Filed with the secretary of state on March 21, 2023  
These rules take effect immediately upon filing with the secretary of state unless adopted  
under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA  
306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become  
effective 7 days after filing with the secretary of state.  
(By authority conferred on the department of licensing and regulatory affairs by section  
427 of the Executive organization act of 1965, 1965 PA 380, MCL 16.527, section 2233  
of the public health code, 1978 PA 368, MCL 333.2233, and Executive Reorganization  
Order Nos. 1996-1, 1996-2, 2003-1, and 2015-1, MCL 330.3101, 445.2001, 445.2011,  
and 400.227)  
R 325.1901, R 325.1924, and R 325.1932 of the Michigan Administrative Code are  
amended, as follows:  
R 325.1901 Definitions.  
Rule 1. As used in these rules:  
(a)"Act" means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.  
(b) "Activities of daily living" means activities associated with eating, toileting,  
bathing, grooming, dressing, transferring, mobility, and medication management.  
(c) "Admission policy" means a home's program statement of its purpose, eligibility  
requirements, and application procedures for admission.  
(d) "Assistance" means help provided by a home or an agent or employee of a home to  
a resident who requires help with activities of daily living.  
(e) "Authorized representative" means that person or agency that has been granted  
written legal authority by a resident to act on behalf of the resident or is the legal  
guardian of a resident.  
(f) "Department" means the department of licensing and regulatory affairs.  
(g) "Director" means the director of the department.  
(h) "Discharge policy" means a home's written statement of the criteria and procedures  
by which a resident is discharged from the home.  
(i) "Elopement" means a resident who has a service plan that requires notice or  
arranged supervision to leave the facility and is absent without notice or supervision.  
(j) "Home" means a home for the aged as defined in section 20106(3) of the act, MCL  
(k) "Incident" means an intentional or unintentional event including, but not limited to,  
elopements and medication errors, where a resident suffers physical or emotional harm.  
August 26, 2022  
(l) "Licensed health care professional" means an individual who is licensed under  
article 15 of the act, MCL 333.16101 to 333.18838, and who is operating within the  
scope of his or her license.  
(m) "Major building modification" means an alteration of walls that creates a new  
architectural configuration or revision to the mechanical or electrical systems that  
significantly revise the design of the system or systems. Normal building maintenance,  
repair, or replacement with equivalent components are not considered major building  
modifications. A change in room function shall not cause a conflict with these rules.  
(n) "Medication management" means assistance with the acquisition and administration  
of a resident’s prescribed medication.  
(o) "Program statement" means a written description of the home's overall philosophy  
and mission reflecting the needs of residents and services provided to residents. A home  
that represents to the public that it provides residential care or services, or both, to  
individuals with Alzheimer's disease or a related condition shall include in its program  
statement the information required by section 20178 of the act, MCL 333.20178.  
(p) "Protection" means the continual responsibility of the home to take reasonable  
action to ensure the health, safety, and well-being of a resident as indicated in the  
resident's service plan, including protection from physical harm, humiliation,  
intimidation, and social, moral, financial, and personal exploitation while on the  
premises, while under the supervision of the home or an agent or employee of the home,  
or when the resident's service plan states that the resident needs continuous supervision.  
(q) "Resident" means an individual who is 55 years of age or older, or an individual  
under the age of 55 who has been admitted through a waiver of the director pursuant to  
section 21311(3) of the act, MCL 333.21311.  
(r) "Resident admission contract" means a written agreement between the home and the  
resident or the resident's authorized representative that specifies the services to be  
provided, the fees to be charged, including all fees related to admission such as deposits,  
admission fees, advance care payments, application fees and all other additional fees, and  
the home's policies related to the admission and retention of a resident.  
(s) "Room and board" means the provision of housing and meals to meet the needs of  
the resident.  
(t) "Service plan" means a written statement prepared by the home in cooperation with  
a resident, the resident's authorized representative, or the agency responsible for a  
resident's placement, if any, that identifies the specific care and maintenance, services,  
and resident activities appropriate for the individual resident's physical, social, and  
behavioral needs and well-being, and the methods of providing the care and services  
while taking into account the preferences and competency of the resident.  
(u) "Supervision" means guidance of a resident in the activities of daily living, and  
includes all of the following:  
(i) Reminding a resident to maintain his or her medication schedule in accordance with  
the instructions of the resident's licensed health care professional as authorized by section  
17708(2) of the act, MCL 333.17708.  
