Ohio Administrative Code|Rule 5123:2-3-04 | General requirements.

                                                
(A) Purpose
This rule establishes standards to ensure that
		  services provided in residential facilities licensed in accordance with section
		  5123.19 of the Revised Code focus on achievement of outcomes that are important
		  to and important for individuals served, that individuals are involved in
		  development and delivery of their services, that the confidentiality of
		  individuals' records is maintained, and that individuals' records are
		  readily accessible for service delivery and for review by the
		  department.
(B) Definitions
(1) "Community participation" means
			 engagement of an individual in daytime and evening activities
			 that:
(a) Are available to the
				general public (such as employment, clubs, meetings, and advocacy
				groups);
(b) Are important to the
				individual;
(c) Involve others with and
				without disabilities who are not paid to provide care to the individual;
				and
(d) Create opportunities
				for the individual to develop meaningful relationships in his or her local
				community as is typical of other citizens of that community.
(2) "Individual" means a person with a
			 developmental disability.
(3) "Individual plan" or
			 "individual service plan" means the written description of services,
			 supports, and activities to be provided to an individual.
(4) "Informed consent" means a
			 documented written agreement to allow a proposed action, treatment, or service
			 after full disclosure provided in a manner the individual or his or her
			 guardian understands, of the relevant facts necessary to make the decision.
			 Relevant facts include the risks and benefits of the action, treatment, or
			 service; the alternatives to the action, treatment, or service; and the right
			 to refuse the action, treatment, or service. The individual or his or her
			 guardian, as applicable, may revoke informed consent at any time.
(5) "Intermediate care facility for
			 individuals with intellectual disabilities" has the same meaning as in
			 section 5124.01 of the Revised Code.
(6) "Licensee" has the same meaning as
			 in section 5123.19 of the Revised Code.
(7) "Major unusual incident" has the
			 same meaning as in rule 5123:2-17-02 of the Administrative Code.
(8) "Modified texture or therapeutic
			 diets" means diets that are altered in any way to enable the individual to
			 eat (e.g., food is chopped or pureed) or diets that are intended to correct or
			 prevent a nutritional deficiency or health problem.
(9) "Operator" means the licensee or an
			 entity with which the licensee has established a contract for the management of
			 and provision of services at the residential facility.
(10) "Residential facility" has the
			 same meaning as in section 5123.19 of the Revised Code.
(11) "Team," as applicable, has the
			 same meaning as in rule 5123:2-1-11 of the Administrative Code or means an
			 interdisciplinary team as that term is used in 42 C.F.R. 483.440 as in effect
			 on the effective date of this rule.
(12) "Unusual incident" has the same
			 meaning as in rule 5123:2-17-02 of the Administrative Code.
(C) Standards of service provision
(1) The operator, administrator, and staff of the
			 residential facility shall:
(a) Provide services only
				to individuals whose needs he or she can meet.
(b) Provide services in a
				person-centered manner.
(c) Be able to effectively
				communicate with each individual receiving services.
(d) Be knowledgeable in the
				individual plan or individual service plan for each individual served prior to
				providing services to the individual.
(e) Implement services in
				accordance with the individual plan or individual service plan.
(f) Take all reasonable
				steps necessary to prevent the occurrence or recurrence of incidents adversely
				affecting health and safety of individuals served.
(g) Comply with the
				requirements of rule 5123:2-2-06 of the Administrative Code.
(2) The operator, administrator, and staff of the
			 residential facility shall not:
(a) Provide services to his
				or her minor (under age eighteen) child or his or her spouse;
(b) Engage in sexual
				conduct or have sexual contact with an individual for whom he or she is
				providing care;
(c) Administer any
				medication to or perform health care tasks for individuals who receive services
				unless he or she meets the applicable requirements of Chapters 4723., 5123.,
				and 5126. of the Revised Code and rules adopted under those chapters;
				or
(d) Use or be under the
				influence of the following while providing services:
(i) Alcohol;
(ii) Illegal drugs;
(iii) Illegal chemical substances;
				  or
(iv) Controlled substances that may adversely
				  affect his or her ability to furnish services.
