(a)

1. (1) Pursuant to federal regulation 42 C.F.R. § 483.13 and state law Arkansas Code § 5-28-101 et seq., and Arkansas Code § 12-12-501 et seq., the facility must develop and implement written policies and procedures to ensure incidents, including alleged or suspected abuse or neglect of residents, accidents, including accidents resulting in death, unusual deaths or deaths from violence, unusual occurrences, and exploitation of residents or any misappropriation of resident property are prohibited, reported, investigated, and documented as required by this part.

2. (2)

   1. (A) A facility is not required under this part to report death by natural causes.
   2. (B) However, nothing in this part negates, waives, or alters the reporting requirements of a facility under other rules or statutes.

3. (3) Facility policies and procedures regarding reporting, as addressed in this part, must be:

   1. (A) Included in orientation training for all new employees; and
   2. (B) Addressed at least annually during in-service training for all facility staff.

(b) Reporting of incidents.

1. (1) The following events shall be reported to the Department of Human Services electronically through the Enterprise Licensing System (ELS) at: https://ardhslicensing.my.site.com/elicensing/s/?language=en_US.

2. (2) The following events shall be reported to the department via ELS no later than 11:00 a.m. on the next business day following discovery by the facility:

   1. (A) Any alleged, suspected, or witnessed occurrences of abuse or neglect to residents;
   2. (B) Any alleged, suspected, or witnessed occurrence of misappropriation of resident property, or exploitation of a resident;
   3. (C)

(i) Any alleged, suspected, or witnessed occurrences of verbal abuse.

1. (ii) For purposes of this part, "verbal abuse" means the use of oral, written, or gestured language that willfully includes disparaging and derogatory terms to residents, or within their hearing distance, regardless of their age, ability to comprehend, or disability.

   1. (iii) Examples of verbal abuse include, but are not limited to:

(b) (b) Saying things to frighten a resident, such as telling a resident that he or she will never be able to see his or her family again;

1. (D) Any alleged, suspected, or witnessed occurrences of sexual abuse to residents by any individual; and

   1. (E) Resident-on-resident physical altercations if involving a willful action that resulted in physical injury, mental anguish, or pain.
2. (3) Questions about the submission of reports should be directed to the Incident and Accidents Unit at IandAReports@dhs.arkansas.gov.

3. (4) In addition to the requirement of electronic submission of Form DMS-7734 by the next business day through the ELS, the facility shall electronically complete an electronic Form DMS-762 in accordance with subsection (c) of this section.

   1. (c)

4. (1) Incidents or occurrences that require internal reporting only. The following incidents or occurrences shall require the facility to prepare an internal report only and do not require electronic submission to DHS:

   1. (A) Incidents in which a resident attempted to cause physical injury to another resident without resultant injury (the facility shall maintain written reports on these types of incidents to document patterns of behavior for subsequent actions;
   2. (B) All cases of reportable disease, as required by the department; and
   3. (C) Loss of heating, air conditioning, or fire alarm system for a duration of greater than two (2) hours.

5. (2)

   1. (A) The internal report shall include all content specified in subsection (d) of this section, as applicable.

   2. (B) Nursing facilities must maintain these incident record files in a manner that allows verification of compliance with this provision.

      1. (d) Internal-only reporting procedure.

6. (1)

   1. (A) Written reports of all incidents and accidents included in subsection (c) of this section shall be completed within five (5) days after discovery.
   2. (B) The written incident and accident reports shall be comprised of all information specified in forms DMS-7734 and Form DMS-762 as applicable.

7. (2)

   1. (A) All written reports will be reviewed, initialed, and dated by the facility administrator or designee within five (5) days after discovery.
   2. (B) All reports involving accident or injury to residents will also be reviewed, initialed, and dated by the director of nursing services or other facility R.N.

8. (3) Reports of incidents specified in subsection (c) of this section:

   1. (A) Will be maintained in the facility only; and
   2. (B) Are not required to be submitted to the Office of Long-Term Care.
9. (4) All written incident and accident reports shall be maintained on file in the facility for a period of three (3) years.

(f) Abuse investigation report.

1. (1)

   1. (A) The facility must ensure that all alleged or suspected incidents involving resident abuse, exploitation, neglect, or misappropriations of resident property are thoroughly investigated.

   2. (B) The facility’s investigation must:

      1. (i) Be in conformance with the process and documentation requirements specified by the department; and
      2. (ii) Prevent further potential incidents while the investigation is in progress.

2. (2) The results of all investigations must be reported to:

   1. (A) The facility’s administrator or designated representative; and
   2. (B) Other officials in accordance with state law, including the department.
3. (3) The electronic submission may be amended and resubmitted at any time circumstances require.

(g) Reporting suspected abuse or neglect. The facility’s written policies and procedures shall include, at a minimum, requirements specified in this subsection:

1. (1)

   1. (A) The requirement that the facility’s administrator or his or her designated agent immediately reports all cases of suspected abuse or neglect of residents of a long-term care facility as specified below:

      1. (i) Suspected abuse or neglect of an adult (eighteen (18) years of age or older) shall be reported to the local law enforcement agency in which the facility is located, as required by Arkansas Code § 5-28-203(b); and
      2. (ii) Suspected abuse or neglect of a child (under eighteen (18) years of age) shall be reported to the local law enforcement agency and to the central intake unit of the department, as required by Acts 1991, No. 1208.
   2. (B) Central intake may be notified by telephone at 1-800-482-5964;
2. (2) The requirement that the facility’s administrator or his or her designated agent report suspected abuse or neglect to the Office of Long-Term Care as specified in this part;
3. (3) The requirement that facility personnel, including but not limited to, licensed nurses, nursing assistants, physicians, social workers, mental health professionals, and other employees in the facility who have reasonable cause to suspect that a resident has been subjected to conditions or circumstances which have or could have resulted in abuse or neglect are required to immediately notify the facility administrator or his or her designated agent;

4. (4) The requirement that, upon hiring, each facility employee:

   1. (A) Be given a copy of the abuse or neglect reporting and prevention policies and procedures; and

   2. (B)

      1. (i) Sign a statement that the policies and procedures have been received and read.
      2. (ii) The statement shall be filed in the employee’s personnel file; and

5. (5) The requirement that:

   1. (A) All facility personnel receive annual, in-service training in identifying, reporting, and preventing suspected abuse or neglect; and
   2. (B) The facility develops and maintains policies and procedures for the prevention of abuse, neglect, and accidents.