[35 Pa.B. 2499]
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GENERAL REQUIREMENTS § 2600.11. Procedural requirements for licensure or approval of personal care homes.
(a) Except for § 20.32 (relating to announced inspections), the requirements in Chapter 20 (relating to licensure or approval of facilities and agencies) apply to personal care homes.
(b) Before a home is initially licensed and permitted to open, operate or admit residents, it will be inspected by the Department and found to be in compliance with applicable laws and regulations. The Department will reinspect newly licensed homes within 3 months of the date of initial licensure.
(c) After the Department determines that a home meets the requirements for a license, the Department's issuance or renewal of a license to a home is contingent upon receipt by the Department of an application fee based on the number of beds in the home, as follows:
(1) 0-20 beds--$15.
(2) 21-50 beds--$20.
(3) 51-100 beds--$30.
(4) 101 beds and over--$50.
§ 2600.12. Appeals.
Appeals related to the licensure or approval of the personal care home shall be made in accordance with 1 Pa. Code Part II (relating to General Rules of Administrative Practice and Procedure).
§ 2600.13. Maximum capacity.
(a) The maximum capacity is the total number of residents who are permitted to reside in the home at any time. A request to increase the capacity shall be submitted to the Department and other applicable authorities and approved prior to the admission of additional residents. The maximum capacity is limited by physical plant space and other applicable laws and regulations.
(b) The maximum capacity specified on the license may not be exceeded.
§ 2600.14. Fire safety approval.
(a) Prior to issuance of a license, a written fire safety approval from the Department of Labor and Industry, the Department of Health or the appropriate local building authority under the Pennsylvania Construction Code Act (35 P. S. §§ 7210.101--7210.1103) is required.
(b) If the fire safety approval is withdrawn or restricted, the home shall notify the Department orally immediately, and in writing, within 48 hours of the withdrawal or restriction.
(c) If a building is structurally renovated or altered after the initial fire safety approval is issued, the home shall submit the new fire safety approval, or written certification that a new fire safety approval is not required, from the appropriate fire safety authority. This documentation shall be submitted to the Department within 15 days of the completion of the renovation or alteration.
(d) The Department will request additional fire safety inspections by the appropriate agency if possible fire safety violations are observed during an inspection by the Department.
§ 2600.15. Abuse reporting covered by law.
(a) The home shall immediately report suspected abuse of a resident served in the home in accordance with the Older Adult Protective Services Act (35 P. S. §§ 10225.701--10225.707) and 6 Pa. Code § 15.21--15.27 (relating to reporting suspected abuse) and comply with the requirements regarding restrictions on staff persons.
(b) If there is an allegation of abuse of a resident involving a home's staff person, the home shall immediately develop and implement a plan of supervision or suspend the staff person involved in the alleged incident.
(c) The home shall immediately submit to the Department's personal care home regional office a plan of supervision or notice of suspension of the affected staff person.
(d) The home shall immediately notify the resident and the resident's designated person of a report of suspected abuse or neglect involving the resident.
§ 2600.16. Reportable incidents and conditions.
(a) A reportable incident or condition includes the following:
(1) The death of a resident.
(2) A physical act by a resident to commit suicide.
(3) A serious bodily injury or trauma requiring treatment at a hospital or medical facility. This does not include minor injuries such as sprains or minor cuts.
(4) A violation of a resident's rights in §§ 2600.41--2600.44 (relating to resident rights).
(5) An unexplained absence of a resident for 24 hours or more, or when the support plan so provides, a period of less than 24 hours, or an absence of a resident from a secured dementia care unit.
(6) Misuse of a resident's funds by the home's staff persons or legal entity.
(7) An outbreak of a serious communicable disease as defined in 28 Pa. Code § 27.2 (relating to specific identified reportable diseases, infections and conditions).
(8) Food poisoning of residents.
(9) A physical or sexual assault by or against a resident.
(10) Fire or structural damage to the home.
(11) An incident requiring the services of an emergency management agency, fire department or law enforcement agency, except for false alarms.
(12) A complaint of resident abuse, suspected resident abuse or referral of a complaint of resident abuse to a local authority.
(13) A prescription medication error as defined in § 2600.188 (relating to medication errors.)
(14) An emergency in which the procedures under § 2600.107 (relating to emergency preparedness) are implemented.
(15) An unscheduled closure of the home or the relocation of the residents.
(16) Bankruptcy filed by the legal entity.
(17) A criminal conviction against the legal entity, administrator or staff that are subsequent to the reporting on the criminal history checks under § 2600.51 (relating to criminal history checks).
(18) A termination notice from a utility.
(19) A violation of the health and safety laws listed in § 2600.18 (relating to applicable health and safety laws).
(b) The home shall develop and implement written policies and procedures on the prevention, reporting, notification, investigation and management of reportable incidents and conditions.
(c) The home shall report the incident or condition to the Department's personal care home regional office or the personal care home complaint hotline within 24 hours in a manner designated by the Department. Abuse reporting shall also follow the guidelines in § 2600.15 (relating to abuse reporting covered by law).
