Current through all regulations passed and filed through September 16, 2024
(A) Each residential care facility
is obligated
to arrange for the services of an administrator who
is obligated
to:
(1) Meet the applicable requirements
of rule 3701-16-06 of the Administrative
Code;
(2) Be responsible for the
daily operation of the residential care facility including, but not limited to,
assuring that residents' ongoing or changing service needs, as identified in
the resident assessments, and services ordered by a licensed health care
professional are acted upon by the appropriate staff member. If the facility
does not provide for the needed service,
the facility is obligated to
discuss
the lack of the needed service with the resident
as required by paragraph (G) of rule
3701-16-08 of the Administrative
Code;
(3) Provide not less than
twenty hours of service in the facility during each calendar week during the
hours of eight a.m. and six p.m. If the administrator is unable to provide at
least twenty hours of service in the residential care facility in a given
calendar week because of a vacation, illness, or other temporary situation, the
administrator is obligated to designate a staff member, who
is not
allowed to be less than twenty-one years of age
and who meets the requirements of paragraphs (D) and (H) of rule
3701-16-06 of the Administrative
Code, to serve as acting administrator;
(4)
The
administrator or acting administrator is obligated to be accessible at all
other times when not present at the residential care facility. A residential
care facility located in the same building as a nursing home, or on the same
lot as a nursing home, both of which are owned and operated by the same entity,
will be considered to have met this requirement if the nursing home has a full-
time administrator licensed under Chapter 4751. of the Revised Code who is
responsible for both the residential care facility and nursing home. For the
purposes of this paragraph, "full-time" means no less than thirty-two hours per
calendar week.
(B)
The residential care facility administrator may provide services to residents
if the administrator meets the applicable qualifications of rule
3701-16-06 of the Administrative
Code. An administrator, providing personal care services, of a facility with:
(1) Sixteen or less beds may be counted
toward meeting the staffing requirements of paragraph (C) of this
rule;
(2) Seventeen to thirty-five
beds is not
allowed to be
counted toward
meeting the staffing requirements of paragraph (C) of this rule until he or she
has met the requirements of paragraph (A)(3) of this rule;
(3) More than thirty-five beds
is not allowed
to be
counted toward meeting
the staffing requirements of paragraph (C) of this rule.
(C) Each residential care facility
is obligated
to have the following staff members who are competent to perform the
duties they are assigned:
(1) At least one
staff member on duty at all times who
meets the qualifications of rule
3701-16-06 of the Administrative
Code for staff members providing personal care services. During the night, the
staff member who is physically present in the facility may be on call if the
facility meets the resident call system requirements of paragraph (B)(5) of
rule 3701-16-14 of the Administrative
Code. When only one staff person is on duty in the facility, the residential
care facility is obligated to designate another staff member who
meets the same qualifications to be on call; and
(2) Sufficient additional staff members who
meet the applicable qualifications of rule
3701-16-06 of the Administrative
Code for the services they perform and appropriate scheduling of sufficient
staff time to adequately do all of the following:
(a) Meet, in a timely manner, the residents'
total care, supervisory and emotional needs as determined by the resident
assessment required under rule
3701-16-08 of the Administrative
Code and consistent with the resident agreement required under rule
3701-16-07 of the Administrative
Code and reasonable and appropriate requests for services, including monitoring
in excess of supervision of residents with increased emotional needs or
presenting behaviors that cause problems for the resident or other residents,
or both;
(b) Properly provide
dietary, housekeeping, laundry, and facility maintenance services and
recreational activities for the residents in accordance with the rules of this
chapter;
(c) Assist, when
necessary, with prompt evacuation of nonambulatory residents. The additional
staff members needed to implement the facility's evacuation plan required by
paragraph (J) of rule
3701-16-13 of the Administrative
Code are
obligated to be present in the facility at all times; and
(d) Provide or arrange for resident
activities required under rule
3701-16-11 of the Administrative
Code.
(3) Each
residential care facility is obligated to have at least one staff member capable
of giving personal care services who has successfully completed the first aid
training required by paragraph (E) of rule
3701-16-06 of the Administrative
Code, if applicable, present in the facility at all times.
(4) In determining the staffing level for the
facility, the facility is not required to consider resident needs:
(a) That are being served through a
contractual arrangement between the resident and a third party
provider;
(b) That the resident
chooses not to have met as documented in the resident's record; or
(c) That the resident has not contracted with
the facility to meet if the facility has complied with paragraph (G) of rule
3701-16-08 of the Administrative
Code.
(5) Unless the
resident's needs are being met by a private psychologist or physician, each
residential care facility that admits or retains residents with a diagnosis of
late-stage cognitive impairment with significant ongoing daily living
assistance needs, cognitive impairments with increased emotional needs or
presenting behaviors that cause problems for the resident or other residents,
or both, or serious mental illness, is obligated to
have a psychologist or physician with experience in the diagnosis and treatment
of the applicable condition or conditions, either on staff or as a
consultant.
