PROPOSED RULEMAKING
DEPARTMENT OF
PUBLIC WELFARE
[55 PA. CODE CHS. 2600 AND 2620]
Personal Care Homes Statutory Authority
[32 Pa.B. 4939] The Department of Public Welfare (Department), under the authority of section 211 and Articles IX and X of the Public Welfare Code (62 P. S. §§ 211, 901--922 and 1001--1087) proposes to adopt amendments to read as set forth in Annex A.
Purpose of the Proposed Rulemaking
This proposed rulemaking will add a new Chapter 2600 (relating to personal care homes) to replace the existing personal care home licensing regulations in Chapter 2620 (relating to personal care home licensing). Personal care homes are a vital and important component of the continuum of community-based residential long-term care services available to the residents of this Commonwealth. This proposed rulemaking will strengthen health and safety requirements based on public input and research.
Background
The development of this proposed rulemaking began in Fall 1999 as part of the Adult Residential Regulations Project (project), a Privatize, Retain, Innovate, Modify and Eliminate (PRIME) initiative to improve existing human service licensing functions within State government by strengthening health and safety protections and reducing duplication within the licensing process. PRIME is the Commonwealth's initiative to make State government more customer-centered, cost-efficient and competitive.
The Department's Office of Licensing and Regulatory Management leads the project. The project will encompass nine chapters under the authorities of the Department and the Department of Health. The goal of the regulatory consolidation is to improve services and protections to consumers by focusing provider effort on compliance with fundamental health and safety regulations. To allow for dialogue and to obtain specific feedback from those most directly affected by this project, the Department solicited ongoing and active consultation and involvement with many providers, provider associations, residents, family members and advocacy organizations.
The Department convened initial briefing meetings with numerous Statewide external stakeholders organizations from Fall 1999 to Spring 2000. In February 2001, the Department convened a Statewide briefing meeting to present information regarding the scope and content of the project. The Department invited legislators, Statewide external stakeholders, educators, field licensing staff, providers, consumers and advocates to attend. The Department posted the first informal draft of the project regulations on the Department's website in April 2001, and mailed copies to interested persons without Internet access. In May 2001, the Department convened a 3-day meeting to obtain input on major issues of particular concern to all stakeholders. The Department also extended the comment period on the first informal draft of the regulations for an additional 2 weeks, to provide additional time for public input. The Department received comments from over 950 interested individuals regarding the first informal draft of the proposed project regulations, with the majority of the comments from the personal care home industry.
In June 2001, after reviewing and considering the comments received, the Department and the Departments of Health and Aging decided to cluster and phase in the promulgation of the project regulations. The personal care home regulations were prioritized due to the tremendous growth in the personal care home population, and the changing nature and complexity of needs and services required by these residents. In June 2001, the Department mailed all providers a letter to inform them of this decision.
In preparation of this proposed rulemaking for personal care homes, the Department met with its Personal Care Home Advisory Committee and external stakeholder groups. Department staff also toured personal care homes across this Commonwealth to discuss the development of the proposed rulemaking with personal care home administrators, residents, family members and staff. The Department reviewed and considered all comments, and then developed a preview draft of the proposed personal care home rulemaking.
In March 2002, the Department posted the preview of the draft personal care home regulations on its website, and invited interested persons to provide comments. Comments received were reviewed and considered in developing this proposed rulemaking. The Department will continue to meet with personal care home stakeholders.
Throughout this public input process, the Department received many valuable comments and suggestions from many external stakeholders who participated in the process. The Department values the comments submitted and has incorporated many of the suggested changes in the proposed rulemaking.
Significant Provisions Reportable Incidents
In § 2600.16 (relating to reportable incidents), the Department proposes enhanced reporting of incidents, beyond those listed in the current regulations, which will serve to protect the health, safety and rights of residents in the home.
Waivers
The proposed provisions in § 2600.19 (relating to waivers) are intended to ensure that waivers of regulatory standards do not have a negative impact on residents. The section is designed to ensure that residents are informed about waiver requests and approved waiver requests in the home in which they live. In addition, the residents are given an opportunity to provide input into the home's waiver request.
Resident-Home Contract
The proposed provisions in § 2600.26 (relating to resident-home contract: information on resident rights) are expanded to provide full disclosure of the contract to be signed and the resident rights. This requirement will promote good business practices, and protect the resident, the resident's family and the facility. The additional regulatory protections include a 72-hour right of rescission of the contract, a requirement that resident's service needs are to be addressed 365 days a year, and a mandate to list the actual amount of allowable resident charges for each service item.
