R0000 Initial Comments R0010 Cannot refuse inspection A.C. 3701-17-53 (C) (C) An operator, administrator, staff member or any other person shall not: (1) Refuse to permit the director for the purpose of inspecting or investigating the operation of a residential care facility, to enter and inspect at any time a building or premise where a residential care facility is located, or to enter and inspect records, including resident medical records, which are kept concerning the operation of the residential care facility for information pertinent to the legitimate interest of the department. R0020 R0021 R0022 R0023 R0024 R0025 R0026 R0027 Not admit/retain if skilled care beyond limits Services provided per acceptable practices Comply with resident rights Not use hospital in name Not admit more than maximum capacity RCF that provides skilled nsg is not a nursing home License applicant may have 2 residents Provisions for retaining license (2) Use profane or abusive language directed at or in the presence of residents or the director. A.C. 3701-17-51 (E) (E) A residential care facility may not admit or retain individuals requiring skilled nursing care or provide skilled nursing care beyond the limits established under section 3721.011 of the Revised Code and rule 3701-17-59.1 of the Administrative Code. A.C. 3701-17-51 (F) (F) Each residential care facility shall provide services as outlined in the resident agreement in accordance with acceptable practices and the facility's policies and procedures. A.C. 3701-17-51 (G) (G) Each residential care facility shall comply with all the residents' rights provisions under Chapter 3721. of the Revised Code. A.C. 3701-17-51 (H) (H) A residential care facility shall not use the word "hospital" in its name, letterhead or advertising. A.C. 3701-17-51 (I) (I) A residential care facility shall not admit residents in excess of the maximum licensed bed capacity. A.C. 3701-17-51 (J) (J) Notwithstanding section 3721.011 of the Revised Code, a residential care facility in which residents receive skilled nursing care as described in section 3721.011 of the Revised Code is not a nursing home. A.C. 3701-17-51 (K) (K) An applicant for a license to operate a residential care facility shall not accept more than two residents who need personal care services, medication administration, supervision of special diets, application of dressings or skilled nursing care before receiving a license. A.C. 3701-17-51 (L) (L) In addition to the above provisions, no person, firm, partnership, association, or corporation shall: (1) Operate a residential care facility as defined in section 3721.01 of the Revised Code and paragraph (GG) of rule 3701-17-50 of the Administrative Code without obtaining a license from the director; (2) Violate any of the conditions or requirements necessary for licensing after the license has been issued; (3) Operate a residential care facility after the license for such has been revoked by the director; Ohio Centers for Assisted Living- June 2016 1
(4) Interfere with the inspection of a licensed residential care facility by any state or local official when he or she is performing duties required of him or her by Chapter 3721. of the Revised Code. All licensed residential care facilities shall be open for inspection. (5) Violate any applicable provision of Chapter 3721. of the Revised Code or rules 3701-17-50 to 3701-17-68 of the R0028 R0029 R0030 County home provisions for retaining license Not allowed practice of nsg without RN or LPN license Cannot use new or altered areas without notice to, & approval by ODH Administrative Code. A.C. 3701-17-51 (M) (M) No county home or district home licensed under section 3721.07 of the Revised Code shall do any of the following: (1) Violate any of the conditions or requirements necessary for licensing after the licensed has been issued; (2) Continue operation after its license has been revoked by the director of health; (3) Fail to be open for an inspection, or interfere with an inspection, by a state or local official performing inspection duties under Chapter 3721. of the Revised Code. (4) Violate any of the provisions of this chapter or any rules adopted thereunder. A.C. 3701-17-51 (N) (N) Nothing contained in rules 3701-17-50 to 3701-17-68 of the Administrative Code shall be construed to permit any individual to engage in the practice of nursing as a registered nurse or the practice of nursing as a licensed practical nurse if the individual does not hold a valid license issued under Chapter 4723. of the A.C. 3701-17-52 (E) Revised Code. (E) If the residential care facility alters its physical facilities in a manner that affects bed capacity or proposes to relocate existing beds to a unlicensed portion of the facility, the facility shall notify the director, in writing, at least sixty days prior to the date the facility wants to commence filling the new beds or relocating existing beds. The residential care facility shall not use the altered or unlicensed area until the department notifies the facility, in writing, that the alteration or move complies with the applicable provisions of Chapter 3721. of the Revised Code and rules 3701-17-50 to 3701-17-68 of the Administrative Code. The written notice from the facility shall include: (1) A floor plan of the area, including beds; (2) The results of the inspection by the state fire marshal or a township, municipal, or other legally constituted fire department approved by the marshal for the area; and (3) A certificate of occupancy for the area. Many of the forms you may need are located at: http://www.odh.ohio.gov Including: LTC Change of Operator License Application, Fire Safety - Self Inspection Form for Nursing Homes & Residential Care Facilities, Physical Restraints Brochure, Locked Specialized Care Units, Guidelines for Restraint Use, Self-Reported Incident Form, Nursing Home Rules, Falls Requirements for Nursing Homes, LTC Initial License Application, LTC License Renewal Form, and Nursing Home Fire Report. Ohio Centers for Assisted Living- June 2016 2
