Ariz. Admin. Code § R9-10-514 - Individual Program Plan
A. An
administrator shall ensure that:
1. A
comprehensive assessment of a resident:
a. Is
conducted or coordinated by a qualified intellectual disabilities professional,
in collaboration with an interdisciplinary team that includes:
i. The resident's attending physician or
designee;
ii. A registered
nurse;
iii. If the resident is
receiving medications as part of active treatment, a pharmacist; and
iv. Personnel members qualified to provide
each type of rehabilitation services identified in a placement evaluation or
the initial assessment required in
R9-10-507(3);
b. Is completed for the resident
within 30 calendar days after the resident's admission to an ICF/IID;
c. Is updated:
i. No later than 12 months after the date of
the resident's last comprehensive assessment, and
ii. When the resident experiences a
significant change;
d.
Includes the following information for the resident:
i. Identifying information;
ii. An evaluation of the resident's hearing,
speech, and vision;
iii. An
evaluation of the resident's ability to understand and recall
information;
iv. An evaluation of
the resident's mental status;
v.
Whether the resident demonstrates inappropriate behavior;
vi. Preferences for customary routine and
activities;
vii. An evaluation of
the resident's ability to perform activities of daily living;
viii. Need for a mobility device;
ix. An evaluation of the resident's ability
to control the resident's bladder and bowels;
x. Any diagnosis that impacts rehabilitation
services or other physical health services or behavioral care that the resident
may require;
xi. Any medical
conditions that impact the resident's functional status, quality of life, or
need for nursing services;
xii. An
evaluation of the resident's ability to maintain adequate nutrition and
hydration;
xiii. An evaluation of
the resident's oral and dental status;
xiv. An evaluation of the condition of the
resident's skin;
xv. Identification
of any medication or treatment administered to the resident during a seven-day
calendar period that includes the time the comprehensive assessment was
conducted;
xvi. Identification of
any treatment or medication ordered for the resident;
xvii. Identification of interventions that
may support the resident towards independence;
xviii. Identification of any assistive
devices needed by the resident;
xix. Identification of the active treatment
needed by the resident, including active treatment not provided by the
ICF/IID;
xx. Identification of
measurable goals and behavioral objective for the active treatment, in priority
order, with time limits for attainment;
xxi. Identification of the methods, schedule,
and strategies to accomplish the goals, including the personnel member
responsible;
xxii. Evaluation
procedures for determining if the methods and strategies in subsection
(A)(1)(d)(xix) are working, including the type of data required and frequency
of collection;
xxiii. Whether any
restraints have been used for the resident during a seven-day calendar period
that includes the time the comprehensive assessment was conducted;
xxiv. If the resident demonstrates
inappropriate behavior, as reported according to subsection (A)(1)(d)(v),
identification of the methods, schedule, and strategies for replacement of the
inappropriate behavior with appropriate behavioral expressions, including the
hierarchy for use;
xxv. If
restraint or seclusion is included in subsection (A)(1)(d)(xxiii), the specific
restraints or conditions of seclusion that may be used because of the
resident's inappropriate behavior;
xxvi. A description of the resident or
resident's representative's participation in the comprehensive
assessment;
xxvii. The name and
title of the interdisciplinary team members who participated in the resident's
comprehensive assessment;
xxviii.
Potential for rehabilitation, including the resident's strengths and specific
developmental or behavioral health needs; and
xxix. Potential for discharge;
e. Is signed and dated by the
qualified intellectual disabilities professional who conducts or coordinates
the comprehensive assessment or review; and
f. Is used to determine or update the
resident's acuity;
2. If
the condition in subsection (A)(1)(d)(v) is answered in the affirmative during
the comprehensive assessment or review, a behavioral health professional
reviews a resident's comprehensive assessment or review and individual program
plan to ensure that the resident's needs for behavioral care are being
met;
3. A new comprehensive
assessment is not required for a resident who is hospitalized and readmitted to
an ICF/IID unless a physician, an individual designated by the physician, a
qualified intellectual disabilities professional, or a registered nurse
determines the resident has a significant change in condition; and
4. A resident's comprehensive assessment is
reviewed at least once every three months after the date of the current
comprehensive assessment and if there is a significant change in the resident's
condition by:
a. A qualified intellectual
disabilities professional; and
b.
If the resident has a nursing care plan or medical care plan, a registered
nurse.