Resident Rights
The proposed provisions in § 2600.42 (relating to specific rights) offer additional regulatory protections for the resident, listing 28 specific resident rights. An appeal procedure is proposed in § 2600.41 (relating to notification of rights and complaint procedures) to allow the resident or the resident's family to file a complaint if they believe a resident's right has been violated.
Staffing
The proposed provisions in § 2600.56 (relating to staffing) maintain the current level of personal care service hours per resident, based on the resident's mobility or immobility needs. This section also proposes that if a resident's personal care needs exceed the current minimum level of personal care hours, the home shall provide a sufficient number of direct care staff to provide the necessary level of care required by the resident.
Administrator Training and Orientation
The Department proposes in § 2600.57 (relating to administrator training and orientation) to provide for greater training and competency requirements for administrators than current regulations require. Training requirements cover additional essential areas such as special populations with dementia, care of residents with mental illness and cognitive impairments and gerontology. Demonstrated competency in the training material is required. Enhanced training will provide additional health and safety protection of residents by ensuring that administrators gain knowledge and competency through training. This section proposes to expand the scope and length of the administrator training program, and also requires new administrators to successfully complete a competency-based internship in a licensed home under a Department-trained administrator. A licensed nursing home administrator hired after the effective date of this rulemaking will be required to pass a competency-based training test, or attend a shortened administrator-training course and achieve a passing grade.
Staff Training and Orientation
Section 2600.58 (relating to staff training and orientation) proposes to mandate greater training and competency requirements for direct care staff. The Department proposes that annual training for all staff is 24 hours and must be related to their job duties. The health and safety of residents will be enhanced by ensuring that staff gain knowledge and competency through training.
Bedrooms
The Department proposes in § 2600.101 (relating to resident bedrooms) that residents with physical disabilities will have larger bedrooms to allow for easy passage and comfortable use of assistive devices.
Safe Management Techniques
A resident's health and safety is most at risk during a time of crisis behavior. The Department reviewed the literature and spoke with experts regarding this topic, and considered other regulations that are being applied to similar services. The positive intervention techniques proposed in § 2600.201 (relating to safe management techniques) applied by staff are designed to assist a resident to return to safe and stable functioning.
Initial Assessment and Annual Assessment
Section 2600.225 (relating to initial assessment and the annual assessment) proposes enhanced screening and assessments of residents, to ensure accurate evaluation of resident needs and to prevent a resident from being inappropriately placed in a home. The proposed provisions require that the resident be comprehensively assessed within 72 hours of admission, to identify the resident's current needs, and to ensure that the facility can meet the resident's needs.
Development of the Support Plan
After the resident's needs are assessed, the Department proposes in § 2600.226 (relating to development of the support plan), the development of a support plan, which is a written document for each resident describing the resident's assessed care, service or treatment needs, and how those needs will be met and by whom. The support plan sets out clearly the care and responsibilities of the facility or outside entities in providing the services that the resident needs. In addition, the facility is required to inform the resident, the resident's family or advocate of the right to have other persons involved in the development of the support plan.
Secured Unit Requirements
Section 2600.231--2600.241 (relating to secured unit requirements) proposes that a home that chooses to operate a secured unit for persons with dementia may open this unit without submitting a waiver for the Department's review and approval. To operate a secured unit, a facility shall comply with all regulations relating to secured units set forth in this sections.
Medications Administration
The Department received numerous comments on previous drafts of proposed §§ 2600.181--2600.188 (relating to medications), concerning who may directly administer medications to residents. Currently, homes are only permitted to provide assistance with medications prescribed for self-administration. Current provisions require that only a licensed physician, nurse or dentist, as appropriate, may administer medications not prescribed for self-administration. The current provisions are retained in the proposed rulemaking. The Department received recommendations to expand the types of persons allowed to directly administer medications not prescribed for self-administration to include trained personal care home staff. As part of this recommendation, commentators recommended creating a specific medical technician training and certification program for personal care home staff. Because of State practice law and regulations, the issue of expanding persons able to directly administer medications not prescribed for self-administration requires review in more detail with the General Assembly, the State Board of Medicine and the State Board of Nursing. The Department will review this recommendation independently from this rulemaking and, if feasible, consider a separate rulemaking in the future.
