Current through Register Vol. 18, September 20, 2024
(1) Personal
care assistance must be provided to each resident in accordance with their
established agreement and needs. Assistance must include, but is not limited to
assisting with:
(a) personal grooming such as
bathing, hand washing, shaving, shampoo and hair care, nail filing or trimming
and dressing;
(b) oral hygiene or
denture care;
(c) toileting and
toilet hygiene;
(d)
eating;
(e) the use of crutches,
braces, walkers, wheelchairs or prosthetic devices, including vision and
hearing aids; and
(f)
self-medication.
(2)
Evidence that the facility is meeting each resident's needs for personal care
services include the following outcomes for residents:
(a) physical well being of the resident means
the resident:
(i) has clean and groomed hair,
skin, teeth and nails;
(ii) is
nourished and hydrated;
(iii) is
free of pressure sores, skin breaks or tears, chaps and chaffing;
(iv) is appropriately dressed for the season
in clean clothes;
(v) risk of
accident, injury and infection has been minimized; and
(vi) receives prompt emergency care for
illnesses, injuries and life threatening situations;
(b) behavioral and emotional well being of
the resident includes:
(i) an opportunity to
participate in age appropriate activities that are meaningful to the resident
if desired;
(ii) a sense of
security and safety;
(iii) a
reasonable degree of contentment; and
(iv) a feeling of stable and predictable
environment;
(c) unless
medically required by a physician or other practitioner's written order, the
resident is:
(i) free to go to bed at the
time desired;
(ii) free to get up
in the morning at the time desired;
(iii) free to have visitors;
(iv) granted privacy;
(v) assisted to maintain a level of self care
and independence;
(vi) assisted as
needed to have good oral hygiene;
(vii) made as comfortable as possible by the
facility;
(viii) free to make
choices and assumes the risk of those choices;
(ix) fully informed of the services that are
provided by the facility;
(x) free
of abuse, neglect and exploitation;
(xi) treated with dignity; and
(xii) given the opportunity to participate in
activities, if desired.
(3) In the event of accident or injury to a
resident requiring emergency medical, dental or nursing care or, in the event
of death, the assisted living facility shall:
(a) immediately make arrangements for
emergency care or transfer to an appropriate place for treatment;
(b) immediately notify the resident's
practitioner and the resident's legal representative.
(4) A resident shall receive skin care that
meets the following standards:
(a) the
facility shall practice preventive measures to identify those at risk and
maintain a resident's skin integrity. Risk factors include:
(i) skin redness lasting more than 30 minutes
after pressure is relieved from a bony prominence, such as hips, heels, elbows
or coccyx; and
(ii)
malnutrition/dehydration, whether secondary to poor appetite or another disease
process; and
(b) an area
of broken or damaged skin must be reported within 24 hours to the resident's
practitioner. Treatment must be provided as ordered by the resident's
practitioner.
(5) A
person with a stage 3 or 4 pressure ulcer may not be admitted or permitted to
remain in a category A facility.
(6) The facility shall ensure records of
observations, treatments and progress notes are entered in the resident's
record and that services are in accordance with the resident health care
plan.
(7) Direct care staff shall
receive training related to maintenance of skin integrity and the prevention of
pressure sores by:
(a) keeping residents
clean and dry;
(b) providing
residents with clean and dry bed linens;
(c) keeping residents well
hydrated;
(d) maintaining or
restoring healthy nutrition; and
(e) keeping the residents physically active
and avoiding the overuse of wheelchairs, sitting no longer than one hour or
remaining in one position for longer than two hours at one time, and other
sources of skin breakdown in ADLs.
Sec.
50-5-103,
50-5-226
and
50-5-227,
MCA; IMP, Sec.
50-5-225,
50-5-226
and
50-5-227,
MCA;
