The Secretary of the Department of Human Services shall adopt rules necessary to implement and administer this subchapter, including without limitation:
(1) Procedures for a long-term care facility to notify the Office of Long-Term Care of admissions; and
(2) Procedures by which a person in a long-term care facility may decline options counseling for long-term care.
(3) These procedures shall include a form promulgated by the Department of Human Services for use by a long-term care facility.
(4) The form shall be limited to one (1) page and shall: Be orally read to the resident or, if applicable, the resident's representative by long-term care facility staff except as provided in this subdivision (2)(B)(ii);
(5) List the date;
(6) State the name of the resident or, if applicable, the resident's representative;
(7) Contain checkboxes indicating that: The office was notified of the admission;
(8) The form was not read orally to the resident or resident's representative because the resident lacks decisional capacity and does not have a representative; and
(9) The resident or the resident's representative declined the options counseling for long-term care;
(10) Contain a statement and an acknowledgment that options counseling for long-term care is an optional program and may be declined by execution of the form;
(11) Be signed by the resident or, if applicable, the resident's representative; and
(12) Be retained by the long-term care facility in the resident's admission file for eighteen (18) months or until the next standard survey, whichever is longer.