(b) The Level I assisted living facility shall not provide services to residents who:

1. (1)

   1. (A) Need twenty-four-hour nursing services except as certified by a licensed home health agency for a period of sixty (60) days with one (1) thirty-day extension.
   2. (B) A copy of the licensed home health agency’s plan shall be filed in the resident’s record;
2. (2) Are bedridden;
3. (3) Have transfer assistance needs, including but not limited to assistance to evacuate the facility in case of emergency that the facility cannot meet with current staffing;
4. (4) Present a danger to self or others or engage in criminal activities; and
5. (5) Require medication administration to be performed by the facility.

(d)

1. (1) No resident shall be permitted to remain in a Level I assisted living facility if his or her condition requires twenty-four-hour nursing care or other services that an assisted living facility is not authorized by law or this part to provide.
2. (2) This prohibition applies even if the resident is willing to execute an agreement relieving the facility of responsibility attendant to the resident’s continued placement.

(e) When the resident evaluation indicates that there is a high probability that a choice or action of the resident has resulted or will result in any of the outcomes of placing the resident or others at risk, leading to adverse outcomes, violating the norms of the facility or program or the majority of the residents, or any combination of the events, the assisted living facility shall:

1. (1) Identify the specific concern or concerns;
2. (2) Provide the resident or his or her responsible party, and if the resident agrees, the resident’s family, with clear, understandable information about the possible consequences of his or her choice or action;

3. (3)

   1. (A) Negotiate a compliance agreement with the resident or his or her responsible party that will minimize the possible risk and adverse consequences while still respecting the resident’s preferences.
   2. (B) Nothing in this provision requires a facility to successfully negotiate a compliance agreement; and
4. (4) Document the process of negotiation and, if no agreement can be reached, the lack of agreement and the decisions of the parties involved.

(f) Any compliance agreements negotiated, or attempted to be negotiated, with the resident or his or her responsible party shall address the following areas in writing:

1. (1) Consequence to resident: any situation or condition that is or should be known to the facility that involves a course of action taken or desired to be taken by the resident contrary to the practice or advice of the facility and could put the resident at risk of harm or injury;
2. (2) The probable consequences if the resident continues the choice or action identified as a cause for concern;
3. (3) The resident or his or her responsible party’s preference concerning how the situation is to be handled and the possible consequences of action on that preference;
4. (4) What the facility will and will not do to meet the resident’s needs and comply with the resident’s preference to the identified course of action;
5. (5) Alternatives offered by the assisted living facility or resident or his or her responsible party to reduce the risk or mitigate the consequences relating to the situation or condition;
6. (6) The agreed-upon course of action, including responsibilities of both the resident or his or her responsible party and the facility;
7. (7) The resident or his or her responsible party’s understanding and acceptance of responsibility for the outcome from the agreed-upon course of action and written proof that the resident or his or her responsible party is making an informed decision, free from coercion, and that the refusal of the resident or his or her responsible party to enter into a compliance agreement with the facility or to revise the compliance agreement or to comply with the terms of the compliance agreement may result in discharge from the facility; and
8. (8) The date the agreement is executed and, if needed, the timeframes in which the agreement will be reviewed.