DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

BUREAU OF COMMUNITY AND HEALTH SYSTEMS

ADULT FOSTER CARE LARGE GROUP HOMES

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 Orders 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 400.15101, R 400.15102, R 400.15103, R 400.15104, R 400.15105, R 400.15106, R  400.15201, R 400.15202, R 400.15203, R 400.15204, R 400.15205, R 400.15206, R  400.15207, R 400.15208, R 400.15209, R 400.15210, R 400.15301, R 400.15302, R  400.15303, R 400.15304, R 400.15305, R 400.15306, R 400.15307, R 400.15308, R  400.15309, R 400.15310, R 400.15311, R 400.15312, R 400.15313, R 400.15314, R  400.15315, R 400.15316, R 400.15317, R 400.15318, R 400.15319, R 400.15401, R  400.15402, R 400.15403, R 400.15404, R 400.15405, R 400.15406, R 400.15407, R  400.15408, R 400.15409, R 400.15410, and R 400.15411 of the Michigan Administrative Code are rescinded, as follows:

PART 1. GENERAL PROVISIONS

R 400.15101   Scope. Rescinded.

  Rule 101. This part applies to all adult foster care large  group  homes that are licensed or proposed for 13 to 20 persons.

R 400.15102 Definitions. Rescinded.

  Rule 102. (1) As used in these rules:

   (a) "Act" means the adult foster care facility licensing act, 1979 PA 218, MCL 400.701 to 400.737.

   (b) "Administrator" means the individual that is designated by the licensee to be responsible for the daily operation and management of the adult foster care large group home. The administrator may be the licensee.

   (c) "Admission policy" means a home's public statement of its purpose, eligibility requirements for admission, and application procedures for admission.

   (d) "Assessment plan" means a written statement that is prepared in cooperation with a responsible agency or individual that identifies the specific care and maintenance, services, and resident activities appropriate for each individual resident's physical and behavioral needs and well-being and the methods of providing the care and services, taking into account the preferences and competency of the individual.

   (e) "Assistive device" means the use of an item such as a pillow, pad, or medically supplied therapeutic support that is intended to achieve or maintain the proper position, posture, or balance of a resident. An assistive device may also be an item that is intended to promote, achieve, or maintain the resident's independence. Anything that is used with  the intent to restrain a resident and that does not permit the resident to remove the device by himself or herself is a restraint and is not an assistive device.

   (f) "Capacity" means the maximum number of residents that a home is licensed for.

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

   (h) "Designated representative" means the individual or agency that has been granted written authority, by a resident, to act on behalf of the resident or that is the legal guardian of a resident.

   (i) "Direct care staff" means the adult that is designated by the licensee to provide personal care, protection, and supervision to residents.

   (j)  "Discharge policy" means a home's written statement of the conditions and procedures that a resident is discharged from the home by.

   (k) "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.

   (l) "Health care appraisal" means a licensed physician's, licensed physician assistant's, or registered nurse's statement that provides an assessment of the general physical condition of a resident.

   (m) "Home" means an adult foster care large group home.

   (n) "House rules" means those rules that are established by the licensee and that set expectations for resident conduct.

   (o) "Incident" means an intentional or unintentional event where a resident sustains physical or emotional harm, unexpected or unnatural death, is displaced by a natural disaster, or elopes.

   (p) "Isolation" means the complete and unattended separation of a resident from staff and other residents.

   (q) "Members of the household" means all individuals that live in the home, exclusive of residents.

   (r) "Occupants" means all individuals that live in the home.

   (s) "Physical restraint" means the bodily holding of a resident with no more force than is necessary to limit the resident's movement.

   (t) "Premises" means the home, grounds, and all other appurtenances.

   (u) "Program statement" means a written description of the home's program that must, at a minimum, include the following:

    (i) The population to be served.

    (ii) Program goals, services, in addition to those provided in the home, and community resources to meet the residents' needs.

    (iii) Services to be provided in the home to the residents, including a description of the types of staff competencies that are necessary to carry out these services.

    (iv) A description of any contract agreement that services and programs are provided through.

   (v) "Related" means any of the following relationships by marriage, blood, or adoption:

    (i) Spouse.

    (ii) Child.

    (iii) Parent.

    (iv) Brother.

    (v) Sister.

    (vi) Grandparent.

    (vii) Aunt.

    (viii) Uncle.

    (ix) Stepparent.

    (x) Stepbrother.

    (xi) Stepsister.

    (xii) Cousin.

   (w) "Resident" means an adult, as that term is defined in section 3 of the act, MCL 400.703.

   (x) "Resident funds" means any money, securities, bonds, or stocks that are received by a licensee from, or on behalf of, a resident. Resident funds includes all of the following:

    (i) Payment for adult foster care services.

    (ii) Personal allowance.

    (iii) Money held as a trust obligation.

    (iv) Money in accounts with financial institutions.

   (y) "Responsible agency" means a public or private organization that, after written agreement with a resident or the resident's designated representative, provides either or both of the following:

    (i) Assessment planning and the establishment of an individual plan of service.

    (ii) Maintenance of ongoing follow-up services while the resident is in the home.

   (z) "Street floor" means any story or floor level that is accessible from the street or from outside the building at grade and, at the main entrance, is not more than 21 inches above, nor more than 12 inches below, street or grade level at those points.

   (aa) "Substantial risk" means that a resident's behavior poses a serious imminent threat of bodily harm to himself or herself or others or the threat of the destruction of property, and the resident is capable of carrying out such harm or destruction.

   (bb) "Transportation services" 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.

   (cc) "Valuables" means personal property of a resident, including jewelry, furniture, electronic equipment, appliances, and clothing items that have a value of more than $25.00.

  (2) Terms defined in the act have the same meanings when used in these rules.

R 400.15103   Licenses; required information; fee; effect of  failure  to cooperate  with  inspection  or  investigation;  posting   of   license; reporting of changes in information. Rescinded.

  Rule 103. (1) An applicant for an adult foster  care  large  group  home license shall make available at the  facility,  or  for  the  department's inspection and copying of all of the following items:

  (a) A current written admission policy and program statement.

  (b) Copies of all of the following:

  (i) Personnel policies.

  (ii) Job descriptions.

  (iii) Standard or routine procedures.

  (iv) Proposed staffing patterns.

  (v) An organizational chart.

  (c) A copy of any current agreement or contract between the applicant or licensee, agency, person, or organization that  provides  or  proposes  to provide funding, care, treatment, or supplemental services as described in the home's program statement.

  (d) A current floor plan of  each  level  and  basement  of  the  entire structure, including the interior layout of foster  care  areas  and  room descriptions and specifics  as  to  use,  the  number  of  beds,  and  the dimensions of floor space.

  (e) A current financial statement and a proposed biennial budget.

  (f)  Verification  of  the  lease,  ownership,  or   right   to   occupy arrangements.

  (g) Current articles of incorporation, a letter  of  authorization  from the board of directors that designates the individual who is authorized to act on behalf of the corporation on licensing matters, a current  list  of the  corporate  directors,   if   applicable,   and   a   certificate   of incorporation.

  (h) A current credit history for noncorporate applicants.

  (2) A license fee shall accompany an original license application and  a license renewal application. This fee is nonrefundable.

  (3) The failure of an  applicant  or  licensee  to  cooperate  with  the department in connection with an  inspection  or  investigation  shall  be grounds for denying, suspending, revoking, or refusing to renew a license.

  (4) The current license, whether  regular,  provisional,  or  temporary, shall be posted in the home and shall be available for public  inspection.

  (5) An applicant or licensee shall give written notice to the department of any changes in information that was previously submitted in or with  an application for a license, including any changes in the household  and  in personnel-related information, within 5 business  days  after  the  change occurs.

  R 400.15104   Licensee and applicant rights. Rescinded.

Rule 104. (1) A licensee or an applicant shall  have  the  right  to  be treated with courtesy, dignity, and fairness  by  the  adult  foster  care licensing division staff of the department and shall not be  discriminated against on the basis of race, religion, color, national origin, sex,  age, handicap, height, weight, or marital status.

  (2) The department shall provide a licensee or an applicant with written notice regarding appeal rights as provided by Act No. 306  of  the  Public Acts of 1969, as amended, being S24.201 et seq. of the  Michigan  Compiled Laws, and the act when there is official notification  of  the  intent  to take an adverse action against an applicant or a licensee.

  (3) A licensee or an applicant shall be informed of, and shall have  the right to bring to  the  attention  of  the  supervisor  of  the  licensing representative, any alleged misapplication of enforcement  of  regulations by a licensing representative or any substantial differences of opinion as may occur  between  the  licensee  or  the  applicant  and  any  licensing representative concerning the proper  application  of  the  act  or  these rules. A meeting with the supervisor shall be afforded upon request.  This subrule notwithstanding, the licensee or the  applicant  may  contact  any other  official  of  the  department  regarding  issues  relating  to  the licensing activities of the department. Any contact with the supervisor or any other departmental official shall not result in any retaliation by the licensing representative.

