CHAPTER 2600. PERSONAL CARE HOMES

§ 2600.1. Purpose.

 (a)  The purpose of this chapter is to protect the health, safety and well-being of personal care home residents.

 (a)  This chapter applies to personal care homes as defined in this chapter, and contains the minimum requirements that shall be met to obtain a license to operate a personal care home.

 (a)  The Department will annually conduct at least one onsite unannounced inspection of each personal care home.

 (b)  A license will be issued to the legal entity by the Department if, after an investigation by an authorized agent of the Department, the requirements for a license are met.

 The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

   ADL—Activities of daily living—The term includes eating, drinking, ambulating, transferring in and out of a bed or chair, toileting, bladder and bowel management, personal hygiene, securing health care, managing health care, self-administering medication and proper turning and positioning in a bed or chair.

   Abuse—The occurrence of one or more of the following acts:

     (i)   The infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain or mental anguish.

     (ii)   The willful deprivation by the personal care home or its staff persons of goods or services which are necessary to maintain physical or mental health.

     (iii)   Sexual harassment, rape or abuse, as defined in 23 Pa.C.S. Chapter 61 (relating to protection from abuse).

     (iv)   Exploitation by an act or a course of conduct, including misrepresentation or failure to obtain informed consent which results in monetary, personal or other benefit, gain or profit for the perpetrator, or monetary or personal loss to the resident.

     (v)   Neglect of the resident, which results in physical harm, pain or mental anguish.

     (vi)   Abandonment or desertion by the personal care home or its staff persons.

   Adult—An individual who is 18 years of age or older.

   Ancillary staff person—An individual who provides services for the residents other than activities of daily living.

   Agent—An individual authorized by the Department to enter, visit, inspect or conduct an investigation of a personal care home.

   Appropriate assessment agency—An organization serving adults who are older or adults with disabilities, such as a county mental health/mental retardation agency, a drug and alcohol agency, an area agency on aging or another human service agency or an individual in an occupation maintaining contact with adults who are older and adults with disabilities, such as medicine, nursing or rehabilitative therapies.

   CAM—Complementary and alternative medications—Practices, substances and ideas used to prevent or treat illness or promote health and well-being outside the realm of modern conventional medicine. Alternative medicine is used alone or instead of conventional medicine. Complementary medicine is used along with or in addition to conventional medicine.

   CPR—Cardiopulmonary resuscitation.

   Commercial boarding home—A type of residential living facility providing only food and shelter, or other services normally provided by a hotel, for payment, for individuals who require no services beyond food, shelter and other services usually found in hotel or apartment rental.

   Complaint—A written or oral criticism, dispute or objection presented by or on behalf of a resident to the Department regarding the care, operations or management of a personal care home.

   Day—Calendar day.

   Dementia—A clinical syndrome characterized by a decline of long duration in mental function in an alert individual. Symptoms of dementia may include memory loss, personality change, chronic wandering and the loss or diminishing of other cognitive abilities, such as learning ability, judgment, comprehension, attention and orientation to time and place and to oneself.

   Department—The Department of Public Welfare of the Commonwealth.

   Designated person—An individual who may be chosen by the resident and documented in the resident’s record, to be notified in case of an emergency, termination of service, personal care home closure or other situations as indicated by the resident or as required by this chapter. A designated person may be the resident’s legal representative or an advocate.

   Designee—A staff person authorized in writing to act in the administrator’s absence.

   Direct care staff person—A staff person who directly assists residents with activities of daily living, and instrumental activities of daily living and provides services or is otherwise responsible for the health, safety and well-being of the residents.

   Emergency medical plan—A plan that ensures immediate and direct access to medical care and treatment for serious injury or illness, or both.

   Financial management—

     (i)   A personal care service provided whenever the administrator serves as representative payee or as a guardian or power of attorney assigned prior to December 21, 1988, for a resident, or when a resident requests and receives assistance in budgeting and spending of the personal needs allowance.

     (ii)   The term does not include solely storing funds in a safe place as a convenience for a resident.

   Fire safety expert—A member of a local fire department, fire protection engineer, Commonwealth-certified fire protection instructor, college instructor in fire science, county or Commonwealth fire school, volunteer trained and certified by a county or Commonwealth fire school, an insurance company loss control representative, Department of Labor and Industry building code inspector or construction code official.

   IADL—Instrumental activities of daily living—The term includes the following activities when done on behalf of a resident:

     (i)   Doing laundry.

     (ii)   Shopping.

     (iii)   Securing and using transportation.

     (iv)   Managing finances.

     (v)   Using a telephone.

     (vi)   Making and keeping appointments.

     (vii)   Caring for personal possessions.

     (viii)   Writing correspondence.

     (ix)   Engaging in social and leisure activities.

     (x)   Using a prosthetic device.

     (xi)   Obtaining and keeping clean, seasonal clothing.

   Legal entity—A person, society, corporation, governing authority or partnership legally responsible for the administration and operation of a personal care home.

   License—A certificate of compliance issued by the Department permitting the operation of a personal care home, at a given location, for a specific period of time, for a specified capacity, according to Chapter 20 (relating to licensure or approval of facilities and agencies).

   Long-term care ombudsman—A representative of the Office of the State Long-Term Care Ombudsman in the Department of Aging who investigates and seeks to resolve complaints made by or on behalf of individuals who are 60 years of age or older who are consumers of long-term care services. These complaints may relate to action, inaction or decisions of providers of long-term care services, of public agencies, of social service agencies or their representatives, which may adversely affect the health, safety, well-being or rights of these consumers.

   Mobile resident—

     (i)   A resident who is physically and mentally capable of vacating the personal care home on the resident’s own power or with limited physical or oral assistance in the case of an emergency, including the capability to ascend or descend stairs if present on the exit path.

       (A)   Physical assistance means assistance in getting to one’s feet or into a wheelchair, walker or prosthetic device.

       (B)   Oral assistance means giving instructions to assist the resident in vacating the personal care home.

     (ii)   The term includes an individual who is able to effectively operate an ambulation device required for moving from one place to another, and able to understand and carry out instructions for vacating the personal care home.

   Neglect—The failure of a personal care home or its staff persons to provide goods or services essential to avoid a clear and serious threat to the physical or mental health of a resident. The failure or omission to provide the care, supervision and services that the personal care home has voluntarily, or by contract, agreed to provide and that are necessary to maintain the resident’s health, safety and well-being, including personal care services, food, clothing, medicine, shelter, supervision and medical services. Neglect may be repeated conduct or a single incident.

   OTC—Over the counter or nonprescription.

   Personal care home or home—

     (i)   A premise in which food, shelter and personal assistance or supervision are provided for a period exceeding 24 hours, for four or more adults who are not relatives of the operator, who do not require the services in or of a licensed long-term care facility, but who do require assistance or supervision in activities of daily living or instrumental activities of daily living.

     (ii)   The term includes a premise that has held or presently holds itself out as a personal care home and provides food and shelter to four or more adults who need personal care services, but who are not receiving the services.

