77 Ill. Adm. Code 295.4010
Service Plan
Section 295
Section 295.4010Â Service
Plan
a)
Based on the
physician's
assessment
and
establishment evaluation (see Section 295.4000),
a written service plan
shall be developed and mutually agreed upon by the establishment and the
resident.
(Section 15 of the Act)Â The establishment shall respect and
accept the resident's choices regarding the service plan.
b)Â Â Â Â Â Â Â Â The service plan shall be developed by:
1)Â Â Â Â Â Â Â Â The resident, resident's representative or any individual
requested by the resident;
2)Â Â Â Â Â Â Â Â The manager or manager's designee; and
3)Â Â Â Â Â Â Â Â A registered nurse, if the resident is receiving nursing
services or medication administration, or is unable to direct self-care.
c)Â Â Â Â Â Â Â Â The service plan shall be signed and dated by all individuals
involved in its development.
d)
The service plan, which shall be reviewed annually, or more
often as the resident's condition, preferences, or service needs change, shall
serve as a basis for the service delivery contract between the provider and the
resident
(see Section 295.2030). (Section 15 of the Act)
e)Â Â Â Â Â Â Â Â The service plan shall be reviewed and revised if necessary
immediately after a significant change in the resident's physical, cognitive,
or functional condition (see Section 295.4000).
f)
Based on the
physician's
assessment, the service
plan may provide for the disconnection or removal of any
kitchen
appliance.
(Section 15 of the Act)
g)Â Â Â Â Â Â Â Â Service plans shall address:
1)Â Â Â Â Â Â Â Â The level of service the resident is receiving, including:
A)Â Â Â Â Â Â Â assistance with activities of daily living;
B)Â Â Â Â Â Â Â dietary needs, if the establishment provides therapeutic diets;
and
C)Â Â Â Â Â Â Â special accommodations for the resident;
2)Â Â Â Â Â Â Â Â The amount, type, and frequency of health-related services
needed by the resident;
3)Â Â Â Â Â Â Â Â Staff responsible for the provisions of the service plan;
4)Â Â Â Â Â Â Â Â Any risk being negotiated; and
5)Â Â Â Â Â Â Â Â Whether the resident requires medication reminders,
supervision of self-administered medication, or medication administration.
h)Â Â Â Â Â Â Â Â The service plan shall include all support services provided
or arranged for by the establishment.
i)Â Â Â Â Â Â Â Â Â Nothing in this Part limits a resident's ability to direct
his or her own care and negotiate the terms of his or her own care. Residents
have the right to refuse certain services or approaches that would otherwise be
recommended based on the physician's assessment if the resident has received
clear information regarding the risks and benefits of such a choice and the
choice does not put other residents or staff at risk. Disclosure of the risks
of refusing services or approaches must be documented in the service plan.