Current through Register Vol. 51, No. 19, September 20, 2024
A. A respiratory care unit shall meet the:
(1) General requirements established for all
special care units as outlined in Regulation .23 of this chapter; and
(2) Requirements of this
regulation.
B. The
nursing home shall submit to the Department and obtain approval of the
following:
(1) All documents required in
Regulation .23 of this chapter;
(2)
Policies and procedures for all aspects of care as outlined in Regulation .23
of this chapter, and the following:
(a)
Qualifications, duties, and responsibilities of staff, including the staff who
are permitted to perform the following procedures:
(i) Cardiopulmonary resuscitation;
(ii) Obtaining arterial blood gas samples and
their analyses;
(iii) Pulmonary
function testing;
(iv) Therapeutic
chest percussion and vibration;
(v)
Bronchopulmonary drainage;
(vi)
Coughing and breathing exercises;
(vii) Mechanical ventilatory and oxygenation
support for residents; and
(viii)
Aerosol, humidification, and medical gas administration;
(b) Weaning from mechanical ventilatory
support and discharge planning for residents of the respiratory care unit;
and
(c) The procurement, handling,
storage, and dispensing of medical gases.
C. Physician Coordinator. If the nursing
home's medical director does not have special training and experience in
diagnosing, treating, and assessing respiratory problems, the nursing home
shall employ or contract with a Board-certified pulmonologist who has the
special knowledge and experience to provide:
(1) Overall medical supervision of the
respiratory care unit; and
(2)
Coordination of all services for the respiratory care unit.
D. Staffing. The nursing home
shall ensure that:
(1) The nurse manager or
the director of nursing of vent units has a background in ventilator care or is
qualified in ventilator management;
(2) Respiratory care services are provided by
a sufficient number of qualified personnel; and
(3) Respiratory care personnel provide
respiratory care services commensurate with their documented training,
experience, and competence.
E. Design.
(1) Emergency Power. The nursing home unit
shall meet all applicable requirements in Regulation .46 of this chapter for
emergency electrical power, including the provision of:
(a) Emergency lighting in the respiratory
care unit where life support equipment is used; and
(b) Duplex receptacles connected to the
facility's emergency generator to provide emergency power to operate life
support equipment and nonflammable medical gas systems in the respiratory care
unit.
(2) Ventilator
Alarms. The facility shall ensure that each ventilator is equipped with an
alarm on both the pressure valve and the volume valve for safety.
(3) Piped Medical Gas Systems.
(a) To service the medical gas systems, a
vendor or staff shall be trained and accredited in accordance with NFPA 99
Health Care Facilities Code.
(b)
The vendor or staff may provide the following services:
(i) Installation;
(ii) Inspection; or
(iii) Testing.
(c) The nursing home shall ensure that all
piped medical gas systems adhere to the following standards:
(i) NFPA 99 Health Care Facilities Code;
and
(ii) NFPA 101 Life Safety
Code.
F. The nursing home shall provide pulmonary
function testing and blood gas or pulse analysis capability on-site or through
contractual arrangements with providers who meet applicable State and federal
laws and regulations.
G.
Contractual Services. When any respiratory care services are provided by an
outside contractor, the facility shall:
(1)
Approve the contractor based on the contractor's credentials, training, and
experience;
(2) Ensure that all
contractors:
(a) Provide services 24 hours a
day;
(b) Meet all safety
requirements;
(c) Abide by all
pertinent policies and procedures of the facility;
(d) Provide services in accordance with all
laws and regulations governing the facility; and
(e) Participate in the monitoring and
evaluation of the appropriateness of services provided as required by the
facility's quality assurance program; and
(3) Ensure that all contractual services
receive overall medical supervision and coordination by the facility's
physician coordinator of the respiratory care unit.
