TITLE 8 SOCIAL SERVICES
CHAPTER 370 OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED
WAIVER PROGRAMS
PART 20 REQUIREMENTS FOR ADULT DAY CARE FACILITIES
8.370.20.1 ISSUING AGENCY: New Mexico Health Care Authority.
[8.370.20.1
NMAC - N, 7/01/2024]
8.370.20.2 SCOPE: These regulations apply to public or private
facilities that provide care, services, and supervision for three or more
non-resident adults for less than 24 hours of any day, and come within the
statutory definition of "health facilities" set out in Subsection D
of Section 24-1-2 of the Public Health
Act, Section 24-1-1 to 24-1-22 NMSA 1978 as amended, and are required to be
licensed by the licensing authority.
[8.370.20.2
NMAC - N, 7/01/2024]
8.370.20.3 STATUTORY AUTHORITY: The regulations set forth herein which govern
the licensing of adult day care facilities have been promulgated pursuant to
the general authority granted under Subsection E of Section 9-8-6 NMSA 1978;
and the authority granted under Subsection D of Section 24-1-2, Subsection I of
Section 24-1-3, and Section 24-1-5 of
the Public Health Act, NMSA 1978, as amended.
Section 9-8-1 et seq. NMSA 1978
establishes the health care authority (authority) as a single, unified
department to administer laws and exercise functions relating to health care
purchasing and regulation.
[8.370.20.3
NMAC - N, 7/01/2024]
8.370.20.4 DURATION: Permanent.
[8.370.20.4
NMAC - N, 7/01/2024]
8.370.20.5 EFFECTIVE DATE: July 1, 2024, unless a different date is
cited at the end of a section.
[8.370.20.5
NMAC - N, 7/01/2024]
8.370.20.6 OBJECTIVE: The purpose of these regulations is to:
A. establish minimum
standards for licensing facilities providing day care to adults, in order to
ensure that participants receive safe and adequate services and that the
health, safety and welfare of participants and employees are protected;
B. direct such
facilities to provide and organize program of services in the community group
setting for the purpose of supporting adult's personal independence, and
promoting their social, physical, and emotional well-being;
C. establish
standards for the construction, maintenance and operation of such facilities;
D. monitor facility
compliance with these regulations through surveys to identify any areas which
could be dangerous or harmful to the health, safety, and welfare of the
participants and staff.
[8.370.20.6
NMAC - N, 7/01/2024]
8.370.20.7 DEFINITIONS: For purposes of these regulations the
following shall apply.
A. "Abuse"
means any single or repeated act of force, violence, harassment, deprivation,
neglect or mental pressure which reasonably could cause physical pain or
injury, or mental anguish or fear.
B. "Adult"
means an individual eighteen years of age or older, and or who otherwise
qualifies as an adult under New Mexico law, and who is elderly, disabled or
handicapped person having impairments which prevents the person from living
independently without supportive services.
C. "Adult day care center"
means a commercial building licensed pursuant to these regulations, where care,
services, and supervision are provided to adults.
D. "Adult day care home"
means a private residence licensed pursuant to these regulations where care,
services and supervision are provided to adults.
E. "Ambulatory"
means a person who is fully mobile and does not need the continuing help of a
person or object for support (except a walking cane).
F. "Applicant" means
the individual who, or organization which, applies for a license. If the applicant is an organization, then the
individual signing the application on behalf of the organization, must have
authority from the organization. The
applicant must be the owner.
G. "Capacity"
means the maximum number of participants allowed to be cared for at any one
time in the facility.
H. "Deficiencies"
means violations of, or failure to comply with, these regulations.
I. "Director"
means the person who is in charge of the day to day operation and program of an
adult day care center.
J. "Dropin"
means an adult who attends the facility on an occasional or unscheduled basis.
K. "Facility"
means an private residence or a commercial building licensed pursuant to these
regulations where care, services, and supervision are provided to adults.
L. "Governing body"
means the individual, agency, group or corporation appointed, elected or
otherwise designated in which the ultimate responsibility and authority for the
conduct of the facility is vested.
M. "Guardian"
means one who has the legal responsibility for the care of a person.
N. "Imminent danger"
means a danger which could reasonably be expected to cause death or serious
physical harm or illness to participants or staff.
O. "License"
means the document issued by the authority which constitutes the authority to
provide services included within the scope of this rule.
P. "Licensee"
means the person(s) who, or organization which, has an ownership leasehold, or
similar interest in the adult day care facility and in whose name a license for
a home health agency has been issued and who is legally responsible for
compliance with these regulations.
Q. Maintenance"
means the care of building(s) by keeping them in a repaired and safe condition
and the grounds in a safe, sanitary and presentable condition.
R. "Mobile non-ambulatory"
means unable to walk without assistance, but able to move from place to place
with the use of devices such as walkers, crutches, wheelchairs, wheeled
platforms, etc.
S. "NMSA"
means the New Mexico Statutes Annotated, 1978 compilation and all the revisions
and compilations thereof.
T. "Participant"
means a person enrolled in an adult day care facility.
U. "Plan of correction"
means the plan submitted by the licensee, applicant, or operator addressing how
and when deficiencies identified at time of a survey will be corrected.
V. "Policy"
means a statement of principle that guides and determines present and future
decisions and actions.
W. "Premises"
means all parts of the buildings, grounds, equipment and vehicles of a facility
licensed pursuant to these regulations.
X. "Private residence"
means the dwelling, where the operator resides on a 24 hour basis, to include
provisions for sleeping, eating, bathing, cooking, etc.
Y. "Relative"
means husband, wife, mother, father, son, daughter, brother, sister,
brother-in-law, sister-in-law, mother-in-law, grandfather, grandmother,
half-brothers, includes adoptive, natural and foster parents, grandparents or
adult children.
Z. "Respite care"
accommodates the family or guardian by providing an alternate place for the
participant to stay when the family or guardian needs a rest from the everyday
physical and emotional strain of caring for the participant.
AA. "Staff member" means
any person who provides direct care, services and supervision to the
participants in a facility licensed pursuant to these regulations.
BB. "Supervision"
means the direct observation and guidance of adults at all times and requires
being physically present with them.
CC. "Survey"
means an entry into, and examination of, the facility's premises, records and
staff interviews.
DD. "U/L approved"
means approved for safety by the national underwriters laboratory.
EE. "Unattended"
means a caregiver is not physically present with an adult under care.
FF. "Variance"
means an act on the part of the licensing authority to refrain from pressing or
enforcing compliance with a portion or portions of these regulations for an
unspecified period of time for facilities which were in existence at the time
these regulations were promulgated, new facilities in existing construction, or
for a new or innovative service where the granting of a variance will not
create a danger to the health, safety and welfare of adults or staff of a
facility, and is at the sole discretion of the licensing authority.
GG. "Waive/waiver"
means to refrain from pressing or enforcing compliance with a portion or
portions of these regulations for a limited period of time provided the health,
safety or welfare of the adults and staff are not in danger. Waivers are issued at the sole discretion of
the licensing authority.
[8.370.20.7
NMAC - N, 7/01/2024]
8.370.20.8 TYPES OF FACILITIES AND SCOPE OF
SERVICES:
A. Adult day care
center is a facility required to be licensed pursuant to these regulations
which provides care, services and supervision to three or more adults, who
because of diminished mental or physical capacity find it difficult to care for
themselves in their own residence during the day. An adult day care center may be located in
any building which meets the applicable state and local building and safety
codes.
B. Adult day care
home is private residence required to be licensed pursuant to these regulations
which provides care, services and supervision to at least three adults but not
more than five adults who because of diminished mental or physical capacity
find it difficult to care for themselves in their own residence during the day.
C. New or innovative
programs for providing adult day care:
Professional organizations which have demonstrated a need for new or
innovative services for day care for three or more adults with special needs
which do not fit into one of the types of facilities outlined in Subsections A
and B of 8.370.20.8 NMAC above may be licensed at the sole discretion of the
licensing authority, if all requirements outlined in section nine are met.
D. These facilities
must be able to provide oversight to the participants such as reminding them of
medications and appointments, providing meals and monitoring their activities
while on the premises of the facility. Hours
of operation are limited from 6 a.m. to
9 p.m.
E. Participants must
be able to ambulate on their own or in a wheelchair with minimal assistance. They must be ambulatory or mobile
non-ambulatory.
F. In the event
federal regulations are promulgated to govern health-related adult day care
("the medical model"), these regulations shall continue to apply
except to the extent a provision of these regulations is in conflict with the
federal, in which case the federal regulation shall control.
