(a)

1. (1) Class A violations are:

   1. (A) Violations that create a condition or occurrence relating to the operation and maintenance of a long-term care facility which results in death or serious harm to a resident; or
   2. (B) Violations that create a condition or occurrence relating to the operation and maintenance of a long-term care facility which creates a substantial probability that death or serious physical harm to a resident will result from the violation.

2. (2) Class A violations and the points assigned to each are:

   1. (A) Listed below in subsections (b) – (d) of this section; and
   2. (B) Subject to the conditions set out in 20 CAR § 401-901.

(b)

1. (1) Any condition or occurrence relating to the operation of a long-term care facility in which the conduct, act, or omission of a person or actor purposely, knowingly, recklessly, or negligently results in the death of a resident shall be a Class A violation.
2. (2) In this instance two thousand five hundred (2,500) points shall be assigned.

(c)

1. (1) Any condition or occurrence relating to the operation of a long-term care facility in which the conduct, act, or omission of a person or actor purposely, knowingly, recklessly, or negligently results in serious physical harm to a resident shall be a Class A violation.
2. (2) In this instance two thousand five hundred (2,500) points shall be assigned.

(d)

1. (1) The conduct, acts, or omissions specified in subsections (d)(2) – (10) of this section, when not resulting in death or serious physical harm, but which create a substantial probability that death or serious physical harm to a resident will result therefrom are conditions or occurrences relating to the operation of a long-term care facility which are Class A violations.
2. (2) One thousand five hundred (1,500) points shall be assigned when a facility fails to maintain required direct care staffing or a safe environment and this failure directly causes a fall by a resident (e.g., equipment not properly maintained, or a fall due to personnel not responding to resident request for assistance).

3. (3)

   1. (A) Two thousand five hundred (2,500) points shall be assigned when a facility fails to maintain required direct care staffing or measures are not taken when it is known that a resident is combative and assaultive with other residents, and this failure causes an assault upon a resident of the facility by another resident.
   2. (B) A Class A violation shall also exist when a facility fails to perform adequate screening of personnel and this failure causes an assault upon a resident by an employee of the facility.
4. (4) Two thousand two hundred fifty (2,250) points shall be assigned when a facility personnel improperly apply physical restraints contrary to published rules.
5. (5) Two thousand five hundred (2,500) points shall be assigned when a facility fails to secure proper medical assistance.
6. (6) Two thousand five hundred (2,500) points shall be assigned when facility personnel knowingly withhold medication from a resident as ordered by a physician and such withholding of medication or medications results in death or serious injury to a resident, or facility personnel fail to order and/or stock medication or medications prescribed by the physician and the failure to order and/or stock medication or medications.
7. (7) Two thousand five hundred (2,500) points shall be assigned when facility personnel knowingly administer medications to a resident and the administration of that medication or medications results in death or serious injury to a resident.

8. (8)

   1. (A) Two thousand five hundred (2,500) points shall be assigned when a facility fails to reasonably maintain its heating and air conditioning system as required by rule.
   2. (B) Isolated incidents of breakdown or power failure shall not be considered a Class A violation under this section.

9. (9) Two thousand (2,000) points shall be assigned when a facility:

   1. (A) Does not train staff in fire/disaster procedures as required by rules; or
   2. (B) When staffing requirements are not met.

10. (10)

    1. (A) Two thousand five hundred (2,500) points shall be assigned when a facility fails to maintain the required life safety code systems.
    2. (B) Isolated incidents of breakdown shall not be considered a Class A violation under this section if the facility has:

(i) Immediately notified the Office of Long-Term Care upon discovery of the problem; and

1. (ii) Taken all necessary measures to correct the problem.