  (4)  All  written  communications,  scheduled  and  unscheduled  visits, routine licensing investigations, and complaint  investigations  shall  be conducted according to the provisions of the act and these rules.

  (5) A licensee or an applicant may request, pursuant to  the  provisions of Act No. 442 of the Public Acts of 1976, as amended,  being  S15.231  et seq. of the Michigan Compiled Laws, copies of department policies or other documents that govern the licensing activities of the department.

  (6) A licensee or an applicant shall be afforded the opportunity to have a conference with the licensing representative before the conclusion of  a routine licensing investigation or complaint investigation and, as soon as practicable thereafter, shall receive a written  response  that  indicates the findings of  the  licensing  representative  or  any  other  licensing official.

  (7) A licensee or  an  applicant  shall  have  the  right  to  review  a licensing study report in which refusal to renew, revocation, or denial of license issuance is being recommended before  that  report  is  finalized, except in situations where the department finds cause to invoke a  summary suspension action. The licensee or the applicant shall have the  right  to submit a written response. The written response shall be considered a part of the official record and shall be subject to disclosure pursuant to  the provisions of Act No. 442 of the Public Acts of 1976,  as  amended,  being S15.231 et seq. of the Michigan Compiled Laws.

  (8) A licensee or an applicant shall have the right to provide a written response  to  the  findings  of  the  licensing  representative  or  other department official if a licensing investigation  report  or  a  complaint investigation report is issued. The written response shall become  a  part of  the  department's  official  licensing  record  and  shall  be  public information according to the provisions of Act No. 442 of the Public  Acts of 1976, as amended, being S15.231 et seq. of the Michigan Compiled  Laws, and the act.

  (9) A licensee or an applicant may request, in  writing,  a  declaratory ruling as to the applicability of a rule as provided in section 63 of  Act No. 306 of the Public Acts of 1969,  as  amended,  being  S24.263  of  the Michigan Compiled Laws.

  (10) The department shall provide advice and technical assistance to the licensee  or  the  applicant  to  assist  the  licensee  in  meeting   the requirements of the act  and  these  rules.  The  department  shall  offer consultation upon request in developing methods  for  the  improvement  of service.

  (11) The department shall provide a licensee  or  an  applicant  with  a written copy of the rights outlined in subrules (1) to (10) of  this  rule at the time of license application or license renewal.

R 400.15105   Licensed capacity. Rescinded.

Rule 105. (1) The number of residents cared for in a home and the number of resident beds shall not be more than the capacity that is authorized by the license.

  (2) Any occupant of a home other than the licensee or  persons  who  are related to the licensee, live-in staff or the live-in staff's  spouse  and minor children, or the spouse of a resident who is not in need  of  foster care shall be considered a resident and  be  counted  as  a  part  of  the licensed capacity.

  (3) The total number of occupants shall not be  more  than  6  over  the licensed capacity.

  (4) If a person who is related to a  resident  lives  in  the  home  and subsequently requires foster care, the licensee shall have not  more  than 30 calendar days to return to the licensed capacity. Failure to do so  may result in the department's refusal to renew a license, revocation  of  the license, or the issuance of a provisional license.

R 400.15106   Rule variance. Rescinded.

Rule 106. (1) Upon the written request of an applicant or licensee,  the department may grant a variance from an administrative rule  if  there  is clear and convincing evidence that the alternative to  the  rule  complies with the intent of the administrative rule  from  which  the  variance  is sought.

  (2) The decision of the department, including the conditions under which the variance is  granted,  shall  be  entered  upon  the  records  of  the department, and a signed copy shall be sent to the applicant or  licensee. This variance may be time-limited or may remain in effect for as  long  as the licensee continues to comply with the intent of the rule.

  (3) A variance that is granted pursuant to this rule is not transferable from one applicant to another or from one licensee to another.

PART 2. PROGRAM REQUIREMENTS

R 400.15201   Qualifications  of  administrator,   direct   care   staff, licensee, and members of household;  provision  of  names  of  employee, volunteer, or member of household on parole or probation or convicted of felony; food service staff. Rescinded.

Rule 201. (1) An administrator and direct care staff  shall  be  persons who are not residents.

  (2) A licensee shall have the financial and administrative capability to operate a home to provide the level of care and program stipulated in  the application.

  (3)  Before  a  temporary  license  is  issued,  an  applicant  and   an administrator shall be competent in all of the following areas:

  (a) Nutrition.

  (b) First aid.

  (c) Cardiopulmonary resuscitation.

  (d) Foster care, as defined in the act.

  (e) Safety and fire prevention.

  (f) Financial and administrative management.

  (g) Knowledge of the needs of the population to be served.

  (h) Resident rights.

  (i) Prevention and containment of communicable diseases.

  (4) An applicant and an  administrator  shall  be  deemed  competent  to operate a home upon successfully completing 1 or more of the following:

  (a) Training that is developed, approved, or provided by the department.

  (b) A competency review that is developed by the department to be  given to the applicant and administrator during the  licensing  process  by  the licensing agent.

  (c) A program of study at an accredited college or university  in  areas relevant to the applicant's admission policy and program statement.

  (d) Experience that is related to the direct care of residents in  areas that are relevant to the populations which are identified  in  the  home's admission policy and program statement.

  (5) An administrator  who  is  designated  by  the  licensee  after  the promulgation of these rules shall meet the requirements of subrule (4)  of this rule.

  (6) A licensee and the administrator shall have a high school diploma or general education diploma or equivalent  and  not  less  than  1  year  of experience working with the population identified in  the  home's  program statement and admission policy.

  (7) The provisions of subrule (6) of this rule shall not apply to  those adult foster  care  licensees  or  administrators  who  are  licensed,  or applying to be licensed, before the promulgation of these rules.

  (8) The provisions of subrule (6) of this rule shall  not  apply  to  an individual who is employed as an administrator of a home that was licensed before the promulgation of these rules.

  (9) A licensee and the administrator shall possess all of the  following qualifications:

  (a)  Be  suitable  to  meet  the  physical,   emotional,   social,   and intellectual needs of each resident.

  (b) Be capable of appropriately handling emergency situations.

  (c)  Be  capable  of  assuring  program   planning,   development,   and implementation of services to residents consistent with the home's program statement and in accordance with the resident's assessment plan  and  care agreement.

  (10) All members of the household, employees, and those  volunteers  who are under the direction of the licensee shall be suitable  to  assure  the welfare of residents.

  (11) A licensee, direct  care  staff,  and  an  administrator  shall  be willing to cooperate fully with  a  resident,  the  resident's  family,  a designated representative of the resident and the responsible agency.

  (12) A licensee, direct care staff, administrator,  or  members  of  the household shall not be the legal guardian or conservator of a resident who lives in the home, except if a person is a relative of the resident or  if the guardianship or conservatorship of the licensee existed  before  April 1, 1989, as specified in section 454 of Act No. 642 of the Public Acts  of 1978, as amended, being S700.454 of the Michigan Compiled Laws.

  (13) A licensee shall provide  the  department  with  the  name  of  any employee, volunteer who is under the direction of the licensee, or  member of the household who is on a court-supervised probation or parole  or  who has been convicted of a felony.

  (14) A licensee shall employ at least 1 individual who is  qualified  by training,  experience,  and  performance  to  be  responsible   for   food preparation. Additional food service staff shall be employed as  necessary to ensure regular and timely meals.

R 400.15202   Administrator; qualifications. Rescinded.

Rule 202. (1) A home shall have an administrator who shall not have less than 1 year of experience working  with  persons  who  are  mentally  ill, developmentally disabled, physically handicapped, or aged.

  (2) A licensee who meets the  qualifications  of  an  administrator  may serve as an administrator.

R 400.15203   Licensee and administrator training requirements. Rescinded.

  Rule 203. (1)  A  licensee  and  an  administrator  shall  complete  the following educational requirements specified in subdivision (a) or (b)  of this subrule, or a combination thereof, on an annual basis:

  (a) Participate in, and successfully  complete,  16  hours  of  training designated  or  approved  by  the  department  that  is  relevant  to  the licensee's admission policy and program statement.

  (b) Have completed 6 credit hours at an accredited college or university in an area that is relevant to the licensee's admission policy and program statement as approved by the department.

  (2) The department may  prescribe  additional  training  if  substantial noncompliance with the act or these rules is evident.

R 400.15204   Direct care staff; qualifications and training. Rescinded.

Rule 204. (1) Direct care staff shall not be less than 18 years  of  age and shall be able to complete required reports and follow written and oral instructions that are related to the care and supervision of residents.

  (2) Direct care staff shall possess all of the following qualifications:

  (a) Be suitable to  meet  the  physical,  emotional,  intellectual,  and social needs of each resident.

  (b) Be capable of appropriately handling emergency situations.

