Current through Register No. 40, October 3, 2024
(a) The licensee
shall comply with the patients' bill of rights as set forth in
RSA
151:19-21.
(b) The licensee shall define, in writing,
the scope and type of services to be provided by the nursing home, which shall
include, at a minimum, the core services listed in
He-P
803.15(d).
(c) The licensee shall develop and implement
written policies and procedures governing the operation and all services
provided by the nursing home.
(d)
All policies and procedures shall be reviewed per licensee policy.
(e) The licensee shall assess and monitor the
quality of care and service provided to residents on an ongoing
basis.
(f) The licensee or any
employee shall not falsify any documentation or provide false or misleading
information to the department.
(g)
The nursing home shall not:
(1) Advertise or
otherwise represent itself as operating a nursing home, unless it is licensed;
and
(2) Advertise that it provides
services that it is not authorized to provide.
(h) The licensee shall comply with all
conditions of warnings and administrative remedies issued by the department,
and all court orders.
(i) Licensees
shall:
(1) Meet the needs of the residents
during those hours that the residents are in the care of the nursing
home;
(2) Initiate action to
maintain the nursing home in full compliance at all times with all relevant
health and safety requirements contained in applicable federal, state, and
local laws, rules, regulations, and ordinances;
(3) Establish, in writing, a chain of command
that sets forth the line of authority for the operation of the nursing
home;
(4) Appoint an administrator
who shall meet the requirements of
He-P
803.17(b)(1);
(5) Appoint a medical director who shall meet
the requirements of
He-P
803.17(a);
(6) Verify the qualifications of all
personnel;
(7) Provide sufficient
numbers of personnel who are present in the nursing home and are qualified to
meet the needs of residents during all hours of operation;
(8) Provide the nursing home with sufficient
supplies, equipment, and lighting to meet the needs of the residents;
(9) Implement any POC that has
been accepted by the department; and
(10) Comply with all conditions of warnings
and administrative remedies issued by the department and all court
orders.
(j) The licensee
shall consider all residents to be competent and capable of making health care
decisions unless the resident:
(1) Has a
guardian appointed by a court of competent jurisdiction;
(2) Has a durable power of attorney for
health care that has been activated; or
(3) Is an un-emancipated minor.
(k) The licensee shall not exceed
the number of occupants authorized by NFPA 101, as adopted pursuant to
RSA 153:1,
VI-a and amended in Saf-FMO 300 by the fire
marshal with the board of fire control, pursuant to
RSA 153:5,
and identified on the licensing certificate.
(l) If the licensee accepts a resident who is
known to have a disease reportable under He-P 301 or an infectious disease,
which is any disease caused by the growth of microorganisms in the body which
might or might not be contagious, the licensee shall follow the required
procedures for the care of the residents, as specified by the United States
Centers for Disease Control and Prevention "2007 Guideline for Isolation
Precautions: Preventing Transmission of Infectious Agents in Healthcare
Settings" (June 2007), available as noted in Appendix A.
(m) The licensee shall report all positive
tuberculosis test results for employees to the office of disease control in
accordance with
RSA
141-C:7,
He-P 301.02,
and
He-P
301.03.
(n) The licensee shall implement measures to
ensure the safety of residents who are assessed as an elopement risk or danger
to self or others.
(o) In addition
to the posting requirements specified in
RSA 151:29,
the licensee shall post the following documents in a public area:
(1) The current license certificate issued in
accordance with
RSA
151:2;
(2) All inspection reports issued in
accordance with
He-P
803.09(b), for the previous 12
months;
(3) A copy of the patients'
bill of rights;
(4) A copy of the
licensee's policies and procedures relative to the implementation of patient
rights and responsibilities as required by
RSA
151:20;
(5) A copy of the licensee's complaint
procedure, including the address and phone number of the department to which
complaints may also be made, which shall also be posted on the nursing home
website if available; and
(6) The
licensee's floor plan for fire safety, evacuation and emergencies identifying
the location of, and access to all fire exits.
(p) All records required for licensing shall
be legible, current, accurate, and available to the department during an
inspection or investigation conducted in accordance with
RSA
151:6 and
RSA
151:6-a.
(q) A licensee shall, upon request, provide a
resident or the resident's guardian or agent, if any, with a copy of his or her
resident record pursuant to the provisions of
RSA 151:21,
X.