Affected Individuals, Groups and Organizations
Personal care homes shall comply with these requirements to operate. The Department's survey indicates that there are 1,786 licensed personal care homes in this Commonwealth, with a licensed capacity of approximately 80,000 beds. Of this total, approximately 1,400 homes are operated for profit, and almost 400 homes are operated as nonprofit. Of the over 53,000 residents in personal care homes, over 10,500 residents receive Supplemental Security Income (SSI) benefits which are accepted as full payment towards the residents' monthly care. There are approximately 370 homes with four to eight beds, approximately 370 homes with 9 to 20 beds, approximately 535 homes with 21 to 50 beds, over 300 homes with 50 to 100 beds and over 300 homes with over 100 beds. The residents receiving care and services in these licensed facilities are directly affected by this proposed rulemaking since they are the consumers that the proposed rulemaking aims to protect. Families of the residents receiving care and services are affected in their interest to assure the health, safety and well-being of their loved ones.
Accomplishments/Benefits
This proposed rulemaking offers standards to improve the operation of all personal care homes in this Commonwealth, such as enhanced consumer protections, strengthened training and competency requirements for administrators and direct care staff, safe management techniques, improved screening and assessments of residents to ensure that the home can meet resident needs, expanded incident reporting, and the development of a support plan to ensure the resident's needs will be met by the facility.
Private Sector Personal Care Home Providers
In drafting the proposed rulemaking, the Department gave careful consideration to the effect the regulations will have on the cost of providing or receiving services. The issues that will have most potential to influence the cost of implementing Chapter 2600 are the following:
1. Mandatory costs for all personal care homes:
(a) Printing costs for policies and procedures, personnel management, quality management and other necessary documents.
(b) Reimbursement of residents' personal needs allowance within 1 week of discharge.
(c) Annual furnace inspection.
(d) Additional annual training costs due to additional required hours of training for administrators and staff.
2. Optional or possible costs for all personal care homes:
(a) A home with possible fire-safety violations will incur additional costs to correct the violations.
(b) Certification as a new personal care home administrator will require upgraded credentials, which may require additional salary. Training and competency-based testing.
(c) A facility with multiple buildings on the premises, that house four or more residents in each building, will need to meet new staffing requirements.
(d) Physical site modifications to serve residents with physical disabilities.
(e) Coliform water testing for homes not connected to a public water system.
3. Individual choice to assume cost:
(a) Those applying to be personal care home administrators for the first time must meet new educational requirements, obtain hands-on experience, and complete and pass competency based testing prior to becoming an administrator.
(b) Those applying to be personal care home administrators for the first time must meet increased certification hours (from 40 hours to 60 hours).
(c) Those applying to be personal care home administrators for the first time must pay cost associated with competency-based testing for new personal care home administrators.
General Public
There will be no costs to the general public as a result of this proposed rulemaking.
Public Sector Commonwealth
The Department anticipates that this proposed rulemaking will have no impact on State revenues. Personal care home residents who meet eligibility requirements can use government funds to pay to live in a personal care home. Approximately 10,000 low-income residents over 65 years of age, disabled or blind receive monthly payments from the SSI Program. In addition, the Commonwealth provides a supplement to SSI recipients. This supplement was increased by 20% (or $15 million in State dollars) for fiscal year 2001-2002.
Local Government
This proposed rulemaking will not impact local government.
Paperwork Requirements
The proposed rulemaking affects the paperwork requirements for the Commonwealth and the general public because additional paperwork is required. However, there is no reasonable alternative to the increased paperwork. Departmental forms required by the regulation, such as the intake assessment and the annual assessment forms, will be developed with input from external stakeholders prior to implementation.
Effective Date
This proposed rulemaking will become effective immediately upon publication of a final-form rulemaking except for § 2600.58(a)--(c), which will take effect 1 year after publication of final-form rulemaking.
Sunset Date
A sunset date is not anticipated because the underlying statute is permanent.
Public Hearings
Public hearings concerning the proposed rulemaking are not planned.
Public Comment Period
Interested persons are invited to submit written comments, suggestions or objections regarding the proposed rulemaking to the Department of Public Welfare, Office of Licensing and Regulatory Management, Teleta Nevius, Director, Room 316 Health and Welfare Building, P. O. Box 2675, Harrisburg, PA 17120, (717) 705-0383 within 30 days of the date of publication of this notice in the Pennsylvania Bulletin. Comments received within 30-calendar days will be reviewed and considered in the preparation of the final-form rulemaking. Comments after the 30-day comment period will be considered for any subsequent revisions of this regulation.
Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
Regulatory Review Act
Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on September 23, 2002, the Department submitted a copy of the proposed rulemaking to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the House Health and Human Services Committee and the Senate Public Health and Welfare Committee. In addition to submitting the proposed rulemaking, the Department has provided IRRC and the Committees with a copy of a detailed Regulatory Analysis Form prepared by the Department in compliance with Executive Order 1996-1, ''Regulatory Review and Promulgation.'' A copy of this material is available to the public upon request.
If IRRC has objections to any portion of the proposed rulemaking, it will notify the Department within 10 days of the expiration of the Committees' review period. The notification shall specify the regulatory review criteria that have not been met by that portion. The Regulatory Review Act specifies detailed procedures for the review of objections raised, prior to final publication of the regulation, by the Department, the General Assembly and the Governor.
FEATHER O. HOUSTOUN,
SecretaryFiscal Note: 14-475. No fiscal impact; (8) recommends adoption.
Annex A
TITLE 55. PUBLIC WELFARE
PART IV. ADULT SERVICES MANUAL
Subpart E. RESIDENTIAL AGENCIES/FACILITIES/SERVICES
CHAPTER 2600. PERSONAL CARE HOMES
Subchapter A. GENERAL ADMINISTRATIVE REQUIREMENTS GENERAL PROVISIONS
Sec.
2600.1. Purpose. 2600.2. Scope. 2600.3. Inspections and licenses or certificates of compliance. 2600.4. Definitions. 2600.5. Access requirements. GENERAL REQUIREMENTS
2600.11. Procedural requirements for licensure or approval of personal care homes. 2600.12. Appeals. 2600.13. Maximum capacity. 2600.14. Fire safety approval. 2600.15. Abuse reporting covered by statute. 2600.16. Reportable incidents. 2600.17. Confidentiality of records. 2600.18. Applicable health and safety laws. 2600.19. Waivers. 2600.20. Resident funds. 2600.21. Offsite services. 2600.22. Legal entity. 2600.23. Personnel management. 2600.24. Tasks of daily living. 2600.25. Personal hygiene. 2600.26. Resident-home contract: information on resident rights. 2600.27. Quality management. 2600.28. Supplemental Security Income (SSI) recipients. 2600.29. Refunds. 2600.30. Fees. RESIDENT RIGHTS
2600.41. Notification of rights and complaint procedures. 2600.42. Specific rights. 2600.43. Prohibition against deprivation of rights.
GENERAL PROVISIONS § 2600.1. Purpose.
The purpose of this chapter is to assure that personal care homes provide safe, humane, comfortable and supportive residential settings for dependent adults who require assistance beyond basic necessities of food and shelter but who do not need hospitalization or skilled or intermediate nursing care. Residents who live in personal care homes meeting the standards in this chapter will receive the encouragement and assistance they need to develop and maintain maximum independence and self-determination.
§ 2600.2. Scope.
(a) This chapter applies to personal care homes as defined in this chapter, and contains the minimum requirements that shall be met to obtain a license to operate a personal care home.
(b) This chapter does not apply to commercial boarding homes or to facilities operated by a religious organization for the care of clergy or other persons in a religious profession.
§ 2600.3. Inspections and licenses or certificates of compliance.
(a) An authorized agent of the Department will conduct onsite inspections of personal care homes.
(b) A certificate of compliance will be issued to the legal entity by the Department if, after an investigation by an authorized agent of the Department, the requirements for a certificate of compliance are met.
(c) The personal care home shall post the current certificate of compliance in a public place in the personal care home.
§ 2600.4. Definitions.
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
ADL--Activities of daily living--The term includes bathing, dressing and undressing, grooming, eating, transferring in out of bed or chair, toileting, bladder management, bowel management and additional personal care activities such as nail care and hair care.
Abuse--One or more of the following acts:
(i) The infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain, or mental anguish.
(ii) The willful deprivation by a caretaker of goods or services which are necessary to maintain physical or mental health.
(iii) Sexual harassment, rape or abuse, as defined in the Older Adult Protective Services Act (35 P. S. §§ 10225.101--10225.502), 6 Pa. Code Chapter 15 (relating to protective services for older adults) and 23 Pa.C.S. Chapter 61 (relating to protection from abuse).
