Arkansas Administrative Code

20 CAR § 413-908. Dietetic services staffing. (a)(1) Staffing will be correlated to the size of the facility and the total client meals served. (2) Staffing will be adequate to provide sufficient staff for the number of meals served. (3) Clients whose individual program plans pro…

20 CAR § 414-1001. Generally. (a) Pursuant to federal regulation 42 C.F.R. § 483.12 (Freedom from abuse, neglect, and exploitation) and state law Arkansas Code § 5-28-101 et seq. (Abuse of Adults) and the Arkansas Child Maltreatment Act, Arkansas Code § 12-12-501 et seq. [repeale…

20 CAR § 414-1002. Next business day reporting of incidents. (a)(1) The following events shall be reported to the Office of Long-Term Care by facsimile transmission to telephone number 501-682-8551 of the completed Incident & Accident Intake Form, Form DMS-7734, no later than 11:…

20 CAR § 414-1003. Incidents or occurrences that require internal reporting only — Facsimile report on Form DMS-762 not required. (a) The following incidents or occurrences shall require the facility to prepare an internal report only and does not require a facsimile report, Form…

20 CAR § 414-1004. Internal-only reporting procedure. (a)(1) Written reports of all incidents and accidents included in 20 CAR § 414-1003 shall be completed within five (5) days after discovery. (2) The written incident and accident reports shall be comprised of all information s…

20 CAR § 414-1005. Other reporting requirements. The facility’s administrator is also required to make any other reports of incidents, accidents, suspected abuse or neglect, actual or suspected criminal conduct, etc. as required by state and federal laws, rules, and regulations.…

20 CAR § 414-1006. Abuse investigation report. (a) The facility must ensure that all alleged or suspected incidents involving resident abuse, exploitation, neglect, or misappropriations of resident property are thoroughly investigated. (b) The facility’s investigation must be in …

20 CAR § 414-1007. Reporting suspected abuse or neglect. (a) The facility’s written policies and procedures shall include, at a minimum, requirements specified in this section. (b) The requirement that the facility’s administrator or his or her designated agent immediately report…

20 CAR § 414-101. Intermediate care facilities for individuals with intellectual disabilities. (a) Pertains to sixteen-bed or more facilities. (b) In addition to meeting all standards outlined in federal regulations, intermediate care facilities for individuals with intellectual …

20 CAR § 414-201. Generally. (a)(1) Intermediate care facilities for individuals with intellectual disabilities (ICFs/IID), or related institutions, shall be operated, conducted, or maintained in this state by obtaining a license pursuant to the provisions of these licensing stan…

20 CAR § 414-202. Application for license. (a)(1) Applicants for license shall file a notarized application with the Division of Provider Services and Quality Assurance upon forms prescribed by the division and shall pay an annual license fee determined by multiplying ten dollars…

20 CAR § 414-203. Renewal of application for licensure. (a) Application for annual license renewal shall be postmarked or delivered to the Office of Long-Term Care no later than June 1 of the year in which renewal is sought. (b) Any fee not paid when due shall be delinquent and s…

20 CAR § 414-204. Issuance of license. (a) License shall be effective on a state fiscal year basis and shall expire on June 30 of each year. (b) License shall be issued only for the premises and persons in the application and shall not be assignable or transferable.…

20 CAR § 414-205. 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)(A) Violation of any of the provisions of Acts 1979, No. 28, or the rules …

20 CAR § 414-206. Notices 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 statin…

20 CAR § 414-207. 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 § 414-208. Penalties. Any person, partnership, association, or corporation, establishing, conducting, managing, or operating any institution without first obtaining a license therefor, or who violates any provision of applicable law, rule, or regulation lawfully promulgate…

20 CAR § 414-209. 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 § 414-210. Compliance. An initial license will not be issued until the applicant has demonstrated to the satisfaction of the division that the facility is in substantial compliance with the licensing standards set forth in this part.

20 CAR § 414-211. Noncompliance. (a) When noncompliance of the licensing standards are 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) The Office of Long-Term Care ma…

20 CAR § 414-212. Voluntary closure. Any ICF/IID, or related institution, that voluntarily closes must meet the rules and regulations for new construction to be eligible for relicensure.

20 CAR § 414-213. 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…

20 CAR § 414-214. Provisional licensure. (a)(1) Subject to the requirements below, a provisional license shall be issued to the applicant and new operator of the long-term care facility when the Office of Long-Term Care has received the Application for Licensure to Conduct a Long…

20 CAR § 414-301. Chief Executive Officer. (a) The Chief Executive Officer of the facility must be a licensed nursing home administrator in Arkansas. (b) In facilities with fifteen (15) beds or less the administrator may be a QIDP and would not be required to have an administrato…

20 CAR § 414-401. Generally. (a)(1) There shall be keys available for all locked doors within the facility. (2) Keys for all locked doors may be available in the main office or a designated place. (b) All containers of substances used in the facility shall be legibly and accurate…

20 CAR § 414-402. Personnel administration. (a) A personnel file shall be maintained for each employee. (b) All employees requiring licensure shall have this licensure verified at appropriate intervals. (c) No employee afflicted with a communicable disease or infected skin lesion…

