W. Va. Code R. § 64-14-3 - State Administrative Procedures
3.1. General Licensing Provisions.
3.1.1. No person, partnership, association,
or corporation may operate an assisted living residence in the state of West
Virginia without first obtaining a license pursuant to W. Va. Code
§16-5D-6 and this rule.
3.1.2. A license is valid only for the person
and for the location named in the application and on the license, and is not
transferable.
3.1.2.a. The assisted living
residence shall notify the Secretary in writing 30 days prior to a change in
name or physical address of the program and request an application for a
licensure amendment.
3.1.2.b. If
the ownership of an assisted living residence changes, the new owner shall
notify the Secretary within 10 days and immediately apply for a new license.
The new owner's application for a license is valid for three months from the
date the application is received by the Secretary.
3.1.3. Each assisted living residence
location shall be licensed separately, regardless of whether the assisted
living residence is operated under the same business name or management as
another assisted living residence.
3.1.4. The words "clinic," "hospital,"
"nursing home," "residential care community" or any other words that suggest a
type of facility other than an assisted living residence shall not be used in
the name or the advertising of the residence.
3.1.5. The licensee is responsible for
compliance with this rule, W. Va. Code §§16-5D-1, et seq.,
and other relevant federal and state laws.
3.1.6. The Secretary may issue an initial or
a renewal license for a period not to exceed one year, except if an applicant
submits an application for renewal of a license currently in effect in
accordance with this rule and W. Va. Code §§16-5D-1, et seq.,
together with the required fee described in W. Va. Code §16-5D-6(i). The
Office of Health Facility Licensure and Certification shall post the annual
consumer price index increases on its website located at:
http://ohflac.wvdhhr.org/. The
license shall continue in effect until:
3.1.6.a. One year following the expiration
date of the license;
3.1.6.b. The
date of a revocation or suspension of the license pursuant to this rule and W.
Va. Code §§16-5D-1, et seq.,
or
3.1.6.c. The date of issuance of
a new license, whichever date occurs first.
3.2. Initial Licensure Application.
3.2.1. An applicant for initial licensure
shall submit a completed application to the Office of Health Facility Licensure
and Certification, along with a non-refundable fee, and any additional
information the Secretary may require.
3.2.2. The applicant shall have his or her
signature on the application and have accompanying forms notarized. The
signature shall serve as a release for obtaining references, credit, and other
background information.
3.2.3. The
applicant shall pay the cost of the initial licensure inspections, pursuant to
W. Va. Code §16-5D-6(i) before
the issuance of an initial license.
3.2.4. The applicant shall provide to the
Secretary a preliminary operating plan that includes a proposed budget with
projected monthly income, a balance sheet showing all expenses and income on
forms provided by the Secretary, including but not limited to, reimbursement of
the owners, lease payment, and monthly rates charged.
3.2.5. The applicant shall submit the
application and fee at least 90 days prior to the date proposed for the
commencement of operations.
3.2.6.
Except as specified in subsection 3.5. of this rule, and after a satisfactory
inspection to ensure compliance with this rule, the Secretary shall issue an
initial license.
3.3.
License Renewal.
3.3.1. The licensee shall
submit an application for renewal of a license to the Secretary at least 90
days before the expiration date of the current license.
3.3.2. Except as specified in subsection 3.4.
of this rule, the Secretary shall issue a renewal license to an assisted living
residence when the following conditions are met:
3.3.2.a. The residence is found to be in
substantial compliance with this rule;
3.3.2.b. The applicant has submitted a
completed application and all requested financial information; and
3.3.2.c. The residence has met all Class I
standards of this rule.
3.4. Non-Issuance of Initial or Renewal
License.
3.4.1. The Secretary may refuse to
issue or may revoke either an initial or a renewal license if he or she finds
evidence of the following:
3.4.1.a. The
applicant or licensee has a lack of financial stability to operate, such as
insufficient capital, delinquent accounts, checks returned because of
insufficient funds, and nonpayment of taxes, utility expenses, and other
essential services;
3.4.1.b. The
applicant or licensee has a personal history that has:
3.4.1.b.1. Evidence of abuse, fraud, or
substantial and repeated violations of applicable laws and rules in the
operation of any health care facility or service organization, or in the care
of dependent persons; or
3.4.1.b.2.