(iv) Exploitation by an act or a course of conduct, including misrepresentation or failure to obtain informed consent which results in monetary, personal or other benefit, gain or profit for the perpetrator, or monetary or personal loss to the resident.
(v) Neglect of the resident, which results in physical harm, pain or mental anguish.
(vi) Abandonment or desertion by a caretaker.
Adult--A person who is 18 years of age or older.
Ancillary staff--A person who provides services for the personal care home but does not provide the services provided by direct care staff.
Agent--A person authorized by the Department or other State agency to enter, visit inspect or conduct an investigation of a personal care home.
Appropriate assessment agency or agent--An organization serving the aged or disabled population, such as a county mental health/mental retardation agency, a drug and alcohol agency, an area agency on aging or another human service agency or an individual in an occupation maintaining contact with the aged and disabled, such as medicine, nursing or rehabilitative therapies.
CAM--Complementary and alternative medications--Practices, substances and ideas used to prevent or treat illness or promote health and well-being outside the realm of modern conventional medicine. Alternative medicine is used alone or instead of conventional medicine. Complementary medicine is used along with or in addition to conventional medicine.
Commercial boarding home--A type of residential living facility providing only food and shelter, or other services normally provided by a hotel, for payment, for persons who require no services beyond food, shelter and other services usually found in hotel or apartment rental.
Complaint--A written or verbal criticism, dispute, or objection presented by or on behalf of a resident regarding the care, operations or management policies of a personal care home.
Department--The Department of Public Welfare of the Commonwealth.
Designee--The person authorized to act in the absence or in capacity of another. The authorization shall be documented in the resident's records when it concerns a resident's designee, and documented in the personnel records when it concerns the administrator's designee.
Direct care staff--
(i) A person who assists residents with activities of daily living, provides services or is otherwise responsible for the health, safety and welfare of the residents.
(ii) The term includes full and part time employees, temporary employees and volunteers.
Emergency medical plan--A plan that ensures immediate and direct access to medical care and treatment for serious injury, or illness, or both.
Financial management--
(i) A personal care service provided whenever the administrator serves as representative payee (or as a guardian or power of attorney assigned prior to December 21, 1988) for a resident, or when a resident receives assistance in budgeting and spending of the personal needs allowance.
(ii) The term does not include storing funds in a safe place as a convenience for a resident.
Fire safety expert--A member of a local fire department, fire protection engineer, Commonwealth-certified fire protection instructor, college instructor in fire science, county or Commonwealth fire school, volunteer trained and certified by a county or Commonwealth fire school or an insurance company loss control representative.
IADL--Instrumental activities of daily living--The term includes the following:
(i) Doing laundry.
(ii) Shopping.
(iii) Using transportation.
(iv) Managing money.
(v) Using a telephone.
Immobile resident--
(i) An individual who is unable to move from one location to another, or has difficulty in understanding and carrying out instructions without the continual and full assistance of other persons, or is incapable of independently operating a device, such as a wheelchair, prosthesis, walker or cane to exit a building.
(ii) The term does not mean that an immobile resident is incapable of self-administering medications.
Legal entity--A person, society, corporation, governing authority or partnership legally responsible for the administration and operation of a personal care home.
License--A certificate of compliance document issued by the Department permitting the operation of a personal care home, at a given location, for a specific period of time, for a specified capacity, according to appropriate Departmental program licensure or approval regulations.
Life care contract/guarantee--An agreement between the licensee and the resident that the licensee will provide care to the resident for the duration of the resident's life.
Long-term care nursing facility--A facility licensed by the Department of Health under the Health Care Facilities Act (35 P. S. §§ 448.101--448.904) that provides skilled or intermediate nursing care or both levels of care to two or more patients, who are unrelated to the nursing home administrator, for a period exceeding 24 hours.
Long-term care ombudsman--An agent of the Department of Aging who investigates and seeks to resolve complaints made by or on behalf of older individuals who are consumers of long-term care services. These complaints may relate to action, inaction or decisions of providers of long-term care services, of public agencies, of social service agencies or their representatives, which may adversely affect the health, safety, welfare or rights of these consumers.
Manual restraint--Any physical means that restricts, immobilizes or reduces a resident's ability to move his arms, legs, head or other body parts freely except that prompting, escorting or guiding a resident to assist in the activities of daily living will not be construed as a manual restraint.
