DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
BUREAU OF COMMUNITY AND HEALTH SYSTEMS  
ADULT FOSTER CARE CONGREGATE FACILITIES  
Filed with the secretary of state on June 8, 2023  
These rules become effective immediately after 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  
9 of the Executive organization act of 1965, 1965 PA 380, MCL 16.109, and sections 10  
and 13 of the adult foster care facility licensing act, 1979 PA 218, MCL 400.710 and  
400.713, and Executive Reorganization Order Nos. 1996-1, 1996-2, 2003-1, 2008-4,  
2011-4, and 2015-1, MCL 330.3101, 445.2001, 445.2011, 445.2025, 445.2030, and  
400.227)  
R 400.2404 and R 400.2454 of the Michigan Administrative Code are amended and  
R 400.2404a is added, as follows:  
PART 4. CONGREGATE FACILITIES  
R 400.2404 Change in health and accidents.  
Rule 404. (1) If an accident or sudden adverse change in a resident's physical condition  
or adjustment occurs, a congregate facility shall obtain needed care immediately and  
notify the responsible relative and the individual or agency responsible for placing and  
maintaining the resident in the congregate facility.  
(2) An occurrence of a reportable communicable disease as defined by the laws of this  
state or the rules implementing the laws must be reported immediately to the local health  
department and the department.  
(3) Immediate investigation of the cause of an accident involving a resident must be  
initiated by a congregate facility licensee or administrator and an appropriate accident  
record must be completed and maintained.  
R 400.2404a Incident notification, incident records.  
Rule 404a. (1) As used in these rules:  
(a) "Department" means the department of licensing and regulatory affairs.  
(b) "Elopement" means a resident that has a service plan that requires notice or  
arranged supervision to leave the facility and is absent without notice or supervision.  
December 8, 2022  
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(c) "Incident" means, consistent with the incident recordkeeping requirement in this  
rule, an intentional or unintentional event where a resident sustains physical or emotional  
harm, an unexpected or unnatural death, is displaced by a natural disaster, or elopes.  
(2) If a resident has a representative identified in writing on the resident’s care  
agreement, the licensee shall report to the resident's representative within 48 hours after  
any of the following:  
(a) Unexpected or unnatural death of a resident.  
(b) Unexpected and preventable inpatient hospital admission.  
(c) Physical hostility or self-inflicted harm or harm to others resulting in injury that  
requires outside medical attention or law enforcement involvement.  
(d) Natural disaster or fire that results in evacuation of residents or discontinuation of  
services greater than 24 hours.  
(e) Elopement from the home if the resident’s whereabouts is unknown.  
(3) If an elopement occurs, staff shall conduct an immediate search to locate the  
resident. If the resident is not located within 30 minutes after the elopement occurred,  
staff shall contact law enforcement.  
(4) An incident must be recorded on a department-approved form and maintained in the  
home for a period of not less than 2 years.  
(5) The department may review incident reports during a renewal inspection or special  
investigation. This does not prohibit the department from requesting an incident report if  
determined necessary by the department. If the department does request an incident  
report, the licensee shall provide the report in electronic form within 24 hours after the  
request. The department shall maintain and protect these documents in accordance with  
state and federal laws, including privacy laws.  
R 400.2454 Accident records.  
Rule 454. An accident record must be prepared for each accident involving a resident.  
An accident record must include the following information:  
(a) The name of the resident involved in the accident.  
(b) The date, hour, place, and cause of the accident.  
(c) The effect of the accident on the resident involved and the care given.  
(d) The name of the physician notified and the time of the notification.  
(e) The physician’s statement regarding the extent of the injuries, the treatment ordered,  
and disposition of the resident involved.  
(f) Corrective measures taken to avoid repetition of the accident.  
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