Tenn. Comp. R. & Regs. 1200-08-11-.04 - ADMINISTRATION

(1) The licensee shall be at least eighteen (18) years of age, of reputable and responsible character, able to comply with these rules, and must maintain financial resources and income sufficient to provide for the needs of the residents, including their room, board and personal services.
(2) The licensee must designate in writing a capable and responsible person to act on administrative matters and to exercise all the powers and responsibilities of the licensee as set forth in this chapter in the absence of the licensee.
(3) Each home must have an administrator who shall be certified by the board, unless the administrator is currently licensed in Tennessee as a nursing home administrator pursuant to T.C.A. § 63-16-101, et seq.
(4) An applicant for certification as a home for the aged administrator shall meet the following requirements:
(a) Must be at least eighteen (18) years of age and a high school graduate or the holder of a general equivalency diploma.
(b) Must not have been convicted of a criminal offense involving the abuse or intentional neglect of an elderly or vulnerable individual.
(c) Must submit an application, on a form provided by the department, and a fee of one hundred eighty dollars ($180) prior to issuance or renewal of a certificate. All certificates shall expire biennially on June 30, thereafter.
(d) Biennial renewal of certification is required. The renewal application and fee of one hundred eighty dollars ($180) shall be submitted with written proof of attendance, during the period prior to renewal, of at least twenty-four (24) classroom hours of continuing education courses. The initial biennial re-certification expiration date of Home for the Aged administrator candidates who receive their initial administrator certification between the dates of January 1 and June 30 of any year will be extended to two (2) years plus the additional months remaining in the fiscal year. The extension applies only to the first biennial certification period for any such administrator and may only be applied when there are less than six (6) months remaining in the State fiscal year.
(e) Continuing education.
1. The twenty-four (24) classroom hours of required continuing education courses shall include instruction in the following:
(i) State rules and regulations for homes for the aged;
(ii) Health care management;
(iii) Nutrition and food service;
(iv) Financial management; and
(v) Healthy lifestyles.
2. All educational courses must be approved by the board. Courses sponsored by the National Association of Residential Care Facilities and the National Association of Nursing Home Administrators are deemed approved by the board.
3. In order to obtain board approval for educational courses, a copy of the course curriculum must be submitted to the board for approval prior to attending the course.
4. Proof of administrator certification course attendance shall be submitted to the department upon completion of the course.
(5) Infection Control. A Home for the Aged shall have an annual influenza vaccination program which shall include at least:
(a) The offer of influenza vaccination to all staff and independent practitioners at no cost to the person or acceptance of documented evidence of vaccination from another vaccine source or facility. The Home for the Aged will encourage all staff and independent practitioners to obtain an influenza vaccination;
(b) A signed declination statement on record from all who refuse the influenza vaccination for reasons other than medical contraindications (a sample form is available at http://tennessee.gov/health/topic/hcf-provider);
(c) Education of all employees about the following:
1. Flu vaccination,
2. Non-vaccine control measures, and
3. The diagnosis, transmission, and potential impact of influenza;
(d) An annual evaluation of the influenza vaccination program and reasons for non-participation; and
(e) A statement that the requirements to complete vaccinations or declination statements shall be suspended by the administrator in the event of a vaccine shortage as declared by the Commissioner or the Commissioner's designee.
(6) Each home for the aged shall:
(a) Have an identified responsible attendant and a sufficient number of employees to meet the needs of the residents. The responsible attendant must be at least eighteen (18) years of age and able to comply with these rules.
(b) Have a responsible awake attendant on the premises at all times.
(c) Maintain documentation of the checks of the "Registry of Persons who have Abused or Intentionally Neglected Elderly or Vulnerable Individuals" prior to hiring any employee.
(d) Have a written statement of policies and procedures outlining the responsibilities of the licensee to the resident and any obligation of the resident to the facility.
(e) Post whether they have liability insurance, the identity of their primary insurance carrier, and if self-insured, the corporate entity responsible for payment of any claims. It shall be posted on a sign no smaller than eleven inches (11") in width and seventeen inches (17") in height and displayed at the main public entrance.
(f) Keep a written up-to-date log of all residents and produce the log for the local fire department in the event of an emergency.
(g) Maintain written policies and procedures informing the resident of his/her rights and how to register grievances and complaints.
(h) Not allow an owner, responsible attendant, employee or representative thereof to act as a court-appointed guardian, trustee, or conservator for any resident of the facility or any of such resident's property or funds, except as provided by rule 1200-08-11-.10.
(i) Cooperate in the Department's inspections including allowing entry at any hour and providing all required records.
(j) Develop and follow a written policy, plan, procedure, technique or system regarding a subject whenever these rules require that a licensee develop such a plan. A residential home which violates a required policy also violates the rule establishing the requirements.
(k) Not retaliate against or, in any manner, discriminate against any person because of a complaint made in good faith and without malice to the board, the department, Adult Protective Services, the Comptroller of the State Treasury or the Long Term Care Ombudsman Program. A home shall neither retaliate nor discriminate because of information lawfully provided to these authorities, because of a person's cooperation with them or because a person is subpoenaed to testify at a hearing involving one of these authorities.
(l) Allow pets in the home only when they are not a nuisance or do not pose a health hazard.
(m) Comply with all local laws, rules or ordinances, and with this chapter.
(n) The facility shall develop a concise statement of its charity care policies and shall post such statement in a place accessible to the public.
(7) No occupant or employee who has a reportable communicable disease, as stipulated by the department, is permitted to reside or work in a home unless the home has a written protocol approved by the department.
(8) All health care facilities licensed pursuant to T.C.A. § 68-11-201, et seq. shall post the following in the main public entrance:
(a) Contact information including statewide toll-free number of the division of adult protective services, and the number for the local district attorney's office;
(b) A statement that a person of advanced age who may be the victim of abuse, neglect, or exploitation may seek assistance or file a complaint with the division concerning abuse, neglect and exploitation; and
(c) A statement that any person, regardless of age, who may be the victim of domestic violence may call the nationwide domestic violence hotline, with that number printed in boldface type, for immediate assistance and posted on a sign no smaller than eight and one-half inches (8½") in width and eleven inches (11") in height.

Postings of (a) and (b) shall be on a sign no smaller than eleven inches (11") in width and seventeen inches (17") in height.

(9) "No Smoking" signs or the international "No Smoking" symbol, consisting of a pictorial representation of a burning cigarette enclosed in a red circle with a red bar across it, shall be clearly and conspicuously posted at every entrance.
(10) Residents of the facility are exempt from the smoking prohibition. The resident smoking practices shall be governed by the policies and procedures established by the facility. Smoke from such areas shall not infiltrate into areas where smoking is prohibited.


Tenn. Comp. R. & Regs. 1200-08-11-.04
Original rule filed June 21, 1997; effective August 6, 1979. Amendment filed August 16, 1988; effective September 30, 1988. Repeal and new rule filed July 27, 2000; effective October 10, 2000. Amendment filed April 20, 2006; effective July 4, 2006. Amendment filed February 23, 2007; effective May 9, 2007. Amendment filed July 18, 2007; effective October 1, 2007. Amendment filed February 22, 2010; effective May 23, 2010. Amendments filed July 18, 2016; effective 10/16/2016.

Authority: T.C.A. §§ 4-5-202, 4-5-204, 39-17-1803, 39-17-1804, 39-17-1805, 68-11-201, 68-11-202, 68-11-204, 68-11-206, 68-11-209, 68-11-257, 68-11-268 and 71-6-121.

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