An ineligible employment fitness determination from the West Virginia Clearance
for Access: Registry and Employment Screening unit of the Department of Health
and Human Resources and not received a variance;
3.4.1.c. The applicant or licensee has been
denied a license or has had a license to operate a health care facility revoked
in West Virginia or any other jurisdiction during the previous five
years;
3.4.1.d. The applicant or
licensee has a record of noncompliance with lawful orders of the department or
other licensing or certification agency for any jurisdiction in which the
applicant has operated, directed, or participated in the operation of a health
care facility;
3.4.1.e. The
applicant, licensee, or person in charge of the residence has refused the
Secretary entry and access to residents and records for an inspection or
survey;
3.4.1.f. The applicant or
licensee has converted the property of a resident for his or her own use, or
has secured property or a bequest of property, from a resident by undue
influence;
3.4.1.g. The applicant,
licensee, or administrator has submitted false information to the Secretary
during the licensure process or during the course of an inspection or survey of
the residence;
3.4.1.h. The
applicant or licensee has moved residents of the assisted living residence to
another location owned or operated by the applicant or licensee without prior
approval of the location by the Secretary;
3.4.1.i. The applicant or licensee has built
or renovated a residence without complying with the requirements of subsection
3.12. of this rule;
3.4.1.j. The
applicant or licensee has failed to correct a violation of any Class I
standard, or has failed to be in substantial compliance with the requirements
of this rule; or
3.4.1.k. The
residence has failed to receive a recommendation for licensure from the state
fire marshal.
3.4.2.
Before refusing to issue an initial or renewal license or revoking a license,
the commissioner shall consider all available evidence at the time of the
determination, including:
3.4.2.a. The history
of the residence and the applicant or licensee in complying with this rule;
and
3.4.2.b. Notices of violations
that have been issued to the residence and the applicant or licensee, findings
of surveys and inspections, and any evidence provided by the applicant or
licensee, residents, law enforcement officials, and other interested
individuals.
3.5. Provisional License.
3.5.1. The Secretary may issue a provisional
license when:
3.5.1.a. The licensee has failed
to meet all the requirements of W. Va. Code §§16-5D-1, et seq.,
but care given in the residence is adequate for the residents' needs and the
licensee has demonstrated improvement and evidences potential for substantial
compliance during the term of the provisional license; or
3.5.1.b. All requirements for renewal of a
license are not met prior to the expiration of the previously issued
license.
3.5.2. When the
Secretary issues a provisional license, he or she shall determine the period of
time for which the license is valid, but the period shall not exceed one
year.
3.5.3. The Secretary shall
not renew a provisional license.
3.5.4. If the Secretary denies a provisional
license or a provisional license expires, the applicant for a license shall
meet the requirements for an initial license, including the cost of an initial
application fee and inspections as determined by the Secretary.
3.5.5. The Secretary shall not issue a
provisional license when the residence is in violation of any Class I standard
or has a record of noncompliance with this rule.
3.6. Inspections.
3.6.1. The Secretary shall inspect an
assisted living residence as necessary to carry out the intent of W. Va. Code
§§16-5D-1, et seq.,
and this rule.
3.6.2. The Secretary
shall conduct at least one inspection of a residence prior to issuing an
initial license, but shall not conduct an inspection until after the following
conditions are met:
3.6.2.a. The application
and application fee have been received and the application has been determined
to be complete; and
3.6.2.b. All
requested documentation has verified the readiness of the residence for an
inspection.
3.6.3. The
Secretary shall conduct periodic unannounced inspections to determine the
residence's continued compliance with this rule.
3.6.4. The Secretary has the right to enter a
home or structure that is believed to be operating or maintained as an assisted
living residence without a license, to conduct inspections without prior
notice. If the operator or person in charge of the suspected assisted living
residence or licensed assisted living residence refuses entry, the Secretary
may apply to the circuit court in which the suspected residence is located or
the circuit court of Kanawha County for a warrant to authorize an inspection or
to compel attendance to the premises of the suspected residence.