  (3) A licensee or administrator shall  provide  in-service  training  or make training available through other sources to direct care staff. Direct care staff shall be competent  before  performing  assigned  tasks,  which shall include being competent in all of the following areas:

  (a) Reporting requirements.

  (b) First aid.

  (c) Cardiopulmonary resuscitation.

  (d) Personal care, supervision, and protection.

  (e) Resident rights.

  (f) Safety and fire prevention.

  (g) Prevention and containment of communicable diseases.

R 400.15205   Health of a licensee,  direct  care  staff,  administrator, other employees, those volunteers under the direction of  the  licensee, and members of the household. Rescinded.

Rule 205. (1)  A  licensee,  direct  care  staff,  administrator,  other employees, those volunteers under  the  direction  of  the  licensee,  and members of the household shall be in such physical and mental health so as not to negatively affect either the health of the resident or the  quality of the resident's care.

  (2) A licensee shall have, on file with the department, a statement that is signed by a licensed physician or his or her designee attesting to  the physician's  knowledge  of  the  physical  health  of  the  licensee   and administrator. The statement shall be signed within 6  months  before  the issuance of a temporary license and at any other  time  requested  by  the department.

  (3) A licensee shall maintain, in  the  home,  and  make  available  for department review, a statement that is signed by a licensed  physician  or his or her designee attesting to the physician's knowledge of the physical health  of  direct  care  staff,  other  employees,  and  members  of  the household.  The  statement  shall  be  obtained  within  30  days  of   an individual's employment, assumption of duties, or occupancy in  the  home.

  (4) A licensee shall provide the department with written  evidence  that he or  she  and  the  administrator  have  been  tested  for  communicable tuberculosis and that if the disease is present,  appropriate  precautions shall be taken. The results of subsequent testing shall be verified  every 3 years thereafter.

  (5) A licensee shall obtain written evidence, which shall  be  available for department review, that each direct care staff,  other  employees  and members of the household have been tested  for  communicable  tuberculosis and that if the disease is present, appropriate precautions shall be taken as required by state law. Current testing  shall  be  obtained  before  an individual's employment, assumption of duties, or occupancy in  the  home. The results  of  subsequent  testing  shall  be  verified  every  3  years thereafter or more frequently if necessary.

  (6)  A  licensee  shall  annually  review  the  health  status  of   the administrator, direct care staff,  other  employees  and  members  of  the household. Verification of annual reviews shall be maintained by the  home and shall be available for department review.

  (7) A licensee shall obtain certification  from  a  volunteer  that  the volunteer is free from  communicable  disease  and  that  the  volunteer's physical and mental health will not negatively affect either the health of the resident or the quality of the residents care.

R 400.15206   Staffing requirements. Rescinded.

  Rule 206. (1) The ratio of direct  care  staff  to  residents  shall  be adequate  as  determined   by   the   department,   to   carry   out   the responsibilities defined in the act and in these rules and  shall  not  be less than 1 direct care staff to 15 residents during waking hours or  less than 1 direct care staff member to 20  residents  during  normal  sleeping hours.

  (2) A licensee shall have sufficient direct care staff on  duty  at  all times for the supervision, personal care, and protection of residents  and to  provide  the  services  specified  in  the  resident's  resident  care agreement and assessment plan.

  (3) Any individual, including a volunteer, shall not  be  considered  in determining the ratio  of  direct  care  staff  to  residents  unless  the individual meets the qualifications of a direct care staff member.

  (4) Direct care staff need not be in the home during the day if  all  of the residents of the home are at out-of-home supervised activities and the home has provided the means  by  which  a  direct  care  staff  member  or administrator can be contacted in an emergency situation.

  (5) A licensee or administrator shall designate, in  writing,  a  person who shall be on-site or immediately  available  and  who  shall  have  the authority to carry out the licensee's or administrator's  responsibilities in the absence of the licensee or administrator and shall ensure that  the identity of the designated person is made known to all staff.

R 400.15207   Required personnel policies. Rescinded.

Rule 207. (1) A licensee shall have written policies and procedures that include all of the following:

  (a) Mandatory reporting, including reporting that is required by law.

  (b) Resident care related prohibited practices.

  (c) Confidentiality requirements, including  requirements  specified  in law.

  (d) Training requirements.

  (e) Resident rights.

  (f) The process for reviewing the licensing statute  and  administrative rules.

  (2) The written policies and procedures identified  in  subrule  (1)  of this rule shall be given to  employees  and  volunteers  at  the  time  of appointment. A verification of receipt  of  the  policies  and  procedures shall be maintained in the personnel records.

  (3) A licensee shall have a written job description for  each  position. The job description shall define the tasks, duties,  and  responsibilities of the position. Each employee and volunteer who is under the direction of the licensee  shall  receive  a  copy  of  his  or  her  job  description. Verification of receipt of a job description shall be  maintained  in  the individual's personnel record.

  (4) Work assignments shall be consistent with job descriptions  and  the level of training, experience, and education of the employee or volunteer.

R 400.15208   Direct care staff and employee records. Rescinded.

Rule 208. (1) A licensee shall maintain a record for each employee.  The record shall contain all of the following employee information:

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

  (b)  The  professional  or   vocational   license,   certification,   or registration number, if applicable.

  (c) A copy of the employee's driver  license  if  a  direct  care  staff member or employee provides transportation to residents.

  (d) Verification of the age requirement.

  (e) Verification of experience, education, and training.

  (f) Verification of reference checks.

  (g) Beginning and ending dates of employment.

  (h) Medical information, as required.

  (i) Required verification of the receipt of personnel policies  and  job descriptions.

  (2) The records  identified  in  subrule  (1)  of  this  rule  shall  be maintained for not less than 3 years after the direct care staff  member's or employee's ending date of employment.

  (3)  A  licensee  shall  maintain  a  daily  schedule  of  advance  work assignments, which shall be kept for 90 days. The schedule  shall  include all of the following information:

  (a) Names of all staff on duty and those volunteers who  are  under  the direction of the licensee.

  (b) Job titles.

  (c) Hours or shifts worked.

  (d) Date of schedule.

  (e) Any scheduling changes.

R 400.15209   Home records generally. Rescinded.

Rule 209. (1) A licensee shall keep, maintain, and  make  available  for department review, all the following home records:

  (a) Admission policy.

  (b) Program statement.

  (c) Discharge policy.

  (d) Resident records.

  (e) A resident register.

  (f) Resident care contracts, if applicable.

  (g) Accident records and incident reports.

  (h) Personnel records, as required in R 400.15208.

  (i) Personnel policies and procedures as required in R 400.15207.

  (j) Program certifications, if applicable.

  (k) Fire drill records.

  (l) Emergency preparedness plans.

  (m) Reports of fire or severe property damage.

  (n) Records of variances granted, if applicable.

  (o) Heating equipment inspection and approval records, if applicable.

  (p) Fire detection  and  sprinkler  equipment  inspection  and  approval records, if applicable.

  (q) Electrical inspection records, if applicable.

  (r) Fire safety reports from the department or the state  fire  marshal, as required by law.

  (s) Environmental inspection reports, as required by law.

  (t) Menus.

  (2) A licensee shall keep a record of the arrangements for services  for the  emergency  repair  of  heating,  cooling,  plumbing,  and  electrical equipment. The record shall include a list of persons to contact and shall be available for reference in the home.

R 400.15210   Resident register. Rescinded.

Rule  210.  A  licensee  shall  maintain  a  chronological  register  of residents who are admitted to the home. The register shall include all  of the following information for each resident:

  (a) Date of admission.

  (b) Date of discharge.

  (c) Place and address to which the resident moved, if known.

PART 3. RESIDENT CARE, SERVICES, AND RECORDS

R 400.15301   Resident  admission  criteria;  resident  assessment  plan; emergency admission; resident care agreement; physician's  instructions; health care appraisal. Rescinded.

Rule 301. (1) A licensee  shall  not  accept,  retain,  or  care  for  a resident who requires continuous nursing care. This does not preclude  the accommodation of a resident who becomes temporarily ill while in the home, but who does not require continuous nursing care.

  (2) A licensee shall not accept or retain a resident for care unless and until the licensee has completed a written assessment of the resident  and determined that the resident is suitable pursuant to all of the  following provisions:

  (a) The amount of personal care, supervision,  and  protection  that  is required by the resident is available in the home.

  (b) The kinds of services, skills, and physical accommodations that  are required of the home to meet the resident's needs  are  available  in  the home.

  (c) The resident appears to  be  compatible  with  other  residents  and members of the household.

  (3) A group home shall not  accept  or  retain  a  person  who  requires isolation or restraint as specified in R 400.15308.

  (4) At  the  time  of  admission,  and  at  least  annually,  a  written assessment plan shall be completed with the  resident  or  the  resident's designated representative, the responsible agency, if applicable, and  the licensee. A licensee shall maintain  a  copy  of  the  resident's  written assessment plan on file in the home.

