Part 400. Rules for Nursing Homes

20 CAR § 400-1612. Review of medication by the nurse and/or pharmacist. (a) There shall be for each patient a separate medication/drug regimen review sheet. (b) This sheet is to be used to document the performance of a medication/drug regimen review by the pharmacist and/or regis…

20 CAR § 400-1613. Review of medications by consultant pharmacist. (a)(1) In an intermediate care facility, the review of the medication/drug regimen of the skilled care patients must be done at least each month, and at least quarterly on the intermediate and minimum care patient…

20 CAR § 400-1614. Cycle-fill, pharmacy notification, and disposition of unused drugs. (a)(1) Schedule II, III, IV, and V drugs dispensed by prescription for a patient and no longer needed by the patient must be delivered in person or by registered mail to the Drug Control Divisi…

20 CAR § 400-1615. Pharmacy-prepared medication container systems designed for administration with the use of medication cards (unit dose system). (a) All policies and procedures related to systems of this type must first be approved by the Office of Long-Term Care before that sy…

20 CAR § 400-1701. Staffing. (a)(1) Staff supervisory responsibility for the dietetic services is assigned to a full-time, qualified dietetic service supervisor or certified dietary manager. (2) A qualified supervisor has: (A) Completed an approved food service manager’s course; …

20 CAR § 400-1702. Hygiene of staff. (a) All food service employees shall: (1) Wear appropriate, light-colored clothing, including hairnet; and (2) Keep themselves and their clothing clean. (b) All persons working as food handlers in nursing homes shall have in their possession o…

20 CAR § 400-1703. Minimum daily food requirements. (a) All patients shall be served an approved, appetizing, adequate diet that conforms to the recommended dietary allowances of the Food and Nutrition Board, National Research Council or with, “Food for Fitness — a Daily Guide” l…

20 CAR § 400-1704. Frequency of meals. (a) At least three (3) meals are served daily. (b)(1) There shall be at least a five-hour span between: (A) Breakfast and the noon meal; and (B) Noon meal and supper. (2) The meals shall be served at approximately the same hours each day. (c…

20 CAR § 400-1705. Meal service. (a) All foods shall be served at the proper temperatures and procedures established and implemented to serve the patient cold foods between forty-five to fifty-five degrees Fahrenheit (45˚F to 55˚F), and hot foods should register one hundred forty…

20 CAR § 400-1706. Menus. (a)(1) Menus shall be: (A) Planned and written two (2) weeks in advance; and (B) Posted at least one (1) week in advance. (2) Menus for each level shall be written. (3) Arrows, etc., are not acceptable. (b)(1) Weekly menus shall not be repeated more ofte…

20 CAR § 400-1707. Therapeutic diets. (a)(1) There shall be a system of written communications between dietetic services and nursing services, i.e., diet order forms. (2) Nursing services should send a written patient diet list monthly and diet change slips as diets are changed b…

20 CAR § 400-1708. Preparation and storage of food. (a)(1) An adequately sized storage room shall be provided with adequate shelving. (2)(A) Seamless containers with tight-fitting lids, clearly labeled, shall be provided for bulk storage of dry foods. (B) It is recommended that t…

20 CAR § 400-1709. Sanitary conditions. (a) Food shall be procured from sources approved or considered satisfactory by federal, state, and local authorities. (b) Floors shall be cleaned after each meal. (c)(1) Dishes, silverware, and glasses shall be free of: (A) Breaks; (B) Tarn…

20 CAR § 400-1710. Dietetic services staffing. (a)(1) Staffing shall be correlated to the: (A) Size of the facility; and (B) Total patient meals served. (2) Facilities with: (A) Fifty-nine (59) beds or less shall be staffed at ten (10) minutes for each meal served; (B) Sixty (60)…

20 CAR § 400-1801. Policies and procedures. (a) Separate policies must be written for social services and activity programs. (b) They shall be individualized for the individual long-term care facility. (c) They shall reflect the actual programs in operation at that facility. (d) …

20 CAR § 400-1802. Job description. (a) Separate for social services designee/worker. (b) Include actual functions of position. (c) Include other duties that may be assigned to designee/worker.

