DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

BUREAU OF COMMUNITY AND HEALTH SYSTEMS

ADULT FOSTER CARE CONGREGATE FACILITIES

Filed with the secretary of state on

These rules become effective immediately after filing with the secretary of state unless adopted under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.233, 24.244, or 24.245a.  Rules adopted under these sections become effective 7 days after filing with the secretary of state.

 (By authority conferred on the department of licensing and regulatory affairs by section 9 of the Executive organization act of 1965, 1965 PA 380, MCL 16.109, and sections 10 and 18 of the adult foster care facility licensing act, 1979 PA 218, MCL 400.710 and 400.718, and Executive Reorganization Order Nos. 1996-1, 1996-2, 2003-1, 2008-4, 2011-4, and 2015-1, MCL 330.3101, 445.2001, 445.2011, 445.2025, 445.2030, and 400.227)

R 400.2401, R 400.2402, R 400.2403, R 400.2404, R 400.2404a, R 400.2405, R 400.2406, R 400.2407, R 400.2411, R 400.2412, R  400.2413, R 400.2414, R 400.2415, R 400.2416, R 400.2417, R 400.2418, R 400.2421, R 400.2422, R 400.2423, R 400.2424, R 400.2431, R 400.2432, R 400.2433, R 400.2434, R 400.2447, R 400.2448, R 400.2451, R 400.2452, R 400.2453, R 400.2454, R 400.2455, R 400.2456, R 400.2457, R 400.2461, R 400.2471, R 400.2472, R 400.2473, R 400.2474, and R 400.2475 of the Michigan Administrative Code are rescinded, as follows:

PART 4. CONGREGATE FACILITIES

R 400.2401   Scope. Rescinded.

 Rule 401. This part applies only to congregate facilities.

R 400.2402   Licensees and administrators. Rescinded.

Rule 402. (1) Care provided by a congregate facility shall be based on a foster care agreement between the congregate facility and the responsible agency or person requesting care. The agreement shall specify that it is the responsibility of the agency or person requesting care to provide all necessary intake information; to provide other required information; to provide initial and ongoing and discharge assessment planning; preparation for discharge; social services assistance in obtaining all necessary care which may be needed by the resident. A copy of the agreement shall be maintained in the congregate facility. Where the agreement is not with the department, a copy shall be filed with the department for its review and approval.

  (2) A licensee or a governing body may appoint an administrator to operate a congregate facility.

  (3) An administrator, all staff participating in resident care and staff who are designated as responsible persons or acting in such capacity shall be at least 18 years of age, be of good moral character and reputation, be in good health and by training and experience be capable of meeting the demands of the position.

  (4) A licensee or an administrator shall designate in writing a responsible person to carry out his responsibilities and duties in his absence.

  (5) A licensee or an administrator shall be willing to cooperate fully with the resident, his own family and responsible relatives and the supervising agency.

R 400.2403   Admission and discharge. Rescinded.

Rule 403. (1) A congregate facility shall have a written admission policy which shall be posted in a conspicuous public area of the facility. The department's assistance in establishing the policy is available upon request of a licensee.

  (2) A prospective resident or his guardian, if the prospective resident is legally incompetent, shall exercise free choice in the selection of a foster care congregate facility. The department shall determine if the congregate facility is capable of meeting an individual's needs.

  (3) A person shall not be denied admission to or discharged from a congregate facility because of race, religion, color, or national origin.

  (4) In administering or managing a congregate facility, an licensee or an administrator shall not accept or keep a person whose behavior requires isolation or restraint. A person shall not be admitted to a congregate facility whose present care requirements   and   service   needs   are incompatible with those of other residents in the facility.  This subrule shall not be used to circumvent subrule (3).

  (5) An admission prerequisite for persons transferring from another residential setting, nursing home, or medical institution is a current written assessment plan outlining the specific service appropriate to the resident’s needs and the method of providing the service.  With a resident's consent, an individual not having a responsible agency shall have an assessment plan completed by department workers and filed in the resident’s record at the congregate facility within  30  days  after admission to the congregate facility.

  (6)  Upon admission a resident’s record  shall  contain  information obtained from the  resident,  his  next  of  kin  or  legal  guardian,  or responsible agency indicating persons to  be  notified  of  an  emergency, including  the  preferred  physician  or  hospital  and  instructions  for emergency care.