  (5) If a resident is referred for emergency admission and  the  licensee agrees to  accept  the  resident,  a  written  assessment  plan  shall  be completed within 15 calendar  days  after  the  emergency  admission.  The written assessment shall be completed in accordance  with  the  provisions specified in subrules (2) and (4) of this rule.

  (6) At the time of a resident's admission, a licensee shall  complete  a written resident care agreement. A resident care agreement is the document which is established between the resident  or  the  resident's  designated representative, the responsible agency, if applicable,  and  the  licensee and which specifies the responsibilities of each party.  A  resident  care agreement shall include all of the following:

  (a) An agreement to provide care, supervision, and  protection,  and  to assure transportation  services  to  the  resident  as  indicated  in  the resident's written assessment plan and health care appraisal.

  (b) A description of services  to  be  provided  and  the  fee  for  the service.

  (c) A description of additional costs in addition to the basic fee  that is charged.

  (d) A description of the transportation services that are  provided  for the basic fee that is charged and the  transportation  services  that  are provided at an extra cost.

  (e)  An  agreement  by  the  resident  or  the   resident's   designated representative  or  responsible  agency  to   provide   necessary   intake information to the licensee, including health-related information  at  the time of admission.

  (f)  An  agreement  by  the  resident  or  the   resident's   designated representative to provide a current health care appraisal as  required  by subrule (10) of this rule.

  (g) An agreement by the resident to follow  the  house  rules  that  are provided to him or her.

  (h) An agreement by the licensee to respect and safeguard the resident's rights and to provide a written copy of these rights to the resident.

  (i) An agreement between the licensee and the resident or the resident's designated representative  to  follow  the  home's  discharge  policy  and procedures.

  (j) A statement of the home's refund policy. The  home's  refund  policy shall meet the requirements of R 400.15315.

  (k) A description of how  a  resident's  funds  and  valuables  will  be handled and how the incidental needs of the resident will be met.

  (l) A statement by the  licensee  that  the  home  is  licensed  by  the department to provide foster care to adults.

  (7) A department resident care agreement form shall be used unless prior authorization for a substitute form has been granted, in writing,  by  the department. A resident shall be provided the care and services  as  stated in the written resident care agreement.

  (8) A copy of the signed resident care agreement shall  be  provided  to the resident or the resident's designated representative. A  copy  of  the resident care agreement shall be maintained in the resident's record.

  (9) A licensee shall review the written resident care agreement with the resident or  the  resident's  designated  representative  and  responsible agency, if applicable, at least annually or more often if necessary.

  (10) At the time of the resident's admission to  the  home,  a  licensee shall  require  that   the   resident   or   the   resident's   designated representative provide a written health care appraisal that  is  completed within the 90-day period before the resident's admission to  the  home.  A written health care appraisal shall be completed at least annually.  If  a written health care appraisal is not available at the time of an emergency admission, a licensee shall require that the  appraisal  be  obtained  not later than 30 days after admission. A  department  health  care  appraisal form shall be used unless prior authorization for a  substitute  form  has been granted, in writing, by the department.

  (11) A licensee shall contact a resident's physician for instructions as to the care of the resident  if  the  resident  requires  the  care  of  a physician while living in the  home.  A  licensee  shall  record,  in  the resident's record, any instructions for the care of the resident.

R 400.15302   Resident  admission  and  discharge  policy;  house  rules; emergency discharge; change of residency; restricting resident's ability to make living arrangements prohibited; provision of resident records at time of discharge. Rescinded.

Rule 302. (1) A home  shall  have  a  written  admission  and  discharge policy. The policy shall be made available to a resident and  his  or  her designated representative.

  (2) A licensee may establish house rules. House rules,  if  established, shall  be  provided,  in  writing,  to  the  resident  or  the  resident's designated representative and responsible agency  upon  admission  to  the home or,  if  established  after  a  resident's  admission  to  the  home, immediately thereafter. House rules shall not conflict with  these  rules.

  (3) A licensee shall provide  a  resident  and  his  or  her  designated representative with a 30-day written  notice  before  discharge  from  the home. The written notice shall state the reasons for discharge. A copy  of the  written  notice  shall  be  sent   to   the   resident's   designated representative and responsible agency. The provisions of this  subrule  do not preclude a licensee from providing other legal notice as  required  by law.

  (4) A licensee may discharge a resident before the  30-day  notice  when the licensee has determined and  documented  that  any  of  the  following exists:

  (a) Substantial risk to the resident due to the inability of the home to meet the resident's needs or assure the safety  and  well-being  of  other residents of the home.

  (b) Substantial risk, or an occurrence, of self-destructive behavior.

  (c) Substantial risk, or an occurrence, of serious physical assault.

  (d) Substantial risk, or an occurrence, of the destruction of  property.

  (5) A licensee who proposes to discharge  a  resident  for  any  of  the reasons listed in subrule (4) of this rule shall take the following  steps before discharging the resident:

  (a) The licensee shall notify the resident,  the  resident's  designated representative,  the  responsible  agency,  and  the  adult  foster   care licensing consultant not less than 24 hours before discharge.  The  notice shall be in writing and shall include all of the following information:

  (i) The reason for the proposed discharge, including the specific nature of the substantial risk.

  (ii) The alternatives to discharge  that  have  been  attempted  by  the licensee.

  (iii) The location to which the resident will be discharged,  if  known.

  (b) The licensee shall confer with the responsible  agency  or,  if  the resident does  not  have  a  responsible  agency,  with  adult  protective services and the local community mental health emergency response  service regarding the proposed discharge. If the responsible  agency  or,  if  the resident does not have a responsible  agency,  adult  protective  services does not agree with the licensee that emergency  discharge  is  justified, the resident shall not be discharged from the  home.  If  the  responsible agency or, if the resident does  not  have  a  responsible  agency,  adult protective services agrees that the emergency discharge is justified, then all of the following provisions shall apply:

  (i) The resident shall not be discharged until  an  appropriate  setting that meets the resident's immediate needs is located.

  (ii) The resident shall have the right to  file  a  complaint  with  the department.

  (iii)  If  the  department  finds  that  the  resident  was   improperly discharged, the resident shall have the right to elect to  return  to  the first available bed in the licensee's adult foster care home.

  (6) A licensee shall not change the residency of  a  resident  from  one home to another without the  written  approval  of  the  resident  or  the resident's designated representative and responsible agency.

  (7) A licensee shall not restrict the resident's ability to make his  or her own living arrangements.

  (8) At the time  of  discharge,  a  licensee  shall  provide  copies  of resident records to the resident and his or her designated  representative when requested, and as determined appropriate, by the resident or  his  or her designated representative.  A  fee  that  is  charged  for  copies  of resident records shall not be more than the cost to the licensee of making the copies available.

R 400.15303   Resident care; licensee responsibilities. Rescinded.

Rule 303. (1) Care and services that are provided to a resident  by  the home shall be designed to maintain and improve a resident's  physical  and intellectual functioning and independence. A licensee  shall  ensure  that all  interactions  with  residents  promote  and  encourage   cooperation, self-esteem, self-direction, independence, and normalization.

  (2) A licensee shall provide supervision, protection, and personal  care as defined  in  the  act  and  as  specified  in  the  resident's  written assessment plan.

  (3) A licensee shall assure the availability of transportation  services as provided for in the resident care agreement.

  (4) A licensee shall provide all of the following:

  (a) An opportunity for the resident to develop positive  social  skills.

  (b) An opportunity for the resident to have contact with  relatives  and friends.

  (c) An opportunity for community-based recreational activities.

  (d) An opportunity for privacy and leisure time.

  (e) An opportunity for religious education and attendance  at  religious services of the resident's choice.

  (5) A licensee shall provide both of the following when specified in the resident's written assessment plan:

  (a) Direction and opportunity  for  the  growth  and  development  of  a resident as achieved through activities that foster  independent  and  age appropriate functioning, such as dressing,  grooming,  manners,  shopping, cooking, money management, and the use of public transportation.

  (b) An opportunity for involvement in educational, employment,  and  day programs.

R 400.15304   Resident rights; licensee responsibilities. Rescinded.

  Rule 304. (1) Upon a resident's admission to the home, a licensee  shall inform a resident or the resident's designated representative of,  explain to the resident or the resident's designated representative,  and  provide to the resident or the resident's designated representative, a copy of all of the following resident rights:

  (a) The right to be free from  discrimination  on  the  basis  of  race, religion, color, national origin, sex, age, handicap, marital  status,  or source of payment in the provision of services and care.

  (b) The right to exercise his or her  constitutional  rights,  including the right to vote, the right to practice religion of his  or  her  choice, the right to freedom of movement, and the right of freedom of association.

  (c) The right to refuse participation in religious practices.

  (d) The right to write, send, and receive uncensured and  unopened  mail at his or her own expense.

