Current through Register Vol. 49, No. 13, September 23, 2024
Subpart
1.
General criteria.
Admissions must be according to the requirements in parts
4655.0400,
4655.0500,
4655.0700, and
4655.1500.
Subp. 2.
Selection of residents.
Of those applicants eligible for admission under part
9050.0050 and Minnesota Statutes,
sections
198.01,
198.022,
and
198.03, the
admissions committee of the facility operated by the commissioner of veterans
affairs, in consultation with the applicant's attending physician, shall
determine whether an applicant is to be admitted by applying the criteria for
each type of facility in subparts
3 and
4.
Subp. 3.
Criteria for admission to and
continued stay in a boarding care facility.
The decision about admission to or continued stay in a
facility operated by the commissioner of veterans affairs licensed to provide
boarding care must be based on the facility's ability to meet the care needs of
the applicant or resident. A person whose care needs can be met by the facility
operated by the commissioner of veterans affairs must be admitted, placed on
the waiting list, or retained as a resident if the admissions committee or
utilization review committee determines the person meets the criteria in items
A to N. A person whose care needs cannot be met must be denied admission or
continued stay if the admissions committee or utilization review committee
determines the person does not meet the criteria in items A to N.
A. The person must have or be assigned to an
appropriate bed through the use of a patient classification system.
B. The person must have a medical and, if
appropriate, psychiatric diagnosis from the attending physician indicating
placement in a boarding care facility is a medical necessity.
C. The person's attending physician must
document the person's need for the services provided in a boarding care
facility. If a resident has not specified an attending physician, the attending
physician must be a Minnesota veterans homes staff physician. If an applicant
for admission has not specified an attending physician, Minnesota veterans
homes facility staff must assist the applicant in finding a physician to
provide an admitting diagnosis.
D.
A person must be alert and oriented to person, place, and time, and able to
function within a structure of daily monitoring by the nursing staff of the
boarding care facility. A person who has a diagnosis of mental illness must be
assessed by a staff psychiatrist or psychologist.
E. A person must be able to recognize and
appropriately react to hazards in the environment. A person who has a diagnosis
of mental illness must be assessed by a staff psychiatrist or psychologist. The
case mix indicator, developed under Minnesota Statutes, section
144.072, for orientation
and self-preservation skills must be used to determine whether the individual
has the mental judgment or physical ability necessary to function in a changing
environment and a potentially harmful situation.
F. The person has the right to participate in
establishing the person's individual care plan. Residents must be advised that
exercising their right to refuse care may lead to their discharge if the
facility is unable to care for them under part
4655.1500, subpart
2. Continuing cooperation
must be measured as specified in the care plan review process in part
9050.0300.
G. A person must be physically and mentally
capable of providing personal care and hygiene including dressing, grooming,
eating, toileting, and washing other than bathing. A person who has a diagnosis
of mental illness must be assessed by an attending psychiatrist or
psychologist.
H. The person must be
assessed by a staff registered nurse as independent in transferring and
mobility.
I. The person must
require no more than twice daily face-to-face monitoring by the nursing staff
of the boarding care facility. For continued stay, face-to-face monitoring for
special medical needs may exceed twice daily for up to five days with approval
of the director of nursing or the assistant director of nursing of the boarding
care facility.
J. An attending
psychiatrist or psychologist must assess persons with a history of violent or
self-abusive behavior and determine if significant risk factors currently exist
which suggest that the individual poses a threat of harm to self or others to
determine the facility's ability to meet the safety needs of the person and
other persons at the facility.
K. A
person diagnosed by the attending physician as actively psychotic must require
no more than twice daily face-to-face monitoring by facility nursing staff and
no more than weekly face-to-face therapeutic contacts with a staff psychiatrist
or psychologist.
L. A person who
has an active substance use disorder must be evaluated by an attending
psychologist or psychiatrist. The evaluation must include an assessment of the
person's chemical health needs, the current severity of the person's disorder,
and whether the facility operated by the commissioner of veterans affairs can
meet the care needs of the person. If the medical records obtained by the
admissions committee do not adequately document a person's substance disorder
status, the person's status may be verified by a collateral contact. For
purposes of this part, "collateral contact" means an oral or written
communication initiated by facility staff for the purpose of gathering
information from an individual or agency, other than the applicant, to verify
or supplement information provided by the applicant. Collateral contact
includes contact with family members, criminal justice agencies, educational
institutions, and employers.
M. The
person must be able to comply with Minnesota veterans homes rules in chapter
9050. Ability to comply may be demonstrated by a documented history of
compliance in a prior placement, if any, or other relevant evidence that
demonstrates ability to comply. Continuing compliance must be measured as
specified in the care plan process in part
9050.0300.
N. An attending physician shall determine
whether the person is free from any communicable disease or infection that
poses a threat to the health and safety of others. Exceptions may be made,
however, subject to the authority granted by a waiver issued by the Minnesota
Department of Health. This subpart complies with Minnesota Statutes, section
144.50,
subdivision 7.
Subp. 4.
Criteria for admission to and continued stay in a nursing home
facility.
The decision about admission or continued stay in a facility
operated by the commissioner of veterans affairs licensed as a nursing home
must be based on the facility's ability to meet the care needs of the person. A
person whose care needs can be met by the facility must be admitted, placed on
the waiting list, or retained as a resident if the admissions committee or
utilization review committee determines that the person meets all of the
criteria in items A to G. A person whose care needs cannot be met must not be
admitted or retained as a resident if the admissions committee determines the
person fails to meet all of the criteria in items A to G.
A. The person must have or be assigned to an
appropriate bed through a patient classification system.
B. The person must have a medical and, if
appropriate, psychiatric diagnosis from the attending physician indicating
placement in a nursing home is a medical necessity. If a resident has not
specified an attending physician, the attending physician must be a Minnesota
veterans homes staff physician. If an applicant for admission has not specified
an attending physician, Minnesota veterans homes facility staff must assist the
applicant in finding a physician to provide an admitting diagnosis.
C. The person's attending physician must
document the person's need for the services provided in a nursing
home.
D. The person must
demonstrate a history of cooperation with an individual treatment or care plan
or with the medical treatment plan prescribed by the attending physician.
Cooperation may be demonstrated by a documented history of cooperation in a
prior placement, if any, or other relevant evidence which demonstrates
cooperation. Continuing cooperation must be measured as specified in the care
plan review process in part
9050.0300.
E. An attending physician shall determine
whether the person is free from any communicable disease or infection that
poses a threat to the health and safety of others. Exceptions may be made,
however, subject to the authority granted by a waiver issued by the Minnesota
Department of Health. This subpart complies with Minnesota Statutes, section
144.50,
subdivision 7.
F. An attending
psychiatrist or psychologist must assess persons with a history of violent or
self-abusive behavior and determine if significant risk factors currently exist
that suggest that the individual poses a threat of harm to self or others to
determine the facility's ability to meet the safety needs of the person and
other persons at the facility.
G. A
person who has an active substance use disorder must be evaluated by an
attending psychologist or psychiatrist. The evaluation must include an
assessment of the person's chemical health needs, the current severity of the
person's disorder, and whether the facility operated by the commissioner of
veterans affairs can meet the care needs of the person. If the medical records
obtained by the admissions committee do not adequately document the person's
substance disorder status, the person's status may be verified by a collateral
contact. For purposes of this part, "collateral contact" means an oral or
written communication initiated by facility staff for the purpose of gathering
information from an individual or agency, other than the applicant, to verify
or supplement information provided by the applicant. Collateral contact
includes contact with family members, criminal justice agencies, education
institutions, and employers.