3.7. Complaint Investigation.
3.7.1. Any person may register a complaint
with the Secretary alleging a violation of this rule by an assisted living
residence or an individual alleged to be unlawfully operating an assisted
living residence, by stating the complaint and identifying the name and address
of the residence.
3.7.2. The
Secretary may conduct investigations as necessary to determine the validity of
the complaint and shall notify the licensee of the residence or the individual
alleged to be operating an illegal assisted living residence of the complaint
at the time of the completion of the investigation.
3.7.3. The Secretary shall notify the
licensee or the operator of an unlicensed residence of any corrective action
required, the time frame for completion of the corrective action, and any
disciplinary action to be taken by the Secretary.
3.7.4. Except as provided in subdivision
3.7.5. of this rule, the Secretary shall keep the names of a complainant and of
any resident named in the complaint confidential and shall not disclose the
names to the public without written or verbal permission of the complainant and
the resident, and his or her legal representative, if any, unless there is an
immediate risk to the resident. The Secretary shall delete the name of a
complainant or resident named in a complaint or information contained in the
report of an investigation that could reasonably identify the complainant or
any resident. Information contained in any report of abuse, neglect, or an
emergency situation made in accordance with W. Va. Code §9-6-8 shall be confidential and
shall not be released except as provided in that article.
3.7.5. If a complaint becomes the subject of
a judicial proceeding, nothing in this rule is construed to prohibit the
disclosure of information that would otherwise be disclosed in judicial
proceedings.
3.7.6. Any type of
discriminatory treatment of a resident or employee by whom or on whose behalf a
complaint has been submitted to the Secretary, within 120 days of the filing of
the complaint or the institution of the action, raises a rebuttal presumption
that the discriminatory treatment action was taken by the licensee in
retaliation for the complaint or action.
3.8. Waivers.
3.8.1. The Secretary may waive a requirement
of this rule if after thorough investigation, he or she determines that the
waiver will not adversely affect the health, safety, welfare, or rights of the
residents.
3.8.2. The licensee
shall submit a written request for a waiver and the request shall:
3.8.2.a. Specify the specific requirement in
this rule for which the waiver is requested;
3.8.2.b. Specify the time period for which
the waiver is requested;
3.8.2.c.
Include specific and detailed reasons for the request;
3.8.2.d. Explain why the specific requirement
cannot be complied with; and
3.8.2.e. Document that there will be no
adverse effect on the residents' health, safety, welfare, or rights if the
waiver is granted.
3.9. Reports and Records.
3.9.1. The Secretary shall prepare a written
report of any inspection made pursuant to this rule within 15 days of the
completion of the inspection and shall mail or electronically transmit to the
licensee or administrator, as applicable, a statement of deficiencies that
contains the violations of this rule.
3.9.2. The names of residents shall be kept
confidential and shall not be disclosed without the resident's written
permission or by order of court of record. Nothing contained in this rule shall
be construed to require or permit the public disclosure of confidential
medical, social, personal, or financial records of any resident. Before
releasing a report or record judged public information, the Secretary shall
delete any information regarding a resident that would reasonably permit
identification of the resident.
3.9.3. The Secretary shall provide
notification to the social security administration if a residence demonstrates
continued noncompliance with this rule.
3.10. Plans of Correction.
3.10.1. The licensee of an assisted living
residence, found on the basis of inspection or other investigation to have
violations of requirements in this rule, shall develop, sign, and date a plan
of correction, and submit it to the Secretary within 15 working days of receipt
of the statement of deficiencies.
3.10.2. The Secretary shall require immediate
correction of violations identified as constituting immediate and serious
threats to the health or safety of a resident or employee.
3.10.3. For deficiencies other than those
constituting immediate and serious threats, the licensee is expected to comply
with the rule within 60 days of the inspection, unless the Secretary waives
this requirement and allows more time to correct certain types of
deficiencies.
3.10.4. The plan of
correction shall specify:
3.10.4.a. The
violations to be corrected;
3.10.4.b. The actions taken or proposed to
correct the violations and procedures to prevent their recurrence;
and
3.10.4.c. The dates on which
each violation is corrected or by which each will be corrected, that allows the
shortest possible time to reasonably correct each specific violation.
