South Carolina Code of Regulations
Chapter 61 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Subchapter 61-103 - Residential Treatment Facilities for Children and Adolescents
Section 61-103.F - Professional Care
Universal Citation: SC Code Regs 61-103.F
Current through Register Vol. 48, No. 9, September 27, 2024
(1) Medical Care: (I)
The facility shall have available, either within its own organizational structure or by written arrangements with outside clinicians or facilities, a full range of services for the treatment of illnesses and the maintenance of general health. The facility's written plan for clinical services shall delineate the ways the facility obtains or provides all general and specialized medical, surgical, nursing and dental services. Definite arrangements shall be made for a licensed medical physician to provide medical care for the residents. This shall include arrangements for necessary visits to the facility as well as office visits. Each resident shall have a primary physician who maintains familiarity with his physical health status. Physicians, psychiatrists and other clinicians must be licensed to practice in South Carolina as required by South Carolina law.
(a) Residents who are physically ill shall be
cared for in surroundings that are familiar to them as long as this is
medically feasible. If medical isolation is necessary, there shall be
sufficient and qualified staff available to give appropriate care and
attention.
(b) Arrangements shall
be made in writing for residents from the facility to receive care from outside
clinicians and appropriate hospital facilities, e.g., surgery, in the event of
serious illness which the facility cannot properly handle.
(c) Every resident shall have a complete
physical examination annually and more frequently if indicated. This
examination shall be as inclusive as the initial examination. Efforts shall be
made by the institution to have physical defects of the residents corrected
through proper medical care. Immunization shall be kept current (DPT, polio,
measles, rubella), appropriate to the resident's age.
(d) Staff shall have knowledge of basic
health needs and health problems of residents, such as mental health, physical
health and nutritional health. Staff shall teach attitudes and habits conducive
to good health through daily routines, examples and discussion, and shall help
the residents to understand the principles of health.
(e) Each institution shall have a definitely
planned program of dental care and dental health which shall be consistently
followed. Each resident shall receive a dental examination by a qualified
dentist and prophylaxis at least twice a year. Reports of all examinations and
treatment should be included in the resident's clinical record.
(2) Emergency Services: (I)
(a) Policies and procedures shall be written
regarding handling and reporting of emergencies and these shall be reviewed at
least quarterly by staff. All clinical staff shall have training in matters
related to handling emergency situations.
(b) There shall be a physician on call
twenty-four (24) hours a day; his name and where he can be reached shall be
clearly posted in accessible places for all staff.
(c) All resident staff must demonstrate
competence in first aid and have CPR certification.
(d) There shall be an adequate number of
first aid kits stored with appropriate safeguards but accessible to staff in
appropriate locations such as living units, recreation and special purpose
areas, buses, etc. A first aid kit shall be equipped with at least an
antiseptic solution, first aid handbook, Band-Aids, 2-inch wide rolled bandage,
gauze pads, 1/2 -inch wide roll adhesive tape, cotton-tip applicators, safety
pins, scissors, soap, tweezers, thermometer and rubbing alcohol.
(e) The facility shall have written
arrangements with appropriate hospitals for emergencies which the facility
cannot properly handle.
(3) Pharmaceutical Services: (II)
(a) The facility shall have policies and
procedures related to pharmaceutical services. They shall include but are not
limited to the following:
(1) If the facility
has a pharmacy directed by a registered pharmacist or a drug room under
competent supervision, the pharmacist shall be responsible to the
administration of the facility for developing, supervising and coordinating all
activities of the pharmacy.
(2) If
there is a drug room with no pharmacist, prescription medication shall be
dispensed by a qualified pharmacist elsewhere and only storing and distributing
are done in the facility. A consulting pharmacist assists in drawing up the
correct procedures, rules and regulations for the distribution of drugs, and
visits the facility as needed.
(3)
The responsible pharmacist shall conduct monthly review of drugs and drug
records in all locations in which drugs are stored and will submit at least
monthly reports to the facility administrator and make recommendations for
improvement concerning the handling, storage and labeling of drugs at the
facility.
(b) Provision
for special locked storage space to meet the legal requirements for storage of
narcotics, alcohol and other prescribed drugs shall be provided. Keys for this
area and drug carts, if utilized, shall be controlled by a physician,
pharmacist, RN, LPN, or staff member credentialed to administer medications and
shall be under the day to day supervision of such persons.
(c) Provision made for emergency
pharmaceutical service.
(d)
Establishment and maintenance of a satisfactory system of records and
bookkeeping in accordance with the policies of the facility.
(e) An automatic stop order on all prescribed
drugs not specifically prescribed as to time and number of doses. These stop
orders shall be in accordance with Federal and State laws. Individual drug
plans shall be reviewed by a physician monthly or more frequently as
needed.
(f) A rule that drugs may
be administered only by a physician, registered nurse, LPN or designated staff
who is under the supervision of a registered nurse.
(g) That all orders are in writing and signed
by the physician. Telephone orders are used sparingly and given only to
designated staff and are signed or initialed by the physician within 48 hours.
Physician order must be dated and timed when signed.
(h) Each facility shall provide
pharmaceutical services in compliance with State and Federal laws and
regulations.
(i) The credentialing
process shall at a minimum address:
(1) Types
of medications which can be administered.
(2) Control and accountability of
drugs.
(3) Rules of
administration.
(4) Medication
administration records.
(5)
Medication errors and adverse reactions.
(4) Laboratory and Pathology Services: (II) Provision shall be made for those services within the facility or with an outside facility to meet the needs of the patient. These services shall be provided by an appropriately licensed or certified facility. Laboratory and pathology tests to be performed require a request from a qualified physician and reports from such tests shall be part of the resident's clinical records. Abnormal laboratory and pathology reports shall be followed up appropriately.
(5) Provisions for Radiology Services: (II)
(a) Each facility
shall have the capability of providing or obtaining diagnostic radiology
services as needed.
(b) A written,
signed report of each x-ray shall be made a part of the resident's record.
Request for x-ray examination shall contain a concise statement of the reason
for the examination. (II)
(6) Direct Resident Care Staffing: (I)
(a) An adequate number of licensed and
ancillary personnel shall be on duty to meet the total needs of
residents.
(b) At least one
registered nurse shall be immediately accessible by phone and available in the
facility within 30 minutes. Additional on site coverage by licensed nurses
shall be required if needed depending upon the size of the facility and needs
of the clients served. Nursing personnel shall be assigned to duties consistent
with their training and experience.
(c) There shall be a responsible staff member
on duty at all times in each building housing residents.
Disclaimer: These regulations may not be the most recent version. South Carolina may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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