(d) The home shall submit a final report, on a form prescribed by the Department, to the Department's personal care home regional office immediately following the conclusion of the investigation.
(e) If the home's final report validates the occurrence of the alleged incident or condition, the affected resident and other residents who could potentially be harmed or his designated person shall also be informed immediately following the conclusion of the investigation.
(f) The home shall keep a copy of the report of the reportable incident or condition.
§ 2600.17. Confidentiality of records.
Resident records shall be confidential, and, except in emergencies, may not be accessible to anyone other than the resident, the resident's designated person if any, staff persons for the purpose of providing services to the resident, agents of the Department and the long-term care ombudsman without the written consent of the resident, an individual holding the resident's power of attorney for health care or health care proxy or a resident's designated person, or if a court orders disclosure.
§ 2600.18. Applicable health and safety laws.
A home shall comply with applicable Federal, State and local laws, ordinances and regulations.
§ 2600.19. Waivers.
(a) A home may submit a written request for a waiver of a specific requirement contained in this chapter. The waiver request must be on a form prescribed by the Department. The Secretary, or the Secretary's appointee, may grant a waiver of a specific requirement of this chapter if the following conditions are met:
(1) There is no jeopardy to the residents.
(2) There is an alternative for providing an equivalent level of health, safety and well-being protection of the residents.
(3) Residents will benefit from the waiver of the requirement.
(b) The scope, definitions, applicability or residents' rights under this chapter may not be waived.
(c) At least 30 days prior to the submission of the completed written waiver request to the Department, the home shall provide a copy of the completed written waiver request to the affected resident and designated person to provide the opportunity to submit comments to the Department. The home shall provide the affected resident and designated person with the name, address and telephone number of the Department staff person to submit comments.
(d) The home shall discuss the waiver request with the affected resident and designated person upon the request of the resident or designated person.
(e) The home shall notify the affected resident and designated person of the approval or denial of the waiver. A copy of the waiver request and the Department's written decision shall be posted in a conspicuous and public place within the home.
(f) The Department will review waivers annually to determine compliance with the conditions required by the waiver. The Department may revoke the waiver if the conditions required by the waiver are not met.
(g) A waiver granted prior to October 24, 2005, is no longer in effect as of October 24, 2006.
§ 2600.20. Financial management.
(a) A resident may manage his personal finances unless he has a guardian of his estate.
(b) If the home provides assistance with financial management or holds resident funds, the following requirements apply:
(1) The home shall keep a record of financial transactions with the resident, including the dates, amounts of deposits, amounts of withdrawals and the current balance.
(2) Resident funds shall be disbursed during normal business hours within 24 hours of the resident's request.
(3) The home shall obtain a written receipt from the resident for cash disbursements at the time of disbursement.
(4) Resident funds and property shall only be used for the resident's benefit.
(5) Commingling of resident funds and home funds is prohibited.
(6) If a home is holding more than $200 for a resident for more than 2 consecutive months, the administrator shall notify the resident and offer assistance in establishing an interest-bearing account in the resident's name at a local Federally-insured financial institution. This does not include security deposits.
(7) The legal entity, administrator and staff persons of the home are prohibited from being assigned power of attorney or guardianship of a resident or a resident's estate.
(8) The home shall give the resident and the resident's designated person, an itemized account of financial transactions made on the resident's behalf on a quarterly basis.
(9) A copy of the itemized account shall be kept in the resident's record.
(10) The home shall provide the resident the opportunity to review his own financial record upon request during normal business hours.
§ 2600.21. Offsite services.
If services or activities are provided by the home at a location other than the premises, the home shall ensure that the residents' support plans are followed and that resident health and safety needs are met.
§ 2600.22. Admission.
The following admission documents shall be completed for each resident:
(1) Preadmission screening completed prior to admission on a form specified by the Department.
(2) Medical evaluation completed 60 days prior to or 30 days after admission on a form specified by the Department.
(3) Personal care home assessment completed within 15 days after admission on a form specified by the Department.
(4) Support plan developed and implemented within 30 days after admission.
(5) Resident-home contract completed prior to admission or within 24 hours after admission.
§ 2600.23. Activities.
(a) A home shall provide each resident with assistance with ADLs as indicated in the resident's assessment and support plan.
(b) A home shall provide each resident with assistance with IADLs as indicated in the resident's assessment and support plan.
§ 2600.24. Personal hygiene.
A home shall provide the resident with assistance with personal hygiene as indicated in the resident's assessment and support plan. Personal hygiene includes one or more of the following:
(1) Bathing.
(2) Oral hygiene.
(3) Hair grooming and shampooing.
(4) Dressing, undressing and care of clothes.
(5) Shaving.
(6) Nail care.
(7) Foot care.
(8) Skin care.
§ 2600.25. Resident-home contract.
(a) Prior to admission, or within 24 hours after admission, a written admission contract between the resident and the home shall be in place. The administrator or a designee shall complete this contract and review and explain its contents to the resident and the resident's designated person if any, prior to signature.
