Code of Colorado Regulations, Rule 6 CCR 1011-1 Chapter 21, Section 6 CCR 1011-1-21-11 - HOSPICE INPATIENT FACILITY | Code of Colorado Regulations

11.1 Staffing

(A) The facility shall provide 24 hours a day nursing services that meet the nursing needs of all patients and are furnished in accordance with each patient's plan of care. Each patient shall receive all nursing services as prescribed and shall be kept comfortable, clean, well groomed, and protected from accident, injury, and infection.

(B) If at least one patient in the facility is receiving acute short-term inpatient care, then each shift shall include a registered nurse who provides direct patient care.

(C) The facility shall also provide, as necessary, for the availability and prompt response of all other core services.

11.2. Environment

The facility shall meet all state and local laws and regulations pertaining to health, safety, accessibility and zoning regulations.

(A) Safety management

(1) The facility shall investigate and correct real or potential threats to the health and safety of the patients, others, and property.

(2) The facility shall have a written disaster preparedness plan in effect for managing the consequences of power failures, natural disasters, and other emergencies that would affect the hospice's ability to provide care. The plan shall be periodically reviewed and rehearsed with staff (including non-employee staff) with special emphasis placed on carrying out the procedures necessary to protect patients and others.

(B) Physical plant and equipment The facility shall ensure:

(1) Adequate light, comfortable temperature, and appropriate ventilation/air exchanges throughout the facility;

(2) Emergency gas, electrical and water supply;

(3) Availability of hot water at all times with plumbing fixtures that regulate the water temperature;

(4) Scheduled and emergency maintenance and repair of all equipment;

(5) A separate clean holding area equipped with:

(a) counter;

(b) sink with mixing faucet;

(c) sink with blade controls;

(d) soap and hand-washing and drying equipment;

(e) waste container; and

(f) shelf space for supplies.

(6) A separate soiled holding area equipped with:

(a) counter;

(b) sink with mixing faucet;

(c) sink with blade controls;

(d) soap and hand-washing and drying equipment;

(e) covered bio-hazard waste container;

(f) covered waste container;

(g) soiled linen hamper with impervious liner; and (h) shelf space for supplies.

(7) A custodial closet equipped with:

(a) cleaning equipment and supplies;

(b) floor-mounted sink with mixing faucets;

(c) shelf space and appropriate storage; and

(d) waste receptacles.

(C) Sanitation

The facility shall provide:

(1) A sanitary environment adhering to current standards of practice, including nationally recognized infection control precautions;

(2) Routine storage and prompt disposal of trash and medical waste;

(3) Clean linen in sufficient amounts for all patient uses that is handled in such a manner as to prevent the spread of contaminants;

(4) Bed linen that is changed as often as necessary but no less than two times per week;

(5) Patient medical supplies and equipment that are stored separately and handled in such a manner as to prevent the spread of contaminants; and

(6) A program to effectively control insect, rodent and pest infestations.

11.3 Patient Areas

The facility shall provide:

(A) Private space for patient/family visiting;

(B) Adequate dining space;

(C) Accommodations for family members to remain with the patient overnight;

(D) Private space for family following a patient's death; and

(E) Flexible visiting hours that do not exclude children or pets.

11.4 Patient Rooms

The facility shall provide:

(A) Patient rooms designed and equipped to provide clinical care, comfort and privacy of patients;

(B) Age and gender appropriate room assignments;

(C) Accommodation for a single room when possible upon patient or family request;

(D) Patient rooms that:

(1) Are at or above grade level;

(2) Provide at least 80 square feet for each patient in a double room and at least 100 square feet for each patient in a single room;

(3) Accommodate no more than two patients;

(4) Contain a suitable bed and other appropriate furniture for each patient;

(5) Have private closet space for clothing and personal belongings;

(6) Are equipped with an easily-activated device accessible to each patient to call for assistance; and

(7) Have toilet and bathing facilities that are easily accessible from each patient room and equipped with grab bars and an easily accessible device to call for assistance.

(a) For existing facilities, one toilet may service two patient rooms only if each patient room also has a sink.

(b) For new construction commencing on or after September 1, 2012, there shall be a minimum of one toilet for every two beds.

11.5 Staff Areas

The facility shall provide staff areas designed and equipped for documentation, medical records, communications, office supplies and equipment, and staff personal effects.

11.6 Dietary

The facility shall provide meals and/or food choices at regular intervals or at a variety of times depending upon the needs of the patients. Food shall be available on a 24-hour, seven-day a week basis and be:

(A) Consistent with the patient's choice, plan of care, nutritional needs, and therapeutic diet;

(B) Palatable and attractive;

(C) Served at the proper temperature, and

(D) Obtained, stored, prepared, distributed, and served in compliance with local sanitary regulations.

Other forms of nourishment shall be provided according to the patient's plan of care.

11.7 Pharmaceutical Services

(A) The facility shall obtain drugs and biologicals in compliance with federal and state law including Colorado Board of Pharmacy regulations.

(B) The facility shall:

(1) Have a written policy and procedure for accurate dispensing of pharmaceuticals; and

(2) Maintain current and accurate records of the receipt and disposition of all controlled substances.

(C) The facility shall limit the administration of patient medications to the following individuals:

(1) A licensed nurse, physician, or other health care professional in accordance with their scope of practice and state law; or

(2) The patient, upon approval by the interdisciplinary group.

(D) The facility shall dispose of medications in compliance with the hospice policy and in accordance with state and federal requirements. The facility shall maintain current and accurate records of the receipt and disposition of all controlled substances.

(E) The facility shall comply with the following additional requirements:

(1) All medications and biologicals shall be stored in secure areas. All controlled substances listed in Schedules II, III, IV, and V of the Comprehensive Drug Abuse Prevention and Control Act of 1976, which is hereby incorporated by reference, shall be stored in locked compartments within secure storage areas. Only personnel authorized to administer controlled substances as noted in section 11.7 of this Chapter shall have access to the locked compartments; and

(2) Discrepancies in the acquisition, storage, dispensing, administration, disposal, or return of controlled substances shall be investigated immediately by the hospice administrator or designee and/or the pharmacist and where required reported to the appropriate state authority. A written account of the investigation shall be made available to state and federal officials if required by law or regulation.

Code of Colorado Regulations1000 - Department of Public Health and Environment1011 - Health Facilities and Emergency Medical Services Division (1011, 1015 Series)6 CCR 1011-1 Chapter 21 - HOSPICESSection 6 CCR 1011-1-21-11 - HOSPICE INPATIENT FACILITY

Code of Colorado Regulations
1000 - Department of Public Health and Environment
1011 - Health Facilities and Emergency Medical Services Division (1011, 1015 Series)
6 CCR 1011-1 Chapter 21 - HOSPICES
Section 6 CCR 1011-1-21-11 - HOSPICE INPATIENT FACILITY