B. An
administrator shall ensure that an individual program plan for a resident:
1. Is developed, documented, and implemented
for the resident within seven calendar days after completing the resident's
comprehensive assessment required in subsection (A)(1);
2. Includes the acuity of the
resident;
3. Is reviewed at least
annually by the interdisciplinary team required in subsection (A)(1)(a) and
revised based on any change to the resident's comprehensive assessment;
and
4. Ensures that a resident is
provided rehabilitation services and other physical health services or
behavioral care that:
a. Address any medical
condition or behavioral care issue identified in the resident's comprehensive
assessment, and
b. Assist the
resident in maintaining the resident's highest practicable well-being according
to the resident's comprehensive assessment.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
A. An administrator shall ensure that:
1. A comprehensive assessment of a resident:
a. Is conducted or coordinated by a qualified intellectual disabilities professional , in collaboration with an interdisciplinary team that includes:
i. The resident's attending physician or designee;
ii. A registered nurse;
iii. If the resident is receiving medications as part of active treatment , a pharmacist; and
iv. Personnel members qualified to provide each type of rehabilitation services identified in a placement evaluation or the initial assessment required in R9-10-507(3) ;
b. Is completed for the resident within 30 calendar days after the resident's admission to an ICF/IID;
c. Is updated:
i. No later than 12 months after the date of the resident's last comprehensive assessment, and
ii. When the resident experiences a significant change;
d. Includes the following information for the resident:
i. Identifying information;
ii. An evaluation of the resident's hearing, speech, and vision;
iii. An evaluation of the resident's ability to understand and recall information;
iv. An evaluation of the resident's mental status;
v. Whether the resident demonstrates inappropriate behavior ;
vi. Preferences for customary routine and activities;
vii. An evaluation of the resident's ability to perform activities of daily living;
viii. Need for a mobility device;
ix. An evaluation of the resident's ability to control the resident's bladder and bowels;
x. Any diagnosis that impacts rehabilitation services or other physical health services or behavioral care that the resident may require;
xi. Any medical conditions that impact the resident's functional status, quality of life, or need for nursing services;
xii. An evaluation of the resident's ability to maintain adequate nutrition and hydration;
xiii. An evaluation of the resident's oral and dental status;
xiv. An evaluation of the condition of the resident's skin;
xv. Identification of any medication or treatment administered to the resident during a seven-day calendar period that includes the time the comprehensive assessment was conducted;
xvi. Identification of any treatment or medication ordered for the resident;
xvii. Identification of interventions that may support the resident towards independence;
xviii. Identification of any assistive devices needed by the resident;
xix. Identification of the active treatment needed by the resident, including active treatment not provided by the ICF/IID;
xx. Identification of measurable goals and behavioral objective for the active treatment , in priority order, with time limits for attainment;
xxi. Identification of the methods, schedule, and strategies to accomplish the goals in subsection (A)(1)(d)(xviii), including the personnel member responsible;
xxii. Evaluation procedures for determining if the methods and strategies in subsection (A)(1)(d)(xix) are working, including the type of data required and frequency of collection;
xxiii. Whether any restraints have been used for the resident during a seven-day calendar period that includes the time the comprehensive assessment was conducted;
xxiv. If the resident demonstrates inappropriate behavior , as reported according to subsection (A)(1)(d)(v), identification of the methods, schedule, and strategies for replacement of the inappropriate behavior with appropriate behavioral expressions, including the hierarchy for use;
xxv. If restraint or seclusion is included in subsection (A)(1)(d)(xxiv), the specific restraints or conditions of seclusion that may be used because of the resident's inappropriate behavior ;
xxvi. A description of the resident or resident's representative 's participation in the comprehensive assessment;
xxvii. The name and title of the interdisciplinary team members who participated in the resident's comprehensive assessment;
xxviii. Potential for rehabilitation, including the resident's strengths and specific developmental or behavioral health needs; and
xxix. Potential for discharge;
e. Is signed and dated by the qualified intellectual disabilities professional who conducts or coordinates the comprehensive assessment or review; and
f. Is used to determine or update the resident's acuity ;
2. If any of the conditions in subsection (A)(1)(d)(v) are answered in the affirmative during the comprehensive assessment or review, a behavioral health professional reviews a resident's comprehensive assessment or review and individual program plan to ensure that the resident's needs for behavioral care are being met;
3. A new comprehensive assessment is not required for a resident who is hospitalized and readmitted to an ICF/IID unless a physician, an individual designated by the physician, a qualified intellectual disabilities professional , or a registered nurse determines the resident has a significant change in condition; and
4. A resident's comprehensive assessment is reviewed at least once every three months after the date of the current comprehensive assessment and if there is a significant change in the resident's condition by:
a. A qualified intellectual disabilities professional ; and
b. If the resident has a nursing care plan or medical care plan , a registered nurse.
B. An administrator shall ensure that an individual program plan for a resident:
1. Is developed, documented, and implemented for the resident within seven calendar days after completing the resident's comprehensive assessment required in subsection (A)(1);
2. Includes the acuity of the resident;
3. Is reviewed at least annually by the interdisciplinary team required in subsection (A)(1)(a) and revised based on any change to the resident's comprehensive assessment; and
4. Ensures that a resident is provided rehabilitation services and other physical health services or behavioral care that:
a. Address any medical condition or behavioral care issue identified in the resident's comprehensive assessment, and
b. Assist the resident in maintaining the resident's highest practicable well-being according to the resident's comprehensive assessment.