  (7) An individual admitted shall have had a health  appraisal  completed within the previous 90 days or in emergency admissions  shall  obtain  the appraisal within 30 days of admission.

(8) A congregate facility licensee shall report all new  admissions  and discharges to the department in a manner prescribed by the department.

(9) A resident shall  not  be  discharged  from  a  congregate  facility without adequate preparation, including a determination that a move is  in a resident's best interest. At  the  time  of  discharge  the  responsible agency or the department of social services shall  update  the  assessment plan to provide for  continuity  in  achieving  objectives.  A  congregate facility shall record the date of discharge, the reason for discharge, the disposition of money and valuables held for safekeeping, and a  forwarding address of the resident, or a  relative,  guardian  or  other  adult.  The foregoing does not restrict the resident's ability to make his own  living arrangements.

  (10) The express wishes of the  resident  shall  be  considered  in  all movements to and from a congregate facility.

  (11)  A  bedfast  person  or  one  requiring  continuous  and   constant professional nursing care  shall  not  be  accommodated  in  a  congregate facility. This does not preclude the accommodation of a  resident  who  is temporarily ill and bedfast but who does not require professional nursing.

R 400.2404  Change in health and accidents. Rescinded.

Rule 404. (1) If an accident or sudden adverse change in a resident's physical condition or adjustment occurs, a congregate facility shall obtain needed care immediately and notify the responsible relative and the individual or agency responsible for placing and maintaining the resident in the congregate facility.

  (2) An occurrence of a reportable communicable disease as defined by the laws of this state or the rules implementing the laws must be reported immediately to the local health department and the department.

  (3) Immediate investigation of the cause of an accident involving a resident must be initiated by a congregate facility licensee or administrator and an appropriate accident record must be completed and maintained. 

R 400.2404a  Incident notification, incident records. Rescinded.

Rule 404a. (1) As used in these rules:

(a) "Department" means the department of licensing and regulatory affairs.

(b) "Elopement" means a resident that has a service plan that requires notice or arranged supervision to leave the facility and is absent without notice or supervision.

  (c) "Incident" means, consistent with the incident recordkeeping requirement in this rule, an intentional or unintentional event where a resident sustains physical or emotional harm, an unexpected or unnatural death, is displaced by a natural disaster, or elopes.

  (2) If a resident has a representative identified in writing on the resident’s care agreement, the licensee shall report to the resident's representative within 48 hours after any of the following:

   (a) Unexpected or unnatural death of a resident.

   (b) Unexpected and preventable inpatient hospital admission.

   (c) Physical hostility or self-inflicted harm or harm to others resulting in injury that requires outside medical attention or law enforcement involvement.

   (d) Natural disaster or fire that results in evacuation of residents or discontinuation of services greater than 24 hours.

   (e) Elopement from the home if the resident’s whereabouts is unknown.

  (3) If an elopement occurs, staff shall conduct an immediate search to locate the resident. If the resident is not located within 30 minutes after the elopement occurred, staff shall contact law enforcement.

  (4) An incident must be recorded on a department-approved form and maintained in the home for a period of not less than 2 years.

  (5) The department may review incident reports during a renewal inspection or special investigation. This does not prohibit the department from requesting an incident report if determined necessary by the department. If the department does request an incident report, the licensee shall provide the report in electronic form within 24 hours after the request. The department shall maintain and protect these documents in accordance with state and federal laws, including privacy laws.

R 400.2405   Deaths of residents. Rescinded.

Rule 405. When a resident  dies,  a  congregate  facility  licensee  or administrator shall notify immediately the resident's physician, the  next of kin or legal guardian and the person or agency responsible for  placing and  maintaining  the  resident  in  the  congregate  facility.   Statutes applicable to the  reporting  of  sudden  or  unexpected  death  shall  be observed. The death shall be reported to the department within  72  hours.

R 400.2406   Personnel policies and health supervision. Rescinded.

  Rule 406. (1) Written personnel policies, practices,  job  descriptions, and procedures shall be made available to all  employees  and  volunteers. Work assignments shall be consistent with job descriptions and  the  level of training and experience of the employee or volunteers.