(b) The contract shall be signed by the administrator or a designee, the resident and the payer, if different from the resident, and cosigned by the resident's designated person if any, if the resident agrees.
(c) At a minimum, the contract must specify the following:
(1) Each resident shall retain, at a minimum, the current personal needs allowance as the resident's own funds for personal expenditure. A contract to the contrary is not valid. A personal needs allowance is the amount that a resident shall be permitted to keep for his personal use.
(2) A fee schedule that lists the actual amount of allowable resident charges for each of the home's available services.
(3) An explanation of the annual assessment, medical evaluation and support plan requirements and procedures, which shall be followed if either the assessment or the medical evaluation indicates the need of another and more appropriate level of care.
(4) The party responsible for payment.
(5) The method for payment of charges for long distance telephone calls.
(6) The conditions under which refunds will be made, including the refund of admission fees and refunds upon a resident's death.
(7) The financial arrangements if assistance with financial management is to be provided.
(8) The home's rules related to home services, including whether the home permits smoking.
(9) The conditions under which the agreement may be terminated including home closure as specified in § 2600.228 (relating to notification of termination).
(10) A statement that the resident is entitled to at least 30 days' advance notice, in writing, of the home's request to change the contract.
(11) A list of personal care services to be provided to the resident based on the outcome of the resident's support plan, a list of the actual rates that the resident will be periodically charged for food, shelter and services and how, when and by whom payment is to be made.
(12) Charges to the resident for holding a bed during hospitalization or other extended absence from the home.
(13) Written information on the resident's rights and complaint procedures as specified in § 2600.41 (relating to notification of rights and complaint procedures).
(d) A home may not seek or accept payments from a resident in excess of one-half of any funds received by the resident under the Senior Citizens Rebate and Assistance Act (72 P. S. §§ 4751-1--4751-12). If the home will be assisting the resident to manage a portion of the rent rebate, the requirements of § 2600.20 (relating to financial management) may apply. There may be no charge for filling out this paperwork.
(e) The resident, or a designated person, has the right to rescind the contract for up to 72 hours after the initial dated signature of the contract and pay only for the services received. Rescission of the contract must be in writing addressed to the home.
(f) The home may not require or permit a resident to assign assets to the home in return for a life care contract/guarantee. A life care contract/guarantee is an agreement between the legal entity and the resident that the legal entity will provide care to the resident for the duration of the resident's life. Continuing care communities that have obtained a Certificate of Authority from the Insurance Department and provide a copy of the certificate to the Department are exempt from this requirement.
(g) A copy of the signed admission contract shall be given to the resident and a copy shall be filed in the resident's record.
(h) The service needs addressed in the resident's support plan shall be available to the resident every day of the year.
§ 2600.26. Quality management.
(a) The home shall establish and implement a quality management plan.
(b) The quality management plan shall address the periodic review and evaluation of the following:
(1) The reportable incident and condition reporting procedures.
(2) Complaint procedures.
(3) Staff person training.
(4) Licensing violations and plans of correction, if applicable.
(5) Resident or family councils, or both, if applicable.
(c) The quality management plan shall include the development and implementation of measures to address the areas needing improvement that are identified during the periodic review and evaluation.
§ 2600.27. SSI recipients.
(a) If a home agrees to admit a resident eligible for SSI benefits, the home's charges for actual rent and other services may not exceed the SSI resident's actual current monthly income reduced by the current personal needs allowance.
(b) The administrator or staff persons may not include funds received as lump sum awards, gifts or inheritances, gains from the sale of property, or retroactive government benefits when calculating payment of rent for an SSI recipient or for a resident eligible for SSI benefits.
(c) The administrator or staff persons may seek and accept payments from funds received as retroactive awards of SSI benefits, but only to the extent that the retroactive awards cover periods of time during which the resident actually resided in the home and for which full payment has not been received.
(d) The administrator shall provide each resident who is a recipient of SSI, at no charge beyond the amount determined in subsection (a), the following items or services as needed:
(1) Necessary personal hygiene items, such as a comb, toothbrush, toothpaste, soap and shampoo. Cosmetic items are not included.
(2) Laundry services for personal laundry, bed linens and towels, but not including dry cleaning or other specialized services.
(3) Personal care services.
(e) Third-party payments made on behalf of an SSI recipient and paid directly to the home are permitted. These payments may not be used for food, clothing or shelter because to do so would reduce SSI payments. See 20 CFR 416.1100 and 416.1102 (relating to income and SSI eligibility; and what is income). These payments may be used to purchase items or services for the resident that are not food, clothing or shelter.
§ 2600.28. Refunds.
(a) If, after the home gives notice of discharge or transfer in accordance with § 2600.228(b) (relating to notification of termination), and the resident moves out of the home before the 30 days are over, the home shall give the resident a refund equal to the previously paid charges for rent and personal care services for the remainder of the 30-day time period. The refund shall be issued within 30-days of discharge or transfer. The resident's personal needs allowance shall be refunded within 2 business days of discharge or transfer.
