1. (a) General program requirements.

   1. (1) Each long-term care facility that advertises or otherwise holds itself out as having one (1) or more special units for residents with a diagnosis of probable Alzheimer's disease or a related dementia shall provide an organized, continuous twenty-four-hour-per-day program of supervision, care and services that shall:

      1. (A) Meet all state, federal, and ASCU regulations;
      2. (B) Require the full protection of residents' rights;
      3. (C) Promote the social, physical, and mental well-being of residents;
      4. (D) Is a separate unit specifically designed to meet the needs of residents with a physician’s diagnosis of Alzheimer’s disease or other related dementia;
      5. (E) Provide twenty-four-hour-per-day care for those residents with a dementia diagnosis and meets all admission criteria applicable for that particular long-term care facility; and
      6. (F) Receive approval of its disclosure statement from the Office of Long-Term Care prior to advertising its ASCU.

   2. (2)

      1. (A) Documentation shall be maintained by the facility and shall include, but not be limited to, a signed copy of all training received by the employee.
      2. (B) Documentation shall be signed by the trainer and employee at the time of training.
   3. (3) Provide for relief of direct care personnel to ensure minimum staffing requirements are maintained at all times.
   4. (4) Upon request, make available to the Department of Human Services payroll records of all staff employed during those pay periods for which the unit or facility is being surveyed or inspected.
   5. (5) Nursing, direct-care, or personal care staff shall not perform the duties of cooks, housekeepers, or laundry personnel during the same shift they perform nursing, direct-care, or personal care duties.

   6. (6) Regardless of other policies or procedures developed by the facility, the ASCU will have specific policies and procedures regarding:

      1. (A) Facility philosophy related to the care of ASCU residents;
      2. (B) Use of ancillary therapies and services;
      3. (C) Basic services provided;
      4. (D) Admission, discharge, transfer; and
      5. (E) Activity programming.

2. (b) Disclosure statement and notice to the office.

   1. (1)

      1. (A) Each facility, prior to advertising that it has an Alzheimer’s special care unit, shall:

3. (i) Develop a disclosure statement; and

   1. (ii) Submit it to the office.

      1. (B) The office shall:

         1. (i) Examine the disclosure statement to ensure compliance with this subpart; and
         2. (ii) Notify the facility of its determination.
      2. (C) Thereafter, the office will, when surveying the facility and unit, determine continued compliance with the disclosure statement.
      3. (D) The disclosure statement, once approved by the office, shall be made available to any person or the person’s guardian or responsible party seeking placement within the ASCU prior to admission.
      4. (E) Specifics as to the minimum requirements of the disclosure statement are listed in 20 CAR § 400-2203 – 400-2208.

   2. (2)

      1. (A) Upon any changes to the services offered by the ASCU, the disclosure statement shall be:

         1. (i) Amended; and
         2. (ii) Submitted to the office within thirty (30) days of the amendment.
      2. (B) The office will examine the amended disclosure statement to ensure compliance with this subpart and shall notify the facility of its determination.
      3. (C) Thereafter, the office will, when surveying the facility and unit, determine continued compliance with the amended disclosure statement.
      4. (D) The amended disclosure statement, once approved by the office, shall be made available to any person or the person’s guardian or responsible party seeking placement within the ASCU prior to admission.

   3. (3)

      1. (A) The facility shall submit to the office in writing the number of beds allocated by the facility for the ASCU.

      2. (B) The notification shall state the number of beds allocated to the ASCU as of the date of the notice, and shall be submitted:

         1. (i) With the initial disclosure statement;
         2. (ii) With any amendment to the disclosure statement; and
         3. (iii) No less than July 1 of each year.

   4. (4)

      1. (A) The facility shall notify the office in writing when the facility no longer provides a special program for residents with a diagnosis of probable Alzheimer’s disease or related dementia.
      2. (B) The notice shall be provided to the office at least thirty (30) days prior to the cessation of services.

   5. (5)

      1. (A) Prior to admission into the Alzheimer’s special care unit, the facility shall provide a copy of the disclosure statement and resident’s rights policy to the applicant or the applicant's responsible party.
      2. (B) The mission statement and treatment philosophy shall be documented in the disclosure statement.
      3. (C) A copy of the disclosure statement signed by the resident or the resident's responsible party shall be kept in the resident’s file.

      4. (D) The disclosure statement shall include, but not be limited to, the following information about the facility's ASCU:

         1. (i) The philosophy of how care and services are provided to the residents;
         2. (ii) The preadmission screening process;
         3. (iii) The admission, discharge, and transfer criteria and procedures;
         4. (iv) Training topics, amount of training time spent on each topic, and the name and qualifications of the individuals used to train the direct care staff utilized in the ASCU;
         5. (v) The minimum number of direct care staff assigned to the ASCU each shift;
         6. (vi) A copy of the resident’s rights;
         7. (vii)
4. (a) (a) Assessment, individual support plan, and implementation.

5. (b) (b) The process used for assessment and establishment of the plan of care and its implementation, including the method by which the plan of care evolves and is responsive to changes in condition of the residents;

   1. (viii) Planning and implementation of therapeutic activities and the methods used for monitoring;

      1. (ix) Identification of what stages of Alzheimer's or related dementia for which the ASCU will provide care;

         1. (x) Each facility shall document in their disclosure statement the assessments and dates assessments shall be completed and revised;
         2. (xi) Admission, discharge, and transfer requirements shall be documented in the facility’s disclosure statement;
         3. (xii) Staffing ratios and staff training requirements shall be documented in the facility’s disclosure statement;
         4. (xiii) The facility shall, in their disclosure statement, state the physical requirements and safety standards for the ASCU; and
         5. (xiv) Types and frequency of therapeutic activities shall be listed in the facility’s disclosure statement.
         6. (c) Residents’ Rights. The ASCU shall meet and comply with the same requirements for resident’s rights applicable to the facility housing the ASCU.
         7. (d) Resident record maintenance. The ASCU shall develop and maintain a record-keeping system that includes a separate record for each resident and that documents each resident’s:
   2. (1) Health care;
   3. (2) Individual support plan;
   4. (3) Assessments;
   5. (4) Social information; and
   6. (5) Protection of each resident’s rights.

6. (e) Resident records. The ASCU must follow the facility’s policies and procedures and applicable state and federal laws and regulations governing:

   1. (1) The release of any resident information, including consent necessary from the:

      1. (A) Client;
      2. (B) Parents; or
      3. (C) Legal guardian;
   2. (2) Record retention;
   3. (3) Record maintenance; and
   4. (4) Record content.

7. (f) Miscellaneous.

   1. (1)

      1. (A) Visitors shall be permitted in the ASCU at all times.

      2. (B) However, facilities may deny visitation in the ASCU when visitation:

         1. (i) Results, or substantial probability exists that visitation will result, in disruption of service to any resident; or
         2. (ii) Threatens the health, safety, or welfare of any resident.

   2. (2)

      1. (A) Birds, cats, dogs, and other animals may be permitted in the Alzheimer’s special care unit.
      2. (B) All animals that enter the facility shall have appropriate vaccinations and licenses.
      3. (C) A veterinary record shall be kept on all animals to verify vaccinations and be made readily available for review.
      4. (D) Pets may not be allowed in food preparation, food storage, or dining or serving areas.
   3. (3) Unmarried male and female residents shall not be housed in the same room unless both residents, or their respective responsible parties, have given consent.

Codification Notes: “ASCU” means Alzheimer’s special care unit.