DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
BUREAU OF COMMUNITY AND HEALTH SYSTEMS
ADULT FOSTER CARE FAMILY 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 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 400.1401 Definitions. Rescinded.
Rule 1. (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) "Capacity" means the
maximum number of residents for which a home is licensed.
(c) "Chemical restraint"
means the use of any drug or chemical in an emergency situation to limit
activity or aggressiveness of a resident if the activity or aggressiveness
would be harmful to the resident, other individuals, or property.
(d) "Department" means
department of licensing and regulatory affairs.
(e) "Designated
representative" means the individual or agency that has been granted the
authority to act on behalf of the resident by the resident or the legal
guardian of that resident.
(f) "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.
(g) "Healthcare appraisal"
means a licensed physician's or registered nurse's statement that provides an
assessment of the general physical condition of a resident.
(h) "Home" means an adult
foster care family home.
(i) "House guidelines" means
those guidelines established by the licensee that set expectations for resident
conduct.
(j) "Incident" means 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.
(k) "Members of the
household" means all individuals living in the home, exclusive of
residents.
(l) "Occupants" means all
individuals living in the home.
(m) "Physical restraint"
means the bodily holding of a resident with no more force than is necessary to
limit the resident's movement.
(n) "Premises" means the
facility, grounds, and all other appurtenances.
(o) "Resident" means an
adult, as that term is defined in section 3 of the act, MCL 400.703, who,
because of mental illness, developmental disability, physical handicap, or aged
condition, requires and receives foster care in an adult foster care family
home and does not require continuous nursing care.
(p) "Responsible agency"
means a public or private organization which, after written agreement with a
resident or the resident's designated representative, provides 1 or more of the
following:
(i) Preplacement and placement
services.
(ii) Assessment planning or the
establishment of an individual plan of service.
(iii) Maintenance of ongoing follow-up
services while the resident is in the home.
(q) "Responsible individual "
means the licensee or adult designated by the licensee to provide foster care
to residents.
(r) "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, or a floor that is
arranged and used as the main floor.
(s) "Substantial risk" means
that a resident's behavior poses a serious imminent threat of bodily harm to
the resident or others or the destruction of property and that the resident is
capable of carrying out the harm or destruction.
(t) "Time-out" means a
behavior management technique employed to reduce undesired behavior by
separating a resident from their surroundings if the undesired behavior occurs.
(u) "Trust fund" means money
or property set aside as a trust for a resident for the benefit of a resident
and held for safekeeping by the licensee.
(2) Terms defined in the act have the
same meanings when used in these rules.
R 400.1402 License application fee.
Rescinded.
Rule 2. A $15.00 license application fee
shall accompany an original license application and a license renewal
application for an adult foster care family home. The fee shall be
nonrefundable.
R 400.1403 Licensee and applicant
rights. Rescinded.
Rule 3. (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, marital status, or source of funding.
(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 department policy
and the provisions of the act.
(5) A licensee or an applicant may
request, under 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 governing 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 indicating 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 within 15 calendar days to
the licensing study report. The final licensing study report shall include
the licensee's or the applicant's written response, and the response shall
be considered a part of the official record and shall be subject to
disclosure under 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 in the event of a licensing
investigation report or a complaint investigation report. Unless otherwise
requested by the licensee or the applicant, in writing, 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 et seq. of the Michigan Compiled Laws and the act.
(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 400.1404 Licensee, responsible
person, and member of the household; qualifications. Rescinded.
Rule 4. (1) A licensee and responsible
person shall not be less than 18 years of age.
(2) A responsible person shall be other
than a resident.
(3) A licensee or responsible person
shall possess all of the following qualifications:
(a) Be of good moral character to
provide for the care and welfare of the residents.
(b) Be suitable to meet the physical,
emotional, social, and intellectual needs of each resident.
(c) Be capable of appropriately handling
emergency situations.
(4) A licensee shall have sufficient
financial resources to provide for the adequate care of the family and
residents.
(5) All responsible persons and members
of the household shall be of good moral character and suitable
temperament to assure the welfare of residents.
(6) A licensee shall provide the
department with the name of any person providing care for a resident or
member of the household who is on a court-supervised probation or parole or who
has been convicted of a felony within the 5-year period before providing
resident care.
(7) A licensee shall require all
members of the household and responsible persons who have been
released from a public or private psychiatric hospital for less than 1
year to provide a written statement verifying the person's personal
fitness to care for or be associated with a resident. The statement
shall be obtained from the medical or administrative director of
the public or private psychiatric hospital and shall be made available to
the department.