  (2)  An  employee  involved  in  food  preparation  or  kitchen  cleanup activities or who comes in contact  with  residents,  as  a  preemployment requirement,  shall  be  certified  by  a  physician  to  be   free   from communicable diseases required to be reported by the laws of this state or by the rules promulgated under such laws. Periodically,  the  licensee  or administrator shall review with each employee his present state of health.

R 400.2407   Staffing. Rescinded.

Rule 407. (1) The ratio of staff to residents shall be adequate to carry out responsibilities defined in the act  and  in  these  rules  and  staff ratios shall conform with requirements set  by  the  department  following study by the department and advice from the council.

  (2) Congregate facilities operating other than  a  general  habilitative and  activities  program  shall  employ  a  program  director  and   other personnel, as necessary, with special  and  appropriate  skills;  or  have formal agreements with other agencies or persons whereby services are made available to the congregate facility according to resident need.

  (3)  A  responsible  person,  capable  of  immediately   responding   to emergencies, shall be on the premises of each living unit of a  congregate facility during sleeping hours although the person need not be  awake  and dressed.

  (4) Personnel shall wear clean  garments,  maintain  a  high  degree  of personal cleanliness, and conform to acceptable hygienic  practices  while on duty.

R 400.2411   Services for residents. Rescinded.

Rule  411.  A  congregate  facility  shall  provide  services  for   the habilitation of its residents. In addition  to  transportation  and  basic self-care and habilitation training, congregate facilities  shall  provide or cause to be provided all of the following program  elements  which  are essential for the habilitation  of  their  residents.  Without  department approval a program element other than  basic  self-care  and  habilitation training shall not be provided on the premises when it is available in the community:

  (a) Basic self-care and habilitation training means a service  to  teach and reinforce skills in dressing, grooming,  eating,  bathing,  toileting, and following of simple directions.

  (b) Social education training means a  service  which  covers  areas  of training inclusive of recreational participation such as  group  programs, community entertainment and recreational  facilities  utilization.  Social graces and acceptable public behavior are covered  in  this  area  as  are leisure time use and skills.

  (c)  Tutorial  and  special  skills  training  is  a  service  typically providing 1-to-1 training in an area.  Services  include  basic  self-care training, mobility training, or advanced skills.

  (d) Adult activity, day  care  or  day  training,  is  an  activity  and training service including basic self-care  skills,  activities  of  daily living, utilization of community resources,  hazard  training,  individual and group programs of therapy and education, recreational programs,  field trips, skills maintenance, and special training. Objectives range from the maintenance of a participant  in  the  community  to  the  development  of prevocational skills to permit placement in a sheltered workshop  setting.

  (e) Work activity is a work activity service provided  in  a  protective setting in a day program to  serve  a  retarded  or  mentally  ill  adult. Activities are divided between  development  of  prevocational  skills  by producing a product in a  structured  work  setting  and  providing  basic social activities of daily living training. The major focus  shall  be  on work skills for which reimbursement from products sold or  from  contracts may be provided.

  (f) Sheltered workshop is a service in a certified  protective  workshop setting which includes special vocational training,  job  evaluation,  and rehabilitation planning with a definite objective of placement in  gainful employment, sheltered or independent. Certification includes  proper  wage deviation  permits  from  the  department  of  labor  and   approvals   as appropriate from the division of vocational rehabilitation.

  (g) Personal adjustment is a service  for  a  person  with  psychiatric, emotional, behavioral, or developmental problems and  includes  counseling and individual or group therapy as well as diagnostic evaluation. It  also includes utilization of appropriate  batteries  of  psychological  testing material  and  related  counseling  to  assist   in classification   and determination of readiness for movement or maintenance in  the  community.

  (h) Transportation means vehicle travel by public or private carrier and related cost to and from program  resources  in  the  community  including consultation, medical, and other services. This  includes  escort  between screening and entry programs.

  (i) Health services include pharmaceutical, medical, or dental  services provided directly or through contractual agreement.

R 400.2412   Care of residents. Rescinded.

Rule 412. (1) A staff member or a responsible  person  shall  always  be present when a resident is in the congregate facility or a living unit.

  (2) Residents shall  be  assured  privacy  and  protection  from  moral, social, and financial exploitation.

  (3) All work performed by a resident shall be  in  accordance  with  the assessment plan.

  (4) A resident shall be treated with dignity, and  his  personal  needs, including protection and safety, shall be attended to at all times.

