The facility shall assure that special care unit policies and procedures are established, implemented by staff and available for review within the facility.  In addition to all applicable policies and procedures for adult care homes, there shall be policies and procedures that address the following:

(1)           the philosophy of the special care unit which includes a statement of mission and objectives regarding the specific population to be served by the unit which shall address, but not be limited to, the following:

(a)           safe, secure, familiar and consistent environment that promotes community integration and minimal use of physical restraints or psychotropic medications;

(b)           a structured but flexible lifestyle through a well developed program of care;

(c)           the facility's policy regarding grouping of residents that takes age, interests, and behaviors into account;

(d)           individualized care plans that stress the maintenance of residents' abilities and promote the highest possible level of physical and mental functioning; and

(e)           methods of behavior management which preserve dignity through design of the physical environment, physical exercise, social activity, appropriate medication administration, proper nutrition and health maintenance;

(2)           the process and criteria for admission to and discharge from the unit;

(3)           the procedures shall include the following to ensure client rights, choice, and service coordination:

(a)           procedures shall specify the responsibility of both the facility and the area program to inform residents of client rights and available choices in treatment options and providers;

(b)           procedures shall specify that an area program shall provide mental health status and diagnostic evaluations and case management; and

(c)           these procedures shall be signed by the facility, the area program and shall be adhered to by any mental health treatment providers providing treatment to residents of the unit to ensure coordination among all parties.  These procedures shall be reviewed and revised, as needed, on an annual basis;

(4)           procedures for safeguarding confidential information and ensuring that that such information is not further disclosed in accordance with G.S. 122C-55(f);

(5)           a description of the special care services offered in the unit;

(6)           resident assessment and care planning, including opportunity for family involvement in care planning, and the implementation of the care plan. The care plan shall include resident involvement, as appropriate, in activities of daily living, participation in psychosocial programs or supported employment, and shall respond to changes in the resident's condition;

(7)           safety measures addressing specific dangers or problems associated with the residents' condition such as aggressive behavior or other behavior management problems;

(8)           staff to resident ratios to meet the needs of the residents;

(9)           staff training based on the special care needs of the residents;

(10)         physical environment and design features that address the needs of the residents;

(11)         activity plans based on personal preferences and needs of the residents;

(12)         opportunity for involvement of families in resident care and the availability of family support programs; and

(13)         additional costs and fees for the special care provided.


History Note:        Authority G.S. 131D-2.16; 131D-4.5; 131D-4.6; 131D-8; 143B-165;

Temporary Adoption Eff. December 1, 1999;

Eff. July 1, 2000.