|
Inappropriate Placement in Type A or Type B
Facilities*
(1) A facility is not required to move a
resident who a DADS surveyor determines is inappropriately placed
if the facility submits the following to DADS not later than the
10th working day after the date the facility is informed in
writing of the specific basis of the surveyor's determination:
| |
(A) a written assessment from a physician
that states the resident is appropriately placed. The
assessment must address the resident's medical conditions
and related nursing needs, ambulatory and transfer
abilities, and mental status; |
| |
(B) a written statement from the resident
that he wishes to remain in the facility. If the resident
lacks capacity to give a written statement, a family member
or guardian may give a statement that he wishes the resident
to remain in the facility; and |
| |
(C) a statement from the facility that
the facility wishes the resident to remain in the facility.
|
(2) A facility that does not meet all
requirements for the evacuation of a designated resident must
apply for a waiver from DADS of all applicable requirements for
evacuation not met with respect to the resident. Documentation
must be submitted not later than the 10th working day after the
date the facility is informed in writing of the specific basis of
the surveyor's determination.
| |
(A) Documentation. When an
evacuation waiver is requested, the following documentation
must be submitted to DADS in addition to the documentation
required in paragraph (1)(A)-(C) of this subsection:
|
| |
|
(i) a detailed plan that
explains how the facility will meet the evacuation needs of
the resident. The plan should include, for example,
(I) the specific staff positions that will be on duty to
assist with evacuation and their shift times;
(II) specific staff positions that will be on duty and awake
at night; and
(III) specific staff training that relates to resident
evacuation;
(ii) a copy of the facility floor plan that indicates the
specific resident's room;
(iii) a copy of the facility's emergency evacuation plan;
(iv) copies of the facility fire drills for the last
12-month period;
(v) a copy of the DADS notice form to the local fire
marshal, or state fire marshal, if applicable (authority
having jurisdiction), advising that the facility is
requesting a waiver of the change of capability of resident
evacuation. The DADS form must contain the signature of the
fire authority having jurisdiction;
(vi) a copy of the DADS notice form to the local fire
suppression authority advising that the facility is
requesting a waiver of the change of capability of resident
evacuation. The DADS form must contain the signature of the
fire suppression authority having jurisdiction;
(vii) a copy of a comprehensive assessment of the resident,
completed within the last 60 days, that addresses the areas
required by subsection (c) of this section, and the service
plan, that addresses all aspects of the resident's care,
particularly those areas identified by DADS. The facility
must address the resident's medical condition(s) and related
nursing needs, hospitalizations within the last 60 days, any
significant change in condition in the last 60 days,
specific staffing needs, and services that are provided by
an outside provider; and
(viii) any other information that relates to the required
fire safety features of the facility that will ensure the
evacuation capability of any resident. |
| |
(B) Criteria.
Each facility has specific characteristics that vary from
other facilities, which prevents the specification of a
universal emergency procedure. A facility must meet the
following criteria to receive a waiver from DADS:
|
| |
|
(i) The facility must have an
emergency plan to meet the evacuation needs of the resident.
The plan must ensure that:
(I) staff is adequately trained;
(II) a sufficient number of staff is on all shifts to move
all residents to a place of safety;
(III) residents will be moved to appropriate locations,
given health and safety issues;
(IV) inclusion of all possible locations of the fire origin
area is included in the emergency plan;
(V) the emergency plan addresses all possible locations of
fire origin areas and the necessity for full evacuation of
the building;
(VI) the fire alarm signal is adequate;
(VII) there is an effective method for warning residents and
staff during a malfunction of the building fire alarm
system;
(VIII) the plan is effective for communicating the actual
location of the fire to staff; and
(IX) the plan satisfies any other safety concerns that could
have an effect on the residents' safety in the event of a
fire.(ii) The facility must show
that the emergency plan will not have an adverse effect on
other residents of the facility who have waivers of
evacuation and other residents of the facility who have
special needs that require staff assistance. In evaluating
whether the emergency plan will have an adverse effect on
other residents, DADS may also review the service plans
provided by the facility. |
| |
(C)
Determination. DADS will review the documentation submitted
under this subsection to determine whether to grant or deny
a request for a waiver under this section. DADS notifies the
facility in writing of its determination not later than the
10th working day after the date the request is received in
the DADS regional office.
(D) Plan of Action. Upon notification that DADS has approved
a waiver of evacuation, the facility must immediately
initiate all provisions of the proposed plan of action. If
the facility does not follow the proper plan of action, and
there are health and safety concerns, DADS may cite the
facility for immediate threat to the health or safety of a
resident.
(E) Waiver Renewal. A waiver of evacuation from DADS will be
reviewed by DADS during the facility's annual renewal
licensing inspection. |
| (3) If a DADS
surveyor determines that a resident is inappropriately
placed at a facility and the facility either agrees with the
determination or fails to obtain the written statements
required in this section, the facility must discharge the
resident. |
| |
(A) The resident
is allowed 30 days after the date of discharge to move from
the facility.
(B) A discharge required under this subsection must be made
notwithstanding: |
| |
|
(i) any other law, including
any law relating to the rights of residents and any
obligations imposed under the Property Code; and
(ii) the terms of any contract. |
| (C) DADS will not
assess an administrative penalty against the facility
because of the inappropriate placement. |
*From: Texas Department of Aging and Disability
Services (DADS) Licensing Standards for Assisted Living Facilities
Subchapter A, §92.41
Return to Code Index
|
|