(b) After a resident gives notice of the intent to leave in accordance with § 2600.228(b) and if the resident moves out of the home before the expiration of the required 30 days, the resident owes the home the charges for rent and personal care services for the entire length of the 30-day time period for which payment has not been made.
(c) If no notice is required, as set forth in subsection (d), the resident shall be required to pay only for the nights spent in the home.
(d) If the home does not require a written notice prior to a resident's departure, the administrator shall refund the remainder of previously paid charges to the resident within 30 days of the date the resident moved from the home.
(e) In the event of a death of a resident under 60 years of age, the administrator shall refund the remainder of previously paid charges to the resident's estate within 30 days from the date the room is cleared of the resident's personal property. In the event of a death of a resident 60 years of age and older, the home shall provide a refund in accordance with the Elder Care Payment Restitution Act (35 P. S. §§ 10226.101--10226.107). The home shall keep documentation of the refund in the resident's record.
(f) Within 30 days of either the termination of service by the home or the resident's leaving the home, the resident shall receive an itemized written account of the resident's funds, including notification of funds still owed the home by the resident or a refund owed the resident by the home. Refunds shall be made within 30 days of discharge.
(g) Upon discharge of the resident or transfer of the resident to a higher level of care, the administrator shall return the resident's funds being managed or stored by the home to the resident within 2 business days from the date the room is cleared of the resident's personal property.
§ 2600.29. Hospice care and services.
Hospice care and services that are licensed by the Department of Health as a hospice may be provided in a personal care home.
RESIDENT RIGHTS § 2600.41. Notification of rights and complaint procedures.
(a) Upon admission, each resident and, if applicable, the resident's designated person, shall be informed of resident rights and the right to lodge complaints without intimidation, retaliation, or threats of retaliation of the home or its staff persons against the reporter. Retaliation includes discharge or transfer from the home.
(b) Notification of rights and complaint procedures shall be communicated in an easily understood manner and in a language understood by or mode of communication used by the resident and, if applicable, the resident's designated person.
(c) The Department's poster of the list of resident's rights shall be posted in a conspicuous and public place in the home.
(d) A copy of the resident's rights and complaint procedures shall be given to the resident and, if applicable, the resident's designated person upon admission.
(e) A statement signed by the resident and, if applicable, the resident's designated person acknowledging receipt of a copy of the information specified in subsection (d), or documentation of efforts made to obtain signature, shall be kept in the resident's record.
§ 2600.42. Specific rights.
(a) A resident may not be discriminated against because of race, color, religious creed, disability, handicap, ancestry, sexual orientation, national origin, age or sex.
(b) A resident may not be neglected, intimidated, physically or verbally abused, mistreated, subjected to corporal punishment or disciplined in any way.
(c) A resident shall be treated with dignity and respect.
(d) A resident shall be informed of the rules of the home and given 30 days' written notice prior to the effective date of a new home rule.
(e) A resident shall have access to a telephone in the home to make calls in privacy. Nontoll calls shall be without charge to the resident.
(f) A resident has the right to receive and send mail.
(1) Outgoing mail may not be opened or read by staff persons unless the resident requests.
(2) Incoming mail may not be opened or read by staff persons unless upon the request of the resident or the resident's designated person.
(g) A resident has the right to communicate privately with and access the local ombudsman.
(h) A resident has the right to practice the religion or faith of the resident's choice, or not to practice any religion or faith.
(i) A resident shall receive assistance in accessing health services.
(j) A resident shall receive assistance in obtaining and keeping clean, seasonal clothing. A resident's clothing may not be shared with other residents.
(k) A resident and the resident's designated person, and other individuals upon the resident's written approval shall have the right to access, review and request corrections to the resident's record.
(l) A resident has the right to furnish his room and purchase, receive, use and retain personal clothing and possessions.
(m) A resident has the right to leave and return to the home at times consistent with the home rules and the resident's support plan.
(n) A resident has the right to relocate and to request and receive assistance, from the home, in relocating to another facility. The assistance shall include helping the resident get information about living arrangements, making telephone calls and transferring records.
(o) A resident has the right to freely associate, organize and communicate with others privately.
(p) A resident shall be free from restraints.
(q) A resident shall be compensated in accordance with State and Federal labor laws for labor performed on behalf of the home. Residents may voluntarily and without coercion perform tasks related directly to the resident's personal space or common areas of the home.
(r) A resident has the right to receive visitors for a minimum of 12 hours daily, 7 days per week.
(s) A resident has the right to privacy of self and possessions. Privacy shall be provided to the resident during bathing, dressing, changing and medical procedures.
(t) A resident has the right to file complaints with any individual or agency and recommend changes in policies, home rules and services of the home without intimidation, retaliation or threat of discharge.
(u) A resident has the right to remain in the home, as long as it is operating with a license, except as specified in § 2600.228 (relating to notification of termination).
(v) A resident has the right to receive services contracted for in the resident-home contract.
(w) A resident has the right to use both the home's procedures and external procedures, if any, to appeal involuntary discharge.