20 CAR § 400-1803. Social services records. (a) Social history/assessment. (1) Should give clear picture of individual over life span to date. (2) Incomplete information should specify reason for such. (3) Reflects current: (A) Functioning level; (B) Limitations; (C) Strengths; a…

20 CAR § 400-1804. Staffing and consultation for social services/activities. (a) The social services designee shall comply with the qualification requirements as set forth in federal regulations. (b) There shall be: (1) One (1) full-time social services designee/activities direct…

20 CAR § 400-1805. Program operation. (a)(1) There shall be adequate staff to provide activity/recreational programs daily, including Saturdays and Sundays. (2) There should be at least two (2) group activities scheduled daily. (b)(1) Activities shall be: (A) Varied in nature; an…

20 CAR § 400-1806. Pet therapy. (a) Animals will be allowed to be brought into the nursing home for a short period of time on a limited basis for therapy sessions. (b) These therapy sessions must be supervised at all times to see that the patients are not in danger at any time du…

20 CAR § 400-1901. Resident record maintenance. (a) The facility will maintain an individual record on all residents admitted in accordance with accepted professional standards and practices. (b) The resident record service must have sufficient staff, facilities, and equipment to…

20 CAR § 400-1902. Contents of records (to facilitate retrieving and compiling information). (a) The resident records will contain sufficient information to identify the resident, his or her diagnosis or diagnoses and treatment, and to document the results accurately. (b) Admissi…

20 CAR § 400-1903. Index. There will be an index of all residents admitted to the facility including: (1) Name of resident; (2) Record number; (3) Former address; (4) Name of physician; (5) Date of birth; and (6) Date of discharge.…

20 CAR § 400-1904. Retention and preservation of records. (a) Retention requirements for active clinical records. (1) The maintenance schedule for records on resident charts are as follows: (A) Admission and discharge records — Permanent; (B) Miscellaneous admission records — Per…

20 CAR § 400-1905. Confidentiality. (a) The information contained in the resident records is confidential and is not to be released without legal authorization or subpoena. (b) The records will be available to state survey agency personnel.

20 CAR § 400-1906. Staffing. (a) An individual will be designated as responsible for the resident record service. (b) There will be written job descriptions for the resident record service personnel.

20 CAR § 400-1907. General information. (a) All entries in the resident records will be recorded in ink. (b) There will be no alteration of information in the resident records. (c) If an error is made, a single line will be drawn through the error, the word “error” written above …

20 CAR § 400-2001. Intent. (a) Green House™ facilities are an attempt to enhance residents’ quality of life through the use of a noninstitutional facility model resulting in a residential-style physical plant and specific principles of staff interaction. (b) The Green House™ mode…

20 CAR § 400-2002. Designation. To be designated by the Office of Long-Term Care as a Green House™ facility, the facility shall meet the minimum standards and have approval to use the Green House™ service mark, issued by the Green House™ Project and NCB Capital Impact at the time…

20 CAR § 400-2003. Staffing. (a)(1) Facilities designated by the Office of Long-Term Care as Green House™ facilities shall employ the same staffing ratios and otherwise comply with 20 CAR § 400-1401 et seq. (2) Provided, however, that certified nursing assistants (CNAs) utilized …

20 CAR § 400-201. Licensure. (a)(1) Nursing homes, or related institutions, shall be operated, conducted, or maintained in this state by obtaining a license pursuant to the provisions of these licensing standards. (2) Separate institutions operated by the same management require …

20 CAR § 400-202. Application for license. (a)(1) Applicants for license shall: (A) File a notarized application with the Division of Provider Services and Quality Assurance upon forms prescribed by the division; and (B) Pay an annual license fee of ten cents (10¢) per patient be…

20 CAR § 400-203. Renewal of application for licensure. (a) Annual licensure fees shall be tendered with each application for a new long-term care facility license and annually thereafter by the anniversary of the date the Department of Human Services issued the long-term care fa…

