Arizona Compliance Checklist

A new checklist was published by the Bureau of Residential Licensing of the Arizona Department of Health Services (“AZ DHS”) in September 2022 for providers to refer to when preparing for their Initial Licensing Inspection: AZ DHS Licensing checklist (homes)

This checklist can also be consulted by existing licensed providers in the context of their annual compliance inspections. It is a useful tool for homeowners and managers to prepare for a state surveyor visit.

Did you know that there is an Arizona regulation that requires a manager to ensure that a current drug reference guide and a current toxicology reference guide are available for use by personnel members ? (See A.C.C. R9-10-816.D.2) Those home that have been in operation for a number of years may have a book on their shelf which is no longer current. A quick check of Amazon’s website can reveal if a new edition needs to be ordered. State surveyors are actually checking Amazon.com and asking caregivers if they know how to access an online drug or toxicology guide if they are not finding a current drug and toxicology reference manual onsite.

One possibly acceptable online guide is: https://druginfo.nlm.nih.gov/drugportal/

Another authoritative reference on toxicology is:

https://wwwn.cdc.gov/TSP/ToxGuides/ToxGuidesLanding.aspx

However, we recommend that licensed providers contact AZ DHS, or your state’s licensing agency if there are similar reference material requirements outside of Arizona, to confirm what websites the licensing agency deems acceptable, and make a note of the date, time and representative’s name providing the advice.

Printouts of online web addresses may be placed in the Medication Administration Record (“MAR”) binder, and/or in the locked cabinet where medications are stored, to ensure that a current guide is available to staff. For those facilities performing electronic recordkeeping, check with your software service provider to see if their systems have resources that are compliant with this regulation. Staff initials on the web address printout, or a verification that they know how to access that area of the online recordkeeping program, can help validate compliance with that rule.

Further training on how and when to use these reference tools and on caregiver duties in general is also recommended. The Arizona Assisted Living Homes Association (AALHA.org) now provides monthly one hour long online classes geared toward caregiver training. Although Caregiver continuing education training is not required under Arizona rules or regulations, (although other states do mandate minimum caregiver training annually), homes will be surveyed in accordance with each facility’s policies and procedures. Some homes’ written policies include internal training requirements. Thus, if a home licensed in Arizona has a policy stating that staff must have a certain number of hours of training annually, they can use AALHA.org’s free course offerings as a resource. Full disclosure: the author of this article is a member of the Board of Directors of AALHA.

Thus, in addition to the items contained on the AZ DHS Initial Licensing checklist referenced at the top of this article, it is wise to review your home’s Policy and Procedures manual routinely.  Managers are expected to verify that they have done so at least once every three years, and update the policies and procedures as needed. (See R9-10-803.C.3)  Based on recent rule changes and statutory updates (i.e. finger print clearance card; fall prevention; etc.), state inspectors will likely be checking to see if the home’s Policies and Procedures manual has been updated as needed.

Just like the drug reference book, a facility’s Policies and Procedures should always be current. If items are included that go above and beyond regulatory requirements (i.e. caregiver training), facilities are encouraged to ensure that personnel records reflect compliance with the policy.  Alternatively, the policy itself can be revised to state that training will be offered in accordance with current state regulations or statutory requirements, and any additional training offered will be at the sole discretion of the manager. Any written policies that state that no training will be provided by the employer, or Policy and Procedure Manuals that do not address the topic of staff training at all because it had not previously been required, may now contradict recent statutory enactments requiring specific subject-area training such as fall prevention or TB screening.

Pinkowski Law & Policy Group recommends that Arizona assisted living providers review their written Policies and Procedures regularly to ensure that they are current and your staff is familiar with them. Also review your state’s licensing agency’s website regularly for postings, such as the new home licensing checklist referenced above, to help stay in compliance.  

The information herein is intended to be educational and an introduction to the subject matter presented. Despite any statutory or regulatory references cited in the article above, it is NOT specific legal advice to be relied upon for specific individual circumstances. Contact your own legal professional or reach out to our firm if you would like specific advice on this topic. Look for more weekly blog posts on topics of interest to licensed Assisted Living and Behavioral Health operators. 

We welcome topic suggestions!  Write to info@pinkowskilaw.com if you are curious to learn more about a certain topic impacting assisted living or other group housing concerns.