(8) A licensee shall have an arrangement
with a responsible person who is available to provide care in an emergency
situation for up to 72 hours.
(9) A licensee, responsible person, or
member of the household shall not be the legal guardian of a resident living
in the home, except where a person is a relative or where the
guardianship relationship existed before the promulgation of these rules.
R 400.1405 Health of a licensee,
responsible person, and member of the household. Rescinded.
Rule 5. (1) A licensee, responsible
person, and a member 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 his or her care.
(2) A licensee shall have on file with
the department a statement signed by a licensed physician or his or her
designee with regard to his or her knowledge of the physical health of the
licensee and each responsible person. The statement shall be signed
within 6 months before the issuance of a license and at any other time
requested by the department.
(3) A licensee shall provide the
department with written evidence that he or she and each responsible person
in the home is free from communicable tuberculosis. Verification
shall be within the 3-year period before employment and verification shall
occur every 3 years thereafter.
R 400.1406 Ratio of responsible
persons to residents. Rescinded.
Rule 6. (1) The ratio of responsible
persons to residents shall not be less than 1 responsible person to 6
residents and 2 children under the age of 12 years or ratio thereof.
(2) The number of occupants in a home,
other than the licensee and the licensee's spouse, shall not exceed 10
persons.
(3) This rule does not apply to those
adult foster care family home applicants or licensees who applied for a
license or who were issued a license before the promulgation of these
rules.
R 400.1407 Resident admission and
discharge criteria; resident assessment plan; resident care agreement;
house guidelines; fee schedule; physician's instructions; health care appraisal.
Rescinded.
Rule 7. (1) A licensee shall not
accept, retain, or care for a resident who, in accordance with a licensed
physician’s medical diagnosis and opinion, 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 a resident assessment plan is made and it
is determined that the resident is suitable pursuant to the following
provisions:
(a) The amount of personal care,
supervision, and protection required by the resident is available in the home.
(b) The kinds of services and skills 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) In situations where a resident is
referred for admission, the resident assessment plan shall be conducted in
conjunction with the resident or the resident's designated representative, the responsible
agency, and the licensee. A licensee shall maintain a copy of the
resident's written assessment plan on file in the home.
(4) In situations where a resident is
referred for emergency admission and the licensee agree to accept the admission,
a resident assessment plan shall be conducted within 15 calendar days following
the emergency admission. The resident assessment plan shall be conducted in
accordance to the provisions outlined in subrules (2) and (3) of this rule.
(5) At the time of a resident's
admission, a licensee shall complete a written resident care agreement
which shall be established between the resident or the resident’s
designated representative, the responsible agency, and the licensee. A
department 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.
(6) A licensee shall review the written
resident care agreement with the resident or the resident’s designated
representative and responsible agency at least annually or more often if
necessary.
(7) A licensee shall contact a
resident's physician for instructions as to the care of the resident under the
following conditions:
(a) If the resident is under the care of
a physician at the time of the resident's admission to the home.
(b) If the resident requires the care of
a physician while living in the home.
(8) A licensee shall record in the
resident’s record the physician's instructions for the care of the
resident as required in subrule (7) of this rule.
(9) If a resident is not under the care
of a physician at the time of the resident's admission to the home, the
licensee shall require that the resident or the resident's designated
representative provide a written health care appraisal completed within
the 90-day period before the resident's admission to the home. If a
written health care appraisal is not available, a licensee shall require
that the appraisal be obtained not later than 30 days after admission. A
department form shall be used unless prior authorization for a substitute form
has been granted in writing by the department.
(10) A licensee may establish house
guidelines. House guidelines, 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
guidelines shall not conflict with these rules.
(11) A licensee shall provide a resident
or his or her designated representative and responsible agency with a
statement of the fee policy at the time of admission. A fee statement
shall include all of the following:
(a) A description of services to be
provided and the fee.
(b) A description of additional costs
above the basic fee policy.
(c) A description of the transportation
costs in the basic fee structure and the transportation which is provided at
extra cost.
(12) A licensee shall provide a resident
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.
(13) A licensee may discharge a resident
before the 30-day notice when it has been determined that any of the following
exists:
(a) Substantial risk or an occurrence of
self-destructive behavior.
(b) Substantial risk or an occurrence of
serious physical assault.
(c) Substantial risk or an occurrence of destruction of property.
(14) A licensee who discharges a
resident pursuant to subrule (13) of this rule shall notify the resident’s
designated representative and responsible agency within 24 hours before
discharge. Such notification shall be followed by a written notice to
the resident's designated representative and responsible agency stating the
reasons for discharge.