R0031 License valid only for premises on application A.C. 3701-17-52 (I) (I) An operator who operates one or more residential care facilities in more than one building shall obtain a separate license for each building except if such buildings are on the same lot and constitute a single residential care facility, such facility may be operated under a single license. On or after the effective date of this rule, an operator who operates one or more residential care facilities in more than one building, where the buildings are intersected by a public roadway, shall not be granted a license to operate the buildings as a single residential care facility, unless before the effective date of this rule the buildings were so licensed. R0032 Post license A.C. 3701-17-52 (J) (J) The operator shall post the license in a conspicuous place in R0033 Written notification of closure A.C. 3701-17-52 (P) the residential care facility. (P) An operator shall give the director written notification of a closing at least sixty days prior to a planned closing date and within twenty four hours of an unplanned closing. This notice shall include: (1) An address where the operator may be reached after the closing of the home; (2) A plan for the transfer and adequate relocation of all residents; and (3) Assurances that the residents will be transferred to the most integrated and appropriate facility or other setting in terms of quality, services, and location, taking into consideration the needs, choice, and best interests of each resident. R0034 Capacity will not include separate independent living & adult day care A.C. 3701-17-52 (R) (R) In determining the number of residents in a residential care facility for the purpose of licensing, the director shall consider all the individuals for whom the facility provides accommodations as one group unless one of the following is the case: (1) The facility maintains, in addition to a residential care facility, a separate and discrete part or unit that provides accommodations to individuals who do not require or receive skilled nursing care and do not receive personal care services from the residential care facility, in which case the individuals in the separate and discrete part or unit shall not be considered in determining the number of residents in the residential care facility if the separate and discrete part or unit is in compliance with the Ohio basic building code established by the board of building standards under Chapters 3781. and 3791. of the Revised Code and the facility permits the director, on request, to inspect the separate and discrete part or unit and speak with the individuals residing there, if they consent, to determine whether the separate and discrete part or unit meets the requirements of section 3721.02 of the Revised Code and this paragraph. Ohio Centers for Assisted Living- June 2016 3
(2) The facility provides an adult day care program on the same site as the facility that is separate and distinct from the facility except as otherwise permitted in rules 3701-17-50 to 3701-17-68 of the Administrative Code, in which case the participants of the adult day care program shall not be considered in determining the number of residents in the facility. R0035 R0070 Maximum licensed capacity of facility Establish policies & review annually A.C. 3701-17-52 (S) (S) The director shall determine the type and number of residents a residential care facility can accommodate which shall be the authorized maximum licensed capacity of the facility. Such determination shall be made on the basis of the physical facilities, personnel of the facility and the services and care needed by the residents to be admitted or retained in the residential care facility, and the permitted occupancy approved by the department of commerce. No operator, administrator, staff member or any other person shall set up beds for resident use in a residential care facility which exceed the authorized maximum licensed capacity. R.C. 3721.12 (A)(1) (A) The administrator of a home shall: (1) With the advice of residents, their sponsors, or both, establish and review at least annually, written policies regarding the applicability and implementation of residents' rights under sections 3721.10 to 3721.17 of the Revised Code, the responsibilities of residents regarding the rights, and the home's grievance procedure established under division (A)(2) of this section. The administrator is responsible for the development of, and adherence to, procedures implementing the policies. R0078 Info on state medical assist program, type of services provided, risk agreements R.C. 3721.19 (A) As used in this section: (1) "Home" and "residential care facility" have the same meanings as in section 3721.01 of the Revised Code; (2) "Sponsor" and "residents' rights advocate" have the same meanings as in section 3721.10 of the Revised Code. A home licensed under this chapter that is not a party to a provider agreement shall provide each prospective resident, before admission, with the following information, orally and in a separate written notice on which is printed in a conspicuous manner: "This home is not a participant in the medicaid program administered by the Ohio department of medicaid. Consequently, you may be discharged from this home if you are unable to pay for the services provided by this home." Ohio Centers for Assisted Living- June 2016 4
If the prospective resident has a sponsor whose identity is made known to the home, the home shall also inform the sponsor, before admission of the resident, of the home's status relative to the medicaid program. Written acknowledgement of the receipt of the information shall be provided by the resident and, if the prospective resident has a sponsor who has been identified to the home, by the sponsor. The written acknowledgement shall be made part of the resident's record by the home. No home shall terminate its provider agreement unless it has complied with section 5165.50 of the Revised Code and, at least ninety days prior to such termination, provided written notice to the residents of the home and their sponsors of such action. This requirement shall not apply in cases where the department of medicaid terminates a home's provider agreement or provider status. (B) A home licensed under this chapter as a residential care facility shall provide notice to each prospective resident or the individual's sponsor of the services offered by the facility and the types of skilled nursing