Code of Massachusetts Regulations
105 CMR - DEPARTMENT OF PUBLIC HEALTH
Title 105 CMR 150.000 - Standards for Long-Term Care Facilities
Section 150.015 - Resident Comfort, Safety, Accommodations and Equipment
Universal Citation: 105 MA Code of Regs 105.150
Current through Register 1531, September 27, 2024
(A) All facilities shall provide for the comfort, safety and mental and physical well-being of residents.
(B) Personal Care.
(1) Every resident shall have a reasonable
amount of privacy.
(2) Residents
shall be treated with dignity and kindness at all times.
(3) Residents' personal effects shall be
treated with respect and care.
(4)
Residents shall be encouraged and assisted to dress and move about from
sleeping quarters to sitting rooms, dining areas and out-of-doors when their
conditions permit.
(C) Safety and Personal Protection.
(1) At all times a responsible staff member
shall be on duty and immediately accessible, to whom residents can report
injuries, symptoms of illness, emergencies, any other discomfort or complaint,
and who is responsible for ensuring prompt, appropriate action is
taken.
(2) Non-skid wax shall be
used on all waxed floors. Throw rugs or scatter rugs shall not be used.
Non-slip entrance mats may be used. Non-skid treads shall be used on
stairs.
(3) Facilities providing
only Level IV care shall provide a first-aid kit in a convenient
place.
(4) A check-out system shall
be maintained for residents leaving the facility. The resident's name, the
destination, the name of the person assuming responsibility, the time of
departure, and the estimated time of return shall be recorded.
(5) Phones:
(a) There shall be at least one functioning
telephone available to staff at all times on each floor or in each unit where
patients, residents or personnel reside. These telephones shall be free of
locks and shall be available for use in emergency for both incoming and
outgoing calls.
(b) Facilities
shall provide access to phone service to residents to make calls in
private.
(6) All
hospital beds shall have brakes set and all wheelchairs shall be equipped with
brakes.
(D) Fire Protection.
(1)
All facilities shall have an approved quarterly fire inspection by local fire
department.
(2) At least once a
year, employees of the long term care facility shall be instructed by the head
of the local fire department or his or her representative on their duties in
case of fire and this noted in the facility's record.
(3) Fire extinguishers shall be recharged and
so labeled at least once a year.
(4) The water pressure shall be checked
weekly by the individual in charge of the facility, and the pressure recorded
in the facility's records.
(5)
Emergency lights shall be checked weekly by the individual in charge of the
facility, and if deficient, repaired immediately.
(6) All exits shall be clearly identified by
exit signs, adequately lighted and free from obstruction.
(7) Clothes dryers shall be inspected at the
time of installation and annually and necessary repairs made
immediately.
(8) Draperies,
upholstery and other such fabrics or decorations shall be fire resistant and
flame proof.
(9) No residents shall
be permitted to have access to lighter fluid or wooden household
matches.
(10) Routine storage of
oxygen tanks shall be permitted only in facilities providing Level I, II or III
care unless specifically approved by the Department:
(a) Wherever oxygen is used or stored it
shall be in accordance with the National Fire Protection Code.
(b) Carriers shall be provided when oxygen is
being used or transported.
(c)
Signs indicating oxygen is available, currently in use or stored shall be
conspicuously posted.
(d) Oxygen
tanks shall be safely stored and labeled when empty.
(E) Emergency and Disaster Plans.
(1) Every
facility shall have a written plan and procedures to be followed in case of
fire, or other emergency, developed with the assistance of local and state fire
and safety experts, and posted at all nurses' and attendants' stations and in
conspicuous locations throughout the facility.
(2) The plan shall specify persons to be
notified, locations of alarm signals and fire extinguishers, evacuation routes,
procedures for evacuating residents, and assignment of specific tasks and
responsibilities to the personnel of each shift.
(3) All personnel shall be trained to perform
assigned tasks.
(4) Simulated
drills testing the effectiveness of the plan shall be conducted for all shifts
at least twice a year.
(5) Each
facility shall ensure a reliable means is available at all times, in accordance
with Department guidelines; for:
(a) sending
information to the Department regarding incidents and emergencies occurring on
the premises; and
(b) receiving
information from the Department and other state and local authorities in the
event of an emergency.