(15) 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.
(16) A licensee shall not establish any
policies that restrict the resident's ability to make his or her own
living arrangements.
(17) 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
charged for copies of resident records shall not exceed the cost to the
licensee for making the copies available.
R 400.1408 Resident care; licensee
responsibilities. Rescinded.
Rule 8. (1) A licensee shall provide
basic self-care and habilitation training in accordance with the
resident's written assessment plan.
(2) A licensee shall assure the
availability of transportation services.
(3) A licensee shall provide the
following when specified in the resident's written assessment plan:
(a) Direction and opportunity for the
growth and development of a resident which are achieved through
activities which foster independent functioning, such as dressing,
grooming, manners, shopping, cooking, money management, and use of public
transportation.
(b) Opportunity for involvement in
educational, employment, and day program opportunities.
(4) A licensee shall provide all of the
following:
(a) Opportunity for the resident to
develop positive social skills.
(b) Opportunity for the resident to
have contact with relatives and friends.
(c) Opportunity for community-based
recreational activities.
(d) Opportunity for privacy and leisure
time.
(e) Opportunity for religious
education and attendance at religious services of the resident's
religious faith.
R 400.1409 Resident rights; licensee responsibilities. Rescinded.
Rule 9. (1) Upon a resident's
admission to the home, the licensee shall inform and explain to the
resident or the resident's designated representative all of the
following resident rights:
(a) The right to be free from
discrimination against the provision of services on the basis of race,
religion, color, national origin, sex, age, handicap, marital status, or
source of payment.
(b) The right to exercise his or her
constitutional rights, including the right to vote, the right to practice
the 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 uncensored and unopened mail at his or her own expense.
(e) The right of reasonable access
to a telephone for private communications. A licensee may charge a
resident for long distance telephone calls. A pay telephone shall not be
considered as meeting this requirement.
(f) The right to voice grievances and
present recommendations pertaining to the policies and services of the home
without fear of retaliation. A resident shall be informed of the home's
complaint process.
(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.
(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.
(2) A licensee shall provide the
resident and the resident's designated representative with a written copy
of the rights outlined in subrule (1) of this rule upon a resident's
admission to the home.
R 400.1410 Resident protection. Rescinded.
Rule 10. A licensee or responsible
person shall always be on the premises when a resident is in the home.
R 400.1411 Resident behavior
management; general requirements. Rescinded.
Rule 11. (1) A licensee shall ensure
that methods of behavior management are positive and relevant to the needs
of the resident.
(2) Methods of behavior management
shall encourage cooperation, self-esteem, self-direction, and
independence, and shall be administered in accordance with a resident's
written assessment plan.
R 400.1412 Resident behavior
management; prohibitions. Rescinded.
Rule 12. (1) A licensee shall not
mistreat or permit the mistreatment of a resident by responsible persons
or other occupants of the home.Mistreatment includes any intentional
action or omission which exposes a resident to a serious risk of physical
or emotional harm.
(2) A licensee, responsible person, or
any person living in the home shall not use any of the following
methods of handling a resident for discipline purposes:
(a) Any form of severe punishment or
physical force.
(b) Restricting a resident's movement by
binding or tying.
(c) Confining a resident in an area such
as a closet, locked room, box, or similar cubicle.
(d) Withholding necessary food, rest, or
toilet use.
(e) Mental or emotional cruelty,
including subjecting a resident to verbal abuse, making derogatory
remarks about the resident or members of his or her family or making
malicious threats.
(f) Refusing the resident entrance to
the home.
R 400.1413 Resident behavior
management; time-out restriction; time-out reporting. Rescinded.
Rule 13. (1) A licensee shall not
use time-out unless authorized, in writing, in the resident's written
assessment plan, by the resident's designated representative and
responsible agency.
(2) A licensee shall not use time-out
until he or she has successfully completed time-out training as required
by the responsible agency.
(3) A licensee shall maintain a written
record of each occurrence of time-out. The record shall include all of
the following information:
(a) The nature of the time-out.
(b) The reason for time-out.
(c) The types of less restrictive
alternatives which were tried.
(d) The name of the person authorizing
the use of time-out.
(e) The times and dates time-out was
used.
(4) A licensee shall make available
reports of all uses of time-out when requested by the resident's designated
representative, responsible agency, or the department.
R 400.1414 Resident behavior
management; use of physical restraint, physical restraint report. Rescinded.