care that the facility may provide. A residential care facility that, pursuant to section 3721.012 of the Revised Code, has a policy of entering into risk agreements with residents or their sponsors shall provide each prospective resident or the individual's sponsor a written explanation of the policy and the provisions that may be contained in a risk agreement. At the time the information is provided, the facility shall obtain a statement signed by the individual receiving the information acknowledging that the individual received the information. The facility shall maintain on file the individual's signed statement. (C) A resident has a cause of action against a home for breach of any duty imposed by this section. The action may be commenced by the resident, or on the resident's behalf by the resident's sponsor or a residents' rights advocate, by the filing of a civil action in the court of common pleas of the county in which the home is located, or in the court of common pleas of Franklin county. Ohio Centers for Assisted Living- June 2016 5
If the court finds that a breach of any duty imposed by this section has occurred, the court shall enjoin the home from discharging the resident from the home until arrangements satisfactory to the court are made for the orderly transfer of the resident to another mode of health care including, but not limited to, another home, and may award the resident and a person or public agency that brings an action on behalf of a resident reasonable attorney's fees. If a home discharges a resident to whom or to whose sponsor information concerning its status relative to the medicaid program was not provided as required under this section, the court shall grant any appropriate relief including, but not limited to, actual damages, reasonable attorney's fees, and costs. R0090 R0091 R0092 Administrator responsible for meeting requirements Applicant residency requirements Time frame for criminal records check, termination A.C. 3701-13-03 (B) (B) The chief administrator of an DCP may designate a representative such as a director of nursing, medical director, facility manager, or personnel officer to carry out the requirements of this rule on the chief administrator's behalf. The chief administrator shall remain ultimately responsible for A.C. 3701-13-03 (C) A.C. 3701-13-04 (A),(D) complying with the requirements of this rule. (C) Residency requirement. (1) If the applicant does not present proof of having been a resident of this state for the five-year period immediately prior to the date the criminal records check is requested or provide evidence that within that five year period the superintendent has requested information about the applicant from the FBI in a criminal records check, the chief administrator of the DCP shall request that the superintendent obtain information from the FBI as part of the criminal records check of the applicant. (2) Even if the applicant presents proof of having been a resident of this state for the five-year period or proof of a FBI criminal records check as specified in paragraph (C)(1) of this rule, the DCP may request that the superintendent include information from the FBI in the criminal records check. (A) A DCP may employ conditionally an applicant for whom a criminal records check request is required under rule 3701-13-02 of the Administrative Code prior to obtaining the results of a criminal records check regarding the applicant if the following requirements are met: (1) The DCP shall not employ an applicant prior to obtaining the completed form(s) and fingerprint impression sheet(s) from the applicant as required in paragraph (F) of rule 3701-13-03 of the Administrative Code. For purposes of this prohibition, the applicant cannot perform or participate in any job related activity pertaining to a position involving the provision of direct care to an older adult that places the applicant in an active pay status. Ohio Centers for Assisted Living- June 2016 6
(2) The DCP shall request a criminal records check in accordance with paragraph (F) of rule 3701-13-03 of the Administrative Code, by submitting the request to BCII not later than five business days after the individual begins conditional employment. (D) The DCP shall terminate the individual's conditional employment if: (1) The results of the criminal records check, other than the results of any request for information from the FBI, are not obtained within thirty days after the date the request is made; or R0093 Conditional employment, termination A.C. 3701-13-04 (B),(C),(D) (2) The results of any part of the records check indicate that the individual has been convicted of or pleaded guilty to any of the offenses listed or described in paragraph (A) of rule 3701-13-05 of the Administrative Code, unless the DCP chooses to employ the applicant pursuant to rule 3701-13-06 of the Administrative Code. (B) The DCP may employ conditionally an applicant for whom a criminal records check is required under rule 3701-13-02 of the Administrative Code if all of the following requirements are met: (1) The applicant has been referred to the DCP by an employment service that supplies full-time, part-time, or temporary staff positions involving the direct care of older adults; and (2) The chief administrator receives from the employment service a letter that: (a) Is on the letterhead of the employment service; (b) Is dated and signed by a supervisor or another designated official of the employment service; (c) States that the employment service has requested the superintendent to conduct a criminal records check regarding the applicant; (d) States that the requested criminal records check will include a determination of whether the applicant has been convicted or pleaded guilty to any offense listed or described in rule 3701-13- 05 of the Administrative Code; (e) States that, as of the date set forth on the letter, the employment service had not received the results of the criminal records check; and (f) States that, when the employment service receives the results of the criminal records check, it will promptly send a copy of the results to the DCP. (C) If a DCP employs an applicant conditionally under paragraph (B) of this rule, the employment service, upon its receipt of the results of the criminal records check, shall promptly send a copy of the results to the DCP, and paragraph (D) of this rule shall apply regarding the conditional employment. Ohio Centers for Assisted Living- June 2016 7