(x) A resident has the right to a system to safeguard a resident's money or property.
(y) A resident has the right to choose his own health care providers without limitation by the home. This includes the right to select the resident's own pharmacist provided that the pharmacy agrees to supply medications in a way that is compatible with the home's system for handling and assisting with the self-administration of resident medications.
§ 2600.43. Prohibition against deprivation of rights.
(a) A resident may not be deprived of his rights.
(b) A resident's rights may not be used as a reward or sanction.
§ 2600.44. Complaint procedures.
(a) Prior to admission, the home shall inform the resident and the resident's designated person of the right to file and the procedure for filing a complaint with the Department's personal care home regional office, local ombudsman or protective services unit in the area agency on aging, Pennsylvania Protection & Advocacy, Inc. or law enforcement agency.
(b) The home shall permit and respond to oral and written complaints from any source regarding an alleged violation of resident rights, quality of care or other matter without retaliation or the threat of retaliation.
(c) If a resident indicates that he wishes to make a written complaint, but needs assistance in reducing the complaint to writing, the home shall assist the resident in writing the complaint.
(d) The home shall ensure investigation and resolution of complaints. The home shall designate the staff person responsible for receiving complaints and determining the outcome of the complaint.
(e) Within 2 business days after the submission of a written complaint, a status report shall be provided by the home to the complainant. If the resident is not the complainant, the resident and the resident's designated person shall receive the status report unless contraindicated by the support plan. The status report must indicate the steps that the home is taking to investigate and address the complaint.
(f) Within 7 days after the submission of a written complaint, the home shall give the complainant and, if applicable, the designated person, a written decision explaining the home's investigation findings and the action the home plans to take to resolve the complaint. If the resident is not the complainant, the affected resident shall receive a copy of the decision unless contraindicated by the support plan. If the home's investigation validates the complaint allegations, a resident who could potentially be harmed or his designated person shall receive a copy of the decision, with the name of the affected resident removed, unless contraindicated by the support plan.
(g) The telephone number of the Department's personal care home regional office, the local ombudsman or protective services unit in the area agency on aging, Pennsylvania Protection & Advocacy, Inc., the local law enforcement agency, the Commonwealth Information Center and the personal care home complaint hotline shall be posted in large print in a conspicuous and public place in the home.
STAFFING § 2600.51. Criminal history checks.
Criminal history checks and hiring policies shall be in accordance with the Older Adult Protective Services Act (35 P. S. §§ 10225.101--10225.5102) and 6 Pa. Code Chapter 15 (relating to protective services for older adults).
§ 2600.52. Staff hiring, retention and utilization.
Hiring, retention and utilization of staff persons shall be in accordance with the Older Adult Protective Services Act (35 P. S. §§ 10225.101--10225.5102) and 6 Pa. Code Chapter 15 (relating to protective services for older adults) and other applicable regulations.
§ 2600.53. Qualifications and responsibilities of administrators.
(a) The administrator shall have one of the following qualifications:
(1) A license as a registered nurse from the Department of State.
(2) An associate's degree or 60 credit hours from an accredited college or university.
(3) A license as a licensed practical nurse from the Department of State and 1 year of work experience in a related field.
(4) A license as a nursing home administrator from the Department of State.
(5) For a home serving 8 or fewer residents, a general education development diploma or high school diploma and 2 years direct care or administrative experience in the human services field.
(b) The administrator shall be 21 years of age or older.
(c) The administrator shall be responsible for the administration and management of the home, including the health, safety and well-being of the residents, implementation of policies and procedures and compliance with this chapter.
(d) The administrator shall have the ability to provide personal care services or to supervise or direct the work to provide personal care services.
(e) The administrator shall have knowledge of this chapter.
(f) The administrator shall have the ability to comply with applicable laws, rules and regulations, including this chapter.
(g) The administrator shall have the ability to maintain or supervise the maintenance of financial and other records.
(h) The administrator shall be free from a medical condition, including drug or alcohol addiction, that would limit the administrator from performing duties with reasonable skill and safety.
§ 2600.54. Qualifications for direct care staff persons.
(a) Direct care staff persons shall have the following qualifications:
(1) Be 18 years of age or older, except as permitted in subsection (b).
(2) Have a high school diploma, GED or active registry status on the Pennsylvania nurse aide registry.
(3) Be free from a medical condition, including drug or alcohol addiction, that would limit direct care staff persons from providing necessary personal care services with reasonable skill and safety.
(b) An individual who is 16 or 17 years of age may be a staff person at a home, but may not perform tasks related to medication administration. A staff person who is 16 or 17 years of age may not perform tasks related to incontinence care, bathing or dressing of residents without supervision.
(c) A volunteer who performs ADLs shall meet the staff person qualifications and training requirements specified in this chapter.
(d) A resident receiving personal care services who voluntarily performs tasks in the home will not be considered a volunteer under this chapter.
§ 2600.55. Exceptions for staff qualifications.
(a) The staff qualification requirements for administrator and direct care staff persons do not apply to individuals hired or promoted to the specified positions prior to December 1, 2004.