   Personal care home administrator or administrator—An individual who is charged with the general administration of a personal care home, whether the individual has an ownership interest in the personal care home, and whether functions and duties are shared with other individuals.

   Personal care services—Assistance or supervision in ADL or IADL, or both.

   Premises—The grounds and buildings on the same grounds, used for providing personal care services.

   Protective services unit—The local area agency on aging unit designated by the Department of Aging to investigate allegations of abuse of adults who are 60 years of age or older and assess the need for protective interventions.

   Referral agent—An agency or individual who arranges for or assists, or both, with placement of a resident into a personal care home.

   Relative—A spouse, parent, child, stepparent, stepchild, grandparent, grandchild, brother, sister, half-brother, half-sister, aunt, uncle, niece or nephew.

   Resident—An individual, unrelated to the legal entity, who resides in a personal care home, and who requires personal care services, but who does not require the level of care provided by a hospital or long-term care facility.

   Resident with mobility needs—An individual who is unable to move from one location to another, has difficulty in understanding and carrying out instructions without the continued full assistance of other individuals or is incapable of independently operating an ambulation device, such as a wheelchair, prosthesis, walker or cane to exit a building.

   Restraint—A manual, chemical or mechanical device used to limit or restrict the movement or normal function of an individual or a portion of the individual’s body.

   SSI—Supplemental Security Income.

   Secretary—The Secretary of the Department.

   Staff person—An individual who works for the personal care home for compensation either on payroll or under contract.

   Support plan—A written document that describes for each resident the resident’s care, service or treatment needs based on the assessment of the resident, and when the care, service or treatment will be provided, and by whom.

   Volunteer—

     (i)   An individual who, of his own free will, and without monetary compensation, provides direct care services for residents in the personal care home.

     (ii)   The term does not include visitors or individuals who provide nondirect services or entertainment on an occasional basis.

   Definition Meets Statutory Requirements

 (a)  The administrator or a designee shall provide, upon request, immediate access to the home, the residents and records to:

   (1)  Agents of the Department.

   (2)  Representatives of the area agency on aging.

   (3)  Representatives of the Long-Term Care Ombudsman Program.

   (4)  Representatives of the protection and advocacy system for individuals with disabilities designated under the Protection and Advocacy for Individual Rights Program of the Vocational Rehabilitation and Rehabilitation Services Act (29 U.S.C.A. §  794e), the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C.A. § §  10801—10851) and the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C.A. § §  15041—15043).

 (b)  The administrator or a designee shall permit community service organizations and representatives of community legal services programs to have access to the home during visitation hours or by appointment for the purpose of assisting or informing the residents of the availability of services and assistance. A resident or a resident’s designated person may decline the services of the community service organization or the community legal service program.

GENERAL REQUIREMENTS

§ 2600.11. Procedural requirements for licensure or approval of personal care homes.

 (a)  Except for §  20.32 (relating to announced inspections), the requirements in Chapter 20 (relating to licensure or approval of facilities and agencies) apply to personal care homes.

 (b)  Before a home is initially licensed and permitted to open, operate or admit residents, it will be inspected by the Department and found to be in compliance with applicable laws and regulations. The Department will reinspect newly licensed homes within 3 months of the date of initial licensure.

 (c)  After the Department determines that a home meets the requirements for a license, the Department’s issuance or renewal of a license to a home is contingent upon receipt by the Department of an application fee based on the number of beds in the home, as follows:

   (1)  0-20 beds—$15.

   (2)  21-50 beds—$20.

   (3)  51-100 beds—$30.

 (a)  The maximum capacity is the total number of residents who are permitted to reside in the home at any time. A request to increase the capacity shall be submitted to the Department and other applicable authorities and approved prior to the admission of additional residents. The maximum capacity is limited by physical plant space and other applicable laws and regulations.

 (a)  Prior to issuance of a license, a written fire safety approval from the Department of Labor and Industry, the Department of Health or the appropriate local building authority under the Pennsylvania Construction Code Act (35 P. S. § §  7210.101—7210.1103) is required.

 (b)  If the fire safety approval is withdrawn or restricted, the home shall notify the Department orally immediately, and in writing, within 48 hours of the withdrawal or restriction.

 (c)  If a building is structurally renovated or altered after the initial fire safety approval is issued, the home shall submit the new fire safety approval, or written certification that a new fire safety approval is not required, from the appropriate fire safety authority. This documentation shall be submitted to the Department within 15 days of the completion of the renovation or alteration.

 (a)  The home shall immediately report suspected abuse of a resident served in the home in accordance with the Older Adult Protective Services Act (35 P. S. § §  10225.701—10225.707) and 6 Pa. Code §  15.21—15.27 (relating to reporting suspected abuse) and comply with the requirements regarding restrictions on staff persons.

 (b)  If there is an allegation of abuse of a resident involving a home’s staff person, the home shall immediately develop and implement a plan of supervision or suspend the staff person involved in the alleged incident.

 (c)  The home shall immediately submit to the Department’s personal care home regional office a plan of supervision or notice of suspension of the affected staff person.

 (d)  The home shall immediately notify the resident and the resident’s designated person of a report of suspected abuse or neglect involving the resident.

 (a)  A reportable incident or condition includes the following:

   (1)  The death of a resident.

   (2)  A physical act by a resident to commit suicide.

   (3)  A serious bodily injury or trauma requiring treatment at a hospital or medical facility. This does not include minor injuries such as sprains or minor cuts.

   (4)  A violation of a resident’s rights in § §  2600.41—2600.44 (relating to resident rights).

   (5)  An unexplained absence of a resident for 24 hours or more, or when the support plan so provides, a period of less than 24 hours, or an absence of a resident from a secured dementia care unit.

   (6)  Misuse of a resident’s funds by the home’s staff persons or legal entity.

   (7)  An outbreak of a serious communicable disease as defined in 28 Pa. Code §  27.2 (relating to specific identified reportable diseases, infections and conditions).

   (8)  Food poisoning of residents.

   (9)  A physical or sexual assault by or against a resident.

   (10)  Fire or structural damage to the home.

   (11)  An incident requiring the services of an emergency management agency, fire department or law enforcement agency, except for false alarms.

   (12)  A complaint of resident abuse, suspected resident abuse or referral of a complaint of resident abuse to a local authority.

   (13)  A prescription medication error as defined in §  2600.188 (relating to medication errors.)

   (14)  An emergency in which the procedures under §  2600.107 (relating to emergency preparedness) are implemented.

   (15)  An unscheduled closure of the home or the relocation of the residents.

   (16)  Bankruptcy filed by the legal entity.

   (17)  A criminal conviction against the legal entity, administrator or staff that are subsequent to the reporting on the criminal history checks under §  2600.51 (relating to criminal history checks).

   (18)  A termination notice from a utility.

   (19)  A violation of the health and safety laws listed in §  2600.18 (relating to applicable health and safety laws).

 (b)  The home shall develop and implement written policies and procedures on the prevention, reporting, notification, investigation and management of reportable incidents and conditions.