(D) In
addition to the requirements set forth in this rule, each residential care
facility that elects to admit or retain residents for whom the facility
provides skilled nursing care beyond the supervision of special diets,
application of dressings, or administration of medication
is obligated
to do all of the following:
(1) Employ
or contract with a registered nurse
to provide onsite supervision of
skilled nursing care provided to residents. For purposes of this rule, "onsite
supervision" means that the registered nurse
is obligated to
spend sufficient time each week in the facility to manage the provision of
skilled nursing care in accordance with accepted standards of
practice;
(2) Have a licensed nurse
on call when one is not present in the facility; and
(3) Have sufficient additional nursing staff
to meet residents' needs.
(E) The operator or administrator
is obligated
to establish a schedule for staff coverage that includes coverage during
vacations, emergency situations, and long- term absences due to illness. The
residential care facility is not allowed to
mandate, coerce or persuade a
resident to supervise other residents, provide personal care services,
supervise special diets, administer medications or manage the facility.
Residents who voluntarily help or receive assistance from one another
are not
allowed to
be counted in
determining whether the residential care facility meets the staffing
requirements of this rule.
(F) Each
residential care facility which elects to administer medication
is obligated
to have one of the following individuals on duty
to
administer medications in accordance with paragraphs (G) and (H) of rule
3701-16-09 of the Administrative
Code and remain on duty for a sufficient amount of time to observe medication
acceptance and reaction:
(1) A registered
nurse;
(2) A licensed practical
nurse holding proof of successful completion of a course in medication
administration approved by the Ohio board of nursing pursuant to Chapter 4723.
of the Revised Code who
will administer medication only at the direction
of a registered nurse or physician;
(3) A physician; or
(4) A person authorized by law to administer
medication.
(G) Each
residential care facility which elects to supervise therapeutic diets
is obligated
to provide or arrange for a dietitian and comply with the applicable
requirements of rule
3701-16-10 of the Administrative
Code.
(H) Each residential care
facility which elects to provide for the application of dressings in accordance
with division (A)(2) of section
3721.011 of the Revised Code
is obligated
to have sufficient nursing staff to provide the service and
comply with the requirements of
paragraph (J) of rule
3701-16-09 of the Administrative
Code.
(I) Each residential care
facility that elects to provide skilled nursing care using staff members, in
accordance with division (C) of section
3721.011 of the Revised Code and
paragraph (B) of rule
3701-16-09.1 of the
Administrative Code, is obligated to have sufficient nursing staff to
provide the skilled nursing care. If the residential care facility elects to
provide enteral tube feedings on a part-time intermittent basis the facility
is obligated
to provide or arrange for a dietitian and provide sufficient nursing
staff with appropriate experience and training in enteral tube feedings.
Skilled nursing care may be delegated in accordance with Chapter 4723-13 of the
Administrative Code.
(J) A
residential care facility that is physically located in the same building or on
the same lot as a nursing home, or that provides an adult day care program, or
both, which are owned and operated by the same entity may use staff from the
residential care facility to provide services in the nursing home or adult day
care program, or use appropriate and qualified staff from the nursing home or
the adult day care program to meet part or all of the staffing requirements of
this rule, if all of the following criteria are met:
(1) The residential care facility at all
times meets the minimal staffing levels required by paragraph (C) of this rule.
The staff members, assigned to and responsible for meeting the residential care
facility residents' needs, may provide services to nursing home residents if
they meet the nurse aide qualifications of rule
3701-17-07.1 of the
Administrative Code, but are not allowed to
be counted towards meeting the nursing home
staffing levels of rule
3701-17-08 of the Administrative
Code;
(2) The nursing home at all
times meets the staffing level requirements of rule
3701-17-08 of the Administrative
Code;
(3) Separate staffing
schedules for the residential care facility, nursing home, and adult day care
program are maintained;
(4) The
residential care facility has the resident call systems required by paragraph
(B)(5) of rule
3701-16-14 of the Administrative
Code, for residents to use in obtaining unscheduled care or services, as
needed, when unexpected care needs arise and the monitoring of resident call
systems in the residential care facility and nursing home is not disrupted. The
residential care facility is not allowed to
limit the use of the resident call systems to
emergencies only;
(5) Utilization
of the nurses or aides, or both, does not adversely affect the quality and
timeliness of meeting the care needs of the nursing home and residential care
facility residents; and
(6) For a
residential care facility on the same lot as a nursing home, the homes are
located within two minutes or less response time from each other.
A staff member simultaneously assigned to the staffing
schedule of the residential care facility and the nursing home
is allowed to
be be counted in determining whether the residential care facility meets
the staffing requirements of paragraph (C) of this rule, unless over fifty per
cent of the staff member's assigned daily working hours are in the residential
care facility.
(K) The operator or the administrator of each
residential care facility is obligated to maintain records, on forms provided by
the director, documenting compliance with the personnel requirements of this
rule.
(L)
Each residential care facility will not admit residents in
excess of the number for which it is able to provide consistent nursing
coverage and other appropriate staffing levels based on the volume and needs of
the residents.