  (e)  The  right  of  reasonable  access  to  a  telephone  for   private communications. Similar access shall be granted for long distance  collect calls and calls which otherwise are paid for by the resident.  A  licensee may charge a resident for long distance and toll telephone calls. When pay telephones are provided in group homes,  a  reasonable  amount  of  change shall be available in the group home to enable residents  to  make  change for calling purposes.

  (f) The right to voice grievances and present recommendations pertaining to the policies, services, and house rules of the  home  without  fear  of retaliation.

  (g)  The  right  to  associate  and  have  private  communications   and consultations with his or her physician, attorney, or any other person  of his or her choice.

  (h) The right to participate in the activities of social, religious, and community groups at his or her own discretion.

  (i) The right to use the services of advocacy  agencies  and  to  attend other community services of his or her choice.

  (j) The right of reasonable access to and use of  his  or  her  personal clothing and belongings.

  (k) The right to have contact with relatives  and  friends  and  receive visitors in the home at a reasonable time. Exceptions shall be covered  in the resident's 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.

  (l) The right to employ the services of a  physician,  psychiatrist,  or dentist of his or her choice for obtaining medical, psychiatric, or dental services.

  (m) The right to refuse treatment and services, including the taking  of medication, and to be made aware of the consequences of that refusal.

  (n) The right to request and receive  assistance  from  the  responsible agency in relocating to another living situation.

  (o) The right to be treated with consideration  and  respect,  with  due recognition of personal dignity, individuality, and the need for  privacy.

  (p) The right of access to his or her room at his or her own discretion.

  (q) The right to confidentiality of records as stated in  section  12(3) of the act.

  (2) A  licensee  shall  respect  and  safeguard  the  resident's  rights specified in subrule (1) of this rule.

R 400.15305   Resident protection. Rescinded.

Rule 305. (1) A resident shall be assured privacy  and  protection  from moral, social, and financial exploitation.

  (2) All work that is performed by a resident shall be in accordance with the written assessment plan.

  (3) A resident shall be treated with dignity and  his  or  her  personal needs, including protection and safety, shall be attended to at all  times in accordance with the provisions of the act.

R 400.15306   Use of assistive devices. Rescinded.

Rule 306. (1) An assistive device shall only  be  used  to  promote  the enhanced mobility, physical comfort, and well-being of a resident.

  (2) An assistive device shall  be  specified  in  a  resident's  written assessment plan  and  agreed  upon  by  the  resident  or  the  resident's designated representative and the licensee.

  (3) Therapeutic supports shall be authorized, in writing, by a  licensed physician. The authorization shall state the reason  for  the  therapeutic support and the term of the authorization.

R 400.15307   Resident behavior interventions generally. Rescinded.

Rule  307.  (1)  A  licensee  shall  ensure  that  methods  of  behavior intervention are positive and relevant to the needs of the resident.

  (2) Interventions to address unacceptable behavior shall be specified in the written assessment plan and employed in  accordance  with  that  plan. Interventions to address unacceptable behavior shall also ensure that  the safety, welfare, and rights of the resident are adequately protected. If a specialized intervention is needed  to  address  the  unique  programmatic needs of a resident, the specialized intervention shall  be  developed  in consultation with, or obtained from, professionals  who  are  licensed  or certified in that scope of practice.

  (3)  A  licensee  and  direct  care  staff  who  are   responsible   for implementing the resident's written assessment plan shall  be  trained  in the applicable behavior intervention techniques.

  (4) Intervention techniques  shall  not  be  used  for  the  purpose  of punishment, discipline, or for the convenience of staff.

R 400.15308   Resident behavior interventions prohibitions. Rescinded.

Rule 308. (1) A licensee shall not mistreat a  resident  and  shall  not permit the administrator, direct care staff, employees, volunteers who are under the direction of the licensee, visitors, or other occupants  of  the home to mistreat a resident. Mistreatment includes any intentional  action or omission which exposes a resident to a  serious  risk  or  physical  or emotional harm or the deliberate infliction of pain by any means.

  (2) A licensee, direct care staff, the  administrator,  members  of  the household, volunteers  who  are  under  the  direction  of  the  licensee, employees, or any person who lives in the home shall not  do  any  of  the following:

  (a) Use any form of punishment.

  (b) Use any form of physical force  other  than  physical  restraint  as defined in these rules.

  (c) Restrain a resident's movement by binding or tying  or  through  the use of medication, paraphernalia, contraptions, material, or equipment for the purpose of immobilizing a resident.

  (d) Confine a resident in an area, such  as  a  room,  where  egress  is prevented, in a closet, or in a bed, box, or chair or restrict a  resident in a similar manner.

  (e) Withhold food, water, clothing, rest, or toilet use.

  (f) Subject a resident to any of the following:

  (i) Mental or emotional cruelty.

  (ii) Verbal abuse.

  (iii) Derogatory remarks about the resident or members  of  his  or  her family.

  (iv) Threats.

  (g) Refuse the resident entrance to the home.

  (h) Isolation of a resident as defined in R 400.15102(1)(m).

  (i) Any electrical shock device.

R 400.15309   Crisis intervention. Rescinded.

Rule 309. (1) Crisis intervention procedures may be utilized only when a person has not previously exhibited the behavior creating  the  crisis  or there has been insufficient time to  develop  a  specialized  intervention plan to reduce the behavior causing the crisis. If the  resident  requires the repeated or prolonged  use  of  crisis  intervention  procedures,  the licensee shall contact the resident's designated  representative  and  the responsible  agency  or,  in  the  absence  of  a  responsible  agency,  a professional who is licensed or certified  in  the  appropriate  scope  of practice to initiate a review process to evaluate positive alternatives or the need for a specialized intervention plan.

  (2) Crisis intervention may be used only for the following reasons:

  (a) To provide for self-defense or the defense of others.

  (b) To prevent a resident from harming himself or herself.

  (c) To quell a disturbance that threatens physical injury to any person.

  (d) To obtain possession of a weapon or other dangerous object  that  is in the possession or control of the resident.

  (e) To prevent serious property destruction.

  (3) Crisis intervention shall be used to  the  minimum  extent  and  the minimum duration necessary and shall be used only after  less  restrictive means of protection have failed.

  (4) Crisis intervention shall be employed  to  allow  the  resident  the greatest  possible  comfort  and  to  avoid  physical  injury  and  mental distress.

  (5) Crisis intervention shall not be used as a routine intervention.

  (6) All uses of crisis intervention shall be  noted  in  the  resident's record. This notation shall include all of the following information:

  (a) The nature of the crisis intervention used and the duration of  use.

  (b) The reasons for the use of the crisis intervention.

  (c) The types of less restrictive  alternatives  that  were  tried,  the duration, the number of trials, and the results obtained.

  (d) The name of the person who authorized the crisis intervention.

  (e) The times and dates that the crisis intervention was  used  and  who implemented the crisis intervention.

  (7) A licensee shall make  available  reports  of  all  uses  of  crisis intervention when requested by the  resident  or  his  or  her  designated representative, the responsible agency, or the department.

  (8) A licensee or a direct  care  staff  member  shall  not  use  crisis intervention  until  he  or  she   has   successfully   completed   crisis intervention training that has been approved by the department.

R 400.15310   Resident health care. Rescinded.

Rule 310. (1) A licensee, with a resident's  cooperation,  shall  follow the instructions and recommendations of a resident's  physician  or  other health care  professional  with  regard  to  such  items  as  any  of  the following:

  (a) Medications.

  (b) Special diets.

  (c)  Susceptibility  to  hyperthermia  and   hypothermia   and   related limitations for physical activity, as appropriate.

  (d) Other resident health care needs that can be provided in  the  home. The refusal to  follow  the  instructions  and  recommendations  shall  be recorded in the resident's record.

  (2) A licensee shall maintain a copy of the annual health care appraisal on file for not less than 2 years.

  (3) A licensee shall record the weight of a resident upon admission  and monthly thereafter. Weight records shall be kept on file for 2 years.

  (4) In case of an accident or sudden  adverse  change  in  a  resident's physical condition or adjustment, a group home shall  obtain  needed  care immediately.

R 400.15311  Incident notification, incident records. Rescinded.

Rule 311. (1) If a resident has a representative identified in writing on the resident’s care agreement, a 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.

  (2) 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.

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

  (4) The department may review incident reports during a renewal inspection or special investigation. This does not prohibit the department from requesting an incident report when 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 400.15312   Resident medications. Rescinded.

Rule 312. (1) Prescription medication, including dietary supplements, or individual special medical procedures shall be given,  taken,  or  applied only as prescribed  by  a  licensed  physician  or  dentist.  Prescription medication shall be kept  in  the  original  pharmacy-supplied  container, which shall be labeled for the specified resident in accordance  with  the requirements of Act No. 368 of the Public Acts of 1978, as amended,  being S333.1101 et seq. of the Michigan Compiled Laws, kept with  the  equipment to administer it in a  locked  cabinet  or  drawer,  and  refrigerated  if required.