 (c)  The home shall report the incident or condition to the Department’s personal care home regional office or the personal care home complaint hotline within 24 hours in a manner designated by the Department. Abuse reporting shall also follow the guidelines in §  2600.15 (relating to abuse reporting covered by law).

 (d)  The home shall submit a final report, on a form prescribed by the Department, to the Department’s personal care home regional office immediately following the conclusion of the investigation.

 (e)  If the home’s final report validates the occurrence of the alleged incident or condition, the affected resident and other residents who could potentially be harmed or his designated person shall also be informed immediately following the conclusion of the investigation.

 (f)  The home shall keep a copy of the report of the reportable incident or condition.

 A home shall comply with applicable Federal, State and local laws, ordinances and regulations.

 (a)  A home may submit a written request for a waiver of a specific requirement contained in this chapter. The waiver request must be on a form prescribed by the Department. The Secretary, or the Secretary’s appointee, may grant a waiver of a specific requirement of this chapter if the following conditions are met:

   (1)  There is no jeopardy to the residents.

   (2)  There is an alternative for providing an equivalent level of health, safety and well-being protection of the residents.

   (3)  Residents will benefit from the waiver of the requirement.

 (b)  The scope, definitions, applicability or residents’ rights under this chapter may not be waived.

 (c)  At least 30 days prior to the submission of the completed written waiver request to the Department, the home shall provide a copy of the completed written waiver request to the affected resident and designated person to provide the opportunity to submit comments to the Department. The home shall provide the affected resident and designated person with the name, address and telephone number of the Department staff person to submit comments.

 (d)  The home shall discuss the waiver request with the affected resident and designated person upon the request of the resident or designated person.

 (e)  The home shall notify the affected resident and designated person of the approval or denial of the waiver. A copy of the waiver request and the Department’s written decision shall be posted in a conspicuous and public place within the home.

 (f)  The Department will review waivers annually to determine compliance with the conditions required by the waiver. The Department may revoke the waiver if the conditions required by the waiver are not met.

 (a)  A resident may manage his personal finances unless he has a guardian of his estate.

 (b)  If the home provides assistance with financial management or holds resident funds, the following requirements apply:

   (1)  The home shall keep a record of financial transactions with the resident, including the dates, amounts of deposits, amounts of withdrawals and the current balance.

   (2)  Resident funds shall be disbursed during normal business hours within 24 hours of the resident’s request.

   (3)  The home shall obtain a written receipt from the resident for cash disbursements at the time of disbursement.

   (4)  Resident funds and property shall only be used for the resident’s benefit.

   (5)  Commingling of resident funds and home funds is prohibited.

   (6)  If a home is holding more than $200 for a resident for more than 2 consecutive months, the administrator shall notify the resident and offer assistance in establishing an interest-bearing account in the resident’s name at a local Federally-insured financial institution. This does not include security deposits.

   (7)  The legal entity, administrator and staff persons of the home are prohibited from being assigned power of attorney or guardianship of a resident or a resident’s estate.

   (8)  The home shall give the resident and the resident’s designated person, an itemized account of financial transactions made on the resident’s behalf on a quarterly basis.

   (9)  A copy of the itemized account shall be kept in the resident’s record.

   (10)  The home shall provide the resident the opportunity to review his own financial record upon request during normal business hours.

 The following admission documents shall be completed for each resident:

   (1)  Preadmission screening completed prior to admission on a form specified by the Department.

   (2)  Medical evaluation completed 60 days prior to or 30 days after admission on a form specified by the Department.

   (3)  Personal care home assessment completed within 15 days after admission on a form specified by the Department.

   (4)  Support plan developed and implemented within 30 days after admission.

 (a)  A home shall provide each resident with assistance with ADLs as indicated in the resident’s assessment and support plan.

 A home shall provide the resident with assistance with personal hygiene as indicated in the resident’s assessment and support plan. Personal hygiene includes one or more of the following:

   (1)  Bathing.

   (2)  Oral hygiene.

   (3)  Hair grooming and shampooing.

   (4)  Dressing, undressing and care of clothes.

   (5)  Shaving.

   (6)  Nail care.

   (7)  Foot care.

 (a)  Prior to admission, or within 24 hours after admission, a written resident-home contract between the resident and the home shall be in place. The administrator or a designee shall complete this contract and review and explain its contents to the resident and the resident’s designated person if any, prior to signature.

 (b)  The contract shall be signed by the administrator or a designee, the resident and the payer, if different from the resident, and cosigned by the resident’s designated person if any, if the resident agrees.

 (c)  At a minimum, the contract must specify the following:

   (1)  Each resident shall retain, at a minimum, the current personal needs allowance as the resident’s own funds for personal expenditure. A contract to the contrary is not valid. A personal needs allowance is the amount that a resident shall be permitted to keep for his personal use.

   (2)  A fee schedule that lists the actual amount of allowable resident charges for each of the home’s available services.

   (3)  An explanation of the annual assessment, medical evaluation and support plan requirements and procedures, which shall be followed if either the assessment or the medical evaluation indicates the need of another and more appropriate level of care.

   (4)  The party responsible for payment.

   (5)  The method for payment of charges for long distance telephone calls.

   (6)  The conditions under which refunds will be made, including the refund of admission fees and refunds upon a resident’s death.

   (7)  The financial arrangements if assistance with financial management is to be provided.

   (8)  The home’s rules related to home services, including whether the home permits smoking.

   (9)  The conditions under which the agreement may be terminated including home closure as specified in §  2600.228 (relating to notification of termination).

   (10)  A statement that the resident is entitled to at least 30 days’ advance notice, in writing, of the home’s request to change the contract.

   (11)  A list of personal care services to be provided to the resident based on the outcome of the resident’s support plan, a list of the actual rates that the resident will be periodically charged for food, shelter and services and how, when and by whom payment is to be made.

   (12)  Charges to the resident for holding a bed during hospitalization or other extended absence from the home.

   (13)  Written information on the resident’s rights and complaint procedures as specified in §  2600.41 (relating to notification of rights and complaint procedures).

 (d)  A home may not seek or accept payments from a resident in excess of one-half of any funds received by the resident under the Senior Citizens Rebate and Assistance Act (72 P. S. § §  4751-1—4751-12). If the home will be assisting the resident to manage a portion of the rent rebate, the requirements of §  2600.20 (relating to financial management) may apply. There may be no charge for filling out this paperwork.

 (e)  The resident, or a designated person, has the right to rescind the contract for up to 72 hours after the initial dated signature of the contract and pay only for the services received. Rescission of the contract must be in writing addressed to the home.

 (f)  The home may not require or permit a resident to assign assets to the home in return for a life care contract/guarantee. A life care contract/guarantee is an agreement between the legal entity and the resident that the legal entity will provide care to the resident for the duration of the resident’s life. Continuing care communities that have obtained a Certificate of Authority from the Insurance Department and provide a copy of the certificate to the Department are exempt from this requirement.

 (g)  A copy of the signed admission contract shall be given to the resident and a copy shall be filed in the resident’s record.

 (h)  The service needs addressed in the resident’s support plan shall be available to the resident every day of the year.