3.10.5. The Secretary shall notify
the licensee in writing of his or her approval, suggested modifications, or
rejection of the plan of correction, or any part thereof.
3.10.6. If modifying or rejecting the
proposed plan of correction, the Secretary shall state the reasons for the
modification or rejection.
3.10.7.
If the Secretary rejects the plan of correction, the licensee has up to 15
working days from the receipt of the Secretary's determination to submit a
revised plan.
3.10.8. The Secretary
may conduct a follow-up, on-site inspection to verify the correction of any
violations identified during an inspection or any other
investigation.
3.11.
Classification of Standards.
In accordance with W. Va. Code §16-5D-5(c), the classification for each standard indicates the most serious classification that may be assigned to that standard.
3.12. New Construction, Additions,
Renovations, and Alterations.
3.12.1. The
requirements of this section apply in total to all proposed assisted living
residences. Existing residences proposing additions and renovations shall meet
only the requirements determined applicable by the Secretary to the new or
renovated portion.
3.12.2. For new
construction, additions, renovations, or alterations to existing residences,
and before construction begins on a proposed residence, the applicant shall
submit a complete set of drawings and specifications for the architectural,
structural, and mechanical work as follows:
3.12.2.a. For a large assisted living
residence, an architect or engineer registered in West Virginia shall prepare,
sign, and seal the submitted set of construction drawings and specifications
and submit one set of these documents to the Secretary and the state fire
marshal for approval. The registered architect or engineer shall also inspect
the new residence, or the additions and renovations, during the construction
phase.
3.12.2.b. For a small
assisted living residence, the applicant shall submit a set of drawings and
specifications that are drawn to scale and fully dimensioned, to the Secretary
and state fire marshal for approval.
3.12.2.c. Unless substantial construction is
started within one year of the date of approval of final drawings, the
architect, engineer, or applicant, whichever applicable, shall obtain written
permission from the Secretary that the plan approval for construction is still
valid and in compliance with this rule.
3.12.3. The Secretary shall inspect sites for
all proposed residences and sites of additions or renovations to existing
residences, prior to the applicant initiating construction. Sites shall:
3.12.3.a. Have adequate drainage to divert
surface water and be located in an area above the 100-year flood
plain;
3.12.3.b. Have a water
supply that is safe and sized to meet all residential needs and requirements of
the sprinkler system and has as its source of water either:
3.12.3.b.1. A public water system that
complies with the Bureau for Public Health rule, "Public Water Systems," W. Va.
Code R. §§64-3-1, et seq.;
or
3.12.3.c. Have
precautions to assure the residents' safety, if located near railroads, freight
yards, traffic arteries, or airports.
3.12.4. A qualified soils engineer shall
review any questionable soil conditions, high walls, or surface water runoff,
and if conditions require, perform earth core borings and laboratory tests. If
engineered soil is installed or other soil tests conducted, the applicant shall
provide the Secretary with copies of the soil test reports.
3.12.5. The Secretary shall inspect and
approve all construction, new additions, renovations, or alterations prior to
the admission of new or additional residents. When construction is
substantially complete, the applicant shall submit a substantial completion
form signed by all the parties involved and a completed inspection request form
to the Secretary.
3.12.6. An
assisted living residence shall pay a $400 fee plus the actual costs of the
initial inspections made by the Secretary prior to issuing a license. The cost
shall be billed to the assisted living residence or owner(s) by the Secretary
after the inspections and must be paid in full before a license is
issued.
3.12.7. The applicant shall
submit plans for the addition, removal, or modification of equipment that is
permanently affixed to the building or that may otherwise involve or
necessitate new construction, alterations, or additions to the residence to the
Secretary for approval.
3.12.8.
Other changes involving equipment, that may or may not require physical changes
in the residence, but that may relate to other standards and requirements of
this rule may require the Secretary's approval. The applicant shall request
approval in advance from the Secretary regarding a specific change or
rearrangement. Areas in which changes are likely to require approval include,
but are not limited to, the kitchen, the laundry, and the heating
equipment.
3.12.9. The applicant
shall submit the plan of operation to the Secretary for approval, and the
Secretary shall determine the licensed bed capacity. For an increase in the
licensed bed capacity, the licensee shall obtain prior written approval of the
Secretary.