(D) The DCP shall terminate the individual's conditional employment if: (1) The results of the criminal records check, other than the results of any request for information from the FBI, are not obtained within thirty days after the date the request is made; or R0094 Disqualifying offenses A.C. 3701-13-05 (A) (2) The results of any part of the records check indicate that the individual has been convicted of or pleaded guilty to any of the offenses listed or described in paragraph (A) of rule 3701-13-05 of the Administrative Code, unless the DCP chooses to employ the applicant pursuant to rule 3701-13-06 of the Administrative Code. (A) Except as provided in rule 3701-13-06 of the Administrative Code no DCP shall employ a person in a position that involves providing direct care to an older adult if the person has been convicted of or pleaded guilty to: (1) A violation of any of the following sections of the Revised Code: (a) 2903.01 -- Aggravated murder; (b) 2903.02 -- Murder (c) 2903.03 -- Voluntary manslaughter (d) 2903.04 -- Involuntary manslaughter (e) 2903.11 -- Felonious assault (f) 2903.12 -- Aggravated assault (g) 2903.13 -- Assault (h) 2903.16 -- Failing to provide for a functionally impaired person (i) 2903.21 -- Aggravated menacing (j) 2903.34 -- Patient abuse or neglect (k) 2905.01 -- Kidnapping (l) 2905.02 -- Abduction (m) 2905.11 -- Extortion (n) 2905.12 -- Coercion (o) 2907.02 -- Rape (p) 2907.03 -- Sexual battery (q) 2907.05 -- Gross sexual imposition (r) 2907.06 -- Sexual imposition (s) 2907.07 -- Importuning (t) 2907.08 -- Voyeurism (u) 2907.09 -- Public indecency (v) Former 2907.12 -- Felonious sexual penetration (w) 2907.25 -- Prostitution; after positive HIV test (x) 2907.31 -- Disseminating matter harmful to juveniles (y) 2907.32 -- Pandering obscenity (z) 2907.321 -- Pandering obscenity involving a minor (aa) 2907.322 -- Pandering sexually oriented matter involving a minor (bb) 2907.323 -- Illegal use of a minor in nudity-oriented material or performance Ohio Centers for Assisted Living- June 2016 8
(cc) 2911.01 -- Aggravated robbery (dd) 2911.02 -- Robbery (ee) 2911.11 -- Aggravated burglary (ff) 2911.12 -- Burglary (gg) 2911.13 -- Breaking and entering (hh) 2913.02 -- Theft (ii) 2913.03 -- Unauthorized use of a vehicle (jj) 2913.04 -- Unauthorized use of property; computer, cable, or telecommunication property (kk) 2913.11 -- Passing bad checks (ll) 2913.21 -- Misuse of credit cards (mm) 2913.31 -- Forgery; identification card offenses (nn) 2913.40 -- Medicaid fraud (oo) 2913.43 -- Securing writings by deception (pp) 2913.47 -- Insurance fraud (qq) 2913.51 -- Receiving stolen property (rr) 2919.25 -- Domestic violence (ss) 2921.36 -- Illegal conveyance of weapons or prohibited items onto grounds of detention facility or institution (tt) 2923.12 -- Carrying concealed weapons (uu) 2923.13 -- Having weapons while under disability (vv) 2923.161 -- Improperly discharging firearm at or into habitation or school safety zone (ww) 2925.02 -- Corrupting another with drugs (xx) 2925.03 -- Trafficking in drugs (yy) 2925.11 -- Possession of drugs (zz) 2925.13 -- Permitting drug abuse (aaa) 2925.22 -- Deception to obtain a dangerous drug (bbb) 2925.23 -- Illegal processing of drug documents (ccc) 3716.11 -- Placing harmful objects in food or confection (2) A violation of an existing or former law of this state, any other state or the United States that is substantially equivalent to any of the offenses or violations listed in paragraph (A)(1) of this rule. R0095 Personal character standards A.C. 3701-13-06 (A),(B) (A) A DCP may employ an applicant who has been convicted of or pleaded guilty to an offense listed in paragraph (A) of rule 3701-13-05 of the Administrative Code in a position involving direct care to an older adult, if all of the following standards are met: (1) The applicant is not a repeat theft related offender as defined in paragraph (M) of rule 3701-13-01 of the Administrative Code; (2) The applicant is not a repeat violent offender as defined in paragraph (N) of rule 3701-13-01 of the Administrative Code; (3) The offense is not a sexually oriented offense as defined in paragraph (O) of rule 3701-13-01 of the Administrative Code; Ohio Centers for Assisted Living- June 2016 9
(4) The offense is not a violation of any of the following sections of the Revised Code or a violation of an existing or former law of this state, any other state, or the United States, if the offense is substantially equivalent to the offenses or violations described in the following sections of the Revised Code: 2903.01 (aggravated murder), 2903.02(murder), 2903.03 (voluntary manslaughter), 2903.34 (patient abuse or neglect), or 3716.11 (placing harmful objects in food or confection); (5) If the offense is an offense of violence as defined in paragraph (J) of rule 3701-13-01 of the Administrative Code, other than one listed in paragraph (A)(4) of this rule; and (a) The victim of the offense was not an older adult; and (b) At least five years have elapsed since the applicant was fully discharged from imprisonment, probation and parole; or (6) If the offense is not an offense of violence as defined in paragraph (J) of rule 3701-13-01 of the Administrative Code or an offense listed in paragraph (A)(4) of this rule; and (a) The applicant is either discharged from imprisonment, sentenced to probation, is fined or is on parole; and (b) The applicant provides proof that all conditions regarding fulfillment of sentencing requirements are being met. (7) The applicant's character is such that it is unlikely that the applicant will harm an older adult. In making that determination, the chief administrator shall consider the following factors for each offense: (a) The applicant's age at the time of the offense; (b) Regardless of whether the applicant knew the victim prior to the committing of the offense, the age and mental capacity of the victim; (c) The nature and seriousness of the offense; (d) The number of previous offenses or length of time since the most recent conviction or guilty plea; (e) The degree to which the applicant participated in the offense and the degree to which the victim contributed to or provoked the offense; (f) The likelihood that the circumstances leading to the offense will reoccur; (g) The applicant's employment record; (h) The applicant's efforts at rehabilitation and the results of those efforts; (i) If known, whether the applicant has been convicted of or pleaded guilty to any violation of an existing or former municipal ordinance substantially equivalent to any offense listed or described in rule 3701-13-05 of the Administrative Code; (j) Whether any criminal proceedings are pending; and Ohio Centers for Assisted Living- June 2016 10
