PURPOSE: This rule prescribes criteria for admission in all community residential facilities except Psychiatric Group Homes II as required by section 630.710, RSMo.

1. (1) Each resident shall have an individualized habilitation or treatment plan either prior to admission or within thirty (30) days of admission.
2. (2) The facility shall follow its written policies and procedures as approved by the department for resident admission. The facility shall describe how its program is especially designed to meet the needs of the residents it admits and any other client groups served.
3. (3) The facility shall not admit more residents than its licensed capacity.
4. (4) If a facility admits a residents whose special needs exceed the facility’s ability to provide for adequate medical care or programming as described in the individual habilitation or treatment plan, the facility shall arrange for the provision of the necessary support services.
5. (5) The facility shall not admit any residents unless the facility has adequate fencing around swimming pools, ponds, sewage lagoons, liquefied petroleum gas (LPG) tanks and other potentially hazardous areas.

6. (6) The head of a facility licensed as a semiindependent living arrangement shall have evidence supporting the following with respect to each residents:

   1. (A) The resident can evacuate the facility without assistance in case of an emergency unless the following conditions are met:

      1. 1. The residents are not in need of con-

stant supervised medical/nursing care;

1. 2. The residents do not have behaviors

that are detrimental to themselves or others;

1. 3. The entire building is covered by a

full alarm system, including a fire sprinkler system;

1. 4. Each living unit has at least three (3)

exits; one (1) of the required exits leads directly outside from the living area at grade level and one (1) of them leads outside from the bedroom at grade level. Exit doors leading outside are equipped with paddle-type hardware mounted close to the floor; and

1. 5. All exits from living units leading to

interior corridors are solid core doors and fit tightly so as to prevent the passage of smoke;

1. (B) The resident has adequate skills or is ready for training in cooking, use of hot water above one hundred fifteen degrees Fahrenheit (115EF), use of toxic chemicals and self-administration of medication, which skills are adequate in consideration of the facility’s policies, procedures and staffing to assure the safety of the resident.

   1. 1. If the record documents that a resi-

dent cannot use toxic chemicals or does not respect the danger of toxic chemicals, their use and storage shall be such that the resident never has access to them. Procedures shall require that toxins are always kept locked unless in use. Procedures shall include precautions to be utilized when toxins are in use.

1. 2. If the record documents that the resi-

dent cannot safely use hot water, hot water at all taps accessible to the resident shall be kept below one hundred fifteen degrees Fahrenheit (115EF). Use of hot water includes the ability to distinguish hot faucets from cold faucets, to manipulate faucets and to call for help in emergencies.

1. 3. If residents self-administer medica-

tions, authorization to do so shall be included in the doctor’s orders and approved by those persons participating in the development of the individualized habilitation plan (IHP). If the required authorization is not documented in each resident’s record or if, despite the documentation, a facility chooses to distribute or administer medications, the following guidelines apply:

1. A. All staff administering medica-

tions shall have completed a course in medications administration approved by the placement office or regional center;

1. B. The record shall have doctor’s

orders for all medications being administered except for nonprescription topical medications;

1. C. The same person who prepares the

medication shall also administer it and chart it at the time it is administered; and

1. D. Doctor’s orders shall be reviewed

every ninety (90) days;

1. (C) The resident is ready for training or has acquired adequate self-care skills including, but not limited to, personal hygiene, laundry, grooming, eating skills, telephone use and money management;
2. (D) The resident is capable of competitive employment, employment in a sheltered workshop or a job-training program or, if elderly, is capable of participating in leisure time activities and programs; and
3. (E) The resident can function safely within the physical environment of a living unit.

1. (7) Within thirty (30) days of admission, each resident who is mentally retarded or developmentally disabled shall be screened for hepatitis B unless his/her medical record indicates one (1) of the following:

   1. (A) S/he has been previously immunized from hepatitis B; or
   2. (B) S/he has been found to be immune by previous screening.

AUTHORITY: sections 630.050 and 630.705, RSMo (1994).* Original rule filed Oct. 13, 1983, effective Jan. 15, 1984. Amended: Filed March 14, 1984, effective Aug. 15, 1984. Amended: Filed July 15, 1985, effective Feb. 1, Licensed by the Division of Aging and Psychiatric Group Homes II 1986. Amended: Filed Sept. 4, 1985, effective Feb. 1, 1986. Amended: Filed Jan. 2, 1990, effective June 11, 1990. Amended: Filed April 1, 1993, effective Dec. 9, 1993. Amended: Filed July 17, 1995, effective March 30,1996. *Original authority: 630.050, RSMo (1980), amended 1993, 1995 and 630.705, RSMo (1980), amended 1982, 1984, 1985, 1990.