[8.370.20.8
NMAC - N, 7/01/2024]
8.370.20.9 INITIAL LICENSURE PROCEDURES: To obtain an initial license for an adult day
care facility pursuant to these regulations, the following procedures must be
followed by the applicant:
A. These regulations must be thoroughly understood by the
applicant and used as reference prior to applying for licensure.
B. Application
form: Will be provided by the licensing
authority.
(1) All information requested
on the application must be provided and complete.
(2) Must be printed or typed.
(3) Must be dated and signed.
(4) Must be notarized.
C. Fees: All applications for license must be
accompanied by the required fee.
(1) Current fee schedules
will be provided by the licensing authority.
(2) Fees must be in the form
of a check or money order made payable to the state of New Mexico.
(3) Fees are not refundable.
D. Floor plans: All applications for initial licensure must
be accompanied by a set of floor plans for the facility.
(1) Floor plans must be of professional
quality, be on substantial paper of at least 18 inches by 24 inches, and be
drawn to an accurate scale of one-quarter of an inch to one inch.
(2) Floor plans must include
at least the following information:
(a) proposed use of each room
i.e., staff office, toilets, activity room(s), kitchen, etc.;
(b) interior dimensions of
all rooms must be included on floor plans;
(c) floor plans must include
one building or wall section showing exterior and interior wall construction;
section must include floor, wall, ceiling and the finishes, i.e., carpet, tile,
gyp board with paint, wood paneling, etc.;
(d) door types, swing, and
sized of all doors, i.e., solid core, hollow core, three feet by six feet eight
inches;
(e) if building is air
conditioned;
(f) all sinks, tubs,
showers, and toilets;
(g) size, type, sill height,
and openable area of windows indicated;
(h) any level changes within the
building i.e., sunken activity room, ramps, steps, etc.;
(i) the location of the
building on a site/plot plan to determine surrounding conditions, including all
steps, ramps, parking, walks, and any permanent structures;
(j) if building is new
construction, renovated, or an addition, indicate both the existing and new
construction on the floor plans.
(3) Floor plans will be reviewed by the
licensing authority for compliance with current building and fire codes, and
comments will be sent to the applicant specifying any needed changes or
requesting any additional information. Exception: Adult day care homes are not
required to submit floor plans.
E. Zoning and
building approvals:
(1) All initial applications must be
accompanied with original written zoning approval from the appropriate
authority, city, county, or municipality.
(2) All initial applications must be
accompanied with written building approval (certificate of occupancy) from the
appropriate authority, city, county, or municipality. Exception: Adult day care homes are not
required to submit building approval.
F. Fire authority
approval: All initial applications must
be accompanied by original written approval of the appropriate fire prevention
authority having jurisdiction: i.e., city, county, or state fire marshal's
office. Exception: Adult day care homes are not
required to submit fire authority approval.
G. New Mexico
environment department approval: All
initial applications must be accompanied by original written approval of the
New Mexico environment department for the following:
(1) kitchen approval if meals
are prepared or served in the facility;
(2) private water supply, if
applicable;
(3) private waste or sewage
disposal, if applicable;
(4) exception:
adult day care homes are not required to submit New Mexico environment
department approval.
H. Health
certificates: Copies of health
certificates of the licensee, caregivers, and staff must accompany all initial
application.
I. Custodial drug
permit: Any facility licensed pursuant
to these regulations which supervises self-administration of medication for the
participants or safeguards medication for participants, must have an
appropriate custodial drug permit as determined by the state board of pharmacy.
J. A list of
equipment for adult activities that the facility will provide on the first day
of operation must accompany all initial applications.
K. A description of
the facility's proposed activities and daily schedule must accompany all
initial applications.
L. Initial
survey: An initial survey of the
proposed facility will be scheduled by the licensing authority upon receipt of
a properly completed application with all supporting documentation, as outlined
in these regulations.
M. Issuance of
license: A license will be issued by the
licensing authority if the initial survey determines that the facility is in
compliance with these regulations.
[8.370.20.9
NMAC - N, 7/01/2024]
8.370.20.10 SPECIAL REQUIREMENTS FOR NEW OR
INNOVATIVE ADULT DAY CARE SERVICES:
A. Applicants for
new or innovative adult day care services which do not fit into any one of the
types of facilities as outlined in Subsections A and B of 8.370.20.8 NMAC must
submit a proposal to the licensing authority for review and approval. The proposal must include the following:
(1) statistical data supporting the need
for a special type of adult day care service;
(2) explanation of the
special problems and needs of the adults who will be receiving these services;
(3) identify portions of
these regulations which would be in conflict with the proposed facility;
(4) how the proposed facility
would resolve these conflicts with alternative measures which would meet the
intent of these regulations, i.e., increased staffing or fire and safety
precautions.
B. If, at its sole discretion, the
licensing authority approves the proposal a license may be granted with
variances for those portions of the regulations where the program would be in
conflict.
[8.370.20.10
NMAC - N, 7/01/2024]
8.370.20.11 LICENSES:
A. Annual
license: An annual license is issued for
a one year period to a facility which has met all requirements of these
regulations.
B. Temporary
license: The licensing authority may, at
its sole discretion, issue a temporary license prior to the initial survey, or
when the licensing authority finds partial compliance with these regulations.
(1) A temporary license shall
cover a period of time, not to exceed 120 days, during which the facility must
correct all specified deficiencies.
(2) In accordance with Subsection
D of Section 24-1-5, NMSA 1978, no more than two consecutive temporary licenses
shall be issued.
C. Amended
license: A licensee must apply to the
licensing authority for an amended license when there is a change of
administrator/director, when there is a change of name of the facility, or if a
change of capacity is sought.
(1) Application must be on a
form provided by the licensing authority.
(2) Application must be
accompanied by the required fee for an amended license.
(3) Application must be
submitted within 10 working days of the change.
(4) Application for increase
or decrease of capacity will not be approved nor an amended license issued
until an on-site visit has been made by the licensing authority to determine if
the facility meets all applicable codes and regulations. A facility must not accept additional
participants or change the layout of the facility until the licensing authority
has approved and issued the amended license.
[8.370.20.11
NMAC - N, 7/01/2024]
8.370.20.12 LICENSE RENEWAL:
A. Licensee must
submit a notarized renewal application on forms provided by the licensing
authority, along with the required fee, at least 30 days prior to expiration of
the current license.
B. Upon receipt of a
notarized renewal application, required fee, and an on-site survey, the
licensing authority will issue a new license effective the day following the
date of expiration of the current license, if the facility is in compliance
with these regulations.
C. If a licensee
fails to submit a notarized renewal application, with the required fee, before
the current license expires, the licensee must submit an initial license
application, and the facility shall cease operations until initial licensure
procedures are completed.
[8.370.20.12
NMAC - N, 7/01/2024]
8.370.20.13 POSTING OF LICENSE: The facility license shall be posted in a
conspicuous place on the licensed premises, in an area visible to staff and
visitors.
[8.370.20.13
NMAC - N, 7/01/2024]
8.370.20.14 NON-TRANSFERABLE RESTRICTIONS OF
LICENSE: A license shall not
be transferred by assignment or otherwise to other persons or location. The license shall be void and must be
returned to the Licensing Authority when any one of the following situations
occur:
A. ownership of the
facility changes;
B. the facility
changes location;
C. licensee of the
facility changes;
D. the facility
discontinues operations;
E. a facility wishing
to continue operation as a licensed facility under circumstances Subsections A
through D of 8.370.20.14 NMAC above shall submit an application for initial
licensure in accordance with Section 8 of these regulations at least 30 days
prior to the anticipated change.
[8.370.20.14
NMAC - N, 7/01/2024]
8.370.20.15 AUTOMATIC EXPIRATION OF LICENSE: A license shall automatically expire at
midnight on the day indicated on the license as the expiration date, unless
sooner renewed, suspended or revoked, or:
A. on the day a
facility discontinues operation.
B. on the day a
facility is sold, leased, or otherwise changes ownership or licensee.
C. on the day a
facility changes location.
[8.370.20.15
NMAC - N, 7/01/2024]
8.370.20.16 SUSPENSION OF LICENSE WITHOUT PRIOR
HEARING: In accordance with
24-1-5 NMSA 1978, if immediate action is required to protect human health and
safety, the licensing authority may suspend a license pending a hearing,
provided such hearing is held within five working days of the suspension,
unless waived by the licensee.