(k) Any other factors related to the position that the chief administrator considers relevant to the performance of job duties. (B) If the applicant fails to provide proof that the personal character standards listed in this rule are met, or if the DCP determines that the proof offered by the applicant is inconclusive, the applicant shall not be employed in a position that involves providing direct care to older adults. R0096 Disclosure limits A.C. 3701-13-07 (A) (A) Criminal records check disclosure. The report of the criminal records check conducted pursuant to a request made under rule 3701-13-03 of the Administrative Code is not a public record for the purposes of section 149.43 of the Revised Code and shall not be made available to any person other than the following: (1) The individual who is the subject of the criminal records check or the individual's representative; (2) The chief administrator of the DCP requesting the criminal records check or the administrator's representative; (3) The chief administrator of the DCP, any other DCP, home health agency defined under section 3701.881 of the Revised Code, or PASSPORT agency that provides direct care to older adults that is owned or operated by the same entity that owns or operates the DCP; (4) Any court, hearing officer, or other necessary individual involved in a case dealing with the denial of employment of the applicant or dealing with employment or unemployment benefits. (5) Any person to whom a report is provided pursuant to paragraph (H) of rule 3701-13-03 of the Administrative Code or paragraph (B) of 3701-13-04 of the Administrative Code. R0097 Personnel record A.C. 3701-13-07 (B) (B) Personnel record. The DCP shall maintain the criminal records report in a confidential manner either sealed within, or R0098 Attestation, Log A.C. 3701-13-07 (C),(D) separate from but a part of, the personnel record. (C) Attestation. The DCP shall, upon request, provide to the director, written confirmation of compliance with the provisions of this rule in a format that is specified by the director and is consistent with state law. (D) Documentation of compliance. The DCP shall maintain an applicant log separate from the personnel record that shall be accessible to the director and shall contain the following information: (1) The name of each applicant; (2) Application date; (3) The date the applicant starts work; (4) The date the criminal records check request is submitted to BCII; (5) The type(s) of criminal records checks requested (BCII, FBI, or both); Ohio Centers for Assisted Living- June 2016 11
(6) The date(s) the BCII and FBI checks are received or, for referred applicants or applicants employed pursuant to a contract, the date a copy of the report of the criminal records check is provided to the DCP for its records; (7) The date the report is completed by BCII, "date of original record check"; (8) Whether the applicant was hired pursuant to the personal character standards listed in rule 3701-13-06 of the Administrative Code; (9) Final disposition of the applicant; and (10) Whether the applicant was terminated pursuant to paragraph (D)(1), paragraph (D)(2) or paragraph (E) of rule 3701- R0100 Administrator requirements A.C. 3701-17-54 (A) 13-04 of the Administrative Code. (A) Each residential care facility shall arrange for the services of an administrator who shall: (1) Meet the applicable requirements of rule 3701-17-55 of the Administrative Code; (2) Be responsible for the daily operation of the residential care facility including, but not limited to, assuring that residents' ongoing or changing service needs, as identified in the resident assessments, and services ordered by a licensed health care professional are acted upon by the appropriate staff member. If the facility does not provide for the needed service, it shall be discussed with the resident as required by paragraph (H) of rule 3701-17-58 of the Administrative Code; (3) Provide not less than twenty hours of service in the facility during each calendar week during the hours of eight a.m. and six p.m. If the administrator is unable to provide at least twenty hours of service in the residential care facility in a given calendar week because of a vacation, illness, or other temporary situation, the administrator shall designate a staff member, who shall not be less than twenty-one years of age and who meets the requirements of paragraphs (D) and (K) of rule 3701-17-55 of the Administrative Code, to serve as acting administrator; The administrator or acting administrator shall be accessible at all other times when not present at the residential care facility. A residential care facility located in the same building as a nursing home, or on the same lot as a nursing home, both of which are owned and operated by the same entity, shall be considered to have met this requirement if the nursing home has a full-time administrator licensed under Chapter 4751. of the Revised Code who is responsible for both the residential care facility and nursing home. For the purposes of this paragraph, "full-time" means no less than thirty-two hours per calendar week. Ohio Centers for Assisted Living- June 2016 12
