Current through all regulations passed and filed through September 16, 2024
(A) Each nursing home operator shall arrange
for the services of a physician to serve as the home's medical director, the
medical director shall:
(1) In collaboration
with the administrator, the nursing director, and other health professionals,
develop formal resident care policies for the nursing home that:
(a) Provide for the total medical and
psycho-social needs of the resident, including admissions, transfer, discharge
planning, range of services available to the resident, emergency procedures and
frequency of physician visits in accordance with resident needs and the
applicable requirements of Chapter 3721. of the Revised Code and of rules
3701-17-01 to
3701-17-26 of the Administrative
Code.
(b) Promote resident rights
as enumerated in section
3721.13 of the Revised Code.
(2) Make available
medical care for residents not under the care of their own physicians and to
make available emergency medical care to all residents, provided their personal
physicians are not readily available.
(3) Meet periodically with nursing and other
professional staff to discuss clinical and administrative issues, including the
need for additional staff, specific resident care problems and professional
staff needs for education or consultants to assist in meeting special needs
such as dentistry, podiatry, dermatology, and orthopedics, offer solutions to
problems, and identify areas where policy should be developed. In carrying out
this function, the medical director shall:
(a) Observe residents and facilities at least
quarterly or more frequently as needed; and
(b) Review pharmacy reports, at least
quarterly, including summaries of drug regimen reviews required by paragraph
(I) of
rule 3701-17-17 of the Administrative
Code and the quality assurance activities required by paragraph
(C) of
rule 3701-17-06 of the Administrative
Code, and take appropriate and timely action as needed to implement
recommendations.
(4)
Monitor the clinical practices of, and discuss identified problems with,
attending physicians; act as a liaison between the attending physicians and
other health professionals caring for residents and the residents' families;
and intervene as needed on behalf of residents or the home's administration.
(5) Maintain surveillance of the
health of the nursing home's staff.
(6) Assist the administrator and professional
staff in ensuring a safe and sanitary environment for residents and staff by
reviewing incidents and accidents, identifying hazards to health and safety,
and advising about possible correction or improvement of the environment.
(B) The nursing home
shall not
administer any medication to any resident unless ordered by a
physician or by other licensed health professionalsacting within
the applicable scope of practice. If orders are
given by telephone, they shall be recorded with the licensed health
professional's name and the date, and the order and signed by the person who
accepted the order. All orders, including facsimile, telephone, or verbal
orders, shall be accepted in accordance with United States drug
enforcement administration and board of pharmacy of the state of Ohio
requirements.
(C)
The nursing home shall not administer any treatment to
any resident unless ordered by a physician or by other licensed health
professionals acting within the applicable scope of practice. If orders are
given by telephone, they shall be recorded with the licensed health
professional's name, the date, the order and signed by the person who accepted
the order. All orders, including facsimile, telephone, or verbal orders, shall
be signed and dated by the physician or other licensed health professional
working in collaboration with the physician who gave the order within fourteen
days after the order was given.
(1)
Telephone orders
shall not be accepted by a person other than a licensed nurse on duty, another
physician or a pharmacist, except that a licensed physical, occupational or
respiratory therapist, audiologist, speech pathologist, dietitian, or other
licensed health professional may receive, document and date treatment orders
concerning that individual's specific discipline for residents under their
care, to the extent permitted by applicable licensing laws.
(2)
The nursing home
may accept signed orders issued by a licensed health professional by facsimile
transmission if the home has instituted procedural safeguards for
authenticating and maintaining confidentiality of the facsimile order, and for
handling it in an expedient and priority manner.
(3)
An entry that is
an electronic record as defined in section
3701.75 of the Revised Code may
be authenticated by an electronic signature in accordance with section
3701.75 of the Revised Code, if
allowed by law.
(D)
Each resident of a nursing home shall be under
the supervision of a physician. Each resident of a nursing home shall be
evaluated by a physician or other licensed health
professionals acting within the applicable scope of practice, at least
once every thirty days for the first ninety days after admission or three
evaluations. After this period, each resident of a nursing home shall be
evaluated by a physician or other licensed health
professionals acting within the applicable scope of practice at least
every sixty days, except that if the attending physician documents in the
medical record why it is appropriate, the resident may be evaluated no less
frequently than once every one hundred twenty days.
(1) The evaluations required by this rule
shall be made
in person
. In conducting the evaluation, the physician or licensed
health professional shall solicit resident input to the extent of the
resident's capabilities.
(2) The
physician or licensed health professional shall write a progress note after
each evaluation depicting the current condition of the resident based upon
consideration of the physical, mental and emotional status of the resident.
(3) A physician or licensed health
professional visit is considered timely if it occurs no later than ten calendar
days after the date the visit was required.
(E)
Each nursing
home shall, on an annual basis, offer to each resident a vaccination against
influenza and a vaccination against pneumococcal pneumonia as required by
section 3721.041 of the Revised
Code.
Effective:
4/1/2012
R.C. 119.032 review dates:
10/27/2011 and
12/01/2016
Promulgated
Under: 119.03
Statutory Authority: 3721.04
Rule
Amplifies: 3721.02, 3701.03, 3721.041, 3721.05, 3721.07
Prior
Effective Dates: 5/2/1966, 11/15/76, 9/30/88, 5/20/91, 12/21/92, 10/20/01