  (2) Medication shall be given,  taken,  or  applied  pursuant  to  label instructions.

  (3) Unless a  resident's  physician  specifically  states  otherwise  in writing, the giving, taking, or applying of prescription medications shall be supervised by the licensee, administrator, or direct care staff.

  (4)  When  a  licensee,  administrator,  or  direct  care  staff  member supervises the taking of medication by a resident, he or she shall  comply with all of the following provisions:

  (a) Be trained in the proper handling and administration of  medication.

  (b) Complete an individual medication  log  that  contains  all  of  the following information:

  (i) The medication.

  (ii) The dosage.

  (iii) Label instructions for use.

  (iv) Time to be administered.

  (v) The initials of the person who  administers  the  medication,  which shall be entered at the time the medication is given.

  (vi) A resident's refusal to accept prescribed medication or procedures.

  (c) Record the reason for each  administration  of  medication  that  is prescribed on an as needed basis.

  (d) Initiate a review process to evaluate a resident's  condition  if  a resident requires the repeated and prolonged use of a medication  that  is prescribed on an as needed basis. The review  process  shall  include  the resident's prescribing physician, the resident or his  or  her  designated representative, and the responsible agency.

  (e) Not adjust or modify a resident's  prescription  medication  without instructions from a physician or a pharmacist who  has  knowledge  of  the medical needs of the resident. A licensee shall record,  in  writing,  any instructions regarding a resident's prescription medication.

  (f) Contact the appropriate health care  professional  if  a  medication error  occurs  or  when  a  resident  refuses  prescribed  medication   or procedures and follow and record the instructions given.

  (5) When a resident  requires  medication  while  out  of  the  home,  a licensee shall assure that the resident or, in the alternative, the person who assumes responsibility for the resident has  all  of  the  appropriate information, medication, and instructions.

  (6)  A  licensee  shall  take  reasonable  precautions  to  insure  that prescription medication is not used by a person other  than  the  resident for whom the medication was prescribed.

  (7) Prescription medication that is no longer  required  by  a  resident shall be properly disposed of after consultation with  a  physician  or  a pharmacist.

R 400.15313   Resident nutrition. Rescinded.

Rule 313.  (1)  A  licensee  shall  provide  a  minimum  of  3  regular, nutritious meals daily. Meals shall be of proper  form,  consistency,  and temperature. Not more than 14 hours shall elapse between the  evening  and morning meal.

  (2) Meals shall meet the nutritional allowances recommended pursuant  to the provisions of "Appendix I:  Recommended  Dietary  Allowances,  Revised 1980" contained in the publication  entitled  "Basic  Nutrition  Facts:  A Nutrition Reference," Michigan Department of Public Health publication no. H-808, 1/89. This publication may be obtained at cost from The Division of Research and Development, Michigan Department of Public Health,  P.O.  Box 30195, Lansing, Michigan 48909.

  (3) Special diets shall be prescribed only by a  physician.  A  resident who has been prescribed a special diet shall be provided such a diet.

  (4) Menus of regular diets shall be written at least 1 week  in  advance and posted. Any change or substitution shall be noted  and  considered  as part of the original menu.

  (5) Records of menus,  including  special  diets,  as  served  shall  be provided upon request by the department.

  (6) Records of menus, including special diets,  shall  be  kept  by  the licensee for 1 calendar year.

R 400.15314   Resident hygiene. Rescinded.

Rule 314. (1) A licensee shall afford a resident  the  opportunity,  and instructions when necessary, for  daily  bathing  and  oral  and  personal hygiene. A licensee shall ensure that a resident bathes  at  least  weekly and more often if necessary.

  (2) A licensee shall afford a resident facilities, and instructions when necessary, for daily shaving.

  (3) A licensee shall afford a resident opportunities,  and  instructions when  necessary,  to  obtain  haircuts,  hair  sets,  or  other   grooming processes.

  (4) A licensee shall afford a resident  opportunities,  and  instruction when necessary, to dress as fashion, fit, cleanliness, and season warrant.

  (5)  A  licensee  shall  afford  a  resident   who   is   capable   with opportunities, and  instructions  when  necessary,  to  routinely  launder clothing. Clean clothing shall be available at all times.

  (6) A licensee shall  afford  a  resident  the  opportunity  to  receive assistance in bathing, dressing, or personal hygiene from a member of  the same sex, unless otherwise  stated  in  the  home's  admission  policy  or written resident care agreement.

R 400.15315   Handling of resident funds and valuables. Rescinded.

Rule 315.  (1)  Upon  a  request  from  a  resident  or  the  resident's designated representative, a licensee may accept a  resident's  funds  and valuables to be held in trust with the licensee.

  (2) The care of any resident funds and valuables that have been accepted by a licensee for safekeeping shall be treated by the licensee as a  trust obligation.

  (3) A licensee shall have a resident's funds and  valuables  transaction form completed and on file for each resident. A department form  shall  be used unless prior authorization for a substitute form has been granted, in writing, by the department.

  (4) A listing of all valuables that are accepted  by  the  licensee  for safekeeping shall be maintained. The listing of valuables shall include  a written description of the items, the date received by the  licensee,  and the date returned to the resident or his or her designated representative. The listing of valuables shall be signed at the time  of  receipt  by  the licensee and the resident or his or her  designated  representative.  Upon return of  the  valuables  to  the  resident  or  his  or  her  designated representative, the listing shall be signed by the resident or his or  her designated representative and the licensee.

  (5) All resident funds, which includes  bank  accounts,  shall  be  kept separate and apart from all funds and monies of the licensee. Interest and dividends earned on resident funds shall  be  credited  to  the  resident. Payments for care for the current month may be used by  the  licensee  for operating expenses.

  (6) Except for bank accounts, a licensee shall not accept resident funds of more than $200.00 for any resident of the home after receiving  payment of charges owed.

  (7) A resident shall have access to  and  use  of  personal  funds  that belong to him or her in reasonable amounts, including immediate access  to not less than $20.00 of his  or  her  personal  funds.  A  resident  shall receive up to his  or  her  full  amount  of  personal  funds  at  a  time designated by the resident, but not more than 5 days after the request for the funds.  Exceptions  to  this  requirement  shall  be  subject  to  the provisions of the resident's assessment plan and the plan of services.

  (8) All resident fund transactions shall require the  signature  of  the resident or the resident's designated representative and the  licensee  or prior written approval from the  resident  or  the  resident's  designated representative.

  (9) A resident's account shall be individual to the resident. A licensee shall be prohibited from having any ownership  interest  in  a  resident's account and shall verify such in a written statement to  the  resident  or the resident's designated representative.

  (10) A licensee, administrator,  direct  care  staff,  other  employees, volunteers under the direction of  the  licensee,  and  members  of  their families shall not accept, take, or  borrow  money  or  valuables  from  a resident, even with the consent of the resident.

  (11) A licensee shall obtain prior written approval from a resident  and his or  her  designated  representative  before  charges  are  made  to  a resident's account.

  (12) Charges against the resident's account shall not exceed the  agreed price for the services rendered and goods furnished or made  available  by the home to the resident.

  (13) A licensee shall provide a complete accounting, on an annual  basis and upon request, of all resident funds and valuables which  are  held  in trust and in bank accounts or which are paid to the home, to the resident, or to his or her designated representative. The accounting of a resident's funds and valuables which are held in trust or which are paid to the  home shall also be provided, upon the resident's or designated representative's request, not more than 5 banking days after the request and at the time of the resident's discharge from the home.

  (14) A licensee shall have a written refund agreement with the  resident or his or her designated representative. The agreement shall  state  under what conditions a refund of the unused portion of the monthly charge  that is paid to the home shall be returned  to  the  resident  or  his  or  her designated representative. The refund agreement shall provide  for,  at  a minimum, refunds under any of the following conditions:

  (a) When an emergency discharge from the home occurs as described  in  R 400.15302.

  (b) When a resident has been determined to be at risk  pursuant  to  the provisions of sections 11 and 11a to 11f of Act No. 280 of the Public Acts of 1939, as amended, being SS400.11 and 400.11a to 400.11f of the Michigan Compiled Laws.

  (c) When a resident has been determined to be at risk due to substantial noncompliance with these licensing rules which results in  the  department taking action to issue a provisional license or  to  revoke  or  summarily suspend, or refuse to renew, a license and  the  resident  relocates.  The amount of the monthly charge that is returned to  the  resident  shall  be based upon the written refund agreement and shall be prorated based on the number of days that the resident lived in the home during that month.

  (15) Personal property and belongings that are left at  the  home  after the death of a resident shall be inventoried and stored by the licensee. A licensee  shall  notify  the  resident's  designated  representative,   by registered mail, of the existence  of  the  property  and  belongings  and request  disposition.  Personal  property  and  belongings   that   remain unclaimed, or for which arrangements have not been made, may  be  disposed of by the licensee after 30 days from the date that  written  notification is sent to the designated representative.

