Current through Register No. 52, December 26, 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 RTRF;
(2) Meets the requirements of
He-P 807.18(k) and (l)
;
(3) Designates, in writing, an alternate
administrator who shall assume the responsibilities of the administrator in his
or her absence; and
(4) In the
event the administrator will be absent for a period to exceed 30 consecutive
days, the facility shall notify the department who the interim administrator
will be and submit credentials to verify he or she meets the requirements of
(2) above.
(b) At the
time of application for admission, the licensee shall provide the client a
written copy of the clientele service agreement pursuant to
RSA
161-J:4.
(c) In addition to (b) above, at the time of
admission, the licensee shall provide a written copy to the client and the
guardian or 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, or monthly fee;
b. A list
of the core services required by
He-P
807.14 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 RTRF's house
rules;
f. The grounds for immediate
termination of the agreement, pursuant to
RSA
151:21, V;
g. The RTRF's responsibility for client
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 RTRF's
responsibility for arranging services; and
3. The fee and payment for services, if
known;
i. The licensee's policies and
procedures 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 client and provided on the RTRF premises;
5. Handling of client funds pursuant to
RSA 151:24
and
He-P
807.14(t) ;
6. Storage and loss of the client's personal
property; and
j. The licensee's
medication management services; and
k. The list of grooming and personal hygiene
supplies provided by the RTRF 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 RTRF's policy and procedure
for implementing the bill of rights pursuant to
RSA 151:20,
II;
(3) The RTRF'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; and
(4) Information on advanced
directives.
(d) The RTRF
shall perform a preliminary assessment of each client's needs and develop a
preliminary care plan upon admission or within 24 hours following
admission.
(e) A comprehensive
evaluation shall be completed within 30 days for neuro-rehabilitation
facilities.
(f) The evaluation
required by (e) above shall:
(1) Be completed
in consultation with the client's licensed practitioner, as applicable, and
guardian or agent, if any;
(2) Be
reviewed every 6 months or after any significant change as defined in
He-P 807.03(bl)
;
(3) Include a medication review;
(4) Include a review of the client's clinical
and treatment record; and
(5)
Include an assessment for pain, vital signs, physical, cognitive, mental, and
behavioral status, as well as an assessment as to how the client is
psychologically adapting to his or her social environment.
(g) A care plan or treatment plan shall be
written and shall include the date the problem or need was identified, the
client goal or treatment to be taken, the date of re-evaluation, and
responsible person(s), as applicable.
(h) The care plan or treatment plan shall:
(1) Be completed within 24 hours of the
comprehensive evaluation;
(2) Be
updated following the completion of each future assessment;
(3) Be made available to personnel who assist
clients in the implementation of the plan; and
(4) Address the needs identified by the
comprehensive evaluation in (e) above.
(i) The care plan or treatment plan as
defined in
He-P 807.03(k)
and required by (g) above, shall include:
(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.
(j) Progress notes shall be written at least
monthly and include at a minimum:
(1)
Treatment care plan outcomes;
(2)
Changes in the client's physical, functional, and mental abilities;
(3) Changes in behavior, such as eating
habits, sleeping pattern, and relationships; and
(4) Summary of protective care that has been
provided.
(k) At the
time of a client's admission, the licensee shall ensure that orders from a
licensed practitioner are obtained for medications, and that special dietary
requirements are documented.
(l)
All personnel shall follow the orders of the licensed practitioner for each
client and encourage clients to follow the practitioner's orders.
(m) The licensee shall have each client
obtain a health examination by a licensed practitioner within 30 days prior to
admission or within 72 hours following admission to the RTRF.
(n) The health examination in (m) above shall
include:
(3) Medical findings, including the presence
or absence of communicable disease;
(5) Prescribed and over-the-counter
medications;
(8) Pain assessment for neuro-rehabilitation
clients.
(o) Each client
shall have at least one health examination every 12 months, unless the licensed
practitioner determines that an annual physical examination is not necessary
and specifies in writing an alternative time frame, or the client refuses in
writing.
(p) A client may refuse
all care and services.
(q) When a
client 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 client and guardian of the
potential results of their refusal;
(2) Notify the licensed practitioner of the
client's refusal of care; and
(3)
Document in the client's record the refusal of care and the client's reason for
the refusal if known.
(r) The licensee shall maintain an
information data sheet in the client's record and promptly give a copy to
emergency medical personnel in the event of an emergency transfer to another
medical facility.
(s) The
information data sheet in (r) above shall include:
(1) Full name and the name the client
prefers, if different;
(2) Name,
address, and telephone number of the client's next of kin, guardian, or agent,
if any;
(4) Medications, including last dose taken
and when the next dose is due;
(6) Functional
limitations;
(8) Insurance
information;
(9) Advanced
directives; and
(10) Any other
pertinent information not specified in (1) -(9) above.
#9873-A, eff
2-24-11
