Current through Register Vol. 48, No. 9, September 27, 2024
(1) General:
Every facility shall be organized, equipped, manned and
administered to provide adequate care for each person admitted.
(2) Governing Authority: The
governing board, or the owner, or the person or persons designated by the owner
as the governing authority shall be the supreme authority responsible for the
management control of the facility and shall develop a written set of bylaws or
other appropriate policies and procedures for operation of the facility. These
shall: (II)
(a) state the purpose of the
facility;
(b) specify by name the
person to whom responsibility for operation and maintenance of the facility is
delegated and methods established by the governing authority for holding such
individual responsible;
(c) provide
for at least annual meetings of the governing authority.
(3) Administrator: The chief administrative
officer shall be selected by the governing authority and shall have charge of
and be responsible for the management and administration of the facility in all
its branches and departments and shall see that the bylaws and amendments
thereto are complied with. Any change in the position of the chief
administrative officer shall be reported immediately by the governing authority
to the Department in writing. An individual shall be appointed to act in the
absence of the administrator.
(4)
Administrative Records: The following essential documents and references shall
be on file in the administrative office of the facility:
(a) appropriate documents showing control and
ownership;
(b) bylaws, policies and
procedures of the governing authority;
(c) minutes of the governing authority
meetings if applicable;
(d) minutes
of the facility's professional and administrative staff meetings;
(e) a current copy of these
regulations;
(f) reports of
inspections, reviews, and corrective actions taken related to
licensure;
(g) contracts and
agreements related to licensure to which the facility is a party; and
(h) a record of each accident or incident
occurring in the facility, including medication errors and drug reactions.
Incidents resulting in hospitalization or death shall be reported in writing to
the Department within 10 days.
(5) Personnel: Qualified personnel shall be
employed in sufficient numbers to carry out the functions of the facility. The
licensee shall obtain written applications for employment from all employees.
Such applications shall contain accurate information as to education, training,
experience, health and personal background of each employee. All applications
for licensed personnel shall contain the South Carolina license number and/or
current renewal number, if applicable. No residential treatment facility shall
knowingly employ or retain an individual who has been convicted of having
committed a crime of violence, an offense against morality and decency or
contributed to the delinquency of a minor. Violent crimes include but are not
limited to such offenses as simple assault committed within the last three
years; assault and battery; assault and battery of a high and aggravated
nature; assault with a deadly weapon; assault with intent to kill; pointing and
presenting a firearm; criminal sexual conduct in the first, second and third
degree (rape); all forms of homicide, e.g., murder and manslaughter;
kidnapping; and arson. Offenses against morality and decency include but are
not limited to committing or attempting lewd acts upon a child under fourteen;
distribution knowingly of obscene matter to a minor under sixteen; employment
or use knowingly of a minor under sixteen to disseminate or promote obscene
matter; photographing of a minor for an obscene film or photograph;
dissemination of sexually oriented material to minors. Conviction includes the
results of a jury trial, guilty plea, plea of no contest or forfeiture of bond
in cases of misdemeanor. (II)
(a) All new
employees who have contact with residents shall have a physical examination
prior to employment, which shall include a tuberculin skin test, unless a
previously positive reaction can be documented. The intradermal (Mantoux)
method, using five tuberculin units of stabilized purified protein derivative
(PPD) is recommended. (II)
(1) Employees with
positive reactions to the pre-employment tuberculin test and those who are
documented with previously positive reactions shall be given a chest x-ray to
determine whether tuberculin disease is present. If tuberculosis is diagnosed,
appropriate treatment should be given.
(2) Employees who complete treatment, either
for disease or infection, may be exempt from further screening unless they have
symptoms of tuberculosis.
(3)
Positive reactors who are unable or unwilling to take preventative treatment
need not receive an annual chest x-ray. These individuals shall be informed of
their lifelong risk of developing and transmitting tuberculosis to individuals
in the facility and in the community. They shall be informed of symptoms which
may suggest the onset of tuberculosis, and of the procedure to follow in
reporting suspect symptoms to a designated member of the facility
staff.