 (a)  The home shall establish and implement a quality management plan.

 (b)  The quality management plan shall address the periodic review and evaluation of the following:

   (1)  The reportable incident and condition reporting procedures.

   (2)  Complaint procedures.

   (3)  Staff person training.

   (4)  Licensing violations and plans of correction, if applicable.

   (5)  Resident or family councils, or both, if applicable.

 (a)  If a home agrees to admit a resident eligible for SSI benefits, the home’s charges for actual rent and other services may not exceed the SSI resident’s actual current monthly income reduced by the current personal needs allowance.

 (b)  The administrator or staff persons may not include funds received as lump sum awards, gifts or inheritances, gains from the sale of property, or retroactive government benefits when calculating payment of rent for an SSI recipient or for a resident eligible for SSI benefits.

 (c)  The administrator or staff persons may seek and accept payments from funds received as retroactive awards of SSI benefits, but only to the extent that the retroactive awards cover periods of time during which the resident actually resided in the home and for which full payment has not been received.

 (d)  The administrator shall provide each resident who is a recipient of SSI, at no charge beyond the amount determined in subsection (a), the following items or services as needed:

   (1)  Necessary personal hygiene items, such as a comb, toothbrush, toothpaste, soap and shampoo. Cosmetic items are not included.

   (2)  Laundry services for personal laundry, bed linens and towels, but not including dry cleaning or other specialized services.

   (3)  Personal care services.

 (e)  Third-party payments made on behalf of an SSI recipient and paid directly to the home are permitted. These payments may not be used for food, clothing or shelter because to do so would reduce SSI payments. See 20 CFR 416.1100 and 416.1102 (relating to income and SSI eligibility; and what is income). These payments may be used to purchase items or services for the resident that are not food, clothing or shelter.

 (a)  If, after the home gives notice of discharge or transfer in accordance with §  2600.228(b) (relating to notification of termination), and the resident moves out of the home before the 30 days are over, the home shall give the resident a refund equal to the previously paid charges for rent and personal care services for the remainder of the 30-day time period. The refund shall be issued within 30-days of discharge or transfer. The resident’s personal needs allowance shall be refunded within 2 business days of discharge or transfer.

 (b)  After a resident gives notice of the intent to leave in accordance with §  2600.228(b) and if the resident moves out of the home before the expiration of the required 30 days, the resident owes the home the charges for rent and personal care services for the entire length of the 30-day time period for which payment has not been made.

 (c)  If no notice is required, as set forth in subsection (d), the resident shall be required to pay only for the nights spent in the home.

 (d)  If the home does not require a written notice prior to a resident’s departure, the administrator shall refund the remainder of previously paid charges to the resident within 30 days of the date the resident moved from the home.

 (e)  In the event of a death of a resident under 60 years of age, the administrator shall refund the remainder of previously paid charges to the resident’s estate within 30 days from the date the room is cleared of the resident’s personal property. In the event of a death of a resident 60 years of age and older, the home shall provide a refund in accordance with the Elder Care Payment Restitution Act (35 P. S. § §  10226.101—10226.107). The home shall keep documentation of the refund in the resident’s record.

 (f)  Within 30 days of either the termination of service by the home or the resident’s leaving the home, the resident shall receive an itemized written account of the resident’s funds, including notification of funds still owed the home by the resident or a refund owed the resident by the home. Refunds shall be made within 30 days of discharge.

 Hospice care and services that are licensed by the Department of Health as a hospice may be provided in a personal care home.

RESIDENT RIGHTS

§ 2600.41. Notification of rights and complaint procedures.

 (a)  Upon admission, each resident and, if applicable, the resident’s designated person, shall be informed of resident rights and the right to lodge complaints without intimidation, retaliation, or threats of retaliation of the home or its staff persons against the reporter. Retaliation includes discharge or transfer from the home.

 (b)  Notification of rights and complaint procedures shall be communicated in an easily understood manner and in a language understood by or mode of communication used by the resident and, if applicable, the resident’s designated person.

 (c)  The Department’s poster of the list of resident’s rights shall be posted in a conspicuous and public place in the home.

 (d)  A copy of the resident’s rights and complaint procedures shall be given to the resident and, if applicable, the resident’s designated person upon admission.

 (e)  A statement signed by the resident and, if applicable, the resident’s designated person acknowledging receipt of a copy of the information specified in subsection (d), or documentation of efforts made to obtain signature, shall be kept in the resident’s record.

 (a)  A resident may not be discriminated against because of race, color, religious creed, disability, handicap, ancestry, sexual orientation, national origin, age or sex.

 (b)  A resident may not be neglected, intimidated, physically or verbally abused, mistreated, subjected to corporal punishment or disciplined in any way.

 (c)  A resident shall be treated with dignity and respect.

 (d)  A resident shall be informed of the rules of the home and given 30 days’ written notice prior to the effective date of a new home rule.

 (e)  A resident shall have access to a telephone in the home to make calls in privacy. Nontoll calls shall be without charge to the resident.

 (f)  A resident has the right to receive and send mail.

   (1)  Outgoing mail may not be opened or read by staff persons unless the resident requests.

   (2)  Incoming mail may not be opened or read by staff persons unless upon the request of the resident or the resident’s designated person.

 (g)  A resident has the right to communicate privately with and access the local ombudsman.

 (h)  A resident has the right to practice the religion or faith of the resident’s choice, or not to practice any religion or faith.

 (i)  A resident shall receive assistance in accessing health services.

 (j)  A resident shall receive assistance in obtaining and keeping clean, seasonal clothing. A resident’s clothing may not be shared with other residents.

 (k)  A resident and the resident’s designated person, and other individuals upon the resident’s written approval shall have the right to access, review and request corrections to the resident’s record.

 (l)  A resident has the right to furnish his room and purchase, receive, use and retain personal clothing and possessions.

 (m)  A resident has the right to leave and return to the home at times consistent with the home rules and the resident’s support plan.

 (n)  A resident has the right to relocate and to request and receive assistance, from the home, in relocating to another facility. The assistance shall include helping the resident get information about living arrangements, making telephone calls and transferring records.

 (o)  A resident has the right to freely associate, organize and communicate with others privately.

 (p)  A resident shall be free from restraints.

 (q)  A resident shall be compensated in accordance with State and Federal labor laws for labor performed on behalf of the home. Residents may voluntarily and without coercion perform tasks related directly to the resident’s personal space or common areas of the home.

 (r)  A resident has the right to receive visitors for a minimum of 12 hours daily, 7 days per week.

 (s)  A resident has the right to privacy of self and possessions. Privacy shall be provided to the resident during bathing, dressing, changing and medical procedures.

 (t)  A resident has the right to file complaints with any individual or agency and recommend changes in policies, home rules and services of the home without intimidation, retaliation or threat of discharge.

 (u)  A resident has the right to remain in the home, as long as it is operating with a license, except as specified in §  2600.228 (relating to notification of termination).

 (v)  A resident has the right to receive services contracted for in the resident-home contract.

 (w)  A resident has the right to use both the home’s procedures and external procedures, if any, to appeal involuntary discharge.