Rule 14. (1) Excluding those forms of
behavior management prohibited in R 400.1412, physical restraint may be used
when it has been determined that any of the following exists:
(a) Substantial risk or an occurrence of
self-destructive behavior.
(b) Substantial risk or an occurrence of
serious physical assault.
(c) Substantial risk or an occurrence of
destruction of property.
(2) Physical restraint shall be used
to the minimum extent and the minimum duration necessary, and then only
after less restrictive means of protection have failed.
(3) Physical restraint shall be
employed to allow the resident the greatest possible comfort and
to avoid physical injury and mental distress.
(4) If a resident requires the repeated
and prolonged use of physical restraint or time-out within a 24-hour
period, the licensee shall initiate a review process which includes all
responsible persons and the resident's designated representative and
responsible agency to evaluate the need for a more intensive treatment
setting.
(5) All uses of physical restraint
shall be noted in the resident's record. This notation shall include
all of the following information:
(a) The nature of the physical restraint
used.
(b) The reason for the use of physical
restraint.
(c) The types of less restrictive
alternatives which were tried.
(d) The person authorizing the physical
restraint.
(e) The times and dates physical
restraint was administered.
(6) A licensee shall make available
reports of all uses of physical restraint when requested by the
resident's designated representative, responsible agency, or the
department.
R 400.1415 Resident behavior
management; chemical restraint restriction; chemical restraint report. Rescinded.
Rule 15. (1) The use of a chemical
restraint shall only be prescribed and authorized by a licensed
physician.
(2) When a chemical restraint is administered
by the licensee or responsible person, the licensee or responsible
person shall contact the resident's physician within a reasonable period
of time following the administration of the chemical restraint.
(3) A licensee shall initiate a review
process as stated in R 400.1414 when a resident requires the repeated and
prolonged use of a chemical restraint.
(4) All uses of a chemical restraint
shall be noted in the resident's record. This notation shall include all
of the following information:
(a) The type of chemical restraint used.
(b) The reason for the use of the
chemical restraint.
(c) The types of less restrictive
alternatives which were tried.
(d) The name of the physician who
prescribed and authorized the chemical restraint.
(e) The time and date the chemical
restraint was administered.
(5) A licensee shall make available
reports of all uses of a chemical restraint when requested by the
resident's designated representative, responsible agency, or the department.
R 400.1416 Resident healthcare. Rescinded.
Rule 16. (1) A licensee, in
conjunction with a resident's cooperation, shall follow the instructions and
recommendations of a resident's physician regarding medications, special diets,
and other resident healthcare needs that can be provided in the home.
(2) A licensee shall maintain a
healthcare appraisal on file for not less than 2 years after the resident's
admission to the home.
(3) A licensee shall record the weight
of a resident on admission and then monthly after that. Weight records must be
maintained for 2 years.
R 400.1416a Incident notification,
incident records. Rescinded.
Rule 16a. (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 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 400.1418 Resident medications. Rescinded.
Rule 18. (1) Prescription
medication, including tranquilizers, sedatives, dietary supplements, or
individual special medical procedures, shall be given or applied only as
prescribed by a licensed physician or dentist. Prescription medication
shall be kept in the original pharmacy container which shall be labeled
for the specific 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.
(2) Medication shall be given pursuant
to label instructions.
(3) Unless a resident's physician
specifically states otherwise, all the giving, taking, or application of
prescription medications shall be supervised by the licensee or
responsible person.
(4) When a licensee or responsible
person supervises the taking of medication by a resident, the licensee
or responsible person shall comply with the following provisions:
(a) Maintain a record as to the time
and amount of any prescription medication given or applied. Records of
prescription medication shall be maintained on file in the home for a
period of not less than 2 years.
(b) Not adjust or modify a resident's
prescription medication without agreement and instructions from a
physician or a pharmacist who has knowledge of the medical needs of the
resident. A licensee shall record in writing any adjustments or
modifications of a resident's prescription medication.
(5) Prescription medication shall
be kept in the original pharmacy-supplied and pharmacy-labeled
container, stored in a locked cabinet or drawer, refrigerated if
required, and labeled for the specific resident.
(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 which is no
longer required by a resident shall be destroyed after consultation with
a physician or a pharmacist.
R 400.1419 Resident nutrition. Rescinded.
Rule 19. (1) A licensee shall provide
a minimum of 3 regular nutritious meals daily. Not more than 14 hours shall
elapse between the evening and morning meal.
(2) A licensee shall assure
proper food preparation, serving, sanitation, and safety.
