(c)

1. (1) The facility shall have at least one (1) registered nurse available at all times.

2. (2) “Available”, in this instance, means:

   1. (A) On call;
   2. (B) Capable of being reached by telephone or pager; and
   3. (C) Capable of appearing at the facility as required to meet residents’ needs.

(e) The facility shall ensure, at a minimum, the following:

1. (1)

   1. (A) Assessment of the healthcare services needs of all residents in the facility shall be performed annually, except that those residents who have a healthcare services plan portion of the occupancy admission agreement shall be reassessed quarterly and revisions made as needed.
   2. (B) The healthcare services plan portion of the occupancy admission agreement shall be revised within fourteen (14) days upon any significant enduring change to the resident;
2. (2) Monitoring of the conditions of the residents on a periodic basis;
3. (3) Notification of the registered nurse if there are significant changes in a resident’s condition;
4. (4) Assessment of the resident’s need for referral to a physician or advanced practice nurse or community agency as appropriate; and
5. (5) Maintenance of records as required.

(f) In the planning of healthcare services:

1. (1) The assisted living facility shall arrange for healthcare services to be provided to residents as needed or ordered by the resident’s physician or advanced practice nurse and documented in the healthcare services plan portion of the occupancy admission agreement;
2. (2) At the time of admission, arrangements shall be made between the assisted living facility and the resident or his or her responsible party regarding the physician or advanced practice nurse and dentist to be called in case of illness or the person to be called for a resident who, because of religious affiliation or personal choice, is opposed to medical treatment, if any; and

3. (3)

   1. (A) The initial healthcare assessment shall be documented by the facility and shall be updated as required, in accordance with professional standards of practice or upon a significant change of condition.
   2. (B) In no event shall the healthcare assessment be updated less frequently than annually.

(g)

1. (1) The resident’s physician or advanced practice nurse shall be notified of any significant change in the resident’s physical or psychological condition and any intervention by the physician or advanced practice nurse shall be recorded.

2. (2) Intervention includes, but is not limited to:

   1. (A) Orders given by the physician or advanced practice nurse; or
   2. (B) Documentation that the physician or advanced practice nurse did not issue an order after notice of the significant change of condition.

3. (3) For purposes of documentation, the facility shall document:

   1. (A) The name and address of the physician or advanced practice nurse whom the facility contacted;
   2. (B) The date and time of the notice to the physician or advanced practice nurse whom the facility contacted;
   3. (C) The information provided to the physician or advanced practice nurse whom the facility contacted regarding the significant change of condition; and
   4. (D) The response of the physician or advanced practice nurse whom the facility contacted.

(h)

1. (1) Residents or their responsible parties shall be permitted free choice of physician or advanced practice nurse and of pharmacy.
2. (2) A facility may make a selection of a treating physician or advanced practice nurse or pharmacy only when the resident or his or her responsible party is fully informed of his or her right of choice and waives that right in writing.
3. (3) The facility shall maintain any written waivers in the resident's file.