R0101 Adm. may provide services to residents A.C. 3701-17-54 (B) (B) The residential care facility administrator may provide services to residents if the administrator meets the applicable qualifications of rule 3701-17-55 of the Administrative Code. An administrator, providing personal care services, of a facility with: (1) Sixteen or less beds may be counted toward meeting the staffing requirements of paragraph (C)(1) of this rule; (2) Seventeen to thirty-five beds shall not be counted toward meeting the staffing requirements of paragraph (C)(1) until he or she has met the requirements of paragraph (A)(3) of this rule; R0102 R0103 1 staff member on duty at all time A.C. 3701-17-54 (C)(1) Sufficient additional staff A.C. 3701-17-54 (C)(2) (3) More than thirty-five beds shall not be counted toward meeting the staffing requirements of paragraph (C)(1) of this rule. (C) Each residential care facility shall have the following staff members who are competent to perform the duties they are assigned: (1) At least one staff member on duty at all times who shall meet the qualifications of rule 3701-17-55 of the Administrative Code for staff members providing personal care services. During the night, the staff member who is physically present in the facility may be on call if the facility meets the call signal system requirements of paragraph (B)(5) of rule 3701-17-64 of the Administrative Code. When only one staff person is on duty in the facility, the residential care facility shall designate another staff member who meets the same qualifications to be on call; and (C) Each residential care facility shall have the following staff members who are competent to perform the duties they are assigned: (2) Sufficient additional staff members who meet the applicable qualifications of rule 3701-17-55 of the Administrative Code for the services they perform and appropriate scheduling of sufficient staff time to adequately do all of the following: (a) Meet, in a timely manner, the residents' total care, supervisory and emotional needs as determined by the resident assessment required under rule 3701-17-58 of the Administrative Code and consistent with the resident agreement required under rule 3701-17-57 of the Administrative Code and reasonable and appropriate requests for services, including monitoring in excess of supervision of residents with increased emotional needs or presenting behaviors that cause problems for the resident or other residents, or both; (b) Properly provide dietary, housekeeping, laundry, and facility maintenance services and recreational activities for the residents in accordance with the rules of this chapter; and Ohio Centers for Assisted Living- June 2016 13
(c) Assist, when necessary, with prompt evacuation of nonambulatory residents. The additional staff members needed to implement the facility's evacuation plan required by paragraph (J) of rule 3701-17-63 of the Administrative Code shall be present in the facility at all times. (d) Provide or arrange for resident activities required under rule R0104 R0105 R0106 1 personal care staff with first aid training Psychologist/ MD for special population Staff for skilled nursing care A.C. 3701-17-54 (C)(3) A.C. 3701-17-54 (C)(5) A.C. 3701-17-54 (D) 3701-17-61 of the Administrative Code. (C) Each residential care facility shall have the following staff members who are competent to perform the duties they are assigned: (3) Each residential care facility shall have at least one staff member capable of giving personal care services who has successfully completed the first aid training required by paragraph (E) of rule 3701-17-55 of the Administrative Code, if applicable, present in the facility at all times. (C) Each residential care facility shall have the following staff members who are competent to perform the duties they are assigned: (5) Unless the resident's needs are being met by a private psychologist or physician, each residential care facility that admits or retains residents with a diagnosis of late-stage cognitive impairment with significant ongoing daily living assistance needs, cognitive impairments with increased emotional needs or presenting behaviors that cause problems for the resident or other residents, or both, or serious mental illness, shall have a psychologist or physician with experience in the diagnosis and treatment of the applicable condition or conditions, either on staff or as a consultant. (D) In addition to the requirements set forth in this rule, each residential care facility that elects to admit or retain residents for whom the facility provides skilled nursing care beyond the supervision of special diets, application of dressings, or administration of medication shall do all of the following: (1) Employ or contract with a registered nurse who shall provide onsite supervision of skilled nursing care provided to residents. For purposes of this rule, "onsite supervision" means that the registered nurse shall spend sufficient time each week in the facility to manage the provision of skilled nursing care in accordance with accepted standards of practice. (2) Have a licensed nurse on call when one is not present in the facility; and (3) Have sufficient additional nursing staff to meet residents' needs. Ohio Centers for Assisted Living- June 2016 14
R0107 Schedule for staff coverage A.C. 3701-17-54 (E) (E) The operator or administrator shall establish a schedule for staff coverage that includes coverage during vacations, emergency situations, and long-term absences due to illness. The residential care facility shall not require, coerce or persuade a resident to supervise other residents, provide personal care services, supervise special diets, administer medications or manage the facility. Residents who voluntarily help or receive assistance from one another shall not be counted in determining whether the residential care facility meets the staffing R0108 Staff to administer medications A.C. 3701-17-54 (F) requirements of this rule. (F) Each residential care facility which elects to administer medication shall have one of the following individuals on duty who shall administer medications in accordance with paragraphs (G) and (H) of rule 3701-17-59 of the Administrative Code and remain on duty for a sufficient amount of time to observe medication acceptance and reaction: R0109 R0110 R0111 Need for dietician for complex therapeutic diets Sufficient nursing staff for applications of dressings Sufficient nursing staff for skilled nursing care (1) A registered nurse; (2) A licensed practical nurse holding proof of successful completion of a course in medication administration approved by the Ohio board of