 (x)  A resident has the right to a system to safeguard a resident’s money and property.

 (y)  A resident has the right to choose his own health care providers without limitation by the home. This includes the right to select the resident’s own pharmacist provided that the pharmacy agrees to supply medications in a way that is compatible with the home’s system for handling and assisting with the self-administration of resident medications.

 (a)  A resident may not be deprived of his rights.

 (b)  A resident’s rights may not be used as a reward or sanction.

 (a)  Prior to admission, the home shall inform the resident and the resident’s designated person of the right to file and the procedure for filing a complaint with the Department’s personal care home regional office, local ombudsman or protective services unit in the area agency on aging, Pennsylvania Protection & Advocacy, Inc. or law enforcement agency.

 (b)  The home shall permit and respond to oral and written complaints from any source regarding an alleged violation of resident rights, quality of care or other matter without retaliation or the threat of retaliation.

 (c)  If a resident indicates that he wishes to make a written complaint, but needs assistance in reducing the complaint to writing, the home shall assist the resident in writing the complaint.

 (d)  The home shall ensure investigation and resolution of complaints. The home shall designate the staff person responsible for receiving complaints and determining the outcome of the complaint.

 (e)  Within 2 business days after the submission of a written complaint, a status report shall be provided by the home to the complainant. If the resident is not the complainant, the resident and the resident’s designated person shall receive the status report unless contraindicated by the support plan. The status report must indicate the steps that the home is taking to investigate and address the complaint.

 (f)  Within 7 days after the submission of a written complaint, the home shall give the complainant and, if applicable, the designated person, a written decision explaining the home’s investigation findings and the action the home plans to take to resolve the complaint. If the resident is not the complainant, the affected resident shall receive a copy of the decision unless contraindicated by the support plan. If the home’s investigation validates the complaint allegations, a resident who could potentially be harmed or his designated person shall receive a copy of the decision, with the name of the affected resident removed, unless contraindicated by the support plan.

 (g)  The telephone number of the Department’s personal care home regional office, the local ombudsman or protective services unit in the area agency on aging, Pennsylvania Protection & Advocacy, Inc., the local law enforcement agency, the Commonwealth Information Center and the personal care home complaint hotline shall be posted in large print in a conspicuous and public place in the home.

   This section cited in 55 Pa. Code §  2600.16 (relating to reportable incidents and conditions).

STAFFING

§ 2600.51. Criminal history checks.

 Criminal history checks and hiring policies shall be in accordance with the Older Adult Protective Services Act (35 P. S. § §  10225.101—10225.5102) and 6 Pa. Code Chapter 15 (relating to protective services for older adults).

 (a)  The administrator shall have one of the following qualifications:

   (1)  A license as a registered nurse from the Department of State.

   (2)  An associate’s degree or 60 credit hours from an accredited college or university.

   (3)  A license as a licensed practical nurse from the Department of State and 1 year of work experience in a related field.

   (4)  A license as a nursing home administrator from the Department of State.

   (5)  For a home serving 8 or fewer residents, a general education development diploma or high school diploma and 2 years direct care or administrative experience in the human services field.

 (b)  The administrator shall be 21 years of age or older.

 (c)  The administrator shall be responsible for the administration and management of the home, including the health, safety and well-being of the residents, implementation of policies and procedures and compliance with this chapter.

 (d)  The administrator shall have the ability to provide personal care services or to supervise or direct the work to provide personal care services.

 (e)  The administrator shall have knowledge of this chapter.

 (f)  The administrator shall have the ability to comply with applicable laws, rules and regulations, including this chapter.

 (g)  The administrator shall have the ability to maintain or supervise the maintenance of financial and other records.

 (h)  The administrator shall be free from a medical condition, including drug or alcohol addiction, that would limit the administrator from performing duties with reasonable skill and safety.

   Credentialing Requirements within Scope of Statute

   Even though authorizing statute only requires a demonstration of competency in specified areas, where authorizing statute gave the Department of Public Welfare specific power to promulgate regulations to provide the ‘‘standards for knowledge, education or training’’ necessary to be qualified as a personal care administrator, Department’s regulation requiring credentialing did not exceed scope of the authorizing statute. Northern Area v. Department of Public Welfare, 899 A.2d 1182, 1190 (Pa. Cmwlth. 2006).

   Personal Care Standards Priority

 (a)  Direct care staff persons shall have the following qualifications:

   (1)  Be 18 years of age or older, except as permitted in subsection (b).

   (2)  Have a high school diploma, GED or active registry status on the Pennsylvania nurse aide registry.

   (3)  Be free from a medical condition, including drug or alcohol addiction, that would limit direct care staff persons from providing necessary personal care services with reasonable skill and safety.

 (b)  An individual who is 16 or 17 years of age may be a staff person at a home, but may not perform tasks related to medication administration. A staff person who is 16 or 17 years of age may not perform tasks related to incontinence care, bathing or dressing of residents without supervision.

 (c)  A volunteer who performs ADLs shall meet the staff person qualifications and training requirements specified in this chapter.

 (d)  A resident receiving personal care services who voluntarily performs tasks in the home will not be considered a volunteer under this chapter.

 (a)  The staff qualification requirements for administrator and direct care staff persons do not apply to individuals hired or promoted to the specified positions prior to December 1, 2004.

 (a)  At all times one or more residents are present in the home a direct care staff person who is 21 years of age or older and who serves as the designee, shall be present in the home. The direct care staff person may be the administrator if the administrator provides direct care services.

 (b)  Direct care staff persons shall be available to provide at least 1 hour per day of personal care services to each mobile resident.

 (c)  Direct care staff persons shall be available to provide at least 2 hours per day of personal care services to each resident who has mobility needs.

 (d)  At least 75% of the personal care service hours specified in subsections (b) and (c) shall be available during waking hours.

 (a)  If a home serves 16 or more residents, all direct care staff persons on duty in the home shall be awake at all times one or more residents are present in the home.

 (a)  For a home with multiple buildings on the same premises that are within 300 feet of one another, the direct care staff person required in §  2600.57 (relating to direct care staffing) shall be on the premises and available by a two-way communication system at all times one, two or three mobile residents are present in the home.

 (a)  Staffing shall be provided to meet the needs of the residents as specified in the resident’s assessment and support plan.

 (b)  The Department may require additional staffing as necessary to protect the health, safety and well-being of the residents. Requirements for additional staffing will be based on the resident’s assessment and support plan, the design and construction of the home and the operation and management of the home.

 (a)  At least one staff person for every 50 residents who is trained in first aid and certified in obstructed airway techniques and CPR shall be present in the home at all times.

 (b)  Current training in first aid and certification in obstructed airway techniques and CPR shall be provided by an individual certified as a trainer by a hospital or other recognized health care organization.

 (c)  Licensed, certified and registered medical personnel meet the qualifications in subsection (a) and are exempt from the training requirements in subsections (a) and (b).

 (a)  Prior to initial employment as an administrator, a candidate shall successfully complete the following:

   (1)  An orientation program approved and administered by the Department.

