Ariz. Admin. Code § R9-10-811 - Medical Records

A. A manager shall ensure that:
1. A medical record is established and maintained for each resident according to A.R.S. Title 12, Chapter 13, Article 7.1;
2. An entry in a resident's medical record is:
a. Only recorded by an individual authorized by policies and procedures to make the entry;
b. Dated, legible, and authenticated; and
c. Not changed to make the initial entry illegible;
3. If a rubber-stamp signature or an electronic signature is used to authenticate an order, the individual whose signature the rubber-stamp signature or electronic signature represents is accountable for the use of the rubber-stamp signature or electronic signature;
4. A resident's medical record is available to an individual:
a. Authorized according to policies and procedures to access the resident's medical record;
5. b. If the individual is not authorized according to policies and procedures, with the written consent of the resident or the resident's representative; or
c. As permitted by law; and
6. 5. A resident's medical record is protected from loss, damage, or unauthorized use.
B. If an assisted living facility maintains residents' medical records electronically, a manager shall ensure that:
1. Safeguards exist to prevent unauthorized access, and
2. The date and time of an entry in a resident's medical record is recorded by the computer's internal clock.
C. A manager shall ensure that a resident's medical record contains:
1. Resident information that includes:
a. The resident's name, and
b. The resident's date of birth;

c. The name and contact information of the resident's representative, if applicable;

2. The names, addresses, and telephone numbers of:
a. The resident's primary care provider;
b. Other persons, such as a home health agency or hospice service agency, involved in the care of the resident; and
c. An individual to be contacted in the event of emergency, significant change in the resident's condition, or termination of residency;
3. If applicable, the name and contact information of the resident's representative and:
a. The document signed by the resident consenting for the resident's representative to act on the resident's behalf; or
b. If the resident's representative:
i. Has a health care power of attorney established under A.R.S. § 36-3221 or a mental health care power of attorney executed under A.R.S. § 36-3282, a copy of the health care power of attorney or mental health care power of attorney; or
ii. Is a legal guardian, a copy of the court order establishing guardianship;
3. 4. The date of acceptance and, if applicable, date of termination of residency;
4. 5. Documentation of the resident's needs required in R9-10-807(B) ;
5. 6. Documentation of general consent and informed consent, if applicable;
6. 7. Except as allowed in R9-10-808(B)(2), documentation of freedom from infectious tuberculosis as required in R9-10-807(A) ;
7. 8. A copy of resident's health care directive, if applicable;
8. 9. The resident's signed residency agreement and any amendments;
9. 10. Resident's service plan and updates;
10. 11. Documentation of assisted living services provided to the resident;
11. 12. A medication order from a medical practitioner for each medication that is administered to the resident or for which the resident receives assistance in the self-administration of the medication;
12. 13. Documentation of medication administered to the resident or for which the resident received assistance in the self-administration of medication that includes:
a. The date and time of administration or assistance;
b. The name, strength, dosage, and route of administration;
c. The name and signature of the individual administering or providing assistance in the self-administration of medication; and
d. An unexpected reaction the resident has to the medication;
13. 14. Documentation of the resident's refusal of a medication, if applicable;
15. If applicable, documentation of any actions taken to control the resident's sudden, intense, or out-of-control behavior to prevent harm to the resident or another individual;
16. If applicable, documentation of a determination by a medical practitioner that evacuation from the assisted living facility during an evacuation drill would cause harm to the resident;
14. 17. Documentation of notification of the resident of the availability of vaccination for influenza and pneumonia, according to A.R.S. § 36-406(1)(d);
15. 18. Documentation of the resident's orientation to exits from the assisted living facility required in R9-10-818(B) ;
16. 19. If a resident is receiving behavioral health services other than behavioral care, documentation of the determination in R9-10-813(3) ;
17. 20. If a resident is receiving behavioral care, documentation of the determination in R9-10-812(3) ;

18. If applicable, documentation that evacuation from the assisted living facility during a drill may cause physical harm to the resident;

19. 21. If applicable, for a resident who is unable to direct self-care, the information required in R9-10-815(F) ;
20. 22. Documentation of any significant change in a resident's behavior, physical, cognitive, or functional condition and the action taken by a manager or caregiver to address the resident's changing needs;
21. 23. Documentation of the notification required in R9-10-803(G) if the resident is incapable of handling financial affairs; and
22. 24. If the resident no longer resides and receives assisted living services from the assisted living facility:
a. A written notice of termination of residency; or
b. If the resident terminated residency, the date the resident terminated residency.

Notes

Ariz. Admin. Code § R9-10-811
Adopted as an emergency effective October 26, 1988, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 88-4). Emergency expired. Readopted without change as an emergency effective January 27, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-1). Emergency expired. Readopted without change as an emergency effective April 27, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-2). Emergency expired. Readopted without change as an emergency effective July 31, 1989, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 89-3). Permanent rules adopted with changes effective October 30, 1989 (Supp. 89-4). Former Section R9-10-811 renumbered to R9-10-814 ; new Section R9-10-811 made by final rulemaking at 9 A.A.R. 319, effective March 31, 2003 (Supp. 03-1). Section repealed; new Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, effective 7/1/2014.

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