(r) Any licensee that maintains electronic
records shall develop written policies and procedures designed to protect the
privacy of residents and employees that, at a minimum, include:
(1) Procedures for backing up files to
prevent loss of data;
(2)
Safeguards for maintaining the confidentiality of information pertaining to
residents and personnel; and
(3)
Systems to prevent tampering with information pertaining to residents and
personnel.
(s)
Accidents, injuries, and unusual incidents shall be documented, including:
(1) The date and time of the
occurrence;
(2) A description of
the occurrence, including identification of injuries, if applicable;
(3) The actions taken;
(4) The signature of the person documenting
the occurrence; and
(5) If medical
intervention was required, the date and time that the emergency contact person
and guardian or agent, if any, and the licensed practitioner were
notified.
(t) For
reportable incidents, allegations of abuse, neglect, mistreatment, or
misappropriation of property the licensee shall:
(1) Notify the department by faxing a notice
to 603 271-5574 within 24 hours from the time the reportable incident,
allegation of abuse, neglect, mistreatment, or misappropriation becomes known,
that an investigation is in progress containing the following information:
a. The nursing home name;
b. A description of the incident including
identification of injuries, if applicable;
c. The name of resident;
d. The date and time of the
incident;
e. If medical
intervention was required, and if so, please provide:
1. Who the medical intervention was provided
by;
2. The date the medical
intervention was provided; and
3.
The time the medical intervention was provided; and
f. When the practitioner and the resident
representative was notified, if applicable; and
(2) Within 5 days, submit a completed
investigation report to the department containing the following information:
a. All items referenced in (1)
above;
b. The names and results of
interview(s) with all personnel, resident(s), or other individuals involved in
the unusual incident, including all applicable statement signatures;
and
c. The action taken by the
licensee in direct response to the unusual incident(s), including any and all
follow-up;
(3)
Immediately notify the local police department, the department, guardian, agent
or personal representative, if any, when a resident, has eloped, after the
licensee has searched the building and the grounds of the nursing home; and
(4) Submit additional information,
if required by the department, to support the incident report referenced in
(t)(2) above.
(u) The
licensee shall provide cleaning and maintenance services, as needed to protect
residents, employees, and the public.
(v) The licensee shall comply with all
relevant federal, state, and local laws, rules, codes, and ordinances as
applicable.
(w) Smoking shall be
prohibited in the nursing home per
RSA 155:66,
I(b), except as permitted by
RSA 155:67. If
allowed, smoking shall be restricted to designated smoking areas as per the
licensee's official smoking policy, but in no case shall smoking be permitted
in any room containing an oxygen cylinder or oxygen delivery system or in a
resident's bedroom.
(x) If the
licensee holds or manages a resident's funds or possessions, it shall first
receive written authorization in accordance with
RSA 151:24
and
RSA 151:21,
VII, and such funds shall not be used for the
benefit of the licensee or other residents.
(y) At the time of admission the licensee
shall give a resident and the resident's guardian, agent, or personal
representative, a listing of all known applicable charges and identify what
care and services are included in the charge.
(z) The licensee shall give a resident 30
days written notice for an increase in the cost or fees for any nursing home
services.
(aa) Except as required to protect
the health, safety, and well-being of the resident or other residents, prior to
a resident room or bed location change, the licensee shall:
(1) Provide written notice to the resident
and/or the resident's guardian or agent, as applicable, including:
a. The reason for the change;
b. The effective date of the change;
and
c. The location to which the
resident is being moved;
(2) Provide verbal notice to the resident
and/or the resident's guardian or agent, as applicable, including performing
the following:
a. Learning the resident's
preferences and taking them into account when discussing changes of rooms or
roommates and the timing of such changes;
b. Explaining to the resident the reason for
the move; and
c. Providing the
opportunity to see the new location, meet the new roommate, and ask questions
about the move;
(3) For
a resident who is receiving a new roommate, give that resident as much notice
and information about the new person as possible, while maintaining
confidentiality regarding medical information; and
(4) Document all information contained in
(1)-(3) above in the resident record.
(ab) The licensee shall develop and follow
policies and procedures regarding resident room or bed location
changes.
(ac) Following the death
of a roommate, the licensee shall facilitate the provision of social services
for the resident as needed.
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