3.12.10. The residence
shall comply with the state fire commission, the International Building Code,
2003 Ed.
3.12.11. The residence
shall comply with the Fire Commission rule, "Fire Code," W. Va. Code R.
§§87-1-1, et
seq.
3.12.12. The
residence shall comply with the Americans with Disabilities Act (ADA) and the
American National Standards Institute (ANSI) codes.
3.12.13. The residence shall comply with
local building or zoning codes if they require standards higher than those
required by this rule.
3.12.14. The
applicant shall have evidence of compliance signed by local fire, building, and
zoning officials available onsite for review.
3.12.15. The residence shall have an
all-weather, hard surface road that connects directly to a highway.
3.12.16. The residence shall have parking
areas with:
3.12.16.a. Clean, solid, earth
beds; a compacted stone base; and a hard surface, all-weather finish coat; free
of broken, gaped, or uneven paving, with slopes that permit good drainage;
and
3.12.16.b. Adequate spaces for
all staff on duty and a minimum of one parking space for each five
beds.
3.12.17. The
residence shall have hard, slip-resistant surface concrete walks at all exits
that connect to the main walk or parking area, that are a minimum of 36 inches
wide.
3.12.18. The applicant shall
ensure that low windows, open porches, changes in floor level, and similar
potential hazards are designed so that the danger of accidents is minimized,
and that dangerous areas on the site are safeguarded.
3.12.19. The applicant shall store oxygen
outdoors in an enclosure protected from the weather or in a well-ventilated
oxygen storage room of approved construction, with doors locked to prevent
unauthorized entry.
3.12.20. The
residence shall have a call system that is audible to staff who are on duty and
that can be accessed from each bed and other areas as necessary for the safety
of residents. Electronic call systems may be required based on the size of the
residence, the staffing patterns, and the configuration of the
building.
3.12.21. Bedrooms shall:
3.12.21.a. Have at least 100 square feet of
floor area per resident in single occupancy rooms, and 90 square feet of floor
area per resident in double occupancy rooms;
3.12.21.b. Have an outside exposure through a
vertical transparent window;
3.12.21.c. Not extend below ground level
unless granted written approval by the Secretary; and
3.12.21.d. Not be occupied by more than two
persons.
3.12.22. The
residence's toilet and bathing facilities shall provide the following:
3.12.22.a. A minimum of two bathrooms, each
containing a flushing toilet and hand washing sink, with a mirror over the
sink, at a ratio of no less than one toilet and lavatory for every six
residents;
3.12.22.b. A minimum of
one bathing facility per floor, with a bath tub or shower, equipped with
non-slip surfaces, a flushing toilet, and a hand washing sink, at a ratio of no
less than one bathing facility for every 10 residents;
3.12.22.c. Grab-bars at toilets, tubs, and
showers that are securely mounted to the finished wall with a steel plate or a
two inch by six-inch wood plate backing behind the wall. Grab bar brackets
shall be spaced to support 250 pounds of a concentrated load at any point on
the grab bar; and
3.12.22.d.
Bathroom doors with locking type hardware that swing outward and can be opened
from outside in the event of an emergency.
3.12.23. The residence shall have a dining
area of at least 15 square feet per resident and an area of at least 15 square
feet per resident for leisure space. The dining room may serve as part of the
leisure room, and if combined, a dining and leisure room area shall have a
minimum of 30 square feet per resident.
3.12.24. If the residence provides laundry
services, the laundry room shall have separation between the soiled and clean
laundry, mechanical ventilation in the soiled area, a clean area large enough
for folding linens, and venting to the outside for any electric or gas
dryer.
3.12.25. The residence shall
have at least one service sink per floor for a sanitary means of disposal of
waste water in an area inaccessible to residents.
3.12.26. The residence shall have sewage
disposal in accordance with Bureau for Public Health rules, "Sewer Systems,
Sewage Treatment Systems, and Sewage Tank Cleaners, "W. Va. Code R.
§§64-9-1, et seq.,
and "Sewage Treatment and Collection System Design Standards," W. Va. Code R.
§§64-47-1, et
seq.
Notes
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