(ii) Reminding a resident of important activities to be carried out.  
(iii) Assisting a resident in keeping appointments.  
(iv) Being aware of a resident's general whereabouts as indicated in the resident's  
service plan, even though the resident may travel independently about the community.  
(v) Supporting a resident's personal and social skills.  
R 325.1924 Reporting of incidents, quality review program.  
Rule 24. (1) A home for the aged must implement and maintain a quality review  
program consistent with section 20175(8) of the act, MCL 333.20175, and the  
professional review function. The program is responsible for all of the following:  
(a) Reviewing and evaluating incidents.  
(b) Identifying effective means to correct any deficient practice.  
(c) Ensuring resident safety and quality of care.  
(d) Improving procedures.  
(2) The program must be reviewed annually by the administrator and governing body.  
(3) The program must be staffed by a multi-disciplinary team. The multi-disciplinary  
team shall consist of not less than 2 personnel that have training or experience with the  
type of the incident being evaluated.  
(4) The multi-disciplinary team shall meet not less than twice each calendar year or  
more frequently as needed to review an incident or incidents.  
(5) Records must be maintained that demonstrate incident reporting to the team,  
analyses, outcomes, corrective action taken, and evaluation to ensure that the expected  
outcome is achieved. These records must be maintained for 2 years.  
(6) The facility must have a policy and procedure to report an incident using a  
department approved form to the multi-disciplinary team responsible for the quality  
review program required under subrule (1) of this rule.  
(7) The facility must have a policy and procedure to ensure that an incident, once known  
by facility staff, is reported as soon as possible, but not later than 48 hours after the  
incident, to a resident’s authorized representative or designated health care professional,  
as appropriate. Verbal or written notification must be documented in the resident’s record  
to reflect the date, time, name of staff who made the notification, and name of the  
representative or professional who was notified.  
(8) If an elopement occurs, staff shall conduct a search to locate the resident. If the  
resident is not located within 30 minutes after the elopement occurred, staff shall comply  
with subrule (7) of this rule and contact the local police authority.  
(9) The department may review a quality review program during a renewal survey to  
confirm that a program is in place. During a complaint investigation, the licensee shall  
confirm if an incident was reviewed and if any corrective actions were taken, but the  
department shall not request any other case-specific information that was part of the  
quality review program. The department shall rely on other documents outside this  
professional review function as part of its investigation. The department shall maintain  
and protect these documents in accordance with state and federal laws, including privacy  
R 325.1932 Resident’s medications.  
Rule 32. (1)A service plan must identify prescribed medication to be self-administered  
or managed by the home.  
(2) Prescribed medication managed by the home shall be given, taken, or applied  
pursuant to labeling instructions, orders and by the prescribing licensed health care  
(3) Staff who supervise the administration of medication for residents who do not self-  
administer shall comply with all of the following:  
(a) Be trained in the proper handling and administration of the prescribed medication.  
(b) Complete an individual medication log that contains all of the following  
(i) The name of the prescribed medication.  
(ii) The prescribed required dosage and the dosage that was administered.  
(iii) Label instructions for use of the prescribed medication or any intervening order.  
(iv) The time when the prescribed medication is to be administered and when the  
medication was administered.  
(v) The initials of the individual who administered the prescribed medication.  
(vi) A record if the resident refuses to accept prescribed medication and notification as  
required in subdivision (c) of this subrule.  
(vii) A record of the reason for administration of a prescribed medication that is on an  
as-needed basis.  
(c) Contact the appropriate licensed health care professional when the prescribed  
medication has not been administered in accordance with the label instruction, an order  
from a health care professional, medication log, or a service plan.  
(4) If a resident requires prescription or over-the-counter medication or medications  
while out of the home, and medication or medications are not identified as self-  
administered, staff responsible for the medication management shall ensure that the  
resident, or the person that assumes responsibility for the resident, has all appropriate  
information, medication, and instructions.  
(5) Prescribed medication that is no longer required by a resident must be properly  
disposed of consistent with the policy established by the home and manufacturer  
(6) For a resident who is identified as self-administered in his or her service plan, the  
home must have a policy to offer a secured method of storage for medications if desired  
by the resident and to notify the applicable health care professional or legal representative  
if there is a change in a resident’s capacity to self-medicate.