[8.370.20.16
NMAC - N, 7/01/2024]
8.370.20.17 GROUNDS FOR REVOCATION OR SUSPENSION OF LICENSE, DENIAL OF
INITIAL OR RENEWAL APPLICATION FOR LICENSE, OR IMPOSITION OF INTERMEDIATE
SANCTIONS OR CIVIL MONETARY PENALTIES: A license may be revoked or suspended, an
initial or renewal application may be denied, or intermediate sanctions or
civil monetary penalties may be imposed after notice and opportunity for a
hearing, for any of the following reasons:
A. failure to comply
with any provision of these regulations.
B. failure to allow
survey by authorized representatives of the licensing authority.
C. any person active
in the operation of a facility licensed pursuant to these regulations, to
include all adults and teenaged children living in an adult day care home shall
not be under the influence of alcohol or narcotics or convicted of a felony.
D. misrepresentation
or falsification of any information on application forms or other documents
provided by the licensing authority.
E. discovery of
repeat violations of these regulations during surveys.
F. hiring of or
continuing to employ any person whose health or conduct impairs their ability
to properly protect the health, safety, and welfare of the participants.
G. exceeding licensed
capacity.
[8.370.20.17
NMAC - N, 7/01/2024]
8.370.20.18 HEARING PROCEDURES:
A. Hearing procedures
for adverse action initiated by the licensing authority against a facility
license as outlined in Sections 16 and 17 above will be held in accordance with
adjudicatory hearings, New Mexico health care authority, 8.370.2 NMAC.
B. A copy of the
above regulations will be furnished to a facility at the time an adverse action
is initiated against its license by the licensing authority, or a copy may be
requested at any time by contacting the licensing authority.
[8.370.20.18
NMAC - N, 7/01/2024]
8.370.20.19 NEW FACILITY: A new facility may be located in an existing
building or a newly constructed building:
A. If opened in an
existing building, a variance may be granted for those building requirements
the facility cannot meet under the same criteria outlined in these regulations,
if not in conflict with existing building and fire codes. This is at the sole discretion of the
licensing authority.
B. A new facility
opened in a newly constructed building shall meet all of the requirements of
these regulations.
[8.370.20.19
NMAC - N, 7/01/2024]
8.370.20.20 FACILITY SURVEYS:
A. Surveys are meant
to be constructive and informative to the licensee and staff of a facility, to
insure that the facility meets the requirements of these regulations, and to
identify any area which could be dangerous or harmful to the health, safety,
and welfare of the participants and staff.
B. A survey will be
conducted at least once annually in each facility licensed pursuant to these regulations
by personnel of the licensing authority using these regulations as criteria. Additional surveys or visits may be made to
assist the facility with technical advice, to check on progress in correction
of violations found on previous survey, or to investigate complaints.
C. At the completion
of a survey, the findings shall be discussed with the licensee or
representative and a plan of correction will be requested. If a plan of correction is not given at the
time of survey the licensee, director or operator must submit within 10 working
days after receiving the official written report of survey, a plan of
correction to the licensing authority for violations found during the survey. The plan of correction must give specifics as
to how the violation will be corrected and the expected date of completion.
D. The licensing
authority may, at its sole discretion, accept the plan of correction as written
or require modifications of the plan by the licensee.
E. Application for
licensure, whether initial or renewal, shall constitute permission for entry
into and survey of a facility by authorized licensing authority representative
during the pendency of the application and, if licensed, during the licensure
period.
F. Surveyors have the
right to enter upon and into the premises of any facility which is licensed or
required to be licensed, whether or not an application for licensure has been
made, at any reasonable time for the purpose of determining the state of compliance
with these regulations.
G. The licensing
authority shall perform, as it deems necessary, unannounced on-site surveys to
determine compliance with these regulations, to investigate complaints, or to
investigate the appropriateness of licensure for any alleged unlicensed
facility.
H. At all times,
there must be a person present in the facility who can represent the licensee
or director for survey purposes. This
person must be able to provide access to all records and keys to any locked
area.
[8.370.20.20
NMAC - N, 7/01/2024]
8.370.20.21 COMPLAINT PROCEDURES:
A. Submission of
complaints: Complaints regarding any facility licensed or required to be
licensed pursuant to these regulations should be submitted to the licensing
authority.
(1) Complaints should be
submitted in writing and signed by the complainant.
(2) Complainants telephoning
the licensing futhority should identify themselves and be able to provide
necessary information needed by the licensing futhority in order to document
the complaint.
B. Written
acknowledgement: The licensing authority
shall, whenever possible acknowledge in writing, within 10 working days,
receipt of all complaints.
C. Initiation of
investigation: If it is probable that the health, safety, and welfare of an
adult or adults is in jeopardy, the complaint will be investigated promptly. Otherwise the licensing authority shall
initiate an investigation within 20 working days from receipt of a compliant.
D. Results of
investigation: Both the licensee of the
facility against whom a complaint is lodged, and the complainant, shall be
notified in writing of the results of the investigation.
E. Anonymity may be
requested by the complainant but cannot be assured.
F. Action by the
licensing authority:
(1) Complaint
unsubstantiated: A complaint which is unsubstantiated by the licensing
authority is not made part of the facility file and the licensing authority
takes no further action.
(2) Substantiated complaint: The licensing authority may take the following
actions if a complaint is substantiated:
(a) Require the facility to
submit a written plan of correction to the licensing authority if violations of
these regulations are found.
(b) Other administrative
sanctions such as the suspension or revocation of a license, or the filing
of criminal charges, or a civil action may be instituted by the licensing
authority if deemed appropriate.
[8.370.20.21
NMAC - N, 7/01/2024]
8.370.20.22 CAPACITY OF A FACILITY: The capacity of a facility licensed pursuant
to these regulations is determined by the following:
A. By the type of
facility:
(1) An adult day care center
may be licensed for at least three adults but is not limited as to maximum
number of participants. Adult relatives
of staff and volunteers receiving care in the facility must be counted in the
licensed capacity.
(2) An adult day care home
may be licensed for at least three adults but not more than five (5) participants. The licensee's own adult relatives under the
care of the facility must be counted in the licensed capacity when present in
the facility.
B. By useable space
for activities:
(1) Adult day care centers
and adult day care homes are required to have 40 square feet of activity area
for each adult included in the licensed capacity.
(2) The
capacity as reflected on the license issued to a facility licensed pursuant to
these regulations must not be exceeded at any time.
[8.370.20.22
NMAC - N, 7/01/2024]
8.370.20.23 REPORTING OF INCIDENTS: All facilities licensed pursuant to these
regulations shall report to the licensing authority any incident or unusual
occurrence which has, or could threaten the health, safety, and welfare of the
participants or staff, such as, but not limited to:
A. lost or missing
participant;
B. sexual or physical
abuse of a participant;
C. accidents or
injuries requiring medical care;
D. fire, flood or
other natural disaster which creates structural damages to the facility or
poses health hazards.
E. notifiable
diseases.
[8.370.20.23
NMAC - N, 7/01/2024]
8.370.20.24 GENERAL RECORDS: The following records must be kept on file in
the facility and available for inspection by the licensing authority during
survey:
A. a copy of the
report of the latest survey conducted by the licensing authority and a copy of
any variances granted by it.
B. record of fire
drills held.
C. a copy of the latest fire prevention inspection by the
authority having jurisdiction. Exception: Adult day care homes are not
required to have fire authority inspections.
D. a copy of the
latest environmental improvement division inspection of the kitchen if meals
are served in the facility. Exception: Adult day care homes are not
required to have environmental improvement division approvals of kitchen.
E. initial and
periodic inspection reports from environmental improvement division for those
facilities which have private water, sewage, or waste disposal systems, when
applicable.
F. documentation of
staff training as required by Section 58 of these regulations.
G. documentation of
current first aid certificates as required by these regulations.
[8.370.20.24
NMAC - N, 7/01/2024]
8.370.20.25 PARTICIPANT RECORDS: There must be maintained a complete record on
file for each adult receiving care within a facility licensed pursuant to these
regulations, which must contain at least the following:
A. Personal information:
(1) name of participant;
(2) date of birth;
(3) sex;
(4) home address (mailing
address and location of residence) and telephone number;
(5) name of responsible
party;
(6) current place of
employment, address and work telephone number of responsible party.
B. Emergency information.
(1) record of any allergies
or medical conditions the participant may have;
(2) name and telephone number
of two persons to be called in case of emergency when the responsible party
cannot be reached;
(3) name and telephone number
of physician or emergency medical facility authorized by guardian to be called
in case of illness or emergency;
(4) permission for emergency
medical transportation and guardian's consent for treatment.
C. Date of enrollment.
D. Date of disenrollment.
E. The following must
be recorded in each participant's file when applicable:
(1) accidents and illnesses
which require first aid or medical attention;
(2) observation of recent
bruises, injuries or signs of abuse or neglect;
(3) use of physical
restraints.