  (16) Personal property and belongings that are left at  the  home  after discharge shall be inventoried and stored by the  licensee.  The  resident and designated representative  shall  be  notified  by  the  licensee,  by registered mail, of the existence of  property  and  belongings.  Personal property and belongings that remain unclaimed, or for  which  arrangements have not been made, may be disposed of by the licensee after 30 days  from the date that written  notification  is  sent  to  the  resident  and  the designated representative.

R 400.15316   Resident records. Rescinded.

  Rule 316. (1) A licensee shall complete, and maintain  in  the  home,  a separate record for each resident and shall provide record information  as required by the department. A resident record shall include, at a minimum, all of the following information:

  (a) Identifying  information,  including,  at  a  minimum,  all  of  the following:

  (i) Name.

  (ii) Social security number, date of birth,  case  number,  and  marital status.

  (iii) Former address.

  (iv) Name, address, and telephone number of  the  next  of  kin  or  the designated representative.

  (v) Name, address,  and  telephone  number  of  the  person  and  agency responsible for the resident's placement in the home.

  (vi) Name, address, and telephone number of the preferred physician  and hospital.

  (vii) Medical insurance.

  (viii) Funeral provisions and preferences.

  (ix) Resident's religious preference information.

  (b) Date of admission.

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

  (d) Health care information, including all of the following:

  (i) Health care appraisals.

  (ii) Medication logs.

  (iii) Statements and instructions for supervising prescribed medication, including dietary supplements and individual special  medical  procedures.

  (iv) A record of physician contacts.

  (v) Instructions for emergency care and advanced medical directives.

  (e) Resident care agreement.

  (f) Assessment plan.

  (g) Weight record.

  (h) Incident reports and accident records.

  (i) Resident funds and valuables record and resident  refund  agreement.

  (j) Resident grievances and complaints.

  (2) Resident records shall be kept on file in the home for 2 years after the date of a resident's discharge from a home.

R 400.15317   Resident recreation. Rescinded.

Rule 317. (1) A licensee shall make reasonable provision  for  a  varied supply of leisure and  recreational  equipment  and  activities  that  are appropriate to  the  number,  care,  needs,  age,  and  interests  of  the residents.

  (2) Leisure and recreational equipment shall be  safe,  clean,  in  good repair, and easily accessible.

  (3) Equipment and materials shall encourage and  reinforce  all  of  the following:

  (a) Social interaction.

  (b) Further growth through firsthand experiences.

  (c) Social graces.

  (d) Productive utilization of leisure time.

R 400.15318   Emergency preparedness; evacuation plan; emergency transportation. Rescinded.

Rule 318. (1) A licensee shall have a written  emergency  procedure  and evacuation plan to be followed in case of fire, medical, or severe weather emergencies. The evacuation plan shall be prominently posted in the  home. Residents who require  special  assistance  shall  be  identified  in  the written procedure.

  (2) An evacuation plan shall, at a minimum, include a  floor  plan  that specifies the locations of evacuation routes and the exiting route  to  be followed in case of fire.

  (3) A telephone shall be available and accessible in a  home.  Emergency telephone numbers shall, at a minimum, include fire, police,  and  medical emergency services and shall be conspicuously posted immediately  adjacent to telephones.

  (4) A licensee shall ensure that residents,  all  employees,  volunteers under the direction of the licensee, and  members  of  the  household  are familiar with emergency and evacuation procedures.

  (5) A licensee shall practice emergency and evacuation procedures during daytime, evening, and sleeping hours at least once per quarter.  A  record of the practices shall be  maintained  and  be  available  for  department review.

  (6) A licensee shall assure emergency transportation through the use  of a recognized available community service or vehicle that is owned  by  the licensee, administrator, or direct care staff on duty.

R 400.15319   Resident transportation. Rescinded.

Rule 319. When a  home  provides  transportation  for  a  resident,  the licensee shall assure all of the following:

  (a) That a vehicle is in good operating condition.

  (b) That a vehicle carries a basic first aid kit.

  (c) That residents who are transported by truck ride only in the cab.

  (d) That a vehicle operator has a valid driver's license. A licensee who uses a motor vehicle with a manufacturer's rated seating capacity of 16 or more persons shall comply with the provisions of section 715a of  Act  No. 300 of the Public Acts  of  1949,  as  amended,  being  S257.715a  of  the Michigan Compiled Laws.

PART 4. ENVIRONMENTAL CONDITIONS

R 400.15401   Environmental health. Rescinded.

Rule 401. (1) Private water  systems  shall  be  in  compliance  with  R 325.10101 et seq. of the Michigan Administrative Code.  A  bacteriological report confirming water quality  shall  be  required  during  the  initial inspection  and  every  2  years  thereafter.  Group  homes  that  use   a community-approved water system  need  not  be  in  compliance  with  this requirement.

  (2) Hot and cold running water that is under pressure shall be provided. A licensee shall maintain the hot water temperature for a  resident's  use at a range of 105 degrees Fahrenheit to  120  degrees  Fahrenheit  at  the faucet.

  (3) All sewage shall be disposed of in a public sewer system or, in  the absence thereof, in a manner that is approved by the health authority.

  (4) All garbage and rubbish that contains food wastes shall be  kept  in leakproof, nonabsorbent containers. The containers shall be  kept  covered with tight-fitting lids and shall be removed from the home daily and  from the premises at least weekly.

  (5) An insect, rodent, or pest control program shall  be  maintained  as necessary and shall be carried out in a manner that  continually  protects the health of residents.

  (6) Poisons, caustics, and other dangerous materials shall be stored and safeguarded in nonresident  areas  and  in  non-food  preparation  storage areas.

  (7) Each habitable room shall have direct outside ventilation  by  means of windows, louvers, air-conditioning, or mechanical  ventilation.  During fly season, from April to November, each door, openable window,  or  other opening to the outside that is used  for  ventilation  purposes  shall  be supplied with a standard screen of not less than 16 mesh.

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

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

  R 400.15402   Food service. Rescinded.

Rule 402. (1) All food shall  be  from  sources  that  are  approved  or considered satisfactory by the department and  shall  be  safe  for  human consumption, clean, wholesome and free from  spoilage,  adulteration,  and misbranding.

  (2) All food shall be protected from contamination while  being  stored, prepared, or served and during transportation to a facility.

  (3) All perishable food  shall  be  stored  at  temperatures  that  will protect against spoilage. All potentially hazardous food shall be kept  at safe temperatures. This means that all cold foods are to be kept cold,  40 degrees Fahrenheit or below, and that all hot foods are to  be  kept  hot, 140 degrees Fahrenheit or above, except during periods that are  necessary for preparation and service. Refrigerators and freezers shall be  equipped with approved thermometers.

  (4) All food service equipment and  utensils  shall  be  constructed  of material that is nontoxic, easily cleaned, and maintained in good  repair. All food services equipment and eating  and  drinking  utensils  shall  be thoroughly cleaned after each use.

  (5) A home  shall  be  properly  equipped  as  required  by  the  health authority, to prepare and serve adequate meals.

  (6)  Household  and  cooking  appliances  shall  be  properly  installed according to the manufacturer's recommended safety practices. Where  metal hoods or canopies are provided, they shall be equipped with  filters.  The filters shall be maintained in an efficient condition and  kept  clean  at all times. All food preparation surfaces and areas shall be kept clean and in good repair.

  R 400.15403   Maintenance of premises. Rescinded.

Rule 403. (1) A home shall be constructed, arranged, and  maintained  to provide adequately for the health, safety, and well-being of occupants.

  (2)  Home  furnishings  and  housekeeping  standards  shall  present   a comfortable, clean, and orderly appearance.

  (3) All living, sleeping, hallway, storage, bathroom, and kitchen  areas shall be well lighted and ventilated.

  (4) A roof, exterior walls,  doors,  skylights,  and  windows  shall  be weathertight and watertight and shall be kept in sound condition and  good repair.

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

  (6) All plumbing fixtures and water and waste pipes  shall  be  properly installed and maintained in good  working  condition.  Each  water  heater shall be equipped with a thermostatic temperature control and  a  pressure relief valve, both of which shall be in good working condition.

  (7) All water closet compartments, bathrooms, and kitchen floor surfaces shall be constructed and maintained so as to be reasonably  impervious  to water and to permit the floor to be easily kept in a clean condition.

  (8) Stairways shall have sturdy and  securely  fastened  handrails.  The handrails shall be not less than 30, nor more than 34,  inches  above  the upper surface of the tread. All exterior and interior stairways and  ramps shall have handrails on the open sides. All porches and decks that  are  8 inches or more above grade shall also have handrails on the open sides.

  (9) Stairway risers and treads shall be a uniform and  consistent  size. Stairways that form a part of a required  means  of  egress  shall  change direction at landings only.