nursing pursuant to Chapter 4723. of the Revised Code who shall administer medication only at the direction of a registered nurse or physician; (3) A physician; or (4) A person authorized by law to administer medication. A.C. 3701-17-54 (G) (G) Each residential care facility which elects to supervise complex therapeutic diets shall provide or arrange for a dietitian and comply with the requirements of rule 3701-17-60 of the Administrative Code. A.C. 3701-17-54 (H) (H) Each residential care facility which elects to provide for the application of dressings in accordance with division (A)(2) of section 3721.011 of the Revised Code shall have sufficient nursing staff to provide the service and shall comply with the requirements of paragraph (J) of rule 3701-17-59 of the Administrative Code. A.C. 3701-17-54 (I) (I) Each residential care facility that elects to provide skilled nursing care using staff members, in accordance with division (C) of section 3721.011 of the Revised Code and paragraph (B)(3) of rule 3701-17-59.1 of the Administrative Code, shall have sufficient nursing staff to provide the skilled nursing care. If the residential care facility elects to provide enteral tube feedings on a part-time intermittent basis the facility shall provide or arrange for a dietitian and provide sufficient nursing staff with appropriate experience and training in enteral tube feedings. Skilled nursing care may be delegated in accordance with Chapter 4723-13 of the Administrative Code. Ohio Centers for Assisted Living- June 2016 15
R0112 Sharing of staff with nursing home A.C. 3701-17-54 (J) (J) A residential care facility that is physically located in the same building or on the same lot as a nursing home, or that provides an adult day care program, or both,which are owned and operated by the same entity may use staff from the residential care facility to provide services in the nursing home or adult day care program, or use appropriate and qualified staff from the nursing home or the adult day care program to meet part or all of the staffing requirements of this rule, if all of the following criteria are met: (1) The residential care facility at all times meets the minimal staffing levels required by paragraph (C)(1) of this rule. The staff members, assigned to and responsible for meeting the residential care facility residents' needs, may provide services to nursing home residents if they meet the nurse aide qualifications of rule 3701-17-07.1 of the Administrative Code, but shall not be counted towards meeting the nursing home staffing levels of rule 3701-17-08 of the Administrative Code; (2) The nursing home at all times meets the staffing level requirements of rule 3701-17-08 of the Administrative Code; (3) Separate staffing schedules for the residential care facility, nursing home, and adult day care program are maintained; and (4) The residential care facility has the call signal systems required by paragraph (B)(5) of rule 3701-17-64 of the Administrative Code, for residents to use in obtaining unscheduled care or services, as needed, when unexpected care needs arise and the monitoring of call signal systems in the residential care facility and nursing home is not disrupted. The residential care facility shall not limit the use of the call signal systems to emergencies only; (5) Utilization of the nurses or aides, or both, does not adversely affect the quality and timeliness of meeting the care needs of the nursing home and residential care facility residents; and (6) For a residential care facility on the same lot as a nursing home, the homes are located within two minutes or less response time from each other. No staff member simultaneously assigned to the staffing schedule of the residential care facility and the nursing home shall be counted in determining whether the residential care facility meets the staffing requirements of paragraph (C) of this rule, unless over fifty per cent of the staff member's assigned daily working hours are in the residential care facility. R0113 Maintain records of personnel requirements A.C. 3701-17-54 (K) (K) The operator or the administrator of each residential care facility shall maintain records, on forms provided by the director, documenting compliance with the personnel requirements of this rule. Ohio Centers for Assisted Living- June 2016 16
R0120 No communicable diseases A.C. 3701-17-55 (A) (A) No person with a disease which may be transmitted in the performance of the person's job responsibilities shall work in a residential care facility during the stage of communicability unless the person is given duties that minimize the likelihood of transmission and follows infection control precautions and procedures. R0121 No alcohol/drug use A.C. 3701-17-55 (B) (B) No person shall work in a residential care facility who uses alcohol or drugs to the extent that it adversely affects the performance of the person's duties or the health or safety of any resident. R0122 Physical exams for staff A.C. 3701-17-55 (C) (C) No person shall work in a residential care facility in any capacity as a full-time, part-time or temporary paid employee of the facility unless the person has been examined by a physician or other health care professional acting within their applicable scope of practice within thirty days before commencing work or on the first day of work. No person shall commence work in a residential care facility in any capacity unless the person is medically capable of performing the person's prescribed duties. Operators shall retain copies of the examinations and tests required by this paragraph and shall furnish them to the director R0124 Physical Exams - Temporary employment service staff A.C. 3701-17-55 (C)(1) upon request. (C) No person shall work in a residential care facility in any capacity as a full-time, part-time or temporary paid employee of the facility unless the person has been examined by a physician or other health care professional acting within their applicable scope of practice within thirty days before commencing work or on the first day of work. No person shall commence work in a residential care facility in any capacity unless the person is medically capable of performing the person's prescribed duties. Operators shall retain copies of the examinations and tests required by this paragraph and shall furnish them to the director upon request. (1) Employees of temporary employment services or, to the extent applicable, paid consultants working in a facility shall have medical examinations in accordance with paragraph (C) of this rule, except that a new physical examination is not required for each new assignment. Each facility in which such an individual works shall obtain verification of the physical examination, as applicable, from the employment agency or consultant before the individual begins work and shall maintain this documentation on file. Ohio Centers for Assisted Living- June 2016 17