F. Medications
prescribed for the resident, including time and dosage.
G. Written
authorization from the participant, responsible party or guardian, must be in
the participants record for the removal of the participant's from the grounds
of the facility to participate in field trips, nature walks, or other
activities whether or not the activity includes transportation by vehicle.
H. Daily attendance
of the participant.
I. Enrollment
agreement signed by the participant, responsible party or guardian which
clearly outlines the following:
(1) services to be provided
by the facility and costs for the same;
(2) acknowledgement by the
participant, responsible party or guardian that they clearly understand the
policies of the facility and agree to them.
J. General:
(1) each participant's record
must be kept on file in the facility at least six months after disenrollment.
(2) participant's records
must be made available to those persons authorized by law or regulation to
review or inspect such records, such as guardians, staff, or representatives of
the licensing authority.
(3) participant's records
must be complete with all documentation at the time of admission, to include drop
ins.
[8.370.20.25
NMAC - N, 7/01/2024]
8.370.20.26 STAFF RECORDS:
A. There must be
maintained a complete record on file for each staff member or volunteer working
more than eight hours of any week and having direct contact with the
participants which must contain at least the following:
(1) name.
(2) address and telephone
number.
(3) position for which
employed.
(4) date of employment and
termination, when applicable.
(5) certificate signed by a
physician or recognized health facility stating that the staff member, or volunteer
is free from tuberculosis in a transmissible form as required by the New Mexico
health care authority regulations, Control of Communicable Disease in Health
Facility Personnel, 7.4.4 NMAC.
B. A daily attendance
record of all employed staff must be kept by the facility.
C. The facility must
maintain weekly work schedules of all employed staff and caregivers. These schedules must be kept on file for at
least six months.
D. Staff records must
be available for review by representatives of the licensing authority at all
times.
[8.370.20.26
NMAC - N, 7/01/2024]
8.370.20.27 FACILITY RULES: Each facility must have written rules
pertaining to the following:
A. admission and
disenrollment of participants.
B. duties and
responsibilities of all employed staff and volunteers regarding the care,
services, and supervision of the participants, which must be updated when staff
duties change.
[8.370.20.27
NMAC - N, 7/01/2024]
8.370.20.28 POLICIES AND PROCEDURES: All facilities licensed pursuant to these
regulations must have written policies and procedures covering the following
areas:
A. actions to be
taken in case of accidents or emergencies involving a participant;
B. policies and
procedures on reporting suspected adult abuse or neglect;
C. policies and
procedures for admission and disenrollment of participants;
D. policies and
procedures for action to be taken in the event a participant is found missing
from the facility;
E. policies and
procedures for handling of medications;
F. policies and
procedures for handling of complaints received from guardians or any other
person;
G. the facility must
have policies and procedures prohibiting the following:
(1) abusing or neglecting a
participant (e.g., slapping, hitting, striking, withholding food as a
punishment, verbally threatening, or failing to provide a participant with the
level of services and degree of supervision;
(2) retaliation against a
participant because of complaints or suggestions regarding the management of
the facility;
(3) social isolation;
(4) the use of chemical
restraint.
H. If at any time a
participant's rights are restricted in order to protect the health, safety, and
welfare of the participant the reasons for the restriction of the rights must
be clearly documented in the participant's record.
I. Policies and
procedures for the use of restraints.
J. These policies and
procedures may be adopted from other sources.
[8.370.20.28
NMAC - N, 7/01/2024]
8.370.20.29 GENERAL BUILDING(S), GROUNDS, AND
SAFETY REQUIREMENTS:
A. New construction, additions and
alternation: When construction of
building, additions, or alterations to existing building are contemplated,
plans and specifications covering all portions of the work must be submitted to
the licensing authority for plan review and approval prior to beginning actual
construction. When an addition or
alteration is contemplated, plans for the entire facility must be submitted.
B. Number of
stories: All building requirements
contained in these regulations are based on building of one (1) story in which
care for adults is not being provided above or below ground level. Facilities housed in multi-storied buildings
and wishing to provide services to adults above or below ground level will have
additional requirements due to the complexities of the building and fire codes. These additional requirements will be
outlined by the appropriate building and fire authorities and by the licensing
authority through plan review and on site surveys during the licensing process.
C. Energy
conservation: New buildings for a
facility must be constructed to provide energy conservation as required by
applicable building codes.
D. Access to the
handicapped: All facilities must provide
access to the handicapped as required in current building codes and other state
and federal regulations. Exception: Adult day care homes are not required to comply with Subsections A
through D of 8.370.20.29 NMAC above.
E. Prohibition on
mobile homes: Trailers and mobile homes
shall not be used for adult day care.
F. Extent of a
facility: All buildings on the premises
used for the care of adults will be considered part of the facility and must
meet all requirements of these regulations.
Adults being cared for in any building on the premises will be counted
in the capacity of the facility.
[8.370.20.29
NMAC - N, 7/01/2024]
8.370.20.30 SPACE REQUIREMENTS: Facilities licensed pursuant to these
regulations must meet the following space requirements for capacity and
service:
A. Adult day care
centers and adult day care homes are required to have 40 square feet of
activity area for each adult for which the facility is licensed to provide
care.
B. Indoor activity
area is computed by measuring the activity areas used for the participants,
excluding kitchens, corridors, bathrooms, storage areas and closets. Measurements are taken from wall to wall in
each room, deducting offsets and built in fixtures.
C. An outside
activity area must be provided.
[8.370.20.30
NMAC - N, 7/01/2024]
8.370.20.31 MAINTENANCE OF BUILDING(S) AND
GROUNDS:
A. All electrical,
signaling, mechanical, water supply, heating, fire protection and sewage
systems must be maintained in a safe and functioning condition, including
regular inspections of these systems.
B. All furniture and
furnishing must be kept clean and in good repair. Furnishings or decorations of an explosive or
highly flammable character shall not be used.
C. The buildings and
grounds of the facility must be maintained in a safe, sanitary, and presentable
condition at all times.
[8.370.20.31
NMAC - N, 7/01/2024]
8.370.20.32 HOUSEKEEPING:
A. The facility must
be kept free from offensive odors and accumulations of dirt, rubbish, dust and
safety hazards.
B. Activity areas for
participants must be cleaned and tidied daily.
C. Floors and walls
must be constructed of a finish that can be easily cleaned. Floor polishes shall provide a non-slip
finish.
D. Bathrooms and
lavatories shall be cleaned as often as necessary to maintain a clean and sanitary
condition.
E. Deodorizers must
not be used to mask odors caused by unsanitary conditions or poor housekeeping
practices.
F. Storage areas must
be kept free from accumulations of refuse, discarded furniture, old newspapers,
and the like.
G. Combustibles, such
as cleaning rags and compounds, must be kept in closed metal containers in
areas providing adequate ventilation and away from participant activity and
sleeping areas.
H. Poisonous or
flammable substances must not be stored in participant's activity areas, or
food storage areas.
[8.370.20.32
NMAC - N, 7/01/2024]
8.370.20.33 HEATING, VENTILATION, AND
AIR-CONDITIONING:
A. Heating,
air-conditioning, piping, boilers, and ventilation equipment must be furnished,
installed and maintained to meet all requirements of current state and local
mechanical, electrical and construction codes.
B. The heating method
used by the facility must provide a minimum temperature of 68 degrees farenheit
in all rooms used by the participants.
C. The use of
unvented heaters, open flame heaters or portable heaters, is prohibited.
D. An ample supply of
outside air must be provided in all spaces where fuel fired boilers or heaters
are located to assure proper combustion.
E. All gas-fired
heating equipment must be provided with a one hundred percent automatic cutoff
control valve in event of pilot failure.
F. Each building
where gas is used must have the outside gas shutoff valve conspicuously painted
red. The facility must have a tool
readily available which will operate the shut-off valve. The tool will also be painted red. All staff of the facility must be instructed
as to location of the gas shut-off valve and must know how to shut off the gas
supply in case of fire or gas leakage. Exception: Adult day care homes are not
required to comply with Subsection F of 8.370.20.33 NMAC above.
G. All boiler,
furnace or heater rooms shall be protected from other parts of the building by
construction having a fire resistance rating of not less than one hour. Doors to these rooms shall be at least one
and three-quarters inches solid core. Exception: Adult day care homes are permitted
to have the normal residential type heating system.
H. A facility must be
adequately ventilated at all times by either mechanical or natural means to
provide fresh air and the control of unpleasant odors.