   (2)  A 100-hour standardized Department-approved administrator training course.

   (3)  A Department-approved competency-based training test with a passing score.

   (4)  Paragraphs (1), (2) and (3) do not apply to an administrator hired or promoted prior to October 24, 2005.

 (b)  The standardized Department-approved administrator training course specified in subsection (a)(2) shall include the following:

   (1)  Fire prevention and emergency preparedness.

   (2)  Medication procedures, medication effects and side effects, universal precautions and personal hygiene.

   (3)  Certification in CPR and obstructed airway techniques and training in first aid.

   (4)  Personal care services.

   (5)  Local, State and Federal laws and regulations pertaining to the operation of a home.

   (6)  Nutrition, food handling and sanitation.

   (7)  Recreation.

   (8)  Care for residents with mental illness.

   (9)  Resident rights.

   (10)  Care for residents with dementia, cognitive impairments and other special needs.

   (11)  Care for residents with mental retardation.

   (12)  Community resources, social services and activities in the community.

   (13)  Staff supervision and staff person training including developing orientation and training guidelines for staff.

   (14)  Budgeting, financial recordkeeping and resident records including:

     (i)   Writing, completing and implementing initial assessments, annual assessments and support plans.

     (ii)   Resident-home contracts.

   (15)  Gerontology.

   (16)  Abuse and neglect prevention and reporting.

   (17)  Cultural competency.

   (18)  The requirements of this chapter.

 (c)  An administrator shall have at least 24 hours of annual training relating to the job duties. The Department-approved administrator training course specified in subsection (a) fulfills the annual training requirement for the first year.

 (d)  Annual training shall be provided by Department-approved training sources listed in the Department’s personal care home training resource directory or by an accredited college or university.

 (e)  An administrator who has successfully completed the training in subsections (a)—(d) shall provide written verification of successful completion to the Department’s personal care home regional office.

 (f)  A record of training including the individual trained, date, source, content, length of each course and copies of certificates received shall be kept.

 (a)  Prior to or during the first work day, all direct care staff persons including ancillary staff persons, substitute personnel and volunteers shall have an orientation in general fire safety and emergency preparedness that includes the following:

   (1)  Evacuation procedures.

   (2)  Staff duties and responsibilities during fire drills, as well as during emergency evacuation, transportation and at an emergency location if applicable.

   (3)  The designated meeting place outside the building or within the fire-safe area in the event of an actual fire.

   (4)  Smoking safety procedures, the home’s smoking policy and location of smoking areas, if applicable.

   (5)  The location and use of fire extinguishers.

   (6)  Smoke detectors and fire alarms.

   (7)  Telephone use and notification of emergency services.

 (b)  Within 40 scheduled working hours, direct care staff persons, ancillary staff persons, substitute personnel and volunteers shall have an orientation that includes the following:

   (1)  Resident rights.

   (2)  Emergency medical plan.

   (3)  Mandatory reporting of abuse and neglect under the Older Adult Protective Services Act (35 P. S. § §  10225.101—10225.5102).

   (4)  Reporting of reportable incidents and conditions.

 (c)  Ancillary staff persons shall have a general orientation to their specific job functions as it relates to their position prior to working in that capacity.

 (d)  Direct care staff persons hired after April 24, 2006, may not provide unsupervised ADL services until completion of the following:

   (1)  Training that includes a demonstration of job duties, followed by supervised practice.

   (2)  Successful completion and passing the Department-approved direct care training course and passing of the competency test.

   (3)  Initial direct care staff person training to include the following:

     (i)   Safe management techniques.

     (ii)   ADLs and IADLs.

     (iii)   Personal hygiene.

     (iv)   Care of residents with dementia, mental illness, cognitive impairments, mental retardation and other mental disabilities.

     (v)   The normal aging-cognitive, psychological and functional abilities of individuals who are older.

     (vi)   Implementation of the initial assessment, annual assessment and support plan.

     (vii)   Nutrition, food handling and sanitation.

     (viii)   Recreation, socialization, community resources, social services and activities in the community.

     (ix)   Gerontology.

     (x)   Staff person supervision, if applicable.

     (xi)   Care and needs of residents with special emphasis on the residents being served in the home.

     (xii)   Safety management and hazard prevention.

     (xiii)   Universal precautions.

     (xiv)   The requirements of this chapter.

     (xv)   Infection control.

     (xvi)   Care for individuals with mobility needs, such as prevention of decubitus ulcers, incontinence, malnutrition and dehydration, if applicable to the residents served in the home.

 (e)  Direct care staff persons shall have at least 12 hours of annual training relating to their job duties.

   (1)  Staff person orientation shall be included in the 12 hours of training for the first year of employment.

   (2)  On the job training for direct care staff persons may count for 6 out of the 12 training hours required annually.

 (f)  Training topics for the annual training for direct care staff persons shall include the following:

   (1)  Medication self-administration training.

   (2)  Instruction on meeting the needs of the residents as described in the preadmission screening form, assessment tool, medical evaluation and support plan.

   (3)  Care for residents with dementia and cognitive impairments.

   (4)  Infection control and general principles of cleanliness and hygiene and areas associated with immobility, such as prevention of decubitus ulcers, incontinence, malnutrition and dehydration.

   (5)  Personal care service needs of the resident.

   (6)  Safe management techniques

   (7)  Care for residents with mental illness or mental retardation, or both, if the population is served in the home.

 (g)  Direct care staff persons, ancillary staff persons, substitute personnel and regularly scheduled volunteers shall be trained annually in the following areas:

   (1)  Fire safety completed by a fire safety expert or by a staff person trained by a fire safety expert. Videos prepared by a fire safety expert are acceptable for the training if accompanied by an onsite staff person trained by a fire safety expert.

   (2)  Emergency preparedness procedures and recognition and response to crises and emergency situations.

   (3)  Resident rights.

   (4)  The Older Adult Protective Services Act (35 P. S. § §  10225.101—10225.5102).

   (5)  Falls and accident prevention.

   (6)  New population groups that are being served at the home that were not previously served, if applicable.

 (h)  If a staff person has completed the required initial direct care staff person training within the past year as a direct care staff person at another home, the requirement for initial direct care staff person training in this section does not apply if the staff person provides written verification of completion of the training.

 (i)  A record of training including the staff person trained, date, source, content, length of each course and copies of any certificates received, shall be kept.

 (a)  A staff training plan shall be developed annually.

 (b)  The plan must include training aimed at improving the knowledge and skills of the home’s direct care staff persons in carrying out their job responsibilities. The staff training plan must include the following:

   (1)  The name, position and duties of each direct care staff person.

   (2)  The required training courses for each staff person.

   (3)  The dates, times and locations of the scheduled training for each staff person for the upcoming year.

 (a)  An institution and the course of study offered by an educational institution, association, professional society or organization for the purpose of educating and qualifying applicants for certification as personal care home administrators shall be registered and approved by the Department prior to offering the course of study.

 (b)  An application for registration of an institution and approval of a course of study shall be submitted to the Department on a form provided by the Department and include the following information:

   (1)  The full name, address, telephone number, facsimile number and electronic mail address of the prospective training provider, each instructor and the program coordinator.

