Current through all regulations passed and filed through September 16, 2024
(A) In the event of a significant adverse
change in residents' health status, the residential care facility
is obligated
to do all of the following:
(1) Take
immediate and proper steps to see that the resident receives necessary
intervention including, if needed, medical attention or transfer to an
appropriate medical facility;
(2)
Make a notation of the change in health status and any intervention taken in
the resident's record;
(3) Provide
pertinent resident information to the person providing the intervention as soon
as possible; and
(4) Notify the
sponsor unless the resident refuses or requests otherwise.
(B) As used in this paragraph, "incident"
means any accident or episode involving a resident, staff member, or other
individual in a residential care facility which presents a risk to the health,
safety, or well-being of a resident. In the event of an incident, the facility
is obligated
to do both of the following:
(1) Take
immediate and proper steps to see that the resident or residents involved
receive necessary intervention including, if needed, medical attention or
transfer to an appropriate medical facility;
(2)
Investigate the incident and document the incident and the investigation
and include information that will enable staff to
identify to the director upon request, the resident involved in an
incident. The facility is obligated to maintain an incident log separate from
the resident record which is
accessible
to the director and
contains the time, place, and date of the
occurrence; a general description of the incident; and the care provided or
action taken. The facility
is obligated to
document
the
incident in the resident's record.
(C) Each residential care facility
will
establish and implement appropriate written policies and procedures to
assure a
safe, sanitary, and comfortable environment for the
residents and to control the development and
transmission of infections and diseases. Each
residential care facility is obligated to establish an infection prevention and
control program to monitor compliance with the home's infection prevention and
control policies and procedures, to prevent, investigate, and control
infections in the home, to institute appropriate interventions, and ensure all
staff are appropriately trained on the home's infection prevention and control
protocol.
An effective infection control
program includes:
(1)
Each residential care facility is obligated to
designate one or more individuals as the infection prevention and control
designee and provide that individuals name and contact information, including
an electronic mail address, on an electronic system prescribed by the director
no later than ten days after hiring or appointing the individual and no later
than ten days after the individual's contact information changes or the
designated individual is replaced. The infection control designee is
responsible for the facility's infection prevention and control program. The
infection prevention and control designee will have:
(a)
Completed
post-secondary education in a health-related field including but not limited to
medicine, nursing, medical technology, laboratory technology, public health,
epidemiology, or biology;
(b)
Have education, training, or experience in infection
control; and
(c)
Work at least part-time at the facility or hold a
contract to provide infection prevention and control at least part-time at the
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 an infection prevention and
control designee who is responsible for both the residential care facility and
nursing home.
(2)
A tuberculosis
control plan that meets the standards set forth in rule
3701-15-03 of the Administrative
Code.
(3)
A written surveillance plan outlining the activities
for monitoring/tracking infections based on nationally-recognized surveillance
criteria such as McGeer criteria and:
(a)
Includes a
surveillance system that includes a data collection tool;
(b)
Uses surveillance
data to:
(i)
Implement timely corrective action when a greater than
expected number healthcare-associated infections are detected;
and
(ii)
Implement timely corrective actions when transmission
of targeted MDROs (e.g., CRE, Candida auris) are detected.
(4)
Written standards, policies, and procedures for the
program, which must include, but are not limited to:
(a)
Standard and
transmission-based precautions to be followed to prevent spread of
infections;
(b)
When and to whom possible incidents of communicable
disease or infections should be reported;
(c)
When and how
isolation should be used for a resident; including but not limited to:
(i)
The type and
duration of the isolation, depending upon the infectious agent or organism
involved, and (B) A requirement; and
(ii)
A requirement
that the isolation should be the least restrictive possible for the resident
under the circumstances.
(5)
Written
standards, policies, and procedures under which the facility will prohibit
employees with a communicable disease or infected skin lesions from direct
contact with residents or their food, if direct contact will transmit the
disease;
(6)
The hand hygiene procedures to be followed by staff
involved in direct resident contact, including, but not limited to:
(a)
Washing hands for
twenty seconds with soap and water; or
(b)
Cleaning of hands
with an alcohol-based product used according to manufacturer's directions or
other alternative methods accepted by the United States Centers for Disease
Control and Prevention or US Food and Drug Administration, as being an
effective alternative, or handwashing with soap and water.
(7)
Written standards, policies, and procedures for laundry to
ensure personnel handle, store, process, and transport linens so as to prevent
the spread of infection including:
(a)
Handling soiled laundry as little as
possible;
(b)
Placing of laundry that is wet or soiled with body
substances in impervious bags that are secured to prevent spillage;
and
(c)
Wearing of impervious gloves and impervious gowns by
individuals performing laundry services, and, if handling soiled or wet laundry
on the unit, the wearing of gloves and, if appropriate, other personal
protective equipment;
(D)
Each residential
care facility will establish and implement an effective water management
program to identify hazardous conditions, and take steps to manage the risk of
occurrence and transmission of waterborne pathogens, including but not limited
to legionella, in building water systems in accordance with guidance from the
United States centers for disease control and prevention (available at
https://www.cdc.gov/legionella/wmp/overview.html) and recommendations of the United States centers for
disease control and prevention healthcare infection control practices advisory
committee, "Environmental Infection Control Guidelines" (2019) or its
successors.
(E)
If the
residential care facility provides an adult day care program which is located,
or shares space, within the same building as the residential care facility,
shares staff between the program and the facility, or where the day care
participants at any time intermingle with residents of the facility, the
requirements of this rule are also applicable to participants of the adult day
care program.
