Arkansas Administrative Code

20 CAR § 413-602. Linens and bedding. (a) Extra pillows shall be available as needed for treatment and/or comfort of clients. (b) Moisture-proof rubber or plastic sheeting shall be provided as necessary to keep mattress or pillows clean or dry. (c) Where laundry service is provid…

20 CAR § 413-603. Equipment and supplies. Nursing equipment and supplies shall be provided as needed to meet the client's needs and maintained in good condition to ensure adequate nursing care of the clients.

20 CAR § 413-604. Sanitation. Methods approved by the Office of Long-Term Care shall be used to sanitize: (1) Bedpans; (2) Urinals; and (3) Emesis basins.

20 CAR § 413-605. Storage. (a)(1) If bedpans, urinals, and emesis basins are assigned to individual clients, they shall be name labeled and stored in the client's bedside cabinet. (2) They shall be cleansed after each use and sanitized by an approved method at least weekly. (3) I…

20 CAR § 413-606. Housekeeping — Maintenance. (a)(1) Housekeeping services for the fifteen-bed or less ICF/IID shall be provided daily including weekend daytime coverage, and for cleanup after the evening meal. (2) Additional staff will be required if deficiencies are found that …

20 CAR § 413-701. Standard — Physician services. (a) The facility must ensure the availability of physician services twenty-four hours a day. (b)(1) The physician must develop, in coordination with licensed nursing personnel, a medical care plan of treatment for a client if the p…

20 CAR § 413-702. Standard — Physician participation in the individual program plan. A physician must participate in: (1) The establishment of each newly admitted client's individual program plan as required by this part that specified plan of care requirements for ICF/IID's; and…

20 CAR § 413-703. Standard — Nursing services. (a) The facility must provide clients with nursing services as needed. (b) These services must include: (1) Participation as appropriate in the development, review, and update of an individual program plan as part of the interdiscipl…

20 CAR § 413-704. Standard — Nursing staff. (a) Nurses providing services in the facility must have a current license to practice in the state. (b) The facility must employ or arrange for licensed nursing services sufficient to care for clients health needs including those client…

20 CAR § 413-705. Standard — Dental services. (a) The facility must provide or make arrangements for comprehensive diagnostic and treatment services for each client from qualified personnel, including licensed dentists and dental hygienist either through organized dental services…

20 CAR § 413-706. Standard — Comprehensive dental diagnostic services. Comprehensive dental diagnostic services include: (1) A complete extraoral and intraoral examination, using diagnostic aids necessary to properly evaluate the client's oral condition, not later than one (1) mo…

20 CAR § 413-707. Standard — Comprehensive dental treatment. The facility must ensure comprehensive dental treatment services that include: (1) The availability for emergency dental treatment on a twenty-four-hour-a-day basis by a licensed dentist; and (2) Dental care needed for:…

20 CAR § 413-708. Standard — Documentation of dental services. (a) If the facility maintains an in-house dental service, the facility must keep a permanent dental record for each client, with a dental summary maintained in the client's living unit. (b) If the facility does not ma…

20 CAR § 413-709. Treatment and medications. (a)(1) No medication or treatment shall be given without the written order of the physician or dentist. (2) Drugs shall be administered in accordance with orders. (b)(1) If it is necessary to take physician's or dentist's orders over t…

20 CAR § 413-710. Pharmaceutical services — Responsibility for pharmacy compliance. (a) The administrator shall be responsible for full compliance with federal and state laws governing procurement, control, and administration of all drugs. (b) Full compliance is expected with the…

20 CAR § 413-711. Standard — Pharmacy services. (a) The facility must provide or make arrangements for the provision of routine and emergency drugs and biologicals to its clients. (b) Drugs and biologicals may be obtained from community or contract pharmacists or the facility may…

20 CAR § 413-712. Standard — Drug regimen review. (a) A pharmacist with input from the interdisciplinary team must review the drug regimen of each client at least quarterly. (b) The pharmacist must report any irregularities in clients' drug regimens to the prescribing physician a…

20 CAR § 413-713. Standard — Drug administration. (a) The facility must have an organized system for drug administration that identifies each drug up to the point of administration. (b) The system must ensure that: (1) All drugs are administered in compliance with the physician's…

20 CAR § 413-714. Equipment for administering medications. (a) There shall be calibrated medicine containers to correctly measure liquid medications. (b) Disposable items shall not be reused. (c) Disposable syringes and needles must be disposed of by incineration.…

20 CAR § 413-715. Medicine cards. (a) In administering medications, medication cards current with physician orders must be used. (b) Medicine cards, except in the case of established self-administration programs, or the distribution of blister packs, shall be provided to include:…

20 CAR § 413-716. Stop-order policy. (a) Medications not specifically limited as to time or number of doses when ordered by the physician shall be controlled by the facility's policy regarding automatic stop orders. (b) The facility's automatic stop-order policy, at a minimum, sh…

20 CAR § 413-717. Storage of drugs. (a) All drugs on the premises of a facility except for the emergency tray as defined by the State Board of Health and the Arkansas State Board of Pharmacy shall be in a properly labeled container as dispensed upon prescription by the pharmacy. …

20 CAR § 413-718. Standard — Drug storage and record keeping. (a)(1) The facility must keep all drugs and biologicals in a locked cabinet or a locked room except when being prepared for administration. (2) Only the nurse responsible for administering the medication or the individ…

20 CAR § 413-719. Standard — Drug labeling. (a) Labeling of drugs and biologicals must: (1) Be based on currently accepted professional principles and practices; and (2) Include the appropriate accessory and cautionary instructions, as well as the expiration date, if applicable. …