   (2)  The training objectives, instructional materials, content and teaching methods to be used and the number of clock hours.

   (3)  The recommended class size.

   (4)  The attendance certification method.

   (5)  Proof that each course instructor is certified by the Department to conduct administrator training.

   (6)  The subject that each instructor will teach and documentation of the instructor’s academic credentials, instructional experience and work experience to teach the subject.

   (7)  The location of the training site, which shall accommodate the number of anticipated participants.

 (c)  A request to amend a Department-approved course of study shall be submitted for the Department’s review and approval prior to implementation of a change in the course of study.

 (a)  Training for personal care home administrators provided by an individual who is not certified as an instructor by the Department will not be considered valid training.

 (b)  To receive the Department’s certification as an approved instructor for personal care home administrators, an instructor shall successfully complete the Department’s train-the-trainer course. The train-the-trainer course is designed to provide and reinforce basic training skills, including the roles and responsibilities of the trainer, training methodology, the use of instructional aids and recordkeeping.

 (c)  An instructor shall demonstrate competent instructional skills and knowledge of the applicable topic and meet the Department’s qualifications for the topic being taught.

 (d)  An instructor is subject to unannounced monitoring by the Department while conducting training.

 (e)  The Department will establish approval standards that include the following:

   (1)  The mechanism to measure the quality of the training being offered.

   (2)  The criteria for selecting and evaluating instructors, subject matter and instructional materials.

   (3)  The criteria for evaluating requests to amend a course.

   (4)  The criteria for evaluating the effectiveness of each course.

   (5)  The instructor qualifications for each subject being taught.

 (f)  The Department may withdraw approval under the following conditions:

   (1)  Failure to follow the approved curriculum.

   (2)  Lack of trainer competency.

   (3)  A pattern of violations of this chapter by a home conducting the training.

PHYSICAL SITE

§ 2600.81. Physical accommodations and equipment.

 (a)  The home shall provide or arrange for physical site accommodations and equipment necessary to meet the health and safety needs of a resident with a disability and to allow safe movement within the home and exiting from the home.

 (a)  Poisonous materials shall be stored in their original, labeled containers.

 (b)  Poisonous materials shall be stored separately from food, food preparation surfaces and dining surfaces.

 (a)  The indoor temperature, in areas used by the residents, must be at least 70°F when residents are present in the home.

 (a)  Sanitary conditions shall be maintained.

 (b)  There may be no evidence of infestation of insects or rodents in the home.

 (c)  Trash shall be removed from the premises at least once a week.

 (d)  Trash in kitchens and bathrooms shall be kept in covered trash receptacles that prevent the penetration of insects and rodents.

 (e)  Trash outside the home shall be kept in covered receptacles that prevent the penetration of insects and rodents.

 (a)  All areas of the home that are used by the resident shall be ventilated. Ventilation includes an operable window, air conditioner, fan or mechanical ventilation that ensures airflow.

 (a)  Floors, walls, ceilings, windows, doors and other surfaces must be clean, in good repair and free of hazards.

 (a)  The home must have hot and cold water under pressure in each bathroom, kitchen and laundry area to accommodate the needs of the residents in the home.

 (b)  Hot water temperature in areas accessible to the resident may not exceed 120°F.

 (c)  A home that is not connected to a public water system shall have a coliform water test at least every 3 months, by a Department of Environmental Protection-certified laboratory, stating that the water is below maximum contaminant levels. A public water system is a system that provides water to the public for human consumption, which has at least 15 service connections or regularly serves an average of at least 25 individuals daily at least 60 days out of the year.

 (d)  If the water is found to be above maximum contaminant levels, the home shall conduct remediation activity to reduce the level of contaminants to below the maximum contaminant level. During remediation activity, an alternate source of drinking water shall be provided to the residents.

 (a)  The home shall have a working, noncoin operated, landline telephone that is accessible in emergencies and accessible to individuals with disabilities.

 (a)  Each ramp, interior stairway and outside steps must have a well-secured handrail.

 (a)  Interior and exterior doors that open directly into a stairway and are used for exit doors, resident areas and fire exits must have a landing, which is a minimum of 3 feet by 3 feet.

 (a)  The home shall have a first aid kit that includes nonporous disposable gloves, antiseptic, adhesive bandages, gauze pads, thermometer, adhesive tape, scissors, breathing shield, eye coverings and tweezers.

 (b)  Staff persons shall know the location of the first aid kit.

 (c)  The first aid kit must be in a location that is easily accessible to staff persons.

 (a)  The home shall have indoor activity space for activities such as reading, recreation and group activities.

 (b)  The home shall have at least one furnished living room or lounge area for residents, their families and visitors. The combined living room or lounge areas shall accommodate all residents at one time. These rooms or areas shall contain tables, chairs and lighting to accommodate the residents, their families and visitors.

 (a)  The exterior of the building and the building grounds or yard must be in good repair and free of hazards.

 (a)  Each single bedroom must have at least 80 square feet of floor space measured wall to wall, including space occupied by furniture.

 (b)  Each shared bedroom must have at least 60 square feet of floor space per resident measured wall to wall, including space occupied by furniture.

 (c)  Each bedroom for one or more residents with a mobility need must have at least 100 square feet per resident, to allow for easy passage between beds and other furniture, and for comfortable use of a resident’s assistive devices, including wheelchairs, walkers, special furniture or oxygen equipment. This requirement does not apply if there is a medical order from the attending physician that states the resident can maneuver without the necessity of the additional space. A legal entity with a personal care home license for the home as of October 24, 2005, that has one or more bedrooms serving a resident with physical mobility needs as of October 24, 2005, shall be exempt from the requirements specified in this subsection for the bedroom. If a bedroom is exempt in accordance with this subsection, additional square footage may be required sufficient to accommodate the assistive devices of the resident with mobility needs.

 (d)  No more than four residents may share a bedroom.

 (e)  Ceiling height in each bedroom must be an average of at least 7 feet.

 (f)  Each bedroom must have a window with direct exposure to natural light.

 (g)  A resident’s bedroom shall be used only by the occupying resident and not for activities common to other residents.

 (h)  A resident shall be able to access toilet, hand washing and bathing facilities without having to pass through another resident’s bedroom.

 (i)  A resident shall have access to his bedroom at all times.

 (j)  Each resident shall have the following in the bedroom:

   (1)  A bed with a solid foundation and fire retardant mattress that is in good repair, clean and supports the resident. A legal entity with a personal care home license for the home as of October 24, 2005, shall be exempt from the requirement for a fire retardant mattress.

   (2)  A chair for each resident that meets the resident’s needs.

   (3)  Pillows, bed linens and blankets that are clean and in good repair.

   (4)  A storage area for clothing that includes a chest of drawers and a closet or wardrobe space with clothing racks or shelves accessible to the resident.

   (5)  A bedside table or a shelf.

   (6)  A mirror.

   (7)  An operable lamp or other source of lighting that can be turned on at bedside.