R 400.2413   Residents; personal care. Rescinded.

Rule 413. (1) A congregate facility shall provide care  and  maintenance to its residents including either or both personal care and supervision as appropriate. Supervision means guidance of an individual as he carries out activities of daily living, including reminding a resident to maintain his medication schedule  as  directed  by  his  physician,  reminding  him  of important  activities  to  be  carried  out,  assisting  him  in   keeping appointments and being aware of his general whereabouts even though he may travel independently about the community. Personal care  means  continuous attendance by a responsible person  to  render  personal  assistance  with dressing,  personal  hygiene,  grooming,  and  maintenance  of  medication schedule as directed and supervised  by  the  individual's  physician  and being aware  of  the  individual's  specific  whereabouts  at  all  times, including his presence in outside activities. Specifically, personal  care shall include, as required, care of the skin, mouth, teeth,  hands,  feet, eyes, and hair.

  (2) A resident shall receive a bath or shower weekly and be afforded the opportunity for daily bathing.

  (3) A resident shall be offered facilities for shaving daily.

  (4) A resident shall  be  afforded  opportunities  to  obtain  haircuts, hairsets, or other hair grooming processes.

  (5) A resident  shall  be  afforded  the  opportunity,  encouraged,  and instructed to dress as fashion, cleanliness, and the season warrants.

  (6) A resident shall be given  assistance  or  trained  in  the  use  of prosthesis as appropriate.

  (7) A resident's dignity and privacy shall be respected  in  all  areas. Female residents requiring assistance  in  activities  such  as  dressing, bathing, and personal hygiene shall be assisted by or in the  presence  of another female.

R 400.2414   Complaints. Rescinded.

Rule 414. A resident shall be afforded a means of presenting  grievances to the congregate facility licensee  or  administrator.  If  the  area  of concern is with the responsible agency, refer to R 400.2119.

R 400.2415   Health care of residents. Rescinded.

Rule 415. (1) A resident shall have a health appraisal at least annually which contains specific recommendations for care, maintenance,  treatment, or special programs and shall reflect the resident's progress  in  meeting scheduled objectives.

  (2) A resident who  in  the  recent  past  has  been  a  patient  in  an institution shall have on file in his individual record a statement of his medical history and his medical and health needs.

  (3) The weight of each resident shall be recorded upon admission  and  a monthly record of the weight of each resident shall be maintained.

  (4) All prescription  medication  shall  be  prescribed  by  a  licensed physician. Medication shall be administered and safeguarded in  accordance with the instructions of a resident's physician.

R 400.2416   Prohibited practices. Rescinded.

Rule 416. Licensees or administrators shall not  establish  or  practice policies of physical restraint, isolation, corporal  punishment,  personal humiliation, or withholding of food, water, or clothing.

R 400.2417   Assessment plan. Rescinded.

  Rule 417. Care, maintenance, and services shall be provided according to an assessment plan. Components of a plan shall include at least:

  (a)  Specific  objectives  of   maximum   self-care   and   independence appropriate for each resident.

  (b) Health appraisal, including medical-dental and,  where  appropriate, other evaluations by health professionals and prescribed treatment.

  (c) Care and maintenance requirements.

  (d) Specific services and planning needed to obtain objectives.

  (e) Work activities.

  (f) Religious activities.

  (g) Restrictions or exceptions to  the  requirements  of  resident  care which are individually set and allowable under licensing rule.

  (h) Payment planning related to the care and services to be obtained  by the resident.

R 400.2418   Resident activities. Rescinded.

Rule 418. (1) A resident shall have access to  the  use  of  the  United States mails; he may write and  send  mail  at  his  own  expense  without censorship and receive mail addressed to him unopened.

  (2) A resident shall  have  daily,  private  access  to  and  use  of  a telephone for local calls. Similar  access  is  to  be  granted  for  long distance calls which are made collect or for which charges  are  otherwise met by the resident.  When  pay  telephones  are  provided  in  congregate facilities, a reasonable amount  of  change  shall  be  available  in  the congregate facility to enable residents to  make  change  for  telephoning purposes.

  (3) A resident shall have immediate access to and use  of  his  personal clothing and personal belongings which he usually or habitually carries on his person or uses  as  a  matter  of  identification,  grooming,  toilet, prosthesis,  hygiene,  communication,   religious   observance,   personal adornment, personal entertainment, study, or personal enhancement.

