Admissions, Discharges, And Transfers

(1) The HIV supportive living facility shall have a policy to admit only residents who meet the following criteria: (a) Has been diagnosed with symptomatic HIV disease; (b) Has a physician who acts as the primary care provider; and (c) Has voluntarily requested admission to, and been accepted by, a licensed HIV supportive living facility. (2) Residents shall be admitted to receive HIV care supportive living services, on the basis of a reasonable expectation that the resident’s medical, nursing and psychosocial needs can be met adequately by the HIV supportive living facility. (3) Care shall follow a written plan of care established and reviewed by the attending physician, the medical director, or the physician’s designee and the interdisciplinary group. Care shall continue under the supervision of the attending physician. (4) The HIV supportive living facility staff shall determine that the resident’s needs can be met by the facility’s services and capabilities. (5) Every person admitted for care or treatment to any HIV supportive living facility covered by these rules shall be under the supervision of a physician who holds a license in good standing to practice in Tennessee. The name of the resident’s attending physician shall be recorded in the resident’s file. (6) The HIV supportive living facility staff shall obtain the resident’s written consent for HIV care services. (7) The signed consent form shall be included with the resident’s individual file. (8) A diagnosis must be entered in the admission records of the HIV supportive living facility for every person admitted for care or treatment. (9) Any admission in excess of the licensed bed capacity is prohibited except when an emergency admission is approved by the department. (10) A resident file shall be developed and maintained for each resident admitted. (11) No resident shall be discharged without a written order from the attending physician or the medical director stating the resident does not meet HIV care criteria, or through other legal processes, and timely notification of next of kin and/or the authorized representative. (12) When a resident is discharged, a summary of the significant findings and events of the resident’s care, the resident’s condition on discharge and the recommendation and arrangement for future care, if any, is required. STANDARDS FOR HIV SUPPORTIVE LIVING CENTERS CHAPTER 0720-29 (13) When a resident is transferred, a summary of treatment given at the HIV supportive living facility, condition of the resident at time of transfer and date and place to which he or she is transferred shall be entered in the file. If the transfer is due to an emergency, this information will be recorded, within forty-eight (48) hours, otherwise, it will precede the transfer of the resident. (14) When a resident is transferred, a copy of the clinical summary shall, with consent of the resident, be sent to the facility that will continue the care of the resident. (15) Except when the Board has revoked or suspended the license, a HIV supportive living facility which intends to close, cease doing business, or reduce its licensed bed capacity by ten percent (10%) or more shall notify both the Department and the area long term care ombudsman at the earliest moment of the decision, but not later than thirty (30) days before the action is to be implemented. The facility shall establish a protocol, subject -to the Department’s approval, for the transfer or discharge of the residents. Should the HIV supportive living facility violate the provisions of this subsection, the department shall request the Attorney General of the State of Tennessee to intervene to protect the residents, as is provided by T.C.A. § 68-11-213(a). (16) The HIV supportive living facility shall ensure that no person on the grounds of race, color, national origin, or handicap, will be excluded from participation in, be denied benefits of, or otherwise subjected to discrimination in the provision of any care or service of the HIV supportive living facility. The HIV supportive living facility shall protect the civil fights of residents under the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973. (17) Facilities utilizing secured units must be able to provide survey staff with twelve (12) months of the following performance information specific to the secured unit and its residents: (a) Documentation that each secured resident has been evaluated by an interdisciplinary team consisting of at least a physician, a social worker, a registered nurse, and a family member and/or significant other (or resident care advocate) prior to admittance to the unit; (b) Ongoing and up-to-date documentation of quarterly review by each resident’s interdisciplinary team as to the appropriateness of placement in the secured unit; (c) A current listing of the number of deaths and hospitalizations with diagnoses that have occurred on the unit; (d) A current listing of all unusual incidents and/or complications on the unit; (e) An up-to-date staffing pattern and staff ratios for the unit that is recorded on a daily basis. The staffing pattern must ensure that there is a minimum of one (1) attendant, awake, on duty, and physically located on the unit twenty-four (24) hours per day, seven (7) days per week at all times; (f) A formulated calendar of daily group activities scheduled including a resident attendance record for the previous three (3) months; (g) An up-to-date listing of any incidences of decubitus and/or nosocomial infections, including resident identifiers; and, (h) Documentation showing that 100% of the staff working on the unit receives and has received annual in-service training which shall include, but not be limited to the following subject areas: STANDARDS FOR HIV SUPPORTIVE LIVING CENTERS CHAPTER 0720-29 1. Basic facts about the causes, progression and management of HIV and related disorders; 2. Dealing with dysfunctional behavior and catastrophic reactions in the residents; 3. Identifying and alleviating safety risks to the resident; 4. Providing assistance in the activities of daily living for the resident; and, 5. Communicating with families and other persons interested in the resident. (18) Any residential facility licensed by the board of licensing health care facilities shall upon admission provide to each resident the division of adult protective services’ statewide toll-free number: 888-277-8366.