Current through Register No. 40, October 3, 2024
(a) The licensee
shall comply with all relevant federal, state and local laws, rules, codes and
ordinances as applicable.
(b) The
licensee shall provide the following core services:
(1) The presence of staff whenever a resident
is in the facility;
(2) Health and
safety services to all residents to minimize the likelihood of accident or
injury, with protective care and oversight provided 24 hours a day regarding:
a. The residents' functioning, safety and
whereabouts; and
b. The residents'
health status, including the provision of intervention as necessary or
required;
(3) Emergency
response and crisis intervention;
(4) Assistance with taking and ordering
medications as determined by a resident's ability or inability to safely manage
medications as determined by the Resident Assessment Tool (RAT);
(5) The provision of 3 nutritious meals and
snacks unless the resident chooses other options according to their residential
service agreement;
(6)
Housekeeping, laundry and maintenance services in accordance with the
residential service agreement;
(7)
The availability of on-site activities, for which the facility shall make
reasonable accommodation for residents with disabilities, to include, but not
be limited to television, radio, internet, games, newspapers, visitors and
music, designed to sustain and promote physical, intellectual, social and
spiritual well-being of all residents in accordance with the residential
service agreement;
(8) Assistance
in arranging medical and dental appointments, including assistance in arranging
transportation to and from such appointments and reminding the residents of the
appointments; and
(9) Personal
supervision of residents when necessary to offset cognitive deficits that might
pose a risk to the safety of self or others if the resident is not
supervised.
(c) The
licensee shall provide access, as necessary, to the following services pursuant
to RSA
151:2, IV and
RSA
151:9, VII(a) (2):
(1) Nursing services, in accordance with RSA
326-B, including supervision and instruction of direct care personnel, relative
to the delivery of nursing care;
(2) Rehabilitation services, including
documentation of the licensed practitioner's order for the service, such as
physical therapy, occupational therapy, and speech therapy; and
(3) Behavioral health care
services.
(d) The
licensee shall assist with arranging transportation to community programs, such
as religious services and cultural, social, educational and recreational
activities according to the availability of such services in the surrounding
communities.
(e) The licensee
shall:
(1) Provide basic supplies necessary
for residents to maintain grooming and personal hygiene, such as soap, shampoo,
toothpaste, toothbrush and toilet paper;
(2) Not be responsible for the cost of
purchasing a specific brand of product at a resident's request;
(3) Ensure that sufficient numbers of
qualified personnel are present in the SRHCF to meet the needs of residents at
all times;
(4) Ensure that
demonstrated competencies required by the "qualified personnel" referenced in
(3) above are documented in the employee personnel file; and
(5) Require any paid provider of direct care,
other than an employee, providing health care related services to provide a
brief written, signed, and dated note describing the reason for the service(s),
and the next planned visit, if known.
(f) The use of chemical or physical
restraints as defined under
He-P
805.03(m) and (ax) , respectively,
shall only be permitted as allowed by
RSA
151:21.
(g) After the use of a physical of chemical
restraint, the facility shall make the following notifications:
(1) To the resident's guardian or agent, if
any, as soon as is practicable and in no case longer than 24 hours;
and
(2) To the health facilities
licensing unit within 48 hours by fax, at (603) 271-5574, or by electronic
means.
(h) The use of
mechanical restraints, limited to locked, secured and/or alarmed SRHCFs or
units within an SRHCF, or anklets, bracelets or similar devices that cause a
door to automatically lock when approached, thereby preventing a resident from
freely exiting the SRHCF or unit within as permitted by the fire code, shall be
allowed.
(i) The following methods
of mechanical restraints shall be prohibited:
(1) Full bed rails;
(2) Gates, if they prohibit a resident's free
movement throughout the living areas of the SRHCF;
(3) Half doors, if they prohibit a resident's
free movement throughout the living areas of the SRHCF;
(4) Geri chairs, when used in a manner that
prevents or restricts a resident from getting out of the chair at
will;
(5) Wrist or ankle
restraints;
(6) Vests or pelvic
restraints; or
(7) Other similar
devices that prevent a resident's free movement.
(j) For reportable incidents, the licensees
shall have responsibility for:
(1) Faxing to
271-5574 or, if a fax machine is not available, conveying by electronic or
regular mail, the following information to the department within 48 hours of a
reportable incident as defined in
He-P
805.03(bf) :
a. The SRHCF name;
b. A description of the incident, including
identification of injuries, if applicable;
c. The name of the licensee(s) or personnel
involved in, witnessing, or responding to the unusual incident;
d. The name of resident(s) involved in the
reportable incident;
e. The date
and time of the reportable incident;
f. The action taken in direct response to the
reportable incident;
g. If medical
intervention was required, by whom and the date and time;
h. When the resident's guardian or agent, if
any, or personal representative, or emergency contact person was
notified;
i. The signature of the
person reporting the reportable incident; and
j. The date and time the residents licensed
practitioner was notified, if applicable;
(2) As soon as practicable, notifying the
local police department, the department and the guardian, agent, or personal
representative, if any, when a resident has an elopement or unexplained absence
and the licensee has searched the building and the grounds of the SRHCF without
finding the resident; and
(3)
Notifying the department with a written report within 5 days describing the
actions taken by personnel, the final outcome or continuation of the reportable
incident and actions taken to prevent a reoccurrence if it was not submitted in
the initial report.
(k)
The licensee shall comply with the patient's bill of rights as set forth in RSA
151.
(l) The licensee shall not
exceed the maximum number of residents or beds licensed by the department,
unless authorized by the department, such as during an emergency.
(m) The licensee shall give a resident a
written notice as follows:
(1) Thirty days
advance notice for an increase in the cost or fees for SRHCF services unless
the increase of cost or fees is due to a change in the resident's condition and
service needs; or
(2) Fourteen days
advance notice for an involuntary change in room or bed location, unless the
change is required to protect the health, safety and well-being of the resident
or other residents, in such case the notice shall be as soon as
practicable.
(n) In
addition to the posting requirements specified in
RSA
151:29, the licensee shall post the following
documents in a public and conspicuous area:
(1) The current license certificate issued in
accordance with RSA
151:2;
(2) The most recent inspection report as
specified in RSA
151:6-a;
(3) A copy of the patient's bill of rights
specified by RSA
151:21;
(4) A copy of the licensee's complaint
procedure, including a statement that complaints may be submitted, in writing,
to The Department of Health and Human Services, Health Facilities
Administration, 129 Pleasant Street, Concord, N.H. 03301 or by calling
1-800-852-3345, and information on how to contact the office of the long-term
care ombudsman; and
(5) The
licensee's evacuation floor plan identifying the location of, and access to all
fire exits.
(o) The
licensee shall determine the smoking status of the SRHCF.
(p) If smoking is to be allowed, the licensee
shall develop and implement smoking policies and designate smoking areas in
accordance with RSA
155:66,
RSA
155:68 and
RSA
155:69 and
He-P
805.25(f) .
(q) The licensee may hold or manage a
resident's funds or possessions only when the facility receives 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, other residents or other household
members.
(r) The licensee shall not
falsify any documentation required by law or provide false or misleading
information to the department.
#8746, eff
10-25-06