  (4) A resident shall be provided with storage space  for  his  immediate and private use.

  (5) A congregate facility shall facilitate family relationships  by  its routine and personnel attitude. Restrictive visiting hours  shall  not  be maintained and residents shall be allowed to receive reasonable numbers of visitors at any reasonable  time.  Exceptions  shall  be  covered  in  the assessment plan. Special consideration shall be given to  visitors  coming from out of town or whose hours of employment warrant deviation from usual visiting hours.

  (6) A resident who is capable shall have the opportunity  of  doing  his own shopping for his personal needs in the nearest community.

  (7) A resident shall be afforded  appropriate  recreational  experiences and opportunities within and outside the congregate facility.

  (8) A resident shall be permitted to practice the  religious  belief  of his choice free of any coercion, and be allowed religious ministration  at reasonable  hours.  Religious  practice  shall  not  be  required  of  any resident.

  (9) An adult shall not be denied admission to, or be discharged from,  a congregate facility because of race, religion, color, or national  origin. The individual, or in the case of the legally  incompetent  his  guardian, shall exercise free choice in the selection of a congregate facility if it is capable of meeting the individual's needs.

  (10) Any  exception  to  resident  activities  shall  be  noted  in  the assessment plan.

R 400.2421   Residents' funds; access; safekeeping. Rescinded.

Rule 421. (1) A resident shall have access to and use of personal  funds belonging to him in reasonable amounts, including immediate access  to  at least  5.00  of  his  personal  funds.  Exceptions  shall  be  subject  to provisions of the assessment plan.

  (2) The maximum value of money and valuables a congregate facility shall accept for  safekeeping  shall  not  exceed  the  amount  of   400.00  per resident.

  (3) Residents' funds shall be kept separate and apart from all funds and monies of the licensee and treated as a trust obligation of the  licensee.

R 400.2422   Accounting of residents' funds. Rescinded.

Rule 422. (1) A resident's funds are subject at all times to a full  and prompt accounting to the resident.  Funds  shall  be  considered  promptly accounted for when the following conditions have been observed:

  (a) A resident receives on request an itemized monthly statement of  all charges against funds held in  trust  which  shall  be  in  such  form  as reasonably to inform the resident of the nature of the charge for goods or services and the amount thereof. A copy of the itemized statement shall be filed in the resident's record.

  (b) A resident receives up to his full amount of  personal  funds  at  a time designated by the  resident  but  in  no  event  later  than  5  days following the request subject to limitations in the resident's  assessment plan.

  (c) The charges against the resident's fund account  bear  a  reasonable relationship to value or agreed price for the services rendered and  goods furnished or made available to the resident.

  (2) A resident who  is  discharged  from  a  congregate  facility  shall receive an itemized  statement  of  his  personal  funds  and  prompt  and reasonable payment of funds remaining  in  his  account  at  the  time  of discharge, but no later than 5 banking days after discharge.

R 400.2423   Charges against residents' funds. Rescinded.

Rule 423. A resident, or in the case of a mentally handicapped resident, the responsible agency, legal guardian, person,  or  relative  responsible for maintaining him, shall be given  prior  written  notice  and  approval obtained before charges are made  against  his  account.  A  copy  of  the authorization shall be maintained in the resident's record.

R 400.2424   Transactions prohibited; review. Rescinded.

  Rule 424. (1) A congregate facility licensee or a member of his  family, or congregate facility staff shall not borrow money or  valuables  from  a resident with or without his consent.

  (2) Transactions between a resident and a congregate facility  shall  be subject to review by the department where it is alleged by a  resident  or his representative that the congregate facility did not  comply  with  any rule pertaining to trust funds. Department review does  not  preclude  any other legal remedy a resident or his representative may have.

R 400.2431   Home environment. Rescinded.

  Rule 431. (1) A congregate facility shall be so  constructed,  arranged, and maintained as to  provide  adequately  for  the  health,  safety,  and well-being of occupants.

  (2)  Furnishings  and  housekeeping  standards  shall  be  such  that  a congregate facility presents a comfortable, clean, and orderly appearance.

  (3)  All  occupied  rooms  shall  be  of  standard  lath   and   plaster construction or equivalent.