(3) Meals shall meet the nutritional
allowances recommended under the "Suggested Daily Eating Guide"
section, which is adapted from the "United States Department of
Agriculture's Daily Food Guide (1979)," and based upon the
"Recommended Dietary Allowances (1980)," and contained in the
publication entitled "Basic Nutrition Facts," pages 28 and 29,
Michigan department of public health publication no. H-808, 1980. This
publication may be obtained without charge from Nutrition Services, Bureau
of Personal Health Services, Michigan Department of Public Health, P.O.
Box 30035, Lansing, Michigan 48909.
(4) Special diets shall be prescribed
only by a physician. A resident who has a special diet prescribed by a
physician shall be provided such a diet.
(5) The department may require menus
to be written when there is substantial noncompliance with this rule.
If menus are required, they shall be kept until substantial compliance
with subrules (1) to (4) of this rule has been determined by the
department.
R 400.1420 Resident hygiene. Rescinded.
Rule 20. (1) A licensee shall afford a
resident the opportunity for daily bathing.
(2) A licensee shall afford a resident
facilities for daily shaving.
(3) A licensee shall afford a resident
opportunities to obtain haircuts, hairsets, or other grooming processes.
(4) A licensee shall afford a resident
opportunities, and instruction when necessary, to dress as fashion and
season warrant.
(5) A licensee shall afford a resident
who is capable, opportunities or 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 and written resident care agreement.
R 400.1421 Handling of resident funds
and valuables. Rescinded.
Rule 21. (1) A licensee may accept a
resident's funds and valuables for safekeeping, to be held in trust with
the licensee, upon request from a resident or the resident's designated
representative.
(2) All resident funds and valuables
which 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) All resident funds and trust fund
accounts shall be kept separate and apart from all funds and monies of
the licensee.
(5) Except for trust fund accounts, a
licensee shall not accept for safekeeping money and valuables exceeding
a value of $200.00 for any resident in the home. Trust fund accounts
between the licensee and the resident are subject to a $1,500.00
limitation.
(6) All trust fund account 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 resident's designated representative.
(7) 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.
(8) A licensee, responsible person, and
members of the licensee's or responsible person's family shall not
borrow money or valuables from a resident, with or without the consent
of the resident. A licensee shall further take reasonable precautions to
assure the prohibition of financial transactions between a resident and
other occupants of the home.
(9) 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.
(10) 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.
(11) A licensee shall provide a
complete accounting of all resident funds and valuables held for
safekeeping and in trust fund accounts or paid to the home to the
resident or to his or her designated representative on a quarterly
basis. A receipt for resident expenditures shall be maintained by the
licensee and shall be provided to the resident or designated representative
upon request. The accounting of a resident's funds and valuables held for
safekeeping or paid to the home shall also be provided, upon the
resident's or designated representative's request, not later than 5 banking
days following the request and at the time of the resident's discharge
from the home.
(12) A licensee shall return the full
amount of funds and valuables remaining in the account to the
resident or his or her designated representative not later than 5
banking days following the request or date of discharge.
(13) A licensee shall report the death
of a resident in writing to the public administrator of the Michigan
Department of Attorney General, 1800 Michigan Plaza Building, 1200 Sixth
Street, Detroit, Michigan 48226, not later than 10 calendar days following
the death of the resident.
R 400.1422 Resident records. Rescinded.
Rule 22. (1) A licensee shall complete
and maintain 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.
(iii) Home address.
(iv) Name, address, and telephone
number of the next of kin or designated representative.
(v) Name, address, and telephone number
of person or agency responsible for the resident's placement in the home.
(vi) Name, address, and telephone number
of the preferred physician and hospital.
(b) Date of admission.
(c) Date of discharge and place to which
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.
(iv) Instructions for emergency care.
(e) Resident care agreement.
(f) Assessment plan.
(g) Weight record.
(h) Incident and accident reports.
(i) Resident funds and valuables record.
(j) Resident grievances and complaint
record.
(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 400.1423 Resident recreation. Rescinded.
Rule 23. (1) A licensee shall make
reasonable provision for a varied supply of leisure and recreational
equipment appropriate to the number, care, needs, and interests of the
residents. Such leisure and recreational equipment shall be safe, clean, in
good repair, and easily accessible.
(2) Equipment and materials shall
encourage and reinforce all of the following:
(a) Social interaction.
(b) Further growth through first-hand
experiences.
(c) Social graces.
(d) Productive utilization of leisure
time.
R 400.1424 Environmental health. Rescinded.
Rule 24. (1) The water supply shall
be adequate, of a safe and sanitary quality, and from an approved source.