Mobile resident--
(i) A resident who is physically and mentally capable of vacating the personal care home on the resident's own power or with limited assistance in the case of an emergency, including the capability to ascend or descend stairs if present on the exit path. Limited physical assistance means assistance in getting to one's feet, into a wheelchair, walker or prosthetic device. Verbal assistance means giving instructions to assist the resident in vacating the personal care home.
(ii) The term includes a person who is able to effectively operate a device required for moving from one place to another, and able to understand and carry out instructions for vacating the personal care home.
Neglect--The failure to provide for oneself or the failure of a caretaker to provide goods or services essential to avoid a clear and serious threat to physical or mental health. An adult who does not consent to the provision of protective services will not be found to be neglected solely on the grounds of environmental factors which are beyond the control of the adult or the caretaker, such as inadequate housing, furnishings, income, clothing or medical care.
OTC--Over the counter.
Personal care home or home--A premise in which food, shelter and personal assistance or supervision are provided for a period exceeding 24 hours, for four or more adults who are not relatives of the operator, who do not require the services in or of a licensed long-term care facility, but who do require assistance or supervision in matters such as dressing, bathing, diet, financial management, evacuation of a home in the event of an emergency or medication prescribed for self-administration.
Personal care home administrator or administrator--An individual who is charged with the general administration of a personal care home, whether or not the individual has an ownership interest in the personal care home, and whether or not functions and duties are shared with other individuals.
Personal care resident or resident--A person, unrelated to the licensee, who resides in a personal care home and who may require and receive personal care services but does not require the level of care provided by a hospital or long-term care facility.
Personal care services--Assistance or supervision in matters, such as dressing, bathing, diet, financial management, evacuation of a resident in the event of an emergency or medication prescribed for self-administration.
Premises--The grounds and buildings on the same grounds, in proximity, used for providing personal care services.
Referral agent--An agency or individual who arranges for or assists, or both, with placement of a resident into a personal care home.
Relative--A spouse, parent, child, stepparent, stepchild, grandparent, grandchild, brother, sister, half-brother, half-sister, aunt, uncle, niece or nephew.
Restraint--
(i) A chemical or mechanical device used to restrict the movement or normal function of an individual or a portion of the individual's body. Mechanical devices used to restrain include geriatric chairs; posey; chest, waist, wrist or ankle restraints; locked restraints; and locked doors to prevent egress.
(ii) The term does not include devices used to provide support for the achievement of functional body position or proper balance as long as the resident can easily remove the device.
(A) Chemical restraint is the use of drugs or chemicals for the specific and exclusive purpose of controlling acute or episodic aggressive behavior.
(B) Drugs administered on a regular basis, as prescribed by a physician for the purposes of treating the symptoms of mental, emotional or behavioral disorders and for assisting the resident in gaining self-control over impulses, are not to be considered chemical restraints.
SP--Support plan--A written document for each resident describing the resident's care, service or treatment needs, and when the care, service or treatment will be provided, and by whom.
State agency--Any executive agency or independent agency as defined in 2 Pa.C.S. § 101 (relating to definitions).
Volunteer--A person who, of his own free will, and without monetary compensation, provides services for residents in the personal care home.
(i) Volunteers who perform direct care services shall meet the minimum qualifications and training of staff persons.
(ii) Residents receiving personal care services who voluntarily perform tasks in the personal care home are not to be considered volunteers for the purpose of determining compliance with the staffing requirements of this chapter.
§ 2600.5. Access requirements.
(a) The Department has the right to enter, visit and inspect any personal care home licensed or requiring a license and shall have full and free access to the records of the personal care home and to the residents therein and full opportunity to interview, inspect or examine the residents.
(b) The administrator and staff shall provide, upon request, immediate access to the personal care home, the residents, and the residents' records to:
(1) Agents of the Department or other State agencies.
(2) Representatives of the Department of Aging's Older Adults Protective Services Program.
(3) The Long-Term Ombudsman Program.
(c) The administrator shall permit a resident's relatives, community service organizations and representatives of community legal services programs to have access to the personal care home during the personal care home's visitation hours or by appointment for the purpose of visiting, assisting or informing the residents of the availability of services and assistance.
GENERAL REQUIREMENTS § 2600.11. Procedural requirements for licensure or approval of personal care homes.
(a) Except for §§ 20.31 and 20.32 (relating to annual inspection; and announced inspections), the requirements in Chapter 20 (relating to licensure or approval of facilities and agencies) apply to personal care homes.