(4) Employees with negative
tuberculin skin tests shall have an annual tuberculin skin test.
(b) Personnel Records: A personnel
record folder shall be maintained for each employee. The folder shall contain
history and physicals, laboratory test results, resumes of training and
experience, and current job description that reflects the employee's
responsibilities and work assignments, orientation and periodic evaluations.
(II)
(c) Job Descriptions:
(1) Written job descriptions which adequately
describe the duties of every position shall be maintained.
(2) Each job description shall include:
position title, authority, specific responsibilities and minimum
qualifications.
(3) Job
descriptions shall be reviewed at least annually, kept current and given to
each employee when assigned to the position and when revised.
(d) Orientation shall be provided
to familiarize each new employee with the facility, its policies, and job
responsibility.
(e) Continuing
education must be provided to all non-clerical employees at least once a year.
Inservice training may be provided by qualified facility staff.
(6) Emergencies: (I)
(a) Each facility shall have a written
transfer agreement with one or more hospitals, or other arrangements approved
by the Department, for the transfer of emergency cases when hospitalization
becomes necessary. The transfer agreement shall be dated and signed by
authorized officials of each facility that is a party to the agreement. The
agreement shall be updated to assure that it continues in effect following
changes in administration or ownership, and at any other time deemed advisable
to improve continuity of care. (I)
(b) Equipment and services shall be provided
to render emergency resuscitative and life-support procedures pending transfer
to a hospital. This equipment and services shall include at a minimum: (I)
(1) a first aid kit;
(2) one or more staff members on duty at all
times who are capable of performing cardiac pulmonary resuscitation, therapy of
shock, and hemostasis.
(c) The facility shall enter into a signed
written agreement with an ambulance service licensed in this state to ensure
the immediate transfer of residents in emergencies, where appropriate, or shall
have on file documented evidence that it has attempted in good faith to effect
such an agreement. (I)
(7) Client's Rights: The residential
treatment facility shall have written policies and procedures to assure the
individual client the right to dignity, privacy, and safety. (I)
(8) Planning Goals, Policies and Procedures:
Each facility shall have a clear written statement of its purpose and
objectives, with a formal, long-range plan adopted to guide and schedule steps
leading to attainment of its projected objectives. This plan shall include a
specifically delineated description of the services the facility offers, so
that there is a frame of reference for judging the various aspects of the
program. The plan shall also include:
(a) the
population to be served, age groups and other limitations;
(b) the initial screening process;
(c) the intake or admission
process;
(d) methods for involving
family members or significant others in assessment, treatment and follow-up
plans;
(e) an organizational chart
with a description of each unit or department and its services, goals, policies
and procedures, staffing patterns and its relationship to other services and
departments and how these are to contribute to the priorities and goals of the
facility;
(f) a plan for
cooperation with other public and private agencies to assure that each child or
adolescent under its care will receive comprehensive treatment. Ongoing working
arrangement contracts with agencies, such as schools, welfare agencies, etc.,
shall be included as indicated, as well as regularly planned interagency
conferences. These shall be documented:
(g) ways in which the facility carries out
any community education consultation programs; and
(h) ways which the facility provides or makes
arrangements for:
(1) other medical, dental,
special assessment and therapeutic services. This shall be in the plan for
clinical services;
(2) emergency
services and crisis intervention;
(3) educational services for all residents;
and
(4) discharge and follow-up
care and evaluation.
(9) Visitors: Policies shall allow visitation
of resident's family and significant others unless clinically contraindicated
and documented in resident's records. Appropriate places for visits shall be
provided.
(10) Telephone and Mail:
Residents shall be allowed to conduct private telephone conversations with
family and friends and to send and receive mail. When restrictions are
necessary because of therapeutic or practical reasons, such as expense, these
reasons shall be documented, explained to the patient and family and
re-evaluated at least monthly.
(11)
Discipline: Discipline shall be fair and consistent and must be administered
based on the individual's needs and treatment plan. Discipline shall not
include corporal punishment.