(D) Health care
(1) Self-administration or assistance with
			 self-administration of prescribed medication shall be conducted in accordance
			 with rule 5123:2-6-02 of the Administrative Code.
(2) Delegation of nursing tasks, excluding the
			 provision of health-related activities, shall be conducted in accordance with
			 rule 5123:2-6-06 of the Administrative Code and Chapter 4723-13 of the
			 Administrative Code.
(3) Administration of prescribed medication
			 pursuant to sections 5123.42 to 5123.46 of the Revised Code shall be conducted
			 in accordance with Chapter 5123:2-6 of the Administrative Code.
(4) The operator shall comply with the
			 requirements for reporting medication/treatment errors in accordance with rules
			 5123:2-6-07 and 5123:2-17-02 of the Administrative Code.
(5) The operator shall develop and implement
			 written procedures for the disposal of prescribed medication. The procedures
			 shall require that disposal of prescribed medication is verified and recorded
			 by two staff members or by an independent external entity. Dangerous drugs
			 shall be disposed in accordance with rule 4729-9-06 of the Administrative
			 Code.
(6) In the event of termination of services
			 pursuant to rule 5123:2-3-05 of the Administrative Code, a written accounting
			 of prescribed medication shall be completed no later than the last day of the
			 individual's residency and verified by two staff members. The operator
			 shall ensure a plan is developed for transfer of prescribed medications to the
			 individual or his or her guardian, as applicable.
(7) In the event of the death of an individual, a
			 written accounting of prescribed medication shall be completed immediately and
			 no later than twenty-four hours following the death and verified by two staff
			 members. The operator shall cooperate with any investigation conducted by a
			 legally authorized entity. Disposal of prescribed medication shall occur in a
			 manner set forth in paragraph (D)(5) of this rule, unless an investigation
			 calls for the disposal to be delayed.
(E) Transportation
(1) The operator shall provide or arrange for
			 transportation of individuals residing in the residential facility in
			 accordance with each resident's individual plan or individual service
			 plan, as applicable.
(2) The operator shall:
(a) Ensure that each
				employee providing transportation holds a valid driver's license as
				specified in Ohio law.
(b) Ensure that each
				employee providing transportation is covered by valid personal or corporate
				liability insurance as specified in Ohio law.
(c) Obtain, for each
				employee providing transportation, a driving record prepared by the bureau of
				motor vehicles no earlier than fourteen calendar days prior to the date of
				initial employment as a driver and at least once every three years thereafter.
				A person having six or more points on his or her driving record is prohibited
				from providing transportation.
(d) Require each employee
				providing transportation to immediately notify the operator in writing if he or
				she accumulates six or more points on his or her driving record or if his or
				her driver's license is suspended or revoked.
(e) Develop and implement
				written policies and procedures regarding vehicle accessibility, vehicle
				maintenance, and requirements for vehicle drivers.
(F) Food
(1) The operator shall offer daily meals and
			 snacks that meet the individuals' nutritional needs and preferences as
			 identified by the individual.
(2) Modified texture or therapeutic diets shall
			 be prepared and served in accordance with the instructions of a physician or
			 licensed dietitian. The operator shall maintain instructions regarding modified
			 texture or therapeutic diets in accordance with paragraph (I) of this
			 rule.
(3) Meals shall provide for variety, substitutions, and
			 accommodation of individuals' personal preferences and religious beliefs.
			 Individuals shall participate in meal planning and preparation to the extent of
			 their interest and ability to do so.
(4) Fresh food supplies sufficient for three calendar days and
			 staple food supplies sufficient for at least five calendar days shall be
			 available in the residential facility at all times.
(5) Food shall be prepared and stored properly and in accordance
			 with health codes to protect it against contamination and spoilage. Food
			 products shall be stored separately from potentially harmful non-food items,
			 particularly cleaning and laundry compounds.
(G) Clothing and personal belongings
(1) The operator shall ensure that each
			 individual has an adequate amount of personal clothing in good repair,
			 well-fitting, and comparable in style to that worn by age peers in the
			 community. The team shall ensure the clothing needs of an individual who does
			 not have personal funds available to cover needed items are met. All clothing
			 shall be clean and appropriate for the season and the activities in which the
			 individual is engaged.