(b) A staff person who transfers to another licensed home, with no more than a 1 year break in service, may continue to work in the same capacity as long as the staff person meets the conditions specified in subsection (a).
§ 2600.56. Administrator staffing.
The administrator shall be present in the home an average of 20 hours or more per week, in each calendar month.
§ 2600.57. Direct care staffing.
(a) At all times one or more residents are present in the home a direct care staff person who is 21 years of age or older and who serves as the designee, shall be present in the home. The direct care staff person may be the administrator if the administrator provides direct care services.
(b) Direct care staff persons shall be available to provide at least 1 hour per day of personal care services to each mobile resident.
(c) Direct care staff persons shall be available to provide at least 2 hours per day of personal care services to each resident who has mobility needs.
(d) At least 75% of the personal care service hours specified in subsections (b) and (c) shall be available during waking hours.
§ 2600.58. Awake staff persons.
(a) If a home serves 16 or more residents, all direct care staff persons on duty in the home shall be awake at all times one or more residents are present in the home.
(b) If a home serves one or more but less than 16 residents with mobility needs, at least one direct care staff person shall be awake at all times residents are present in the home.
§ 2600.59. Multiple buildings.
(a) For a home with multiple buildings on the same premises that are within 300 feet of one another, the direct care staff person required in § 2600.57 (relating to direct care staffing) shall be on the premises and available by a two-way communication system at all times one, two or three mobile residents are present in the home.
(b) For a home with multiple buildings on the same premises regardless of the distance between buildings, the direct care staffing requirements in § 2600.57 apply at all times four or more mobile residents, or one or more residents with mobility needs, are present in the home.
§ 2600.60. Additional staffing based on the needs of the residents.
(a) Staffing shall be provided to meet the needs of the residents as specified in the resident's assessment and support plan.
(b) The Department may require additional staffing as necessary to protect the health, safety and well-being of the residents. Requirements for additional staffing will be based on the resident's assessment and support plan, the design and construction of the home and the operation and management of the home.
(c) Additional staff hours, or contractual hours, shall be provided as necessary to meet the laundry, food service, housekeeping and maintenance needs of the home.
§ 2600.61. Substitute personnel.
When regularly scheduled direct care staff persons are absent, the administrator shall arrange for coverage by substitute personnel who meet the direct care staff qualifications and training requirements as specified in §§ 2600.54 and § 2600.65 (relating to qualifications for direct care staff persons; and direct care staff person training and orientation).
§ 2600.62. List of staff persons.
The administrator shall maintain a current list of the names, addresses and telephone numbers of staff persons including substitute personnel and volunteers.
§ 2600.63. First aid, CPR and obstructed airway training.
(a) At least one staff person for every 50 residents who is trained in first aid and certified in obstructed airway techniques and CPR shall be present in the home at all times.
(b) Current training in first aid and certification in obstructed airway techniques and CPR shall be provided by an individual certified as a trainer by a hospital or other recognized health care organization.
(c) Licensed, certified and registered medical personnel meet the qualifications in subsection (a) and are exempt from the training requirements in subsections (a) and (b).
(d) A staff person who is trained in first aid or certified in obstructed airway techniques or CPR shall provide those services in accordance with his training, unless the resident has a do not resuscitate order.
§ 2600.64. Administrator training and orientation.
(a) Prior to initial employment as an administrator, a candidate shall successfully complete the following:
(1) An orientation program approved and administered by the Department.
(2) A 100-hour standardized Department-approved administrator training course.
(3) A Department-approved competency-based training test with a passing score.
(4) Paragraphs (1), (2) and (3) do not apply to an administrator hired or promoted prior to October 24, 2005.
(b) The standardized Department-approved administrator training course specified in subsection (a)(2) shall include the following:
(1) Fire prevention and emergency preparedness.
(2) Medication procedures, medication effects and side effects, universal precautions and personal hygiene.
(3) Certification in CPR and obstructed airway techniques and training in first aid.
(4) Personal care services.
(5) Local, State and Federal laws and regulations pertaining to the operation of a home.
(6) Nutrition, food handling and sanitation.
(7) Recreation.
(8) Care for residents with mental illness.
(9) Resident rights.
(10) Care for residents with dementia, cognitive impairments and other special needs.
(11) Care for residents with mental retardation.
(12) Community resources, social services and activities in the community.
(13) Staff supervision and staff person training including developing orientation and training guidelines for staff.
(14) Budgeting, financial recordkeeping and resident records including:
(i) Writing, completing and implementing initial assessments, annual assessments and support plans.
(ii) Resident-home contracts.
(15) Gerontology.
(16) Abuse and neglect prevention and reporting.
(17) Cultural competency.
(18) The requirements of this chapter.
(c) An administrator shall have at least 24 hours of annual training relating to the job duties. The Department-approved administrator training course specified in subsection (a) fulfills the annual training requirement for the first year.
(d) Annual training shall be provided by Department-approved training sources listed in the Department's personal care home training resource directory or by an accredited college or university.
