Section 87463 - [Operative 1/1/2025] Reappraisals(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal.(b) The reappraisal shall document significant changes in the resident's physical, mental, cognitive, behavioral, or functional condition, including those required to be documented as specified in Section 87466, Observation of the Resident. (1) Significant changes in condition, as defined in Section 87101, Definitions, include, but are not limited, to:(A) Physical trauma, such as a heart attack or stroke.(B) Cognitive functions, such as thinking, remembering, reasoning, exercising judgement, and decision-making.(C) Behavioral expression, as defined in Section 87101, Definitions, that may result in harm to self or others, such as unsafe wandering, elopement, hallucinations, lacking in hazard awareness, or lacking in impulse control.(D) A mental or social trauma, such as the loss of a loved one.(E) Illness or injury that results in a significant change in the health care or dietary needs of the resident.(F) Whether the resident's and other residents' safety would be at risk if the resident is allowed to have access to any of the items specified in Section 87307, Personal Accommodations and Services and in Section 87309, Storage Space and Access.(c) If the licensee observes or is made aware of behavioral expression, as defined in Section 87101, that has caused or may cause harm to the resident or others, the licensee shall document all of the following in the resident's reappraisal: (1) A description of the behavioral expression.(2) If known, identification of events occurring just prior to the behavioral expression including, but not limited to, interactions with other residents or staff, sudden or recent changes in the physical environment, signs of possible new physical illness or injury (such as fever, cough, urinary urgency, or limping), overstimulation (such as from noise or visitors), or physical sensations a resident may not be able to express verbally that may include, but are not limited to, fatigue, heat, cold, pain, hunger, thirst, boredom, fear, wanting to walk, or need for toileting.(3) Interventions to be implemented to minimize the risks to the health and safety of the resident or others associated with the resident's behavioral expression. The licensee shall use the least restrictive intervention to manage the behavioral expression based on the individual needs of the resident.(d) If a resident is receiving specialized services, the licensee shall consult with those care providers in order to ensure changes in the resident's condition are properly addressed, document such consultation, and place documentation in the resident's record.(e) The licensee shall immediately, or as soon as reasonably possible, bring any significant change in condition, as defined in Section 87101, Definitions, to the attention of the appropriate licensed medical professional and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident's record and shall include: (1) Description of the significant change in condition;(2) Date and time the communication occurred and the name of the appropriate licensed medical professional, and if applicable, other specialized care provider, with whom the licensee communicated;(3) Recommendation, if any, of the appropriate licensed medical professional, and if applicable, other specialized care provider; and(4) Change in care to be provided, if any.(f) The licensee shall immediately, or as soon as reasonably possible, communicate with the resident and, if applicable, the resident's representative, about any significant change in condition and the recommendation, if any, of the appropriate licensed medical professional, and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident's record.(g) The licensee shall ensure corresponding changes are made in the care and supervision provided to the resident.(h) The licensee shall request that all residents receive an annual routine visit with a licensed medical professional once every twelve months, either in person or by video appointment. (1) Documentation of the annual routine visit, such as a visit summary, shall be added to the resident's record.(2) Documentation of a resident's refusal to receive an annual routine visit, or if applicable, their representative's refusal on their behalf, shall be added to the resident's record.(3) If a resident refuses to receive an annual routine visit, or if applicable, their representative refuses an annual routine visit on their behalf, but later agrees to one, documentation of the annual routine visit shall be added to the resident's record.(i) When there is significant change in condition, as defined in Section 87101, Definitions, or once every 12 months, whichever occurs first, the licensee shall arrange an in-person or virtual meeting or conference call to share the reappraisal with the resident, the resident's representative, if applicable, and appropriate facility staff, as specified in Section 87467, Resident Participation in Decision Making.(j) The licensee shall evaluate staffing needs to ensure that there is a sufficient number of direct care staff, as specified in Section 87411, Personnel Requirements -- General, to support each resident's physical, social, emotional, safety and health care needs, as identified in their current appraisal.Cal. Code Regs. Tit. 22, § 87463
Note: Authority cited: Section 1569.30, Health and Safety Code. Reference: Sections 1569.1, 1569.156, 1569.2, 1569.31, 1569.312 and 1569.315, Health and Safety Code.
Note: Authority cited: Section 1569.30, Health and Safety Code. Reference: Sections 1569.1, 1569.156, 1569.2, 1569.31, 1569.312 and 1569.315, Health and Safety Code.
1. Change without regulatory effect renumbering former section 87587 to section 87463, including amendment of section and Note, filed 3-5-2008 pursuant to section 100, title 1, California Code of Regulations (Register 2008, No. 10).
2. Amendment filed 10-17-2024; operative 1/1/2025 (Register 2024, No. 42).