20 CAR § 414-403. Staff development. (a) Job orientation shall be provided for all personnel to acquaint them with the needs of the clients, the physical facility, disaster plan, and the employees’ specific duties and responsibilities. (b)(1) All employees shall be involved in th…

20 CAR § 414-404. Reports. (a) A report by telephone or in writing shall be promptly submitted to the administrator, Certification Division, and Office of Long-Term Care, in all cases of: (1) Fire; (2) Damage to the facility due to any natural disaster; (3) Major incidents; (4) A…

20 CAR § 414-405. Infection control. (a) Written policies and procedures shall be established for investigating, controlling, and preventing infections. (b) Procedures shall be reviewed annually and revised as necessary for effectiveness and improvement. (c) The policies and proc…

20 CAR § 414-406. Handling of oxygen and flammable gases. (a) Policies shall be written for the proper handling of oxygen and flammable gases. (b) There shall also be written procedures for the care of equipment such as humidifiers, masks, cannulas, etc.

20 CAR § 414-407. Transportation of clients. The facility shall establish a written policy regarding transportation of clients, when necessary, to: (1) The hospital; (2) Medical clinics; and (3) Dentist offices.

20 CAR § 414-501. New construction. (a) All new construction shall meet the following standards outlined in this section: (1) General; (2) Site location, inspection, approvals, and subsoil investigation; (3) Submission of plans, specifications, and estimates; (4) Plans and specif…

20 CAR § 414-502. Existing construction. (a) All existing facilities must be maintained, managed, and equipped to provide adequate care, safety, and treatment of each resident. (b) All exterior doors shall be effectively weather-stripped. (c) Doors which open onto corridors shall…

20 CAR § 414-503. Hot water heaters. (a)(1) The hot water heating and storage equipment shall have sufficient capacity to supply: (A) Six and one-half gallons (6 ½ gals.) of water at one hundred ten degrees Fahrenheit (110˚ F) (forty-three degrees Celsius (43˚ C)) per hour per be…

20 CAR § 414-504. Plumbing and other piping systems. (a) All plumbing systems shall be designed and installed in accordance with the requirements of Arkansas Plumbing Code, 17 CAR pt. 65. (b) From the cold water service and hot water tanks, cold water and hot water mains and bran…

20 CAR § 414-506. Furnishings, equipment, and supplies. (a)(1) Each resident shall be provided with a rigid single bed in good repair measuring a minimum of thirty-six inches (36”) in width. (2) The beds shall be equipped with a suitable, comfortable pillow and a comfortable, fir…

20 CAR § 414-507. Linens and bedding. (a)(1) A sufficient supply of clean bed linen shall be available at all times. (2) A minimum of two (2) clean sheets and one (1) clean pillowcase shall be provided for each bed on a weekly basis. (3) Linens shall be changed as often as indica…

20 CAR § 414-508. Equipment and supplies. (a)(1) Nursing supplies and equipment shall be provided as indicated to meet the needs of the residents. (2) As a minimum, the following shall be maintained: (A) Items for personal care and grooming; (B) Individual soap dishes; (C) Hypode…

20 CAR § 414-509. Housekeeping/maintenance. (a)(1) All rooms and every part of the building, exterior and interior, shall be kept: (A) Clean; (B) Orderly; and (C) Free of offensive odors. (2) Bath and toilet facilities and all food areas shall be clean and sanitary at all times. …

20 CAR § 414-601. Professional nurse supervision. (a) A registered nurse shall be employed full-time as the Director of Nursing Services and work on the day shift. (b)(1) The Director of Nursing Services shall be responsible for: (A) The development and maintenance of nursing ser…

20 CAR § 414-602. 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 § 414-603. Tuberculosis surveillance. (a)(1) Upon admission to the nursing home, physician orders shall be obtained to administer a PPD (intermediate strength) tuberculin skin test to the resident and to repeat in ten (10) to fourteen (14) days if necessary. (2) If this in…

20 CAR § 414-701. 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 Comprehensive Drug Abuse …

20 CAR § 414-702. Administration of medication. (a) No medication shall be given without a written order by a physician or dentist. (b)(1) All medications shall be given by licensed nursing personnel. (2) The administrator or his or her appointed assistant shall be responsible fo…

20 CAR § 414-703. 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 breaking and incineration.…

20 CAR § 414-704. Medicine cards. (a) In administering medications, medication cards current with physician order must be used. (b) Medicine cards, except in the case of established self-administration programs, shall be provided to include: (1) Name of client; (2) Location of cl…

20 CAR § 414-705. 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 § 414-706. Storage of drugs. (a) All drugs on the premises of a nursing home 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 pharma…

20 CAR § 414-707. 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: (A) Name, strength, and quantity of drug re…

20 CAR § 414-708. Controlled drug accountability. (a)(1) There shall be a count of all CII controlled medications at each change of shift. (2) All Schedule III, Schedule IV, and Schedule V controlled medications should be counted at least once daily unless a true unit dose system…