(4) The atmosphere and routine of the congregate facility shall be  such that a resident may spend the majority of his nonsleeping hours out of the bedroom.

  (5) Dining,  bath,  sitting,  living,  and  recreation  rooms  shall  be maintained by an adequate central heating system or its  equivalent  at  a temperature range of 68-72 degrees Fahrenheit during nonsleeping hours.

  (6) A congregate facility shall make adequate provision  for  laundering personal laundry.

  (7) A congregate facility shall  be  equipped  to  provide  an  adequate amount of hot water for a resident's use between the temperature range  of 110-120 degrees Fahrenheit at the fixture.

  (8) A toilet, lavatory, and  bathing  or  showering  facility  shall  be provided for each 8 adults in  a  congregate  facility  including  live-in staff and residents. At least 1 toilet and lavatory shall be  provided  on each floor having resident bedrooms.

  (9) Bathrooms and toilet facilities without windows  shall  have  forced ventilation to the outside. Bathroom windows used  for  ventilation  shall open easily.

  (10)  Toilets,  bathtubs,  and  showers  shall  provide  for  individual privacy.

  (11) Floors, walls, and ceilings shall be finished so as  to  be  easily cleanable, and shall be kept clean and in good repair.

R 400.2432   Living and sleeping areas. Rescinded.

Rule 432. (1) A congregate facility shall provide  distinct  living  and sleeping areas. All areas shall be well lighted, heated,  and  ventilated.

  (2) A congregate facility shall provide 1 or more attractively furnished multipurpose  areas  of  adequate   size   for   training,   recreational, family-style dining and other diversional and social activities.

  (3) The living and sleeping areas for a given resident shall not  be  in noncontiguous wings, units, or buildings.

  (4) A living room, dining room, or other room not  ordinarily  used  for sleeping shall not be used for sleeping by residents or  family  or  staff members.

  (5) Traffic to and from any room  shall  not  be  through  a  resident's bedroom.

R 400.2433   Bedrooms. Rescinded.

Rule 433. (1) A room shall not be used as a bedroom where more than  1/2 the room height is below grade, except where the ceiling of  such  portion of a building is located 5 feet or more above grade for more than  25%  of the perimeter measurement of the building.

  (2) Bedrooms for residents shall be separated from halls, corridors, and other rooms  by  floor-to-ceiling  walls  containing  no  openings  except doorways.

  (3) Interior  doorways  of  bedrooms  occupied  by  residents  shall  be equipped with  a  side-hinged,  permanently  mounted  door  equipped  with positively latching hardware which will insure opening of the  door  by  a single motion, such as turning a knob or by pressing with normal  strength on a latch.

  (4) Residents of opposite sex shall not occupy the same  bedroom  unless they are husband and wife.

(5) Residents having impaired mobility shall not sleep in or be assigned bedrooms located above the first or main floor.

  (6) Bedrooms shall have at  least  1  window.  Bedrooms  shall  be  well ventilated and maintained at a comfortable temperature.

  (7) A single occupancy bedroom shall have at least  80  square  feet  of usable floor space (70 square feet for existing facilities). Usable  floor space is defined as that floor space under a ceiling at  least  6  feet  6 inches in height.

  (8) A multi-occupancy bedroom shall have at  least  70  square  feet  of usable floor space per bed (65 square feet for existing facilities) with a maximum of 4 beds per bedroom. Usable floor space is defined as that floor space under a ceiling at least 6 feet 6 inches in height.

  (9) There shall be at  least  a  3-foot  clearance  between  beds  in  a multiresident bedroom.

  (10) Rollaways, cots, double deck, stacked bunks, hide-a-beds,  daybeds, and studio couches are prohibited.

  (11) Provision shall be made for a resident to mount or hang pictures on bedroom walls.

  (12) A resident bedroom shall be equipped with a mirror appropriate  for grooming.

  (13) Bedroom furnishings shall include an adequate closet  or  wardrobe, lighting sufficient for reading and other resident activities,  bureau  or dresser or equivalent, and at least 1 chair with arms in each bedroom  for every 2 residents.

R 400.2434   Bedding and linen. Rescinded.