I. All gas burning
heating and cooking equipment must be connected to an approved venting system
to take the products of combustion directly to the outside air. Exception: Adult day care homes are not
required to vent cooking stoves.
J. All openings to
the outer air used for ventilation must be screened with screening material of
not less than sixteen (16) meshes per lineal inch.
K. The facility must
be provided with a system for maintaining participant's comfort during periods
of hot weather.
[8.370.20.33
NMAC - N, 7/01/2024]
8.370.20.34 WATER:
A. A facility must be
provided with an adequate supply of water which is of a safe and sanitary
quality suitable for domestic use.
B. If the water
supply is not obtained from an approved public system, the private water system
must be inspected, tested and approved by the New Mexico environment department
prior to licensure. It is the facility's
responsibility to ensure that subsequent periodic testing or inspection of such
private water systems be made at intervals prescribed by the New Mexico
environment department.
C. Hot and cold
running water, under pressure, must be distributed to all food preparation
areas, lavatories, washrooms, laundries and bathrooms.
[8.370.20.34
NMAC - N, 7/01/2024]
8.370.20.35 WATER HEATERS:
A. All fuel-fired
water heaters must be separated from other parts of the facility by partitions
having a fire-resistive rating of one hour.
Doors to the enclosure must be 1 3/4" solid core. Exception: Adult day care homes.
B. All water heaters
must be equipped with a pressure relief valve (pop-off-valve) complete with
relief drain line to the outside of the facility.
C. Water heaters must
not be located in participant areas used for activity or sleeping.
D. Temperature of hot
water for lavatories must not be above 110 degrees farenheit.
[8.370.20.35
NMAC - N, 7/01/2024]
8.370.20.36 SEWAGE AND WASTE DISPOSAL:
A. All sewage and
liquid wastes must be disposed of into a municipal sewage system where such
facilities are available.
B. Where a municipal
sewage system is not available, the systems used must be inspected and approved
by the New Mexico environment department, and the construction industries
division. Exception:
Adult day care homes.
C. Where municipal or
community garbage collection and disposal service are not available, the method
of collection and disposal of garbage used by the facility must be inspected
and approved by the New Mexico environment department. Exception: Adult day care homes.
D. All garbage and
refuse receptacles must be durable, have tight fitting lids, must be insect and
rodent proof, washable, leak proof, and constructed of materials which will not
absorb liquids. Receptacles must be kept
clean.
[8.370.20.36
NMAC - N, 7/01/2024]
8.370.20.37 LIGHTING AND LIGHTING FIXTURES:
A. All areas of the
facility, including storerooms, stairways, hallways, and entrances must be lighted
sufficiently to make all parts of the area clearly visible.
B. All lighting
fixtures must be shielded in participant activity areas and food preparation
areas.
C. Adult day care
centers must be provided with emergency lighting which will activate
automatically upon disruption of electrical service.
D. Adult day care
homes must have at least a flashlight readily available and in operable
condition for use as emergency lighting.
[8.370.20.37
NMAC - N, 7/01/2024]
8.370.20.38 ELEMENTS OF FACILITY ELECTRICAL
SYSTEM:
A. Electrical
installations and electrical equipment must comply with all current state and
local codes.
B. All fuse and
breaker boxes must be labeled to indicate the area of the facility to which
each fuse or circuit breaker provides services.
C. The main
electrical service line must have a readily available disconnect switch. All staff and caregivers must know the
location of the electrical disconnect switch and how to operate it in case of
emergency.
D. The use of jumpers
or devices to bypass circuit breakers or fuses is prohibited.
[8.370.20.38
NMAC - N, 7/01/2024]
8.370.20.39 ELECTRICAL CORDS, APPLIANCES, AND
OUTLETS:
A. Electrical cords
and appliances must be U/L approved.
(1) Electrical cords shall be
replaced as soon as they show wear.
(2) Under no circumstances
shall extension cords be used as a general wiring method.
(3) Extension cords must be
plugged into an electrical outlet within the room where used and must not be
connected in one room and extended to another room.
B. The use of
multiple sockets (gang plugs) in electrical outlets is strictly prohibited.
[8.370.20.39
NMAC - N, 7/01/2024]
8.370.20.40 WINDOWS: All activity areas for participants must have
a least one (1) window or skylight area of at least 1/20 of the floor area.
[8.370.20.40
NMAC - N, 7/01/2024]
8.370.20.41 EXITS:
A. There must be at
least two exits remote from each other from each floor of the facility.
B. Exit ways must be
kept free from obstructions at all times.
C. All exits must be
marked by signs having letters at least six inches high whose principal strokes
are at least three-fourths of an inch wide.
D. Exit signs, when applicable, must be visible at all times. Exception: Adult day care homes are not
required to have exit signs.
[8.370.20.41
NMAC - N, 7/01/2024]
8.370.20.42 DOORS:
A. Required exit
doors must be openable from the inside at all times the facility is in
operation.
B. All required exit
doors must have a minimum width of 36 inches.
Exception: Adult day care homes.
C. Required exit
doors in facilities having a capacity of 50 or more must open outward.
D. Locks and latches
on closets and bathrooms must be of the type that the lock can be released from
the outside.
[8.370.20.42
NMAC - N, 7/01/2024]
8.370.20.43 OUTDOOR AREAS:
A. Outdoor area must
be located on the premises of the facility.
B. If required by the
agency, the outdoor area must be fenced and have at least one latched gate
available for emergency exit.
C. Outdoor areas must
be kept free of sharp objects, trash, weeds, or other hazardous items.
D. Outdoor areas must
be designed to permit direct supervision of the participants at all times.
[8.370.20.43
NMAC - N, 7/01/2024]
8.370.20.44 TOILET AND BATHING FACILITIES:
A. Bathrooms must be
completely enclosed. A window or
mechanical system for ventilation must be provided.
B. Toilets and
lavatories (hand washing sinks) must be provided for each sex in the following
ratios in adult day care centers:
(1) One toilet for one to 15
participants.
(2) One toilet for each
additional 15 participants or fraction thereof.
(3) Lavatories must be
provided within each toilet room at a ratio of one to 40participants.
(4) Toilet paper, soap, and
disposable towels must be provided in all toilet rooms.
(5) The use of a common towel
or wash cloth is prohibited.
(6) Bathrooms and lavatories
must be cleaned as often as necessary to maintain a clean and sanitary condition.
C. Adult day care
homes are required to have at least one toilet and one lavatory.
D. Facilities
accepting participants with special bathing needs, or provide bathing as a
service, will provide approved bathing facilities.
[8.370.20.44
NMAC - N, 7/01/2024]
8.370.20.45 FIRE SAFETY COMPLIANCE: All current applicable requirements of state
and local codes for fire prevention and safety must be met by the facility.
[8.370.20.45
NMAC - N, 7/01/2024]
8.370.20.46 FIRE CLEARANCE AND INSPECTIONS:
A. Written
documentation from the state fire marshal's office or fire authority having
jurisdiction evidencing a facility's compliance with applicable fire prevention
codes must be submitted to the licensing authority prior to issuance of an
initial license. Exception: Adult day care homes are not
required to have fire authority inspections.
B. Each facility
shall request from the fire authority having jurisdiction an annual fire
inspection. If the policy of the fire
authority having jurisdiction does not provide for annual inspection of the
facility, the facility must document the date the request was made and to whom. If the fire authority having jurisdiction
does make annual inspections, a copy of the latest inspection must be kept on
file in the facility. Exception: Adult day care homes are not
required to have annual fire inspections.
[8.370.20.46
NMAC - N, 7/01/2024]
8.370.20.47 FIRE ALARMS, SMOKE DETECTORS AND OTHER
EQUIPMENT:
A. The facility must
be equipped with an approved, manually operated alarm system or other
continuously sounding alarm approved in writing by the fire authority having
jurisdiction. Exception: Adult day care homes are not
required to have manually operated alarm systems.
B. The facility must
be equipped with smoke detectors approved in writing by the fire authority
having jurisdiction as to number, type, and placement. Exception: Adult day care homes are only
required to have one smoke detector in the participants activity rooms which
may be battery operated.
C. Fire extinguishers
as approved by the state fire marshal or fire authority having jurisdiction
must be located in the facility. Facilities
must as a minimum have two 2A10BC fire extinguishers, one centrally located in
the facility activity areas. Exception: Adult day care homes are only
required to have one 2A10BC fire extinguisher located in the kitchen or food
preparation area.