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

  (11) Handrails and nonskid surfacing shall be installed in  showers  and bath areas.

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

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

  (14) Hot water pipes and steam radiators that are  located  in  resident occupied areas shall be shielded to protect against burns.

  (15) A written report shall be made to the adult foster  care  licensing division of the department, the resident's designated representative,  and the responsible agency within 48 hours, excluding holidays  and  weekends, of the occurrence of any fire and property damage of more than  $5,000.00.

R 400.15404   Laundry. Rescinded.

  Rule 404. A home shall make adequate provision for the laundering  of  a resident's personal laundry.

R 400.15405   Living space. Rescinded.

Rule 405. (1) A licensee shall provide, per occupant, not less  than  35 square feet of indoor living space, exclusive of bathrooms, storage areas, hallways, kitchens, and sleeping areas.

  (2) A resident shall be  provided  with  reasonable  storage  space  for storing his or her personal belongings.

  (3) Living, dining, bathroom, and sleeping areas used by  residents  who have impaired mobility shall be accessible and located on the street floor level of the home that contains the required means of egress.

  (4) A resident shall not be housed above a second  floor  of  a  3-story residence. This subrule shall  not  apply  to  those  licensees  who  were approved to house residents above the second floor of a 3-story residence, who were licensed on the effective date of these rules, and whose  license has been in continuous effect.

  (5) Where there is a change of ownership or a  change  in  licensee  for those licensees and homes that were licensed  on  the  effective  date  of these rules and whose licenses have been  in  continuous  effect,  use  of living space above the second  floor  of  a  3-story  residence  shall  be allowed to  continue  without  interruption  when  all  of  the  following conditions have been met:

  (a) The resident or his or her designated representative has agreed,  in writing, to continue to reside above  the  second  floor  of  the  3-story residence.

  (b) The home is in compliance with all applicable state fire safety  and environmental health standards.

  (c) The licensee meets all applicable staffing requirements as set forth in R 400.15206.

  (d) The licensee  is  in  compliance  with  the  emergency  preparedness provisions as required in these rules.

  (6) The living, dining, bathroom, and sleeping areas for residents shall be contained within the home.

  (7) A group home shall provide 1 or more multipurpose areas of  adequate size for training, recreation, family-style dining and  other  diversional and social activities.

  (8) A home shall have dining space that can accommodate all residents of the home at the same time.

  (9) The provisions of subrule (1) of this rule shall not apply to  those licensees who are licensed on the effective date of these rules and  whose licenses have been in  continuous  effect.  A  variance  that  is  granted pursuant to the provisions of this  rule  is  not  transferable  from  one licensee to another.

R 400.15406   Room temperature. Rescinded.

Rule 406. All resident-occupied rooms of a home shall  be  heated  at  a temperature range between 68 and 72 degrees Fahrenheit during non-sleeping hours. Precautions shall be taken to prevent prolonged  resident  exposure to stale, noncirculating air that  is  at  a  temperature  of  90  degrees Fahrenheit or above. Variations from the requirements of this  rule  shall be based upon a resident's health care appraisal and shall be addressed in the resident's written assessment plan. The resident care agreement  shall address the resident's preferences for variations  from  the  temperatures and requirements specified in this rule.

R 400.15407   Bathrooms. Rescinded.

  Rule 407. (1) Bathrooms and toilet facilities that do not  have  windows shall have forced ventilation to the outside. Bathroom  windows  that  are used for ventilation shall open easily.

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

  (3)   Bathrooms    shall    have    doors.    Only    positive-latching, non-locking-against-egress hardware may be used. Hooks  and  eyes,  bolts, bars, and other similar devices shall not be used on bathroom doors.

  (4) A home shall have a minimum of 1 toilet, 1 lavatory, and  1  bathing facility for every 8 occupants of the home.

  (5) At least 1 toilet and 1 lavatory that are available for resident use shall be provided on each floor that has resident bedrooms.

  (6) At least 1 bathing facility that is available for resident use shall be provided on each floor that has resident bedrooms.

  (7) The provisions of subrule (6) of this rule shall not apply to  those licensees who are licensed on the effective date of these rules and  whose licenses have been in continuous effect.

R 400.15408   Bedrooms generally. Rescinded.

Rule 408. (1) A room shall not be used as a  resident  bedroom  if  more than 1/2 of 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.  Such  acceptable bedrooms shall be provided 2 acceptable means of egress.

  (2) A living room, dining room, hallway,  or  other  room  that  is  not ordinarily used for sleeping or a room that contains a required  means  of egress shall not be used for sleeping purposes by anyone.

  (3) Bedrooms for residents shall be separated from halls, corridors, and other rooms by floor-to-ceiling walls that do not  have  openings,  except for doorways.

  (4) Interior doorways of bedrooms that are occupied by  residents  shall be equipped with a side-hinged, permanently mounted door that is  equipped with positive-latching, non-locking-against-egress hardware.

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

  (6) For 2 adjoining rooms to be considered as 1 bedroom, there shall  be a 7-foot horizontal opening between the rooms.

  (7) Bedrooms shall have at least 1 easily openable window.

  (8) Residents of the opposite sex shall not occupy the same bedroom  for sleeping purposes, unless they are husband and wife.

  (9) A resident who has impaired  mobility  shall  not  sleep  in  or  be assigned a bedroom that is located above the street floor of the home.

R 400.15409   Bedroom space; "usable floor space" defined. Rescinded.

Rule 409. (1) As used in this rule, "usable  floor  space"  means  floor space that is under a ceiling which is not less than 6 feet, 6  inches  in height, excluding closets and space that is  under  a  portable  wardrobe. When determining usable floor space, an alcove or any other  part  of  the room that does not have at least a 7-foot horizontal  dimension  shall  be excluded.

  (2) A single occupancy bedroom shall have not less than 80  square  feet of usable floor space.

  (3) A multioccupancy resident bedroom shall have not less than 65 square feet of usable floor space per bed.

  (4) A maximum of 2 beds shall be allowed in any multioccupancy  bedroom, except as provided in subrule (5) of this rule.

  (5) A maximum of 4 beds shall be allowed in any  multioccupancy  bedroom for those licensees and homes that were licensed on the effective date  of these rules and that have had licenses in continuous effect.

  (6) Where there is a change of ownership or a  change  in  licensee  for those licensees and homes that were licensed  on  the  effective  date  of these rules and whose licenses have been in continuous effect, a maximum 4 beds shall be allowed in  any  multioccupancy  bedroom  when  all  of  the following conditions have been met:

  (a) The resident or his or her designated representative has agreed,  in writing, to continue to reside in the multioccupancy room.

  (b) The home is in compliance with all applicable state fire safety  and environmental health standards.

  (c) The multioccupancy bedroom provides not less than 70 square feet (65 square feet for homes licensed on or before December 31, 1976)  of  usable floor space per bed. "Usable floor space" means the floor  space  under  a ceiling that is not less than 6 feet 6 inches in height.

  (d) The licensee has made provision for individual privacy  as  required in these rules.

  (7) There shall not be less than a 3-foot clearance between  beds  in  a multioccupancy bedroom.

R 400.15410   Bedroom furnishings. Rescinded.

  Rule 410. (1) The bedroom furnishings in each bedroom shall include  all of the following:

  (a) An adequate closet or wardrobe.

  (b)  Lighting  that  is  sufficient  for  reading  and  other   resident activities.

  (c) A bureau or dresser or equivalent.

  (d) At least 1 chair.

  (2) A  resident  bedroom  shall  be  equipped  with  a  mirror  that  is appropriate for grooming.

  (3) Provision shall be made for a resident to mount or hang pictures  or decorative items on his or her bedroom walls.

  (4) All of the following shall not be used by residents for sleeping:

  (a) Roll-a-way beds.

  (b) Cots.

  (c) Double-deck beds.

  (d) Stacked bunks.

  (e) Hide-a-beds.

  (f) Daybeds.

  (5) A licensee shall provide a resident with a bed that is not less than 36 inches wide and not less than 72 inches long. The foundation  shall  be clean, in good condition, and provide adequate support. The mattress shall be clean, comfortable, in good condition, well  protected,  and  not  less than 5 inches thick or 4 inches thick if made of synthetic materials.  The use of a water bed is not prohibited by this rule.

R 400.15411   Linens. Rescinded.

  Rule 411. (1) A licensee shall provide clean bedding  that  is  in  good condition. The bedding shall include 2 sheets, a pillow case, a minimum of 1 blanket, and a bedspread for each bed. Bed linens shall be  changed  and laundered at least once a week or more often if soiled.

  (2) A licensee shall provide at least 1  standard  bed  pillow  that  is comfortable, clean, and in good condition for each resident bed.

  (3) A licensee shall provide bath  towels  and  washcloths.  Towels  and washcloths shall be changed and laundered not less than  twice  weekly  or more often if soiled.