Current through Register No. 40, October 3, 2024
(a) The licensee
shall provide administrative services that include the appointment of a
full-time, on-site administrator who:
(1) Is
responsible for the day-to-day operations of the SRHCF;
(2) Works no less than 35 hours per week at
the SRHCF, which may include day, evening, night and weekend hours;
(3) Meets the requirements of
He-P
805.18(g) and (h); and
(4) Designates, in writing, an alternate
administrator who shall assume the responsibilities of the administrator in his
or her absence.
(b) At
the time of application for admission, the licensee shall provide the resident
and legal agent, if any or personal representative, a written copy of the
residential service agreement pursuant to RSA 161-J, except that a copy of the
residential service agreement shall not be required if the facility admission
contract includes all of the provisions of a residential service
agreement.
(c) In addition to (b)
above, at the time of admission, the licensee shall provide a written copy to
the resident and legal agent, if any, or personal representative, and receive
written verification of receipt for the following:
(1) An admissions contract including the
following information:
a. The basic daily,
weekly and monthly fee;
b. A list
of the core services required by
He-P
805.14(b) that are covered by the
basic fee;
c. Information regarding
the timing and frequency of cost of care increases;
d. The time period covered by the admissions
contract;
e. The SRHCF's house
rules;
f. The reasons a resident
may be transferred or discharged in accordance with
RSA
151:5-a, II, or
RSA
151:21, V;
g. The SRHCF's responsibility for resident
discharge planning;
h. Information
regarding nursing, other health care services or supplies not provided in the
core services, to include:
1. The
availability of services;
2. The
SRHCF's responsibility for arranging services; and
3. The fee and payment for services, if
known;
i. The licensee's policy regarding:
1. Arranging for the provision of
transportation;
2. Arranging for
the provision of third party services, such as a hairdresser or cable
television;
3. Acting as a billing
agent for third party services;
4.
Monitoring third party services contracted directly by the resident and
provided on the SRHCF premises;
5.
Handling of resident funds pursuant to
RSA
151:24 and
He-P
805.14(q);
6. Bed hold, in compliance with
RSA
151:25;
7. Storage and loss of the resident's
personal property; and
8.
Smoking;
j. If the
facility is not constructed to meet the health care occupancy chapter of NFPA
101, the admission agreement shall note that the resident may need to be
discharged or transferred when the facility can no longer meet the resident's
evacuation needs as required by the approved fire safety and emergency plan
approved by the local fire department;
k. The licensee's medication management
services and associated costs; and
l. The list of grooming and personal hygiene
supplies provided by the SRHCF as part of the basic daily, weekly or monthly
rate;
(2) A copy of the most current version of the
patients' bill of rights under
RSA
151:21 and the SRHCF's policy and procedure
for implementing the bill of rights pursuant to
RSA
151:20, II;
(3) A copy of the resident's right to appeal
an involuntary transfer or discharge under
RSA
151:26, II(5);
(4) The SRHCF's policy and procedure for
handling reports of abuse, neglect or exploitation which shall be in accordance
with RSA
161-F:46 and
RSA
169-C:29;
(5) Information on accessing the long-term
care ombudsman;
(6) Information on
advanced directives;
(7) Whether or
not personnel are trained in cardiopulmonary resuscitation (CPR), first aid or
both; and
(8) Whether or not the
facility has an AED onsite and available for use in an emergency.
(d) The SRHCF shall assess each
resident's needs using the "Care Assessment for Residential Services Tool"
(April 2022)."
(e) All personnel
who administer the RAT shall be trained to complete the RAT by the department
or entities listed in
RSA
151:5-c, III.
(f) The assessment described in (d) above
shall:
(1) Be completed no more than 30 days
prior to admission to the SRHCF;
(2) Be completed in consultation with the
resident and guardian or agent, if any; and
(3) Be repeated every 6 months or after any
significant change as defined in
He-P
805.03(br).
(g) The facility shall have documented
evidence that the resident and guardian or agent, if any, has had an
opportunity to review the RAT.
(h)
If the RAT identifies the need for a nursing assessment, the nursing assessment
shall be completed within 72 hours of the completion of the RAT.
(i) If the RAT identifies a need for a care
plan, the care plan shall be:
(1) Completed
within 24 hours of the resident's admission for the initial RAT and within 24
hours of the completion of all subsequent RATs;
(2) Made available to personnel who assist
residents;
(3) Be completed in
consultation with the resident and guardian or agent, if any; and
(4) If the resident and guardian or agent are
unable or unwilling to participate as required by (3) above, it shall be
documented in the resident record.
(j) The care plan identified in (i) above
shall include on an ongoing basis:
(1) The
date the problem or need was identified;
(2) A description of the problem or
need;
(3) The goal or objective of
the plan;
(4) The action or
approach to be taken;
(5) The
responsible person(s) or position; and
(6) The date of reevaluation, review, or
resolution.
(k) All care
plans shall be reviewed at least every 6 months to determine if:
(1) The care plan will be continued for
another 6 months;
(2) The care plan
will be revised to meet the needs of the resident; and/or
(3) The care plan will be discontinued
because the plan is no longer needed.
(l) Progress notes shall be written at least
every 90 days and include, at a minimum:
(1)
Care plan outcomes if a care plan was developed as identified by the
RAT;
(2) The resident's physical,
functional and mental abilities; and
(3) Changes in behavior, such as eating
habits, sleeping pattern, and relationships.
(m) At the time of a resident's admission,
the licensee shall obtain written and signed orders from a licensed
practitioner for medications, treatment, and special diet.
(n) The licensee shall have each resident
obtain a health assessment by a licensed practitioner within one year prior to
admission or within 72 hours following admission to the SRHCF.
(o) The health assessment referenced in (n)
above shall include:
(1) Diagnoses, if
any;
(2) The medical
history;
(3) A list of current
medications including over-the-counter medications, treatments and special
diets, if applicable; and
(4)
Allergies.
(p) Each
resident shall have at least one health assessment every 12 months, unless the
primary care licensed practitioner determines annually that a health assessment
is not necessary and specifies in writing an alternative time frame, or the
resident annually refuses in writing.
(q) A resident may refuse all care and
services.
(r) When a resident
refuses care or services that could result in a threat to their health, safety
or well-being, or that of others, the licensee or their designee shall:
(1) Inform the resident of the potential
results of their refusal;
(2)
Notify the licensed practitioner and guardian, if any, of the resident's
refusal of care; and
(3) Document
in the resident's record the refusal of care and the resident's reason for the
refusal.
(s) The
licensee shall maintain an information data sheet in the resident's record and
promptly give a copy to emergency medical personnel in the event of an
emergency transfer to another medical facility.
(t) The information data sheet referenced in
(s) above shall include:
(1) Full name and the
name the resident prefers, if different;
(2) Name, address and telephone number of the
resident's next of kin, guardian or agent, if any;
(3) Diagnosis;
(4) Medications, including last dose taken
and when the next dose is due;
(5)
Allergies;
(6) Functional
limitations;
(7) Date of
birth;
(8) Insurance
information;
(9) Advanced
directives; and
(10) Any other
pertinent information not specified in (1)-(9) above.
#8746, eff
10-25-06
The amended version of this section by
New
Hampshire Register Volume 42, Number 19, eff.
4/20/2022 is not yet
available.