D. Fire
extinguishers, alarm systems, automatic detection equipment, and other fire
fighting equipment must be properly maintained and inspected at least yearly,
and more often if recommended by the manufacturer, state fire marshal, or fire
authority having jurisdiction. Fire
extinguishers must be tagged noting the date of inspection.
E. All fire
extinguishers must be inspected yearly and recharged as specified by the
manufacturer, state fire marshal or local fire prevention authorities. All fire extinguishers must be tagged noting
the date of inspection.
[8.370.20.47
NMAC - N, 7/01/2024]
8.370.20.48 STAFF FIRE AND SAFETY TRAINING:
A. All staff of a
facility must know the location of and be instructed in proper use of fire
extinguishers and other procedures to be observed in case of fire or other
emergencies. The facility should request
the local fire prevention authority to give periodic instruction in fire
prevention and techniques of evacuation.
B. The staff of a
facility must be instructed as part of their duties to constantly strive to
detect and eliminate potential safety hazards, such as loose handrails, frayed
electrical cords, blocked exits or exit ways, and any other condition which
could cause burns, falls, or other personal injury to the participants or
staff.
C. Fire drills: The
facility must conduct at least one fire drill each month.
(1) Fire drills must be held
at different times of the day.
(2) The fire alarm system or
detector system in the facility shall be used in the conduct of fire drills.
(3) In the conduct of fire
drills, emphasis must be placed upon orderly evacuation under proper discipline
rather than upon speed.
(4) A record of fire drills
held must be maintained on file in the facility. Such record must show date and time of the
drill, number of personnel participating in the drill, and any problem noted
during the drill.
(5) The local fire department
should be requested to supervise and participate in fire drills.
D. Each facility must
have a fire evacuation plan conspicuously posted in the facility, and all staff
must be familiar with the evacuation plan.
Exception: Adult day care homes
are not required to have evacuation.
[8.370.20.48
NMAC - N, 7/01/2024]
8.370.20.49 PROVISIONS FOR EMERGENCY CALLS:
A. An easily
accessible telephone for summoning help in case of emergency must be available
in each facility. A pay telephone will
not fulfill this requirement.
B. A list of
emergency numbers including, but not limited to, fire department, police
department, ambulance services, and poison control center shall be posted by
each telephone in the facility.
[8.370.20.49
NMAC - N, 7/01/2024]
8.370.20.50 SMOKING:
A. Smoking in the
kitchen or food preparation areas is strictly prohibited.
B. Separate smoking
areas must be designated and provided with suitable ashtrays.
C. Smoking must never
be permitted in any area where oxygen is in use.
[8.370.20.50
NMAC - N, 7/01/2024]
8.370.20.51 CARPETS:
A. Carpeting, if used
in new facilities, must be of at least class II rating. Existing facilities, as they replace
carpeting, must replace with carpet having at least a class II rating.
B. Carpets must be of
a stable and regular surface to prevent tripping or slipping hazards and allow
wheelchair mobility.
[8.370.20.51
NMAC - N, 7/01/2024]
8.370.20.52 ACCESS REQUIREMENTS FOR THE
HANDICAPPED:
A. Accessibility to
the handicapped must be provided in all facilities and shall include the
following: Exception: Adult day care
homes are not required to have access for the handicapped.
(1) Main entry into the
facility must be ground level or ramped to allow wheelchair access.
(2) Building must allow
access to participant's activity areas.
(3) Access to at least one
toilet is required to have a minimum door clearance of 32 inches, 36 inches is
recommended. Toilet room must also
provide a 60 inch diameter clear space (turning radius for a wheelchair).
(4) If ramps are provided to
the building, the slope must be at least 12 inches horizontal run for each one
inch of vertical rise.
(5) Ramps leading to doorways
must have a five foot by five foot level area at the doorway.
(6) Ramps exceeding a six
inch rise shall be provided with handrails.
B. Requirements
contained herein are minimum and additional handicap requirements may apply
depending on size and complexity of the facility.
C. Consultation will
be given to new facilities on handicap requirements upon submission of floor
plans during the initial licensing process.
[8.370.20.52
NMAC - N, 7/01/2024]
8.370.20.53 ADULT DAY CARE CENTERS IN MULTI-USE
FACILITIES:
A. An adult day care
program must be self-contained with its own staff and separate area.
B. Depending on the
nature of other activities in the building, it may or may not be appropriate
for day care participants to share in them on a planned basis. Such involvement must be as part of the day
care program plan and must be supervised by a day care staff member, i.e.,
senior center crafts and social events and lunch at a congregate meal site.
C. It is not
appropriate for persons from other activity groups in the building to move
through the day care area at will or to attend day care activities on an
informal basis. The day care program is
in a sense a "closed" program in that participation is open only to
persons enrolled in the program and to visitors on a planned basis.
[8.370.20.53
NMAC - N, 7/01/2024]
8.370.20.54 GENERAL PERSONNEL AND STAFFING
REQUIREMENTS:
A. All persons
involved with the care of participants shall be of good character and
physically, mentally and emotionally equipped to provide good care and maintain
responsible supervision for the participants.
B. All involved with
the care of participants must be screened by the licensee. Their qualifications, references and
employment history must be verified prior to employment.
C. A person who has
been convicted of a felony or of a misdemeanor involving moral turpitude shall
not be allowed to work as an administrator/director/operator, direct service
staff, or support staff member in a facility licensed pursuant to these
regulations. This includes family
members who work or reside in an adult day care home.
D. All persons
volunteering with the facility, are deemed to be staff and are subject to these
regulations.
E. Staff members who
work directly with participants and who are counted in the staff/participant
ratio must be 18 years of age or older.
F. Persons under the
age of 18 shall at all times work directly under the supervision of a staff
member who is physically present.
G. Persons employed
solely for clerical, cooking and maintenance shall not be included in the
staff/participant ratio.
H. Substitutes and
part-time staff members, who are counted in the staff/participant ratios, shall
meet the same requirement as regular staff.
[8.370.20.54
NMAC - N, 7/01/2024]
8.370.20.55 QUALIFICATIONS FOR DIRECTORS OF
CENTERS:
A. The adult day care
center shall have a full-time program director.
B. The program
director shall have the authority and responsibility for the management of
activities and direction of staff to insure that activities and services are
provided appropriately and in accordance with established policies.
C. The program
director shall meet all of the minimum qualifications and personal
characteristics stated below.
(1) 18 years of age or older;
(2) shall have completed at
least a baccalaureate degree from a nationally accredited institution of
education in the field of geriatrics, or a health related course of study which
includes the care of the elderly, or be a registered nurse;
(3) shall have a minimum of
two years experience and training in services to elderly or handicapped adults;
(4) shall have demonstrated
ability in supervision and administration.
D. Meet the
requirements of Section 53.
[8.370.20.55
NMAC - N, 7/01/2024]
8.370.20.56 QUALIFICATIONS OF OPERATORS OF ADULT
DAY CARE HOMES: Licensees of adult
day care homes must have the following minimum qualifications:
A. 18 years of age or
older;
B. be competent and
have a demonstrated ability to manage all aspects of a day care program;
C. have a minimum of
a high school education or the equivalent;
D. have at least two years
of full-time work experience in services to elderly or handicapped adults;
E. provide a written
statement from a physician or a recognized health facility stating that the
operator is free from communicable disease;
F. have the ability
to work with people;
G. provide
references, including former employer(s);
H. meet the
requirements of Section 53.
[8.370.20.56
NMAC - N, 7/01/2024]
8.370.20.57 VOLUNTEERS:
A. When volunteers
are used in an adult day care program, adequate planning prior to the placement
of the volunteers will take place in order to provide the volunteer with a
written description of their duties and responsibilities. This written description shall outline in
detail the tasks to be performed, qualifications for performing the tasks, and
specifics about hours, days and length of commitment needed from the volunteer.
B. The volunteer
shall take part in a formal or informal orientation and training session to
inform him/her of the goals of the program, the operation and daily schedule of
the program, specific needs of the adults being served and any necessary ,
specialized approaches the volunteer will be expected to use.
C. Employees of the
program shall be properly informed of the use of a volunteer prior to their
working in the program, staff's responsibility and role and the volunteer's
responsibility and role. Employees shall
be involved in planning for the volunteer and shall assist in writing the
duties the volunteer will perform.
D. Volunteers working
more than half-time and having direct contact with participants shall have a
certificate from a physician or medical facility stating that they are free
from tuberculosis in a transmissible form.
[8.370.20.57
NMAC - N, 7/01/2024]
8.370.20.58 STAFF TRAINING:
A. All facilities
shall provide training for each staff member.
B. Documentation for
training shall be kept on file at each facility and available for inspection by
representatives of the licensing authority.