(e) An administrator who has successfully completed the training in subsections (a)--(d) shall provide written verification of successful completion to the Department's personal care home regional office.
(f) A record of training including the individual trained, date, source, content, length of each course and copies of certificates received shall be kept.
(g) A licensed nursing home administrator who is em- ployed as an administrator prior to October 24, 2006, is exempt from the training and educational requirements of this chapter if the administrator continues to meet the requirements of the Department of State. A licensed nursing home administrator hired as an administrator after October 26, 2006, shall complete and pass the Department-approved personal care home administrator competency-based training test.
§ 2600.65. Direct care staff person training and orientation.
(a) Prior to or during the first work day, all direct care staff persons including ancillary staff persons, substitute personnel and volunteers shall have an orientation in general fire safety and emergency preparedness that includes the following:
(1) Evacuation procedures.
(2) Staff duties and responsibilities during fire drills, as well as during emergency evacuation, transportation and at an emergency location if applicable.
(3) The designated meeting place outside the building or within the fire-safe area in the event of an actual fire.
(4) Smoking safety procedures, the home's smoking policy and location of smoking areas, if applicable.
(5) The location and use of fire extinguishers.
(6) Smoke detectors and fire alarms.
(7) Telephone use and notification of emergency services.
(b) Within 40 scheduled working hours, direct care staff persons, ancillary staff persons, substitute personnel and volunteers shall have an orientation that includes the following:
(1) Resident rights.
(2) Emergency medical plan.
(3) Mandatory reporting of abuse and neglect under the Older Adult Protective Services Act (35 P. S. §§ 10225.101--10225.5102).
(4) Reporting of reportable incidents and conditions.
(c) Ancillary staff persons shall have a general orientation to their specific job functions as it relates to their position prior to working in that capacity.
(d) Direct care staff persons hired after April 24, 2006, may not provide unsupervised ADL services until completion of the following:
(1) Training that includes a demonstration of job duties, followed by supervised practice.
(2) Successful completion and passing the Department-approved direct care training course and passing of the competency test.
(3) Initial direct care staff person training to include the following:
(i) Safe management techniques.
(ii) ADLs and IADLs.
(iii) Personal hygiene.
(iv) Care of residents with dementia, mental illness, cognitive impairments, mental retardation and other mental disabilities.
(v) The normal aging-cognitive, psychological and functional abilities of individuals who are older.
(vi) Implementation of the initial assessment, annual assessment and support plan.
(vii) Nutrition, food handling and sanitation.
(viii) Recreation, socialization, community resources, social services and activities in the community.
(ix) Gerontology.
(x) Staff person supervision, if applicable.
(xi) Care and needs of residents with special emphasis on the residents being served in the home.
(xii) Safety management and hazard prevention.
(xiii) Universal precautions.
(xiv) The requirements of this chapter.
(xv) Infection control.
(xvi) Care for individuals with mobility needs, such as prevention of decubitus ulcers, incontinence, malnutrition and dehydration, if applicable to the residents served in the home.
(e) Direct care staff persons shall have at least 12 hours of annual training relating to their job duties.
(1) Staff person orientation shall be included in the 12 hours of training for the first year of employment.
(2) On the job training for direct care staff persons may count for 6 out of the 12 training hours required annually.
(f) Training topics for the annual training for direct care staff persons shall include the following:
(1) Medication self-administration training.
(2) Instruction on meeting the needs of the residents as described in the preadmission screening form, assessment tool, medical evaluation and support plan.
(3) Care for residents with dementia and cognitive impairments.
(4) Infection control and general principles of cleanliness and hygiene and areas associated with immobility, such as prevention of decubitus ulcers, incontinence, malnutrition and dehydration.
(5) Personal care service needs of the resident.
(6) Safe management techniques
(7) Care for residents with mental illness or mental retardation, or both, if the population is served in the home.
(g) Direct care staff persons, ancillary staff persons, substitute personnel and regularly scheduled volunteers shall be trained annually in the following areas:
(1) Fire safety completed by a fire safety expert or by a staff person trained by a fire safety expert. Videos prepared by a fire safety expert are acceptable for the training if accompanied by an onsite staff person trained by a fire safety expert.
(2) Emergency preparedness procedures and recognition and response to crises and emergency situations.
(3) Resident rights.
(4) The Older Adult Protective Services Act (35 P. S. §§ 10225.101--10225.5102).
(5) Falls and accident prevention.
(6) New population groups that are being served at the home that were not previously served, if applicable.
(h) If a staff person has completed the required initial direct care staff person training within the past year as a direct care staff person at another home, the requirement for initial direct care staff person training in this section does not apply if the staff person provides written verification of completion of the training.
(i) A record of training including the staff person trained, date, source, content, length of each course and copies of any certificates received, shall be kept.
§ 2600.66. Staff training plan.
(a) A staff training plan shall be developed annually.
(b) The plan must include training aimed at improving the knowledge and skills of the home's direct care staff persons in carrying out their job responsibilities. The staff training plan must include the following:
(1) The name, position and duties of each direct care staff person.