R0125 Physical Exams adult day care program A.C. 3701-17-55 (C)(2) (C) No person shall work in a residential care facility in any capacity as a full-time, part-time or temporary paid employee of the facility unless the person has been examined by a physician or other health care professional acting within their applicable scope of practice within thirty days before commencing work or on the first day of work. No person shall commence work in a residential care facility in any capacity unless the person is medically capable of performing the person's prescribed duties. Operators shall retain copies of the examinations and tests required by this paragraph and shall furnish them to the director upon request. (2) Individuals used by an adult day care program provided by and on the same site as the residential care facility shall have medical examinations in accordance with paragraph (C) of this rule if the adult day care program is located or shares space within the same building as the residential care facility or if there is a sharing of staff between the residential care facility and adult day care program. R0126 Age requirements; able to A.C. 3701-17-55 (D) read & write; activity planner training (D) Each residential care facility staff member and volunteer: (1) Who provides personal care services shall be at least sixteen years of age. Staff members or volunteers who provide personal care services who are under the age of eighteen shall have onsite supervision by a staff member over the age of eighteen. The administrator shall be at least twenty-one years of age; (2) Who assists residents with self-administration of medications shall demonstrate an ability to read, write and understand information and directions in English. All other staff members and volunteers shall demonstrate an ability to understand and communicate job-related information and directions in English. R0127 Evidence of first aid training A.C. 3701-17-55 (E)(1) (3) Who plan activities for residents with late-stage cognitive impairment with significant ongoing daily living assistance needs, cognitive impairments with increased emotional needs or presenting behaviors that cause problems for the resident or other residents, or both; or, serious mental illness shall have training in appropriate activities for such residents. (E) Staff members who provide personal care services in a residential care facility, except licensed health professionals whose scope of practice include the provision of personal care services, shall meet the following training requirements: (1) Within sixty days of hire, have first-aid training evidenced by one of the following: (a) Currently valid documentation of successful completion of the "American Red Cross Standard First-Aid Course", the "American Red Cross First-Aid Basics", or any other American Red Cross course covering the training topics described in paragraph (E)(1)(c) of this rule; Ohio Centers for Assisted Living- June 2016 18
(b) Currently valid documentation of successful completion of the "American Heart Association Heartsaver First-Aid" course, or any other "American Heart Association" course covering the training topics described in paragraph (E)(1)(c) of this rule; or (c) Documentation of successful completion, within the past three years, of first-aid training by a physician or registered nurse, an emergency medical technician, or an instructor certified by the "American Red Cross" or the "American Heart Association." This training shall include recognition and emergency management of bleeding, burns, poisoning, respiratory distress including choking, musculoskeletal injury, wounds including animal and insect bites, sudden illness, shock, hypothermia, heat stroke and exhaustion, and frost bite; R0128 Types of allowed personal care services training A.C. 3701-17-55 (E)(2) (E) Staff members who provide personal care services in a residential care facility, except licensed health professionals whose scope of practice include the provision of personal care services, shall meet the following training requirements: (2) Have documentation that, prior to providing personal care services without supervision in the facility, the staff member met one of the following requirements: (a) Successfully completed training or continuing education that shall cover, as is necessary to meet the needs of residents in the facility, the following: (i) The correct techniques of providing personal care services as required by the staff member's job responsibilities; (ii) Observational skills such as recognizing changes in residents' normal status and the facility's procedures for reporting changes; and (iii) Communication and interpersonal skills. The training or continuing education shall be provided by a registered nurse or a licensed practical nurse under the direction of a registered nurse and be sufficient to ensure that the staff member receiving the training can demonstrate an ability to provide the personal care services. The facility may utilize other health care professionals acting within the scope of the professional's practice as part of the training or continuing education; or (b) Successfully completed the training and competency evaluation program and competency evaluation program approved or conducted by the director under section 3721.31 of the Revised Code; or (c) Successfully completed the training or testing requirements in accordance with the medicare condition of participation of home health aide services, 42 C.F.R. 484.4(January 15, 2008) and 42 C.F.R.484.36(June 18, 2001); Ohio Centers for Assisted Living- June 2016 19