Immediately upon appointment of a receiver the Department of Human Services shall assist the receiver and ensure the following functions and responsibilities are accomplished: (1) Identify the need for additional staff as necessary to e…

20 CAR § 400-2307. Assistance with duties of the receiver to staff. Immediately upon completion of the assessment in 20 CAR § 400-2307, but in no event more than seventy-two (72) hours after appointment, the Department of Human Services shall assist the receiver to: (1)(A) Conduc…

20 CAR § 400-2308. Assistance with responsibilities of receiver to residents, guardians, and families. Immediately upon completion of assessment in 20 CAR § 400-2306, but in no event more than seventy-two (72) hours after appointment, the Department of Human Services shall assist…

20 CAR § 400-2309. Long range responsibilities of receiver. (a) Upon appointment, the Department of Human Services shall assist in taking appropriate action with regard to the on-going operation of the facility. (b) That action shall include: (1) Meeting regularly with other staf…

20 CAR § 400-2310. Reporting of progress of receiver. (a)(1) The receiver shall report to the court, the Department of Human Services, the owner, and administrator licensee on the progress of the receivership action: (A) Before the receivership can be concluded; (B) At such times…

20 CAR § 400-2311. Qualifications and maintenance of list for receiver. (a)(1) Through consultation with the long-term care industry associations, professional organizations, consumer groups, and health-care management corporations, the Department of Human Services shall maintain…

20 CAR § 400-2312. Department to furnish receiver with copy of legal proceedings. (a) Upon appointment of a receiver for a facility by a court, the Department of Human Services shall inform the individual of all legal proceedings to date which concern the facility. (b) The receiv…

20 CAR § 400-2313. Mandated patient transfer. In the case of Department of Human Services-ordered patient transfers, the receiver may: (1) Assist in providing for the orderly transfer of all residents in the facility to other suitable facilities, or make other provisions for thei…

20 CAR § 400-2401. Generally. (a)(1) When a long-term care facility does not agree with deficiencies cited on a statement of deficiencies, the facility may request an informal dispute resolution (IDR) meeting of the deficiencies in lieu of, or in addition to, a formal appeal. (2)…

20 CAR § 400-2402. Requesting an informal dispute resolution. (a) A written request for an informal dispute resolution must be made to the Department of Health, Health Facility Services, 5800 West 10th, Suite 400, Little Rock, AR 72204 within ten (10) calendar days of the receipt…

20 CAR § 400-2403. Matters which may be heard at IDR. (a) The IDR is limited to deficiencies cited on a statements of deficiencies. (b) Issues that may not be heard at an IDR include, but are not limited to: (1) The scope and severity assigned the deficiency by the Office of Long…

20 CAR § 400-2404. Appeal of IDR results. (a)(1) If a Medicaid-certified facility is not satisfied with the results of the informal dispute resolution, it may request a hearing before the Long-Term Care Facility Advisory Board [abolished] within the sixty-day time frame for appea…

20 CAR § 400-2501. Written policies. (a)(1) The facility shall have written policies and procedures defining the rights and responsibilities of residents. (2) The policies shall present a clear statement defining how residents are to be treated by the facility, its personnel, vol…

6 CAR § 400-2502. Staff. (a) Staff members must fully understand all residents’ rights. (b)(1) Facility staff will be provided a copy of residents’ rights. (2) Staff shall complete a written acknowledgement stating they have received and read the residents' rights. (3) A copy of …

6 CAR § 400-2503. Services. (a)(1) Each resident admitted to the facility will be fully informed, prior to or at the time of admission, and as need arises during residency, of: (A) Services available in the facility; and (B) any charges for services. (2) Residents have the right …

6 CAR § 400-2504. Resident care. (a)(1) Each resident admitted to the facility shall be fully informed by a physician of his or her medical condition. (2) The resident shall be afforded the opportunity to participate in the planning of his or her total medical care and may refuse…

6 CAR § 400-2505. Transfer or discharge. (a)(1) A resident may be transferred or discharged only for: (A) Medical reasons; (B) His or her welfare or the welfare of other residents; (C) The resident presents a danger to the safety or health of other residents; (D) Because the resi…

20 CAR § 400-2506. Change in room or roommate. The facility must provide reasonable written notice of change in room or roommate.