C. Documentation may
take the form of certificates or a training log with the date, name of staff
member or caregiver, hours spent in training, subject and source of training.
D. Before beginning
work all facilities shall provide for each staff member an orientation which
includes the following as a minimum:
(1) scope of services,
activities, and program offered by the facility;
(2) emergency first aid
procedures, recognition of illness and indicators of abuse;
(3) fire prevention measures
and emergency evacuation plans;
(4) review of licensing
regulations;
(5) special problems of the
elderly and disabled;
(6) participant rights;
(7) sanitation procedures.
E. Emergency staff
and substitutes are not required to participate in training.
F. Adult day care
centers:
(1) All staff members,
including the director, shall participate in at least 40 documented clock hours
of training during each year of employment.
(2) Of the 40 hours of
required training, 20 hours shall be in areas covering the physical, emotional,
intellectual, and social needs of adults.
(3) Other training may
include, but is not limited to the following: nutrition, sanitation procedures,
first aid, and cardiovascular resuscitation techniques.
G. Adult day care
homes:
(1) All staff members shall
participate in at least 24 documented clock hours of training during each year
of licensure.
(2) The required 24 hours of
training shall be in the subjects specified in these regulations.
H. Training may be
obtained from, but not limited to, the following resources:
(1) public health division, health
care authority.
(2) social services division,
health care authority.
(3) adult day care
associations and information and referral services.
(4) university related programs.
(5) vocational/technical
schools.
(6) county extension offices.
(7) local fire department.
(8) red cross.
(9) self-study as approved by
the licensing authority.
(10) In
service training by a qualified staff member whose qualifications are approved
by the licensing authority.
[8.370.20.58
NMAC - N, 7/01/2024]
8.370.20.59 STAFFING REQUIREMENTS:
A. General:
(1) Staff/participant ratios
must be maintained at all times.
(2) The responsibility of
staff members included in the staff/participant ratio shall be direct care of
the participants.
(3) Each facility must keep a
list on file of two readily available persons who can be called to the facility
to substitute for any staff member in case of an emergency or illness. These persons names telephone numbers, and
health certificates must be on file.
B. Staff/participant ratios:
(1) Adult day care centers -
One full time equivalent staff position with responsibility for direct
participant care for each five participants.
(2) Adult day care homes -
One full time equivalent staff position with responsibility for direct care for
no more than five participants.
[8.370.20.59
NMAC - N, 7/01/2024]
8.370.20.60 GENERAL:
A. The health,
safety, and welfare of the participants must be the primary concern in all
activities and services provided by facilities licensed pursuant to these
regulations.
B. Participants must
never be left unattended. Staff members
must be physically present with the participants at all times.
[8.370.20.60
NMAC - N, 7/01/2024]
8.370.20.61 CARE AND SERVICES FOR ADULTS WITH
SPECIAL NEEDS: In addition to all
other requirements contained in these regulations, facilities providing care
and services to adults with special needs including respite care, must comply
with the following:
A. Facilities which
are able to appropriately mainstream special needs adults may do so at their
own discretion.
B. An adult with a
severe diagnosed mental or physical handicap may be admitted to a facility upon
the written recommendation of a licensed physician or therapist.
C. The facility must
make appropriate provisions to meet the needs of adults who require special
services such as additional space, wide doors, halls, ramps and specially
equipped toilet rooms.
D. The licensing
authority may require higher staff/adult ratios and staff qualifications to
properly care for the adults with special needs, if deemed necessary.
[8.370.20.61
NMAC - N, 7/01/2024]
8.370.20.62 ACTIVITIES:
A. Adult day care
activities shall be designed to meet the specific needs and interests of the
participants, as determined by individual plans of care, and shall be
consistent with the program's goals.
B. Activities shall
be planned by staff, participants, family/caregivers, volunteers and other
interested individuals and groups.
C. The day care
center shall assure safe and healthy conditions for activities in and outside
the facility.
D. The plan for, and
conduct of, activities must be an ongoing process and shall be reviewed,
revised and evaluated as necessary.
E. The adult day care
program shall provide for a balance of activities to meet the interrelated
needs and interest (social, intellectual, cultural, economic, emotional and
physical) of participants.
F. Activities shall
be designed to promote personal growth and improve the self-image of
participants by providing opportunities to:
(1) learn new skills and gain
knowledge;
(2) challenge and tap the
potential of participants;
(3) participate in activities
of interest;
(4) improve capacity for
independent functioning;
(5) develop satisfying and
interpersonal relationships;
(6) be exposed to, and
involved in, activities and events within the greater community;
(7) develop cultural
enrichment;
(8) have fun and enjoyment.
G. Activities shall
respond to individual differences in health status, lifestyle, ethnicity,
values, experiences, needs, interests, abilities, skills and age by providing
opportunities for a variety of types and levels of involvement, including:
(1) small and large group
activities;
(2) individualized
activities;
(3) active and spectator
participation;
(4) inter-generational
experience;
(5) involvement in the
greater community;
(6) services to individuals
and to the program
H. Activities shall
be flexible and responsive to changes in:
(1) the needs and interests
of individual participants;
(2) functional capacities of
participants;
(3) the characteristics of
the adult population in the service area.
I. Activities shall
emphasize individual participant's strengths and abilities rather than
impairments, and shall contribute to participant's feeling of competence and
accomplishment.
J. All program
activities shall be supervised by program staff.
K. Participants shall
have the choice of refusing to participate in any given activity, and time
shall be allowed for rest and relaxation.
[8.370.20.62
NMAC - N, 7/01/2024]
8.370.20.63 SCHEDULE:
A. A monthly calendar
of activities shall be prepared and distributed to participants and
family/caregivers.
B. Daily activities
(and services) shall be posted in a visible location within the center.
C. The participant
and family caregivers shall be encouraged to evaluate activities and plan
future activities on a six month basis.
[8.370.20.63
NMAC - N, 7/01/2024]
8.370.20.64 EQUIPMENT:
A. Each facility
shall have a living or multi-purpose room for the use of participants. Such rooms shall be provided with reading
lamps, tables, chairs, and couches. These
furnishings shall be well constructed, comfortable, and in good repair.
B. The living room or
multi-purpose rooms shall be provided with supplies to meet the varied
interests and needs of the participants, including, but not limited to games,
current magazines, books, radio and television.
C. The interest areas
shall be arranged so that quiet and noisy activities can occur concurrently
without disturbing each other.
D. Equipment,
furniture and materials shall be kept in good condition and present no safety
hazards.
[8.370.20.64
NMAC - N, 7/01/2024]
8.370.20.65 LINENS: Linens and bedding shall be kept clean at all
times.
A. There shall be
separate handling and storage of clean and soiled linens.
B. Clean linen shall
be stored in clean storage area.
C. Linens shall be
laundered and disinfected prior to re-use by another participant.
D. Any linen which
has been used by a sick participant, or which has been dirtied by urine or
defecation shall be collected, laundered and disinfected separately from other
items.
E. New linens must be
laundered before use.
[8.370.20.65
NMAC - N, 7/01/2024]
8.370.20.66 FIRST AID REQUIREMENTS: At all times there shall be one staff member
on duty who holds current first aid certificate and has completed an approved
cardiopulmonary resuscitation course.
A. A first-aid,
accessible to all personnel, shall be kept in the facility.
B. The first aid kit
shall contain as a minimum: band aids, gauze pads, adhesive tape, scissors,
soap, and syrup of ipecac.
C. In case of
accidental poisoning, the facility shall immediately contact the poison control
center and their directions shall be followed.
D. Syrup of Ipecac
must not be given to any participant without first contacting the poison
control center.
E. All facilities are
strongly encouraged to send all of their personnel to an approved
cardiopulmonary resuscitation course.
F. All facilities
shall have a first aid manual available to the staff or caregivers.
[8.370.20.66
NMAC - N, 7/01/2024]
8.370.20.67 PETS: The facility shall inform participants and
guardians of the presence of pets in the facility.
A. There shall be no
pets in the kitchen or food serving areas.
B. Pets shall be
inoculated as prescribed by a veterinarian.
C. Proof of inoculation
shall be kept on file in the facility.
D. Pets must be kept
well groomed and healthy.
[8.370.20.67
NMAC - N, 7/01/2024]
8.370.20.68 FOOD SERVICE AND PREPARATION: Each facility that serves meals shall meet
all state and local regulations governing food services establishments. Exception:
Adult day care homes.
A. There shall be no
smoking in food service and food preparation areas.
B. Refrigerators,
work tables, cupboards, and stoves shall be maintained in clean condition.