(b) Personal care homes shall be inspected as often as required by section 211(l) of the Public Welfare Code (62 P. S. § 211(l)), and more often as necessary. After initial approval, homes need not be visited or inspected annually except that the Department will schedule inspections in accordance with a plan that provides for the coverage of at least 75% of the licensed personal care homes every 2 years and all homes shall be inspected at least once every 3 years.
§ 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 licensed capacity is the total number of residents who are permitted to reside in the personal care section of the personal care 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 licensed capacity is limited by physical plant space, zoning and other applicable statutes and regulations.
(b) The maximum capacity specified on the license or certificate of compliance may not be exceeded.
§ 2600.14. Fire safety approval.
(a) Except in the cities of Scranton, Pittsburgh and Philadelphia, a personal care home shall have written fire safety approval prior to issuance of a certificate of compliance. Written fire safety approval shall be from either the Department of Labor and Industry or the Department of Health. In the cities of Scranton, Pittsburgh and Philadelphia, a personal care home shall have written fire safety approval prior to issuance of a certificate of compliance from the appropriate department of public safety. When fire safety approval is not required by these agencies, a valid written fire safety approval from a fire safety expert is required.
(b) If the fire safety approval is withdrawn or restricted, the personal care home shall notify the Department orally within 24 hours 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 personal care 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 30 days of the completion of the renovation or alteration.
(d) Authorized agents of the Department will request additional fire safety inspections by the appropriate agency if, during an inspection, an authorized agent observes possible fire safety violations.
(e) A personal care home shall be in compliance with applicable Federal, State and local statutes, ordinances, and regulations, including those statutes or regulations pertaining to fire and panic.
§ 2600.15. Abuse reporting covered by statute.
(a) The personal care 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).
(b) If there is an allegation of abuse of a resident involving the home's staff, the home shall immediately implement a plan of supervision or suspension of the staff person and shall submit to the personal care home regional field licensing office a plan of supervision or notice of suspension of the affected staff person.
§ 2600.16. Reportable incidents.
(a) A reportable incident includes the following:
(1) The death of a resident due to accident, abuse, neglect, homicide, suicide, malnutrition, dehydration or other unusual circumstances.
(2) Attempted suicide by a resident.
(3) A serious physical bodily injury, trauma or medication error 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--2600.43 (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.
(6) Misuse of a resident's funds by the personal care home staff or legal entity.
(7) An outbreak of a serious communicable disease as defined in 28 Pa. Code § 27.2 (relating to reportable diseases).
(8) Food poisoning of residents.
(9) A physical assault by or against a resident.
(10) Fire or structural damage to the personal care home.
(11) An incident requiring the services of an emergency management agency, fire department or law enforcement agency.
(12) A condition that results in an unscheduled closure of the personal care home or the relocation of the residents for more than 1 day of operation.
(13) A complaint of resident abuse, suspected abuse, referral of a complaint of resident abuse to a local authority for an investigation or the results of any investigation conducted by the personal care home of possible resident abuse.
(14) Any disasters under § 2600.107 (relating to internal and external disasters).
(15) A situation in which there are no staff to supervise the personal care home.
(16) Bankruptcy filed by the personal care home or its legal entity.
(17) Criminal convictions against the legal entity, administrator or staff that are subsequent to the reporting on the criminal history checks under § 2600.51 (relating to resident abuse and criminal history checks).
(18) A termination notice from a utility.
(b) The personal care home shall develop and implement written policies and procedures on the prevention, reporting, notification, investigation and management of reportable incidents.
(c) The personal care home shall immediately report the incident to the home regional field licensing office or a designee in a manner designated by the Department. Abuse reporting shall also follow the guidelines in § 2600.15 (relating to abuse reporting covered by statute).
(d) A preliminary written notification of incidents, on a form prescribed by the Department, shall be sent to the personal care home regional field licensing office within 5 days of the occurrence. Abuse reporting shall also follow the requirements in § 2600.15.
(e) The personal care home shall submit a final report, on a form prescribed by the Department, to the regional field licensing office immediately following the conclusion of the investigation.
(f) The personal care home shall keep a copy of the incident report on file as required by § 2600.243 (b) (relating to record retention and disposal).
§ 2600.17. Confidentiality of records.
Resident records shall be confidential, and, except in emergencies, may not be open to anyone other than the resident, the resident's designee, if any, agents of the Department and the long-term care ombudsman unless the resident, or a designee, consents, or a court orders disclosure.
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