55 Pa. Code § 2800.239 - Application to Department
(a) The
legal entity shall submit an application to the Department at least 60 days
prior to the following:
(1) Opening a special
care unit.
(2) Adding a special
care unit to an existing residence.
(3) Increasing the maximum capacity in an
existing unit.
(4) Changing the
locking system, exit doors or floor plan of an existing
unit.
(b) The Department
will inspect and approve the special care unit prior to operation or change.
The requirements of this chapter shall be met prior to operation.
(c) The following documents shall be included
in the application specified in subsection (a):
(1) The name, address and legal entity of the
residence.
(2) The name of the
administrator of the residence.
(3)
The maximum capacity of the residence.
(4) The requested resident population of the
special care unit.
(5) A building
description.
(6) A unit
description.
(7) The type of
locking system.
(8) Policy and
procedures to be implemented for emergency egress and resident
elopement.
(9) A sample of a 2-week
staffing schedule.
(10)
Verification of completion of additional training requirements.
(11) The operational description of the
special care unit locking system of the doors.
(12) The manufacturer's statement regarding
the special care unit locking system.
(13) A written approval or a variance
permitting locked exit doors from the Department of Labor and Industry, the
Department of Health or the appropriate local building authority.
(14) The name of the municipality or 24-hour
monitoring service maintaining the interconnection with the residence's fire
alarm system.
(15) A sample plan of
care and service for the resident addressing the resident's physical, medical,
social, cognitive and safety needs for the residents.
(16) The activity standards.
(17) The complete medical and cognitive
preadmission assessment that is completed upon admission and reviewed and
updated annually.
(18) A consent
form agreeing to the resident's placement in the special care unit, to be
signed by the resident or the resident's designated person.
(19) A written agreement containing full
disclosure of services, admission and discharge criteria, change in condition
policies, services, special programming, costs and fees.
(20) A description of environmental cues
being utilized.
(21) A general
floor plan of the entire residence.
(22) A specific floor plan of the special
care unit, outside enclosed area and exercise
space.
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