20 CAR § 400-2507. Exercise of rights. (a)(1) Each resident admitted to the facility will be encouraged and assisted to exercise all constitutional and legal rights as a resident and as a citizen including the right to vote, and the facility shall make reasonable accommodations t…

20 CAR § 400-2508. Complaints and suggestions. (a) Complaints or suggestions made to the facility's staff shall be responded to within ten (10) days. (b) Documentation of such response will be maintained by the facility administrator or his or her designee.

20 CAR § 400-2509. Personal belongings. Each resident may retain and use personal clothing and possessions as space and rules permit.

20 CAR § 400-2510. Resident council. (a)(1) A representative resident council shall be established in each facility. (2) The resident council's duties shall include: (A) Review of policies and procedures required for implementation of resident rights; (B) Recommendation of change…

20 CAR § 400-2511. Family council. (a) The facility shall inform residents' families of the right to establish a family council within the facility. (b) The establishment of such council shall be encouraged by the facility. (c) This family council shall: (1) Have the same duties …

20 CAR § 400-2512. Management of personal financial affairs. Each resident admitted to the facility may manage his or her personal financial affairs, or if the resident requests such affairs be managed by the facility, an accounting shall be maintained in accordance with applicab…

20 CAR § 400-2513. Free from abuse. (a) Residents shall 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 purposes and limited time as is reasonably necessary…

20 CAR § 400-2514. Restraint. (a) “Physical restraint” includes the use of devices designed or intended to limit residents' total mobility. (b) Physical restraints are not to be used to limit resident mobility: (1) For the convenience of staff; (2) As a means of punishment; or (3…

20 CAR § 400-2515. Confidentiality of records. (a) Each resident is assured confidential treatment of his or her personal and medical records. (b) Residents may approve or refuse the release of such records to any individual except: (1) In case of a transfer to another health car…

20 CAR § 400-2516. Treatment of residents. (a) Each resident will be treated with consideration, respect, and full recognition of dignity and individuality, including privacy in treatment and care for personal needs. (b) Staff shall: (1) Display respect for residents when speakin…

20 CAR § 400-2517. Residents’ choices. (a) Schedules of daily activities shall provide maximum flexibility and allow residents to exercise choice in participation. (b) Residents' individual preferences regarding such things as menus, clothing, religious activities, friendships, a…

20 CAR § 400-2518. Privacy. (a)(1) Residents shall be examined or treated in a manner that maintains and ensures privacy. (2) A closed door or a drawn curtain shall shield the resident from passers-by. (3) People not involved in the care of the residents are not to be present dur…

20 CAR § 400-2519. Visitors. (a) Policies and procedures shall permit residents to receive visits from anyone they wish, provided a particular visitor may be restricted for the following reasons: (1) The resident refuses to see the visitor; (2) The resident's physician specifical…

20 CAR § 400-2520. Financial affairs. (a) Residents are allowed to manage their own personal financial affairs. (b) Should the facility manage the resident's personal financial affairs, this authorization must be in writing and shall be signed appropriately as follows: (1) If the…

20 CAR § 400-2601. Definitions. As used in this part, the following definitions will apply, unless the context requires otherwise: (1) "Agency" means the Division of Medical Services; (2)(A) "Act" means a bodily movement and includes speech and the conscious possession or control…

20 CAR § 400-2602. Civil penalties. (a)(1) The following listed civil penalties pertaining to classified violations may be assessed by the Director of the Office of Long-Term Care against long-term care facilities. (2) In the case of Class A violations, the following civil penalt…

20 CAR § 400-2603. Factors in assessment of civil penalties. (a) In determining whether a civil penalty is to be assessed and in affixing the amount of the penalty to be imposed, the Director of the Office of Long-Term Care shall consider: (1) The gravity of the violation, includ…