C. All food and drink
shall be protected from spoiling by proper storage and by putting it in
air-tight containers or wrapping it.
D. All raw fruits and
vegetables shall be washed thoroughly before being cooked or served.
E. All foods shall be
protected from insects, rodents and other vermin.
F. Foods shall be
served promptly and refrigerated immediately after use.
G. Utensils that can
be re-used shall be washed and sanitized.
[8.370.20.68
NMAC - N, 7/01/2024]
8.370.20.69 KITCHENS:
A. There shall be no
through traffic in the kitchen during food preparation or service. Exception: Adult day care homes.
B. Facilities may
allow participants to prepare food as a program activity under careful
supervision. [8.370.20.69 NMAC - N,
7/01/2024]
8.370.20.70 FOOD PREPARATION:
A. Outer clothing of
persons preparing or serving food shall be maintained with the highest degree
of cleanliness.
B. When staff members
are involved in food preparation or service, these persons shall thoroughly
scrub their hands and wear clean fresh outer clothing before preparing or
serving formula or food.
C. In facilities not
under the jurisdiction of the New Mexico environment department, only snacks
which require no cooking shall be served.
Exception: Adult day care homes.
[8.370.20.70
NMAC - N, 7/01/2024]
8.370.20.71 FOOD TEMPERATURE REQUIREMENTS:
A. All perishable
food shall, except when being prepared, be kept at 45 degrees farenheit or
below, or 140 degrees farenheit or above.
B. Foods requiring
refrigeration shall be kept at 45 degrees farenheit or below. Frozen foods shall be kept at zero degrees farenheit
or below.
C. Refrigerators and
separate freezers shall have thermometers.
Metal stem thermometers shall be available to measure proper internal
cooking and holding temperatures.
[8.370.20.71
NMAC - N, 7/01/2024]
8.370.20.72 MENUS:
A. The same menu must
not be served twice in one week.
B. A copy of the
current week's menu, including snacks, shall be posted in the kitchen and the
entrance of the facility where it can be readily seen.
C. Posted menus shall
be followed. Substitutions shall be of
equivalent nutritional value and shall be recorded on the posted menu.
D. The weekly menu
plans must be dated and kept on file for 30 days.
[8.370.20.72
NMAC - N, 7/01/2024]
8.370.20.73 MEAL TIMES AND NUTRITION:
A. Staff/participant
ratios must be maintained at meal times.
B. Time allowed for
meals shall enable the participants to eat at a leisurely rate.
C. Meals may be
served in areas of main activity.
D. Dining areas shall
be equipped with tables, chairs, eating utensils and dishes.
E. Nutrition:
(1) A meal shall be provided to each
participant in attendance at the program during standard mealtimes. Each meal shall provide at lease one-third of
an adult's daily nutritional requirement.
(2) A nutritious mid-morning and
mid-afternoon snack shall be offered daily to participants. Snacks shall be planned to keep sugar, salt
and cholesterol intake to a minimum.
(3) Participants shall not go for more
than three hours without being offered a meal or a snack.
(4) A therapeutic diet shall be
provided, if prescribed in writing by a physician, for any participant. If therapeutic diets are prepared by program
staff, such staff shall have training in planning and preparing therapeutic
diets or shall provide documentation of previous training and education
sufficient to assure ability to prepare meals in accordance with a physician's
prescription.
(5) A registered dietitian/nutritionist
must be consulted by the staff on basic and special nutritional needs and
proper food handling techniques. Instruction
in nutrition, weight control and safe food handling techniques may be provided
as an ongoing part of program activities.
[8.370.20.73
NMAC - N, 7/01/2024]
8.370.20.74 NOTIFIABLE DISEASES: Facilities shall report any notifiable
disease occurring to the participants to the local public health field office:
A. Each facility
shall secure the current list of notifiable diseases published by the New
Mexico health care authority and post it conspicuously in the facility.
B. Facilities shall
not admit or allow the continued attendance of participants who are ill or who
are known or suspected of having notifiable diseases.
C. After a
participant has had a notifiable communicable disease, he or she shall be
re-admitted to the facility only upon written approval of the attending
physician.
[8.370.20.74
NMAC - N, 7/01/2024]
8.370.20.75 ISOLATION:
A. A participant who
becomes sick at the facility must be separated from the rest of the
participants until leaving the facility.
The guardian or responsible party must be promptly notified of the
participant's illness and arrangements must be made for the participant to be
removed from the facility.
B. The facility must
have a bed available for a sick participant which must be thoroughly cleaned
after use.
C. The sick
participant must be kept in an area where he/she can be under constant
observation.
D. Staff must wash
their hands thoroughly after caring for sick participants.
[8.370.20.75
NMAC - N, 7/01/2024]
8.370.20.76 MEDICATIONS: Any facility licensed pursuant to these
regulations who supervises self-administration of medication for the
participants or safeguards medication for residents must have an appropriate
custodial drug permit as determined by the state board of pharmacy.
A. To apply for a
custodial drug permit, or to obtain information concerning management of drugs
and pharmaceutical, the facility should contact the state board of pharmacy.
B. Only medications
which can be self-administered by the participant, unless they will be
administered by a licensed physician, dentist, or nurse, can be kept by a
facility.
C. Medications
prescribed for one participant must not be given to any other participant.
D. Drugs and
medications shall neither be supplied nor given to participants, unless ordered
or prescribed by a licensed physician, dentist, or other practitioner licensed
to do so.
E. Over the counter
medications may be given to a participant by the facility, if the facility has
a written procedure reviewed and approved by a licensed physician for giving
such medications.
F. Medications must
be kept in a locked cabinet or other suitable container approved by the state
board of pharmacy. Medications must be
separated, by individual, in the storage area.
G. The key for the
medication storage area must be made available only to personnel duly
authorized by the director of the facility.
H. Medication which
requires refrigeration must be kept in a separate locked box within a
refrigerator, a locked refrigerator, or a refrigerator in a locked room.
I. All medications
must be kept in their original containers.
J. Poisonous
substances and medications labeled for "external use only" must not
be accessible to participants and must be kept separate from other medications.
K. All outdated
medications shall be disposed of in a manner approved by the state board of
pharmacy.
L. No facility will
prepare dosages of medications, in advance, to be given to participants for
self-administration with assistance. The
medications must be in the original container, the staff member assisting may
hold the container, assist the participant in opening the container, and assist
the participant in administering the medication. Exception: If a facility has on [sic] the
staff nurses registered in the state of New Mexico who prepare dosage and
administer to the resident.
[8.370.20.76
NMAC - N, 7/01/2024]
8.370.20.77 USE OF PHYSICAL RESTRAINTS:
A. Physical
restraints may only be used when authorized by a physician in writing for a
specified period of time or in emergencies.
B. The use of
physical restraints may only be applied by a licensed nurse.
C. Physical
restraints must be applied in accordance with the written policies and
procedures of the facility.
D. Supervision of
participants in restraints shall be on a one to one basis for the duration of
the time the restraints are in place.
[8.370.20.77
NMAC - N, 7/01/2024]
8.370.20.78 TRANSPORTATION:
A. If a facility licensed
pursuant to these regulations provides transportation to participants it is
responsible for the participant from the time picked up until delivered.
B. All vehicles used
for transportation of participants must be licensed and meet all applicable
laws of the state of New Mexico.
C. All vehicles used
for transportation of participants must be equipped with a fire extinguisher
and first aid kit.
D. Participants must
be loaded and unloaded at the curb side of the vehicle.
E. Drivers may leave
the vehicle only to assist participants in boarding and leaving the vehicle,
and must remain in sight of the vehicle at all times.
F. Drivers of
vehicles used to transport participants must be licensed and abide by state and
local laws.
G. Participants shall
be transported no more than 30 minutes without being offered the opportunity to
have a rest stop.
H. Vehicles used to
transport participants shall be equipped with seatbelts. Drivers shall insure participants use
seatbelts while being transported.
[8.370.20.78
NMAC - N, 7/01/2024]
8.370.20.79 RELATED REGULATIONS AND CODES: Adult day care facilities subject to these
regulations are also subject to other regulations, codes and standards as the
same may, from time to time, be amended as follows:
A. Health facility
licensure fees and procedures, New Mexico health care authority, 8.370.3 NMAC.
B. Health facility
sanctions and civil monetary penalties, New Mexico health care authority,
8.370.4 NMAC.
C. Adjudicatory hearings,
New Mexico health care authority, 8.370.2 NMAC.
[8.370.20.79
NMAC - N, 7/01/2024]
HISTORY
OF 8.370.20 NMAC: RESERVED