1. (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. (1) A floor plan design that does not require visitors or staff to pass through the ASCU to reach other areas of the facility;
   2. (2) A multipurpose room or rooms for dining, group and individual activities, and family visits, which complies with the LTC licensure requirements for common space;

   3. (3)

      1. (A) Secured outdoor space and walkways that allow residents to ambulate, with or without assistive devices such as wheelchairs or walkers, but prevents undetected egress.
      2. (B) Such walkways shall meet the accessibility requirements of the most current LTC and Americans with Disabilities Act, 42 U.S.C. § 12101 et seq. structural building codes or regulations at the time of licensure.
      3. (C) Unrestricted access to secured outdoor space and walkways shall be provided, and such areas shall have fencing or barriers that prevent injury and elopement.
      4. (D) Fencing shall be no less than seventy-two inches (72”) high;
   4. (4) Prohibit the use of plants that are poisonous or toxic for human contact or consumption;

   5. (5)

      1. (A) Visual contrasts between floors and walls, and doorways and walls, in resident use areas.
      2. (B) Except for fire exits, exit doors and access ways shall be designed to minimize contrast and to obscure or conceal areas the residents should not enter;
   6. (6) Nonreflective floors, walls, and ceilings to minimize glare;
   7. (7) Evenly distributed lighting to minimize glare and shadows; and

   8. (8) A monitoring or nurses’ station with:

      1. (A) A call system to alert staff to any emergency needs of the residents; and
      2. (B) A space for charting and for storage of residents' records.

2. (b) Physical environment and safety. The Alzheimer’s special care unit shall:

   1. (1)

      1. (A) Provide freedom of movement for the residents to common areas and to their personal spaces.
      2. (B) The facility shall not lock residents out of, or inside, their rooms;

   2. (2) Provide plates and eating utensils that:

      1. (A) Have visual contrast between the:

3. (i) Plates;

   1. (ii) Utensils; and

      1. (iii) Table; and
      2. (B) Maximizes the independence of the residents;

   2. (3)

      1. (A) In common areas, provide comfortable seating sufficient to seat all residents at the same time.
      2. (B) The seating shall consist of a ratio of one (1) gliding or rocking chair for every five (5) residents;
   3. (4) Encourage and assist residents to decorate and furnish their rooms with personal items and furnishings based on the resident’s needs and preferences as documented by the ISP in the social history;

   4. (5) Individually identify each resident's room based on the resident’s cognitive level to:

      1. (A) Assist residents in locating their rooms; and
      2. (B) Permit them to differentiate their room from the rooms of other residents;

   5. (6) Keep corridors and passageways through common-use areas free of objects that may:

      1. (A) Cause falls; or
      2. (B) Obstruct passage by physically impaired individuals; and

   6. (7) Only use public address systems in the unit for emergencies.

      1. (c) Egress policies.
   7. (1) The Alzheimer’s Special Care Unit shall develop policies and procedures to deal with residents who wander or may wander.

   8. (2) The procedures shall include actions to be taken by the facility to:

      1. (A) Identify missing residents;
      2. (B) Notify all individuals or institutions that require notification under law or rule when a resident is missing; and

      3. (C) Attempt to locate the missing resident.

         1. (d) Locking devices.

   9. (1) All locking devices used on exit doors shall:

      1. (A) Be approved by the Office of Long-Term Care, building code agencies, and the fire marshal having jurisdiction over the facility;
      2. (B) Be electronic; and
      3. (C) Release upon activation of the fire alarm or sprinkler system.
   10. (2) If the unit uses keypads to lock and unlock exits, directions for the keypad's operations to allow entrance shall be posted on the outside of the door.
   11. (3) The keypads and locks shall meet the NFPA 101, Life Safety Code.
   12. (4) Staff shall be trained in all methods of releasing, or unlocking the locking device.

Codification Notes: “ASCU” means Alzheimer’s special care unit. "ISP" means individual support plan. "NFPA" means National Fire Protection Association.