Hot and cold running water under pressure shall be provided.
(2) All sewage shall be disposed of in a
public sewer system or, in the absence thereof, in a manner approved by the
health authority.
(3) All garbage and rubbish containing
food wastes shall be kept in leakproof, nonabsorbent containers which
shall be kept covered with tight-fitting lids and removed from the
premises at least weekly.
(4) Effective measures shall be taken to
protect against the entrance of vermin into the home and against the
breeding or presence of vermin on the premises.
(5) Poisonous and toxic materials shall
be identified and shall be used only in such manner and under such
conditions as will not contaminate food or constitute a hazard to residents.
(6) Open windows shall be screened from
May to October.
R
400.1425 Food service. Rescinded.
Rule
25. (1) All food shall be from sources approved or considered
satisfactory by the department and shall be clean; wholesome; free from
spoilage, adulteration, and misbranding; and safe for human consumption.
(2) While being stored, prepared, or served, or during transportation to a
home, all food shall be protected from contamination.
(3) All perishable food shall be stored at such temperature as will
protect against spoilage. All potentially hazardous food shall be
maintained at safe temperatures (40 degrees Fahrenheit or below or 140
degrees Fahrenheit or above), except during necessary periods of
preparation and service.
(4) All equipment and utensils shall be
so designed and of such material and workmanship as to be easily
cleanable. All eating and drinking utensils shall be thoroughly cleaned
after each usage.
R
400.1426 Maintenance of premises. Rescinded.
Rule
26. (1) The premises shall be maintained in a clean and safe
condition.
(2) All living, sleeping, and kitchen areas shall be well lighted and
ventilated.
(3) A roof, exterior walls, doors, skylights, and windows shall be
weathertight and watertight and shall be kept in sound condition and good
repair.
(4) Floors, interior walls, and ceilings shall be sound, in good repair, and
maintained in a clean condition.
(5) 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.
(6) 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.
(7) Stairways shall have sturdy and
securely fastened handrails which are not less than 30, nor more than 34
inches above the upper surface of the tread. Exterior and interior
stairways shall have handrails on the open sides. Porches shall also
have handrails on the open sides.
(8) Scatter or throw rugs on hard
finished floors shall have a nonskid backing.
(9) Handrails and nonskid surfacing
shall be installed in showers and bath areas.
(10) Sidewalks, fire escape routes,
and entrances shall be kept reasonably free of hazards, such as ice,
snow, and debris.
(11) A yard area shall be kept
reasonably free from all hazards, nuisances, refuse, and litter.
(12) Cooking appliances shall be
properly installed in accordance with the manufacturer's recommended
safety practices. Where metal hoods or canopies are provided, they
shall be equipped with filters which shall be maintained in an efficient
condition and kept clean at all times.
(13) A written report shall be made to
the adult foster care licensing division of the department, the
resident's designated representative, and responsible agency within 48
hours, excluding holidays and weekends, of the occurrence of fire or
severe weather conditions that result in bodily injury or property damage
exceeding $100.00.
R 400.1427 Living space. Rescinded.
Rule 27. (1) A licensee shall provide,
per occupant, not less than 35 square feet of indoor living space,
exclusive of bathrooms, storage areas, hallways, kitchen, and sleeping
areas.
(2) A resident shall not be housed above
a second floor of a 3-story single-family residence.
(3) Living and sleeping areas for a
resident shall be contained within the home.
(4) Subrules (1) and (2) of this rule do
not apply to those adult foster care family home applicants or licensees who
applied for a license or who were issued a license before the promulgation
of these rules.
R 400.1428 Dining space. Rescinded.
Rule 28. A family home shall have
dining space which can accommodate all occupants in the home at the same
time.
R 400.1429 Room temperature.
Rescinded.
Rule 29. All occupied rooms of a home
shall be heated at a temperature not less than 68 degrees Fahrenheit.
R 400.1430 Bathrooms.
Rescinded.
Rule 30. (1) Toilets, bathtubs, and
showers shall provide for individual privacy.
(2) Bathroom doors may be
equipped with positive latching, non-locking-against-egress hardware.
Hooks and eyes, bolts, bars, and other similar devices shall not be
used on bathroom doors.
(3) A home shall have a minimum of 1
toilet, 1 lavatory, and 1 bathing facility for each 8 occupants of the
home.
(4) A home housing more than 8
occupants shall have a minimum of 2 toilets, 2 lavatories, and 2
bathing facilities.
