Subject 111-8-71 TRAUMATIC BRAIN INJURY FACILITIES
The legal authority for this chapter is Chapter 7 of Title 31 of the Official Code of Georgia annotated.
The purpose of these rules is to implement the requirements of Chapter 7 of Title 31 of the Official Code of Georgia Annotated pertaining to the licensure of facilities that are devoted to the provision of treatment and rehabilitative care for periods continuing for 24 hours or longer for persons who have traumatic brain injury.
|(1)||"Department" means the Georgia Department of Community Health.|
|(2)||"Facility" means a place which is devoted to the provision of treatment and rehabilitative care for periods continuing for 24 hours or longer for persons who have traumatic brain injury. Such facility is not classified by the Department as a hospital, nursing home, intermediate care facility, or personal care home.|
|(3)||"Traumatic Brain Injury" means a traumatic insult to the brain and its related parts resulting in organic damage thereto which may cause physical, intellectual, emotional, social, or vocational changes in a person. Persons having a traumatic brain injury may have organic damage or physical or social disorders, but for the purpose of these rules, traumatic brain injury shall not be considered mental illness.|
Each facility shall have a governing body empowered and responsible to determine all policies and procedures, and to ensure compliance with these rules and regulations.
No facility shall be operated without a permit or provisional permit issued by the Department.
|(a)||A permit shall be issued by the Department upon a facility's compliance with these rules and regulations.|
provisional permit shall be issued by the Department on a conditional basis for
one of the following reasons.
|(c)||Any permit shall be displayed in a conspicuous place on the premises of the facility.|
|(d)|| Permits issued shall remain in force and
effect until revoked or suspended.
Provisional permits shall remain in force and effect for such limited period of time as may be specified by the Department. Any permit is only valid at the location for which issued, and is not transferable between governing bodies.
Applications for a permit to operate a facility shall be submitted by the governing body on forms prescribed by the Department. An approved Certificate of Need shall accompany the application. Failure or refusal to file an application shall constitute a violation of Chapter 7 of Title 31 of the Official Code of Georgia Annotated.
|(1)||Upon submission of a completed application, the Department shall conduct an inspection of a facility to determine compliance with these rules and regulations. Following an inspection, the Department may issue or refuse to issue a permit or a provisional permit.|
|(2)||The Department shall conduct such additional inspections as needed to determine if a facility continues to fulfill requirements. Failure to fulfill requirements may result in the revocation of a permit as provided in Chapter 111-8-71-.16.|
|(1)||Written policies and procedures shall be established and implemented for admission to the facility. Such policies shall include a description of the types of traumatic brain injured persons it serves, the continuum of treatment and rehabilitative care it provides, and the functional outcomes it intends to achieve for its clients in regard to degree of personal and living independence, level of work productivity, and psychosocial adjustment.|
|(2)||Initial admissions shall be screened through review of a written application form, review of referral information and the client's most recent medical records, and personal interviews with the client. Factors to be considered in the screening include the client's medical history, functional status, and social circumstances.|
|(3)|| At admission the
following information shall be explained to each client, and a responsible
family member, guardian, or representative. Documentation of the explanation
shall be maintained in the client's case record.
|(1)||Written policies and procedures shall be established and implemented to provide for a complete, written assessment of the client within four weeks following admission. The purpose of the assessment shall be to determine client rehabilitation potential or need for ongoing lifetime support and the facility's ability to deliver appropriate treatment and rehabilitative care, or support to the client.|
|(2)||The assessment shall be performed under the supervision of the program manager in collaboration with the rehabilitation professionals that provide therapies and services in the facility. The assessment must also include documentation of contact and input from the client's physician, previous rehabilitation providers and facilities, and rehabilitation professionals previously involved in the client's treatment and rehabilitative care. The assessment must identify the client's rehabilitation potential and behavioral, cognitive, educational, emotional, functional, medical, nursing, sociological, and vocational characteristics and needs. Whenever feasible, clients, families, and guardians or representatives should participate in assessments.|
|(3)|| An individual, written program plan shall
be developed for each client, with his participation, by professional staff
that participated in the assessment. The plan shall be based on the
characteristics and needs identified in the assessment. The plan shall include
specific goals oriented towards outcomes to achieve independence for the
An individual care record shall be maintained for each client admitted to the facility. Case records must be maintained in a central location, and contain the following materials:
|(a)||Case identification information;|
|(b)||Names, addresses, and telephone numbers of responsible family members, guardians, or representatives;|
|(c)||Names, addresses, and telephone numbers of emergency contacts to include the client's physicians;|
|(e)||The client's complete written assessment;|
|(f)||The client's written program plan, including the designation of a case manager; and|
|(g)||Signed and dated progress reports, notes or similar documentation related to the mental and physical health, treatment, and rehabilitation of the client to include current drug regimens, treatment, and dietary needs.|
A facility shall provide one or two levels of treatment and rehabilitative care. These are:
Transitional Living. Such treatment and rehabilitative care shall be delivered
to clients that require education and training for independent living with a
focus on compensating for skills that cannot be restored. Such care prepares
clients for maximum independence, teaches necessary skills for community
interaction, works with clients on pre-vocational and vocational training, and
stresses cognitive, speech, and behavioral therapies structured to the
individual needs of clients.