(F) Residents' Accommodations.
(1) All resident
areas shall be cheerful, homelike, pleasant, clean, well-kept, free from
unpleasant odors, sights and noises, and maintained in good repair.
(2) Space and furnishing shall provide each
resident with comfortable and reasonably private living accommodations. Beds
shall be placed to avoid drafts, heat from radiators, unpleasant noises or
other discomforts.
(3) Every
bedroom and every bed location shall be permanently, clearly and distinctively
identified by a number or letter in addition to the resident's name.
(4) All resident areas must have adequate
lighting, heating and ventilation.
(a) Each
resident's room shall have direct outside exposure with adequate, unobstructed
natural light and adequate ventilation.
(b) Adequate artificial lighting shall be
available in all rooms, stairways, hallways, corridors, bathrooms toilets,
nurses' or attendants' stations.
(c) Adequate heating shall be provided in all
rooms used by residents in order to maintain a minimum temperature of 75/F at
winter temperatures for the hours between 6:00 A.M through 10:00 P.M.; and a
minimum temperature of 70/F at winter temperatures for the hours between 10:00
P.M. through 6:00 A.M.
(G) Residents' Equipment and Supplies.
(1) Equipment and
supplies appropriate in quantity and kind shall be provided for the routine
care, comfort and special nursing care of residents.
(2) All equipment and supplies shall be kept
in good working condition and in a clean and sanitary manner.
(3) All facilities shall use techniques
approved by the Department to sterilize, disinfect or dispose of equipment and
supplies.
(4) Every resident shall
be provided with the following basic equipment and supplies:
(a) A comfortable bed. In facilities
providing Level I or II care, each resident shall have a hospital-type bed
which shall not be less than 76 inches long and 36 inches wide and shall be
equipped with a headboard and swivel lock casters. In facilities providing
Level III and IV care, beds of household size or hospital beds may be used.
Cots and folding beds are prohibited.
(b) Bed springs and a clean, comfortable
mattress with waterproof covering on all beds. Each mattress shall be at least
four inches thick, 36 inches wide and not less than 72 inches long.
(c) At least two comfortable pillows of
standard hospital size. Other pillows shall be available if requested or needed
by the resident.
(d) An adequate
supply of clean bed linen, blankets, bedspreads, washcloths, and towels of good
quality and in good condition. This shall mean a supply of linen equal to at
least three times the usual occupancy. In facilities providing Level I or II
care, towels and washcloths shall be changed and laundered every day; in
facilities providing Level III and IV care, at least every week and more
frequently, if indicated. Bed linen shall be laundered at least weekly and more
frequently if needed.
(e) An easy
chair or a comfortable padded or upholstered straight back chair with arms,
suited to individual resident needs.
(f) A bedside cabinet that accommodates the
needs of the resident.
(g) All
facilities shall ensure each resident has an individual mouthwash cup, a tooth
brush and dentifrice, containers for the care of residents' dentures if
necessary, an individual comb and brush, soap dish, bar of soap, shaving
equipment, individual sputum containers (when needed), and other equipment for
personal care.
(h) All facilities
shall provide for each resident a permanently located, readily accessible,
storage space equipped with a lock and key, th large enough to accommodate
small personal possessions such as letters, jewelry, pictures or small amounts
of money. Storage space shall be located within each resident's room. A key to
secure personal storage space shall be in the possession of each resident, and
the facility administrator or his designee shall hold a master key to any such
locked space.
(H) Behavior Modification Programs in a SNCFC.
(1) Time out
means a procedure designed to improve a resident's behavior by removing
positive reinforcement or by removing the resident physically from the
environment when his or her behavior is undesirable.
(2) Time-out procedures shall only be used as
part of approved behavior modification exercises and only by an individual (or
individuals) appropriately trained to carry out such exercises and under the
supervision of a behavior modification trainer. Time-out shall not be used for
longer than one hour for time-out involving removal from a situation.
(3) Behavior modification programs involving
the use of time-out procedures shall be conducted only after documented failure
of less severe alternatives and with the consent of the resident or his or her
guardian; and shall be described in the care plan along with written plans kept
on file.
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