20 CAR § 413-720. Record of controlled drugs. (a)(1) A record shall be kept in a bound ledger book with consecutively numbered pages of all controlled drugs procured and administered. (2) This record shall contain on each separate page the following: (A) Name, strength, and quant…

20 CAR § 413-721. Controlled drug accountability. (a)(1) There shall be a weekly count of all Schedule II, III, IV, and V controlled medications. (2) This count shall be made by the person in charge of medications in the facility and witnessed by a nonlicensed employee who cosign…

20 CAR § 413-722. Wasting of controlled drugs. (a) When a dose of a controlled drug is dropped or broken, two (2) people should make a statement in the bound ledger as to what occurred, and both must sign their names. (b) One (1) of these people shall be a licensed nurse.…

20 CAR § 413-723. Disposition of unused drugs. (a)(1) Schedule II, III, IV, and V drugs dispensed by prescription for a client and no longer needed by the client must be delivered in person or by registered mail to: Division of Pharmacy Services and Drug Control, Arkansas Departm…

20 CAR § 413-724. Standard — Laboratory services. (a) For purposes of this section, "laboratory" means an entity for the microbiological, serological, chemical, hematological, radiobioassay, sytological, immunohematological, pathological, or other examination of material derived …

20 CAR § 413-725. Standard — Active treatment. (a) Each client must receive a continuous active treatment program, which includes aggressive, consistent implementation of a program of specialized and generic training, treatment, health services, and related services described in …

20 CAR § 413-726. Standard — Admissions, transfers, and discharge. (a) Clients who are admitted by the facility must be in need of and receiving active treatment services. (b) Admission decisions must be based on a preliminary evaluation of the client that is conducted or updated…

20 CAR § 413-727. Standard — Individual program plan. (a) Each client must have an individual program plan developed by an interdisciplinary team that represents the professions, disciplines, or service areas that are relevant to: (1) Identifying the client's needs, as described …

20 CAR § 413-728. Standard — Program implementation. (a) As soon as the interdisciplinary team has formulated a client's individual program plan, each client must receive a continuous active treatment program consisting of needed interventions and services in sufficient number an…

20 CAR § 413-729. Standard — Program documentation. (a) Data relative to accomplishment of the criteria specified in client individual program plan objectives must be documented in measurable terms. (b) The facility must document significant events that are related to the client'…

20 CAR § 413-730. Standard — Program monitoring and change. (a) The individual program plan must be reviewed at least by the qualified intellectual disability professional and revised as necessary, including, but not limited to situations in which the client: (1) Has successfully…

20 CAR § 413-801. Standard — Facility practices — Conduct toward clients. (a) The facility must develop and implement written policies and procedures for the management of conduct between staff and clients. (b) These policies must: (1) Promote the growth, development, and indepen…

20 CAR § 413-802. Standard — Management of inappropriate client behavior. (a)(1) The facility must develop and implement written policies and procedures that govern the management of inappropriate client behavior. (2) These policies and procedures must be consistent with the prov…

20 CAR § 413-803. Standard — Physical restraints. (a) The facility may employ physical restraints only: (1) As an integral part of an individual program plan that is intended to lead to less restrictive means of managing and eliminating the behavior for which the restraint is app…

20 CAR § 413-804. Standard — Drug usage. (a) The facility must not use drugs in doses that interfere with the individual client's daily living activities. (b) Drugs used for the control of inappropriate behavior must be approved by the interdisciplinary team and be used only as a…

20 CAR § 413-805. Standard — QIDP. Each client's active treatment program must be integrated, coordinated, and monitored by a qualified intellectual disability professional.

20 CAR § 413-806. Standard — Professional program services. (a)(1) Each client must receive the professional program services needed to implement the active treatment program defined by each client's individual program plan. (2) Professional program staff must work directly with …

20 CAR § 413-807. Standard — Facility staffing. (a) The facility must not depend on clients or volunteers to perform direct care services for the facility. (b) There must be responsible direct care staff on duty and awake on a twenty-four-hour basis, when clients are present, to …

20 CAR § 413-808. Standard — Direct care residential living unit staff. (a) The facility must provide sufficient direct care staff to manage and supervise clients in accordance with their individual program plans. (b) Direct care staff are defined as the present on-duty staff cal…

20 CAR § 413-901. Hygiene of staff. (a)(1) All food service employees shall wear appropriate, light-colored clothing including hairnet and shall keep themselves and their clothing clean. (2) Males may wear caps. (b) All persons working as food handlers in facilities shall have in…

20 CAR § 413-902. Standard — Food and nutrition services. (a) Each client must receive a nourishing, well-balanced diet including modified and specially prescribed diets. (b) A qualified dietitian must be employed either full-time, part-time, or on a consultant basis at the facil…

20 CAR § 413-903. Standard — Meal services. (a) Each client must receive at least three (3) meals daily, at regular times comparable to normal mealtimes in the community with: (1) Not more than fourteen (14) hours between a substantial evening meal and breakfast of the following …

20 CAR § 413-904. Standard — Menus. (a)(1) Menus shall be planned and written two (2) weeks in advance and posted at least one (1) week in advance. (2) Arrows, etc. are not acceptable. (b) Menus shall provide a variety of foods at each meal. (c) Menus shall be different for the s…

20 CAR § 413-905. Standard — Dining areas and service. The facility must: (1) Serve meals for all clients, including persons with ambulation deficits, in dining areas, unless otherwise specified by the interdisciplinary team or a physician; (2) Provide table service for all clien…

20 CAR § 413-906. Preparations and storage of food. (a)(1) An adequately sized storage room shall be provided with adequate shelving. (2) Seamless containers with tight-fitting lids, clearly labeled, shall be provided for bulk storage of dry foods. (3) The storage room shall be o…

20 CAR § 413-907. 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) Tarni…