|(b)|| Lifelong Living. Such treatment and
rehabilitative care shall be delivered to clients that have been discharged
from rehabilitation, cannot live at home independently, and require ongoing
|(1)||A facility must be designed, constructed, equipped and maintained to protect the health and safety of clients and staff.|
|(2)||Floors, walls, and ceilings shall be in good repair.|
|(3)||A facility must be in compliance with applicable fire safety laws, and regulations of the Georgia Safety Fire Commissioner.|
|(4)||A facility must provide sufficient space and equipment in recreation, program, and treatment and rehabilitation areas to provide needed services as required by these rules and as identified in each client's individual, written program plan.|
|(5)||A facility must be wheelchair accessible.|
|(6)|| Client rooms must
be designed and equipped for adequate care and treatment, comfort, and privacy
of clients. Bedrooms must:
|(7)||Each client must be provided with a separate bed of proper size and height for the convenience of the client; a clean, comfortable mattress; clean linen and bedding appropriate to the weather and climate; functional furnishings appropriate to the client's needs; and individual closet space in the client's bedroom with clothes racks and shelves accessible to the client.|
|(8)||Each resident room must be equipped with or located near lavatory, toilet and bathing facilities. Such facilities used by clients in wheelchairs must be equipped for their use. A functional lavatory, toilet, and bath or shower shall be provided for every five residents or fraction thereof.|
|(9)|| A facility must provide a safe,
functional, sanitary, and comfortable environment for clients and staff.
|(10)||Facilities that have motor vehicles for the transportation of clients shall ensure that vehicles are maintained in a safe condition with insurance coverage. Facility operators shall possess valid driver's licenses for the class of vehicles used for transportation. Safety restraining devices and equipment must be available in vehicles transporting clients with disabilities.|
A facility shall have a written and regularly rehearsed disaster preparedness plan approved by the Department. Such plan shall be in accordance with Rules for Disaster Preparedness Plans, Chapter 111-8-16.
|(1)||The facility must provide each client with a nourishing, palatable, well-balanced diet that meets the daily nutritional and special dietary needs of each client.|
|(2)||At least three meals daily must be provided or made available to each client, at regular times comparable to normal mealtimes in the community. There must be no more than 14 hours between a substantial evening meal and breakfast the following day.|
|(3)||The facility shall provide special eating equipment and utensils, and assistance for clients in need of such services.|
|(4)||Food must be stored, prepared, distributed, and served under sanitary conditions.|
|(5)||Sufficient space, equipment, and durable supplies and utensils for dining shall be maintained appropriate to the client's needs.|
The Department upon application or petition may grant variances and waivers to these rules and regulations when it is shown that the rule and regulation is not applicable or to allow experimentation or demonstration of new and innovative approaches to delivery of services.
The department may refuse to grant a permit for the operation of any facility that does not fulfill the requirements of these rules and regulations and may revoke a permit which has been issued if a facility violates any such rules and regulations. The applicant or permit holder shall be afforded an opportunity for a hearing as provided in O.C.G.A. §§ 31-2-8 or 31-7-2.2 as applicable and the Rules and Regulations for General Licensing and Enforcement Requirements, Chapter 111-8-25.
In the event that any rule, sentence, clause or phrase of any of these rules and regulations may be construed by any court of competent jurisdiction to be invalid, illegal, unconstitutional, or otherwise unenforceable, such determination or adjudication shall in no manner affect the remaining rules or portions thereof and such remaining rules or portions thereof shall remain in full force and effect, as if such rule or portions thereof so determined, declared or adjudged invalid or unconstitutional were not originally a part thereof.