Rule 434. (1) A congregate facility shall provide an individual  bed  at least 36 inches wide and 72 inches long with comfortable springs  in  good condition, a clean protected mattress not less than 5 inches  thick  or  4 inches if of a synthetic construction, and a pillow.

  (2) A congregate facility shall provide bedding which includes 2 sheets, a pillow case, a minimum of 1  blanket,  and  a  bedspread.  A  congregate facility shall maintain a linen supply for twice the number of beds in it. A congregate facility shall provide towels and washcloths which  shall  be changed at least twice weekly and more often if soiled. Bed linen shall be changed at least weekly and more often if soiled.

R 400.2447   Safety generally. Rescinded.

Rule 447. (1) Scatter or throw rugs on hard finished floors shall have a nonskid backing.

  (2) Handrails and nonskid surfacing or  strips  shall  be  installed  in showers and bath areas.

  (3) Sidewalks, fire escape routes and entrances shall be  kept  free  of any hazards such as ice, snow, and debris.

  (4) A yard area shall be kept free from all hazards,  nuisances,  refuse and litter.

R 400.2448   Water and sanitation. Rescinded.

  Rule 448. (1) Private water systems shall meet the department of  public health rules,  "Regulations  for  Certain  Water  Supplies  in  Michigan," available from the Department of Public Health, 3500 North  Martin  Luther King, Jr. Blvd., Lansing, MI 48915. A  bacteriological  report  confirming water quality shall be required during  initial  inspection  and  every  2 years thereafter. Congregate facilities using a  community-approved  water system need not comply with this requirement.

  (2) Sewage disposal systems shall meet the  requirements  of  the  state department of public health.

  (3) Kitchen and bathroom areas shall be maintained to insure cleanliness and sanitation so as to protect health.

  (4) Waste which is not disposed of by mechanical means shall be kept  in a leakproof, nonabsorbent container with close-fitting covers for garbage, refuse, and other solid waste. Waste shall be  removed  from  the  kitchen daily and from the premises at least weekly.

  (5) Hand-washing facilities provided in both kitchen and bathroom  areas shall include hot and cold water, soap and individual  towels,  preferably of paper.

  (6) An insect, rodent or pest-control program  shall  be  maintained  as necessary, and carried out in a  manner  which  continually  protects  the health of residents. Poisons,  caustics,  and  other  dangerous  materials shall be stored and  safeguarded  in  nonresident  areas  and  in  nonfood preparation and storage areas.

  (7) Open windows shall be screened May through October.

  (8) When a resident is discharged, his room and its  contents  shall  be thoroughly cleaned. Blankets and spreads shall be sanitized.

R 400.2451   Records generally. Rescinded.

Rule 451. Resident records, a resident register,  accident  records  and incident reports, residents' grievances and complaints, employee  records, employee work schedules and record of resident funds and  valuables  shall be kept in the congregate facility and shall be available to the  director or his authorized representative.

R 400.2452   Resident records. Rescinded.

Rule 452. (1) An individual resident record shall be provided  for  each resident in the congregate facility.

  (2) It shall be the shared responsibility  of  the  congregate  facility licensee and the responsible agency to  assure  that  a  current  resident record is maintained and that all entries are dated and signed.

  (3) The resident record shall include all of the following  information:

  (a) Identifying information including all of the following  information:

  (i) Name.

  (ii) Social security number.

  (iii) Agency case number.

  (iv) Veteran status and number.

  (v) Marital status.

  (vi) Age.

(vii) Sex.

  (viii) Home address.

  (ix) Religious preference.

  (x) Insurance information.

  (xi) Burial provisions.

  (b) Assessment plan.

  (c) Name, address,  and  telephone  number  of  next  of  kin  or  legal guardian.

  (d) Name, address, and telephone number  of  person  or  placing  agency responsible  for  resident's  maintenance  and  care  in  the   congregate facility.

  (e) Date of admission.

  (f) Date of discharge and place to which resident was discharged.

  (g) Health information including all health  appraisals  and  statements and instructions for administering prescribed medication.

  (h) The name and address of the preferred physician  and  hospital  and instructions for emergency care.

  (i) Information available from the resident about insurance policies and prearranged funeral arrangements.

R 400.2453   Resident register. Rescinded.

Rule 453. A chronological register of residents shall be maintained  and include the following information for each resident:  date  of  admission, date of discharge, and place to which resident was  discharged,  including date and location for temporary absences.