20 CAR § 400-204. Issuance of license. (a) A license shall remain effective unless revoked, suspended, or terminated by the Department of Human Services. (b) A license shall be issued only for the premises and persons in the application and shall not be assignable or transferable…

20 CAR § 400-205. Denial, revocation, or suspension of license. The Division of Provider Services and Quality Assurance is empowered to deny, suspend, or revoke licenses on any of the following grounds: (1) Violation of any of the provisions of Acts 1979, No. 28, or the rules law…

20 CAR § 400-206. Change of ownership/management. (a)(1) If a long-term care facility intends to add, remove, or otherwise change the management company, owner, operator, or other management agent that manages the long-term care facility, the long-term care facility shall notify …

20 CAR § 400-207. Notice and procedure on hearing prior to denial, suspension, or revocation of license. (a) Whenever the Division of Provider Services and Quality Assurance decides to deny, suspend, or revoke a license, it shall send to the applicant or licensee a notice stating…

20 CAR § 400-208. Appeals to courts. (a) Any applicant or licensee who considers himself or herself injured in his or her person, business, or property by final agency action shall be entitled to judicial review thereof. (b) Proceedings for review shall be made by filing a petiti…

20 CAR § 400-209. Penalties. Any person, partnership, association, or corporation establishing, conducting, managing, or operating any institution within the meaning of Acts 1961, No. 414 (Arkansas Code §§ 20-9-201 – 20-9-217, § 20-9-219, and §§ 20-10-214 – 20-10-228), without fi…

20 CAR § 400-210. Inspection. All institutions to which this part applies shall be subject to inspection for reasonable cause at any time by the authorized representation of the Division of Provider Services and Quality Assurance.

20 CAR § 400-2101. Pilot project. (a) The construction and operation of HomeStyle facilities is a pilot project of the State of Arkansas to determine the efficacy of an alternative long-term care model. (b)(1) Facilities participating in the project will be required to maintain d…

20 CAR § 400-2102. Definitions. As used in this subpart: (1)(A) “Clinical support team” means nonuniversal workers of the entire facility that provide services to HomeStyle homes and any traditional nursing facility around which a HomeStyle home is constructed by providing suppor…

20 CAR § 400-2103. Designation. (a) Facilities meeting the requirements for HomeStyle shall be designated as such on the license issued to the facility, with the designation specifying the number of HomeStyle homes and the total number of beds in the HomeStyle homes. (b) Faciliti…

20 CAR § 400-2104. Staffing. (a)(1)(A) Facilities designated by the Office of Long-Term Care as HomeStyle facilities shall employ the same staffing ratios and otherwise comply with 20 CAR § 400-1401 et seq. (B) Provided, however, that certified nurse assistants (CNAs) utilized in…

20 CAR § 400-2105. Staff training. (a) In addition to any state or federal training requirements pertaining to long-term care facilities, each CNA working in a HomeStyle home shall complete the following eighty (80) hours of training to include but not limited to: TRAININGHOURS H…

20 CAR § 400-2106. Training approval. (a) Each facility seeking designation as a HomeStyle facility shall provide to the Office of Long-Term Care a syllabus, a list of required reference and study materials, and a proposed curriculum of training as required in 20 CAR § 400-2105. …

20 CAR § 400-211. Compliance. An initial license will not be issued until the applicant has demonstrated to the satisfaction of the Division of Provider Services and Quality Assurance that the facility is in substantial compliance with the licensing standards set forth in this pa…

20 CAR § 400-212. Noncompliance. (a) When noncompliance of the licensing standards is detected during surveys, licensees will be notified of the violations and will be requested to provide a plan of correction with a timetable for corrections. (b) If an item of noncompliance is o…

20 CAR § 400-213. Voluntary closure. Any nursing home, or related institution, that voluntarily closes must meet the rules for new construction to be eligible for relicensure.

20 CAR § 400-214. Exception to licensing standards. (a)(1) The Division of Provider Services and Quality Assurance reserves the right to make temporary exceptions to these standards where it is determined that the health and welfare of the community requires the services of the i…