(2) The required training courses for each staff person.
(3) The dates, times and locations of the scheduled training for each staff person for the upcoming year.
(c) Documentation of compliance with the staff training plan shall be kept.
§ 2600.67. Training institution registration.
(a) An institution and the course of study offered by an educational institution, association, professional society or organization for the purpose of educating and qualifying applicants for certification as personal care home administrators shall be registered and approved by the Department prior to offering the course of study.
(b) An application for registration of an institution and approval of a course of study shall be submitted to the Department on a form provided by the Department and include the following information:
(1) The full name, address, telephone number, facsimile number and electronic mail address of the prospective training provider, each instructor and the program coordinator.
(2) The training objectives, instructional materials, content and teaching methods to be used and the number of clock hours.
(3) The recommended class size.
(4) The attendance certification method.
(5) Proof that each course instructor is certified by the Department to conduct administrator training.
(6) The subject that each instructor will teach and documentation of the instructor's academic credentials, instructional experience and work experience to teach the subject.
(7) The location of the training site, which shall accommodate the number of anticipated participants.
(c) A request to amend a Department-approved course of study shall be submitted for the Department's review and approval prior to implementation of a change in the course of study.
(d) The training institution shall issue a training certificate to each participant who successfully completes the Department-approved course and passes the competency test. Each training certificate must indicate the participant's name, the name of the training institution, the date and location of the training and the number of clock hours completed for each training topic.
§ 2600.68. Instructor approval.
(a) Training for personal care home administrators provided by an individual who is not certified as an instructor by the Department will not be considered valid training.
(b) To receive the Department's certification as an approved instructor for personal care home administrators, an instructor shall successfully complete the Department's train-the-trainer course. The train-the-trainer course is designed to provide and reinforce basic training skills, including the roles and responsibilities of the trainer, training methodology, the use of instructional aids and recordkeeping.
(c) An instructor shall demonstrate competent instructional skills and knowledge of the applicable topic and meet the Department's qualifications for the topic being taught.
(d) An instructor is subject to unannounced monitoring by the Department while conducting training.
(e) The Department will establish approval standards that include the following:
(1) The mechanism to measure the quality of the training being offered.
(2) The criteria for selecting and evaluating instructors, subject matter and instructional materials.
(3) The criteria for evaluating requests to amend a course.
(4) The criteria for evaluating the effectiveness of each course.
(5) The instructor qualifications for each subject being taught.
(f) The Department may withdraw approval under the following conditions:
(1) Failure to follow the approved curriculum.
(2) Lack of trainer competency.
(3) A pattern of violations of this chapter by a home conducting the training.
PHYSICAL SITE § 2600.81. Physical accommodations and equipment.
(a) The home shall provide or arrange for physical site accommodations and equipment necessary to meet the health and safety needs of a resident with a disability and to allow safe movement within the home and exiting from the home.
(b) Wheelchairs, walkers, prosthetic devices and other apparatus used by residents must be clean, in good repair and free of hazards.
§ 2600.82. Poisons.
(a) Poisonous materials shall be stored in their original, labeled containers.
(b) Poisonous materials shall be stored separately from food, food preparation surfaces and dining surfaces.
(c) Poisonous materials shall be kept locked and inaccessible to residents unless all of the residents living in the home are able to safely use or avoid poisonous materials.
§ 2600.83. Temperature.
(a) The indoor temperature, in areas used by the residents, must be at least 70°F when residents are present in the home.
(b) If a home does not provide air conditioning, fans shall be made available to residents when the indoor temperature exceeds 80°F.
§ 2600.84. Heat sources.
Heat sources, such as steam and hot heating pipes, water pipes, fixed space heaters, hot water heaters and radiators exceeding 120°F that are accessible to the resident must be equipped with protective guards or insulation to prevent the resident from coming in contact with the heat source.
§ 2600.85. Sanitation.
(a) Sanitary conditions shall be maintained.
(b) There may be no evidence of infestation of insects or rodents in the home.
(c) Trash shall be removed from the premises at least once a week.
(d) Trash in kitchens and bathrooms shall be kept in covered trash receptacles that prevent the penetration of insects and rodents.
(e) Trash outside the home shall be kept in covered receptacles that prevent the penetration of insects and rodents.
(f) For a home serving 9 or more residents that is not connected to a public sewer system there shall be a written sanitation approval for its sewage system by the sewage enforcement official of the municipality in which the home is located.
§ 2600.86. Ventilation.
(a) All areas of the home that are used by the resident shall be ventilated. Ventilation includes an operable window, air conditioner, fan or mechanical ventilation that ensures airflow.
(b) A bathroom that does not have an operable, outside window shall be equipped with an exhaust fan for ventilation.
§ 2600.87. Lighting.
The home's rooms, hallways, interior stairs, outside steps, outside doorways, porches, ramps, evacuation routes, outside walkways and fire escapes shall be lighted and marked to ensure that residents, including those with vision impairments, can safely move through the home and safely evacuate.
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