Current through Register Vol. 42, No. 11, August 30, 2024
(1) Each
resident must receive and the facility must provide the necessary care and
services to attain or maintain the highest practicable physical, mental, and
psychosocial well-being, in accordance with the comprehensive assessment and
plan of care.
(2) Activities of
daily living. Based on the comprehensive assessment of a resident, the facility
must ensure that-
(a) A resident's abilities
in activities of daily living do not diminish unless circumstances of the
individual's clinical condition demonstrate that diminution was unavoidable.
this includes the resident's ability to-
1.
Bathe, dress, and groom;
2.
Transfer and ambulate;
3.
Toilet;
4. Eat; and
5. Use speech, language, or other functional
communication systems.
(b) A resident is given the appropriate
treatment and services to maintain or improve his or her abilities specified in
paragraph (2)a above; and
(c) A
resident who is unable to carry out activities of daily living receives the
necessary services to maintain good nutrition, grooming, and personal
hygiene.
(3) Vision and
hearing. To ensure that residents receive proper treatment and assistive
devices to maintain vision and hearing abilities, the facility must, if
necessary, assist the resident-
(a) In making
appointments, and
(b) By arranging
for transportation to and from the office of a practitioner specializing in the
treatment of vision or hearing impairment or the office of a professional
specializing in the provision of vision or hearing assistive devices.
(4) Pressure sores. Based on the
comprehensive assessment of a resident, the facility must ensure that-
(a) A resident who enters the facility
without pressure sores does not develop pressure sores unless the individual's
clinical condition demonstrates that they were unavoidable; and
(b) A resident having pressure sores receives
necessary treatment and services to promote healing, prevent infection and
prevent new sores from developing.
(5) Urinary Incontinence. Based on the
resident's comprehensive assessment, the facility must ensure that-
(a) A resident who enters the facility
without an indwelling catheter is not catheterized unless the resident's
clinical condition demonstrates that catherization was necessary; and
(b) A resident who is incontinent of bladder
receives appropriate treatment and services to prevent urinary tract infections
and to restore as much normal bladder function as possible.
(6) Range of motion. Based on the
comprehensive assessment of a resident, the facility must ensure that-
(a) A resident who enters the facility
without a limited range of motion does not experience reduction in range of
motion unless the resident's clinical condition demonstrates that a reduction
in range of motion is unavoidable; and
(b) A resident with a limited range of motion
receives appropriate treatment and services to increase range of motion and/or
to prevent further decrease in range of motion.
(7) Mental and Psychosocial functioning.
Based on the comprehensive assessment of a resident, the facility must ensure
that--
(a) A resident who displays mental or
psychosocial adjustment difficulty, receives appropriate treatment and services
to correct the assessed problem; and
(b) A resident whose assessment did not
reveal a mental or psychosocial adjustment difficulty does not display a
pattern of decreased social interaction and/or increased withdrawn, angry or
depressive behaviors, unless the resident's clinical condition demonstrates
that such a pattern was unavoidable.
(8) Naso-gastric tubes. Based on the
comprehensive assessment of a resident, the facility must ensure that--
(a) A resident who has been able to eat
enough alone or with assistance is not fed by a naso-gastric tube unless the
resident' clinical condition demonstrates that use of a naso-gastric tube was
unavoidable; and
(b) A resident who
is fed by a naso-gastric or gastrostomy tube receives the appropriate treatment
and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration,
metabolic abnormalities, and nasal-pharyngeal ulcers and to restore, if
possible, normal feeding function.
(9) Accidents. The facility must ensure
that--
(a) The resident environment remains
as free of accident hazards as is possible; and
(b) Each resident receives adequate
supervision and assistance devices to prevent accidents.
(10) Nutrition. Based on a resident's
comprehensive assessment, the facility must ensure that a resident -
(a) Maintains acceptable parameters of
nutritional status, such as body weight and protein, unless the resident's
clinical condition demonstrates that this is not possible; and
(b) Receives a therapeutic diet when there is
a nutritional problem.
(11) Hydration. The facility must provide
each resident with sufficient fluid intake to maintain proper hydration and
health.
(12) Special needs. The
facility must ensure that residents receive proper treatment and care for the
following special services:
(a)
Injections;
(b) Parenteral and
enteral fluids;
(c) Colostomy,
ureterostomy, or ileostomy care;
(d) Tracheotomy care;
(e) Tracheal suctioning;
(f) Respiratory care;
(g) Foot care; and
(h) Prostheses.
(13) Unnecessary drugs.
(a) General. Each resident's drug regimen
must be free from unnecessary drugs. An unnecessary drug is any drug when used:
1. in excessive dose (including duplicate
therapy); or
2. for excessive
duration; or
3. without adequate
monitoring; or
4. without adequate
indications for its use; or
5. in
the presence of adverse consequences which indicate the dose should be reduced
or discontinued; or
6. any
combination of the reason above.
(b) Antipsychotic Drugs. Based on a
comprehensive assessment of a resident, the facility must ensure that--
1. Residents who have not used antipsychotic
drugs are not given these drugs unless antipsychotic drug therapy is necessary
to treat a specific condition as diagnosed and documented in the clinical
record; and
2. Residents who used
antipsychotic drugs receive gradual dose reductions, and behavioral
interventions, unless clinically contraindicated, in an effort to discontinue
these drugs.
(14) Medication Errors. The facility must
ensure that-
(a) It is free of medication
error rates of five percent or greater; and
(b) Residents are free of any significant
medication errors.
Author: Patricia E. Ivie
Statutory Authority:
Code of Ala.
1975, §§
22-21-20,
et
seq.