   (8)  If a resident shares a bedroom with other residents, the items specified in paragraphs (4)—(7) may be shared with one other resident.

 (k)  Cots and portable beds are prohibited.

 (l)  Bunk beds or other raised beds that require residents to climb steps or ladders to get into or out of bed are prohibited.

 (m)  A bedroom may not be used as a exit from or used as a passageway to another part of the home unless in an emergency situation.

 (n)  A resident may not be required to share a bedroom with an individual of the opposite sex.

 (o)  The bedrooms must have walls, floors and ceilings, which are finished, clean and in good repair.

 (p)  There must be doors on the bedrooms.

 (q)  Space for storage of personal property shall be provided in a dry, protected area.

 (r)  There must be drapes, shades, curtains, blinds or shutters on the bedroom windows. Window coverings must be clean, in good repair, provide privacy and cover the entire window when drawn.

 (a)  There shall be at least one functioning flush toilet for every six or fewer users, including residents, staff persons and household members.

 (b)  There shall be at least one sink and wall mirror for every six or fewer users including residents, staff persons and household members.

 (c)  There shall be at least one bathtub or shower for every ten or fewer users, including residents, staff persons and household members.

 (d)  Toilet and bath areas must have grab bars, hand rails or assist bars. Bathtubs and showers must have slip-resistant surfaces.

 (e)  Privacy shall be provided for toilets, showers and bathtubs by partitions or doors.

 (f)  An individual towel, washcloth and soap shall be provided for each resident.

 (g)  Individual toiletry items including toothpaste, toothbrush, shampoo, deodorant, comb and hairbrush shall be made available to residents who are not recipients of SSI. If the home charges for these items, the charges shall be indicated in the resident-home contract. Availability of toiletry items for residents who are recipients of SSI is specified in §  2600.27(d)(1) (relating to SSI recipients).

 (h)  Toilet paper shall be provided for every toilet.

 (i)  A dispenser with soap shall be provided within reach of each bathroom sink. Bar soap is not permitted unless there is a separate bar clearly labeled for each resident who shares a bathroom.

 (j)  Towels and washcloths shall be in the possession of the resident in the resident’s living space unless the resident has access to the home’s linen supply.

 (k)  Use of a common towel is prohibited.

 (l)  Shelves or hooks for the resident’s towel and clothing shall be provided.

 (a)  A home shall have access on the grounds to an operable kitchen with a refrigerator, sink, stove, oven, cooking equipment and cabinets or shelves for storage. If the kitchen is not in the home, the home shall have a kitchen area with a refrigerator, cooking equipment, a sink and food storage space.

 (b)  Kitchen surfaces must be of a nonporous material and cleaned and sanitized after each meal.

 (c)  Food shall be protected from contamination while being stored, prepared, transported and served.

 (d)  Food shall be stored off the floor.

 (e)  Food served and returned from an individual’s plate may not be served again or used in the preparation of other dishes. Leftover food shall be labeled and dated.

 (f)  Food requiring refrigeration shall be stored at or below 40°F. Frozen food shall be kept at or below 0°F. Thermometers are required in refrigerators and freezers.

 (g)  Food shall be stored in closed or sealed containers.

 (h)  Food shall be thawed either in the refrigerator, microwave, under cool water or as part of the cooking process.

 (i)  Outdated or spoiled food or dented cans may not be used.

 (a)  A dining room area shall be equipped with tables and chairs and able to accommodate the maximum number of residents scheduled for meals at any one time.

 (b)  Dishes, glassware and utensils shall be provided for eating, drinking, preparing and serving food. These utensils must be clean, and free of chips and cracks. Plastic and paper plates, utensils and cups for meals may not be used on a regular basis.

 (c)  Condiments shall be available at the dining table.

 (d)  Adaptive eating equipment or utensils shall be available, if needed, to assist residents in eating at the table.

 (e)  Breakfast, midday and evening meals shall be served to residents in a dining room except in the following situations:

   (1)  Service in the resident’s room shall be available at no additional charge when the resident is unable to come to the dining room due to illness.

 (a)  Laundry service for bed linens, towels and personal clothing shall be provided by the home, at no additional charge, to residents who are recipients of or eligible applicants for SSI benefits. Laundry service does not include dry cleaning.

 (b)  Laundry service for bed linens, towels and personal clothing for the residents who are not recipients of SSI shall be provided by the home unless otherwise indicated in the resident-home contract.

 (c)  The supply of bed linens and towels shall be sufficient to ensure a complete change of bed linen and towels at least once per week.

 (d)  Bed linens and towels shall be changed at least once every week and more often as needed to maintain sanitary conditions.

 (e)  Clean linens and towels shall be stored in an area separate from soiled linen and clothing.

 (f)  Measures shall be implemented to ensure that residents’ clothing are not lost or misplaced during laundering or cleaning. The resident’s clean clothing shall be returned to the resident within 24 hours after laundering.

 If a home operates a swimming area, the following requirements apply:

   (1)  Swimming areas shall be operated in accordance with applicable laws and regulations.

 (a)  The administrator shall have a copy and be familiar with the emergency preparedness plan for the municipality in which the home is located.

 (b)  The home shall have written emergency procedures that include the following:

   (1)  Contact information for each resident’s designated person.

   (2)  The home’s plan to provide the emergency medical information for each resident that ensures confidentiality.

   (3)  Contact telephone numbers of local and State emergency management agencies and local resources for housing and emergency care of residents.

   (4)  Means of transportation in the event that relocation is required.

   (5)  Duties and responsibilities of staff persons during evacuation, transportation and at the emergency location. These duties and responsibilities shall be specific to each resident’s emergency needs.

   (6)  Alternate means of meeting resident needs in the event of a utility outage.

 (c)  The home shall maintain at least a 3-day supply of nonperishable food and drinking water for residents.

 (d)  The written emergency procedures shall be reviewed, updated and submitted annually to the local emergency management agency.

 Firearms, weapons and ammunition shall be permitted on the licensed premises of a home only when the following conditions are met:

   (1)  Firearms and weapons shall be contained in a locked cabinet located in a place other than the residents’ room or in a common living area.

   (2)  Ammunition shall be contained in a locked area separate from firearms and weapons, and located in a place other than the residents’ room or in a common living area.

   (3)  The key to the locked cabinet containing the firearms, weapons and ammunition shall be in the possession of the administrator or a designee.

   (4)  The administrator or a designee shall be the only individual permitted to open the locked cabinet containing the firearms and weapons and the locked area containing the ammunition.

 (a)  The home rules shall specify whether the home permits pets on the premises.

 (b)  Cats and dogs present at the home shall have a current rabies vaccination. A current certificate of rabies vaccination from a licensed veterinarian shall be kept.

 (c)  Pets that are accessible to the residents shall be in good health and nonaggressive to the residents.

 (d)  If a home has additional charges for pets, the charges shall be included in the resident-home contract.

FIRE SAFETY

§ 2600.121. Unobstructed egress.

 (a)  Stairways, hallways, doorways, passageways and egress routes from rooms and from the building must be unlocked and unobstructed.