(5) Subrule (4) of this rule does not
apply to those adult foster care family home applicants or licensees who
applied for a license or who were issued a license before the promulgation
of these rules.
R 400.1431 Bedrooms generally. Rescinded.
Rule 31. (1) A living room, dining
room, hallway, basement, or other room not ordinarily used for sleeping
shall not be used for sleeping purposes by residents of the home.
(2) Bedrooms for residents shall be
separated from halls, corridors, and other rooms by floor to ceiling walls.
(3) Interior doorways of bedrooms
occupied by residents shall be equipped with a side-hinged,
permanently mounted door equipped with positive-latching,
non-locking-against-egress hardware.
(4) Traffic to and from any room
shall not be through a resident bedroom.
(5) Bedrooms shall have at least 1
window.
(6) Residents of the opposite sex shall
not occupy the same bedroom for sleeping purposes, unless they are husband
and wife.
(7) A resident having impaired mobility,
as determined by a licensed physician, shall not sleep in or be assigned
a bedroom located above the street floor in a single-family residence.
(8) A resident shall be provided with
reasonable storage space for storage of his or her personal belongings.
R 400.1432 Bedroom space;
"usable floor space" defined. Rescinded.
Rule 32. (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 under a portable wardrobe.
(2) A bedroom shall have not less than
65 square feet of usable floor space per bed.
(3) A maximum of 4 beds shall be allowed
in any multi-occupancy bedroom.
(4) There shall not be less than a
3-foot clearance between beds in a multi-occupancy bedroom.
R 400.1433 Bedroom furnishings.
Rescinded.
Rule 33. (1) Bedroom furnishings
shall include an adequate closet, wardrobe, or a dresser.
(2) Rollaway beds, cots, double-deck
beds, stacked bunks, hide-a-beds, and day beds shall not be used by
residents for sleeping.
(3) A licensee shall provide a resident
with a bed that is not less than 36 inches wide and 72 inches long, with comfortable
springs in good condition, a clean protected mattress which is not less
than 5 inches thick or 4 inches thick if of synthetic construction, and
with a pillow.
R 400.1434 Linens. Rescinded.
Rule 34. (1) A licensee shall provide
bedding which includes 2 sheets, a pillow case, a minimum of 1 blanket, and
a bedspread. Bed linens shall be changed at least weekly or more often if
soiled.
(2) A licensee shall provide towels
and washcloths which shall be changed at least weekly or more often if
soiled.
R 400.1435 Interior finish of walls
and ceilings; prohibited materials. Rescinded.
Rule 35. (1) Asphalt paper; cork;
cardboard; carpeting, whether fire retardant treated or not; foam
plastics; plastic materials; or other finish materials that will
contribute to the rapid spread of fire or give off dense smoke or toxic
gases shall not be permitted as interior finish of a home.
(2) This rule shall only apply to those
adult foster care family homes licensed or proposed to be licensed after
March 27, 1980.
R 400.1436 Interior finishes and
materials. Rescinded.
Rule 36. (1) Interior finish materials
shall be a minimum class C throughout the home.
(2) Interior finish materials shall be
securely attached to, or furred out at least 1 inch from, dry wall,
plaster, masonry wall, ceiling, or natural solid wood which is a minimum
of 3/4 of an inch thick.
(3) The attaching of interior finish
materials, other than dry wall, plaster, or natural solid wood, which is
a minimum of 3/4 of an inch thick, directly to wall studs or to
floor or ceiling joists, is prohibited.
(4) Class C materials shall be those
interior finish materials which have the following minimum
classifications:
(a) Flame spread -- 76-200.
(b) Smoke density -- 126-200.
(5) This rule does not apply to
those adult foster care family home applicants or licensees who applied
for a license or who were issued a license before the promulgation of
these rules.
R 400.1437 Smoke detection equipment.
Rescinded.
Rule 37. (1) At least 1
single-station smoke detector shall be installed at the following locations:
(a) Between the sleeping areas and the
rest of the home. In homes with more than 1 sleeping area, a smoke
detector shall be installed to protect each separate sleeping area.
(b) On each occupied floor, in the
basement, and in areas of the home which contain flame- or heat-producing
equipment.
(2) If batteries are used as a source of
energy, they shall be replaced in accordance with the recommendations of
the smoke or heat detection equipment manufacturer.
(3) Detectors shall be tested and
examined as recommended by the manufacturer.
(4) Approved heat detectors may be
installed in the kitchen and in other areas of the home containing flame- or
heat-producing equipment instead of smoke detectors.