(2) The operator shall encourage each individual
			 to select, purchase, and maintain his or her own clothing and to dress as
			 independently as possible.
(3) For an individual who has been assessed to
			 need assistance with management of personal possessions, the operator shall
			 record the individual's clothing and personal items within fourteen
			 calendar days of admission and update the record at least annually
			 thereafter.
(4) Any single item with a purchase price of
			 fifty dollars or more purchased by or on behalf of an individual who has been
			 assessed to need assistance with management of personal possessions, shall be
			 added to the record when acquired and deleted from the record when discarded or
			 lost.
(5) The operator shall not discard clothing and
			 personal items without the consent of the individual or the individual's
			 guardian, as applicable.
(H) Community participation and day activities for individuals
		  who reside in intermediate care facilities for individuals with intellectual
		  disabilities
(1) The operator shall ensure that each
			 individual routinely has information in formats the individual understands
			 about day activities offered by other providers and opportunities to explore
			 and experience community participation in accordance with his or her individual
			 plan and desired outcomes as they relate to community employment in accordance
			 with rule 5123:2-2-05 of the Administrative Code.
(2) The operator shall ensure that each
			 individual participates in day activities that foster community participation
			 unless his or her individual plan indicates why, based on evaluations and
			 assessments, such participation is medically contraindicated.
(3) The operator shall ensure that individuals
			 have access to a variety of day activities.
(4) Day activities shall not be provided in an
			 intermediate care facility for individuals with intellectual disabilities or
			 within two hundred feet of the intermediate care facility for individuals with
			 intellectual disabilities except that an intermediate care facility for
			 individuals with intellectual disabilities that was providing day activities in
			 or on the grounds of the intermediate care facility for individuals with
			 intellectual disabilities prior to July 1, 2005 may continue to provide day
			 activities at that same location.
(I) Individuals' service records
(1) The following current records for each
			 individual shall be maintained at the residential facility:
(a) A photograph of the
				individual.
(b) Legal status of the
				individual.
(c) Individual plan or
				individual service plan, as applicable, including documentation of informed
				consent for services, supports, and activities provided.
(d) A signed authorization
				to seek medical treatment or documentation to demonstrate that attempts to
				secure such authorization were unsuccessful.
(e) Medication and/or
				treatment records which indicate the person who prescribed the medication
				and/or treatment and the date, time, and person who administered the medication
				and/or treatment.
(2) The following records for each individual
			 shall be maintained by the operator in an accessible location and shall be
			 provided upon request to the department for review at the residential facility
			 or at another location mutually agreed upon by the operator and the
			 department.
(a) Former versions of
				records specified in paragraphs (I)(1)(a) to (I)(1)(e) of this
				rule.
(b) Admission and referral
				records.
(c) All service
				documentation including notations of progress.
(d) Records of all medical
				and dental examinations and immunization records as appropriate based upon the
				individual's age.
(e) Records of major
				unusual incidents and unusual incidents.
(f) Major unusual incident
				investigation files.
(g) Reconciliations of the
				individual's account transaction record as described in rule 5123:2-2-07
				of the Administrative Code.
(h) Records of negotiable
				items owned by the individual which can be transferred or converted to cash
				(such as bonds or promissory notes).
(i) Records of clothing and
				personal items for individuals who have been assessed to need assistance with
				management of personal possessions.
(j) Termination of services
				summary which shall be prepared within seven calendar days following
				termination of services pursuant to rule 5123:2-3-05 of the Administrative
				Code. The termination of services summary shall include the individual's
				progress during residence and new address of residence. In the event of an
				individual's death, a termination of services summary shall be completed
				within thirty calendar days of death and include the disposition of the
				individual's personal items.
(3) If operation of a residential facility is
			 transferred from one operator to another, the outgoing operator shall convey
			 the records specified in paragraphs (I)(1) and (I)(2) of this rule to the
			 incoming operator.
(4) All information contained in an
			 individual's record shall be considered privileged and confidential.
			 Records shall be maintained in accordance with state and federal regulations in
			 such a manner to ensure their confidentiality and protect them from
			 unauthorized disclosure.
(5) The operator shall develop a records
			 retention schedule for all records in accordance with applicable state and
			 federal requirements.