R 400.2454   Accident records. Rescinded.

Rule 454. An accident record must be prepared for each accident involving a resident. An accident record must include the following information: 

  (a) The name of the resident involved in the accident.

  (b) The date, hour, place, and cause of the accident.

  (c) The effect of the accident on the resident involved and the care given.

  (d) The name of the physician notified and the time of the notification.

  (e) The physician’s statement regarding the extent of the injuries, the treatment ordered, and disposition of the resident involved.

  (f) Corrective measures taken to avoid repetition of the accident.

R 400.2455   Employee records and schedules. Rescinded.

  Rule 455. (1) A record shall be maintained for permanent  full-time  and permanent part-time employees only and shall include the following:

  (a) Name, address, telephone number, and social security number.

  (b) License or registration number, if applicable.

  (c) Date of birth.

  (d) Summary of experience and education (resume).

  (e) References.

  (f) Beginning date of employment and position for which employed.

  (g) Performance evaluation.

  (h) Results of annual health certifications.

  (i) Periodic health review information.

  (j) Date employment ceased and reasons therefor.

  (2) A daily work schedule shall be maintained to include the number  and type of personnel on duty in the congregate facility. Work schedules shall be kept for 90 days.

R 400.2456   Resident's grievances and complaints record. Rescinded.

Rule 456. A resident grievances and complaint record shall be maintained which shall include copies of all resident grievances or complaints  filed in chronological order.  The  report  shall  include  the  nature  of  the complaint, the date of the complaint, and a statement indicating  how  the issue was resolved.

R 400.2457   Resident funds and valuables. Rescinded.

  Rule 457. The resident funds and valuables  record  shall  indicate  the date and receipt number of all deposits and dispersals, and the amount and description of monies or valuables or both given for safekeeping for  each resident. It shall also include any written authorization by the  resident for charges made by the congregate facility to the fund.

R 400.2461   Emergency preparedness. Rescinded.

  Rule 461. (1) A congregate facility shall have a telephone. A congregate facility shall have a written procedure to be  followed  in  the  case  of fire, or medical emergency. Responsible employees and  residents,  to  the best of their ability, shall be familiar with emergency planning  and  his or her responsibilities.

  (2) An emergency plan shall specify persons to be notified, locations of alarm signals and fire extinguishers, evacuation  routes,  procedures  for evacuating residents of limited mobility and visitors, and provide for  at least 4 fire drills per year.

  (3) The emergency plan, including appropriate telephone  numbers,  shall be prominently posted and made fully known to all  residents,  staff,  and responsible persons and be reviewed annually.

  (4) Staff shall be trained to perform assigned  tasks  and  be  familiar with all fire fighting equipment.

  (5) Fire drills shall be conducted  quarterly  and  a  record  of  their performance shall be maintained. Evacuation  planning  shall  include  the possibility of nighttime movements of residents.

R 400.2471   Quality of meals. Rescinded.

Rule 471. (1) A minimum of 3 regular, nutritious, attractively  prepared meals shall be provided daily. No more than 15 hours shall elapse  between the evening and morning meal. Meals shall be of proper form,  consistency, and temperature. Meals shall meet the general requirements  for  nutrition published by the department or currently found in  the recommended  daily dietary allowances, food and nutrition board, national academy of science.

  (2) Special diets shall be prescribed only by a physician.

R 400.2472   Food service. Rescinded.

Rule 472. (1) All perishable foods shall be stored at such  temperatures as will protect against spoilage.

  (2) All foods while being stored, prepared, or served shall be protected against contamination and be safe for human consumption.

R 400.2473   Equipment. Rescinded.

Rule 473. A congregate facility shall be equipped  properly  to  prepare and serve adequate meals.

R 400.2474   Meal planning. Rescinded.

  Rule 474. (1) Menus shall be written 3 days prior to the serving of  the meal. Any change or substitution shall be noted and considered as  a  part of the original menu.

  (2) Records of menus as served shall be provided  upon  request  by  the department.

R 400.2475   Staff. Rescinded.

Rule 475. A minimum of 1 individual qualified by  training,  experience, and performance shall be responsible for food preparation. Such additional food service  assistance,  including  relief  persons,  as  necessary  for regular and timely meals, shall be employed.