(5) Detectors mounted on ceilings shall
be spaced not less than 6 inches away from any walls. Detectors mounted on
walls shall be spaced between 6 and 12 inches away from the ceiling. A smoke
detector shall not be mounted where ventilation systems or other
obstructions keep smoke away.
(6) This rule shall only apply to those
adult foster care family homes licensed or proposed to be licensed after
March 27, 1980.
R 400.1438 Emergency preparedness;
evacuation plan; emergency transportation. Rescinded.
Rule 38. (1) A licensee shall have an
evacuation plan and written procedures to be followed in case of fire,
medical emergency, or severe weather emergency. Residents who require
special assistance shall be identified in the written procedure.
(2) The evacuation plan and emergency
procedures shall be prominently posted in the home.
(3) A telephone shall be available and
accessible in the home. Emergency telephone numbers, including fire, police,
physician, health agency, and ambulance, shall be conspicuously posted
immediately adjacent to the telephone.
(4) Fire drills shall be conducted 4
times a year. Two of the 4 required fire drills shall be conducted during
sleeping hours. A record of the fire drills shall be incorporated with the
evacuation plan.
(5) A licensee shall assure that
residents and all occupants of the home are familiar, to the best of their
ability, with the evacuation plan and emergency procedures.
(6) A licensee shall assure emergency
transportation through the use of an ambulance service or a vehicle owned
or in the possession of the licensee or responsible person.
(7) This rule shall only apply to those
adult foster care family homes licensed or proposed to be licensed after
March 27, 1980.
R 400.1439 Means of egress;
wheelchairs. Rescinded.
Rule 39. (1) Family homes
accommodating residents who regularly require wheelchairs shall minimally be
equipped with 1 ramp located at a primary means of egress from the first floors.
(2) A ramp shall not exceed 1 foot of
rise in 12 feet of run and shall terminate on a firm surface or solid
unobstructed ground which will allow the wheelchair occupant to move a safe
distance away from the building.
(3) This rule shall only apply to those
adult foster care family homes licensed or proposed to be licensed after
March 27, 1980.
R 400.1440 Heat-producing equipment.
Rescinded.
Rule 40. (1) Heating shall be from an
approved central heating plant or factory mutual and underwriters
laboratories labeled or listed permanently installed, fixed-type electrical
heating, such as a recognized panel or baseboard electrical heating
system.
(2) A furnace, water heater, heating appliances,
pipes, woodburning stoves and furnaces, and other flame- or heat-producing
equipment shall be installed in a fixed and permanent manner and in accordance
with a manufacturer's instructions and shall be maintained in a safe
condition.
(3) Where conditions indicate a need
for inspection, heat-producing equipment shall be inspected by a qualified inspection
service. If there are violations, a copy of the inspection report shall be
submitted to the department, together with a written corrective action plan. A
copy of the certificate of approval from the qualified inspection service
shall be maintained in the home and available for department review.
(4) Hot water pipes and steam radiators
located in resident-occupied areas shall be shielded to protect against
burns.
(5) Portable heating devices shall not
be used.
(6) Heat-producing equipment located in
a basement shall be separated from the remainder of the home by means of a
floor separation. Standard building material shall be sufficient for the floor
separation and shall include at least a 1 3/4-inch solid wood core door or
equivalent which is installed in a substantially fully stopped wood or steel
frame and which is so constructed to effectively stop the spread of smoke and
fire. The door shall be equipped with an automatic self-closing
device and positive-latching hardware.
(7) This rule shall only apply to those
adult foster care family homes licensed or proposed to be licensed after
March 27, 1980.
R 400.1441 Electrical service. Rescinded.
Rule 41. (1) The electrical service
shall be maintained in a safe condition.
(2) Where conditions indicate a need for
inspection, the electrical service shall be inspected by a qualified electrical
inspection service. If there are violations, a copy of the inspection
report shall be submitted to the department, together with a corrective
action plan. A copy of the certificate of approval from the qualified
electrical inspection service shall be maintained in the home and
available for department review.
(3) This rule shall only apply to those
adult foster family homes licensed or proposed to be licensed after March
27, 1980.
R 400.1442 Exemption from rules. Rescinded.
Rule 42. (1) Upon written request of an
applicant or licensee, the department may grant an exemption 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 exemption is sought.
(2) The decision of the department,
including the conditions under which the exemption is granted, shall be entered
upon the records of the department, and a signed copy shall be sent to the
applicant or licensee. This exemption 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) An exemption granted pursuant to
this rule is not transferrable from one applicant to another or from one licensee
to another.