Rules & Regulations of the State of Tennessee
Title 0250 - Children's Services
Subtitle 0250-04 - Standards for Regulated Institutions
Chapter 0250-04-07 - Standards for Maternity Homes
Section 0250-04-07-.07 - AGENCY SERVICES
Universal Citation: TN Comp Rules and Regs 0250-04-07-.07
Current through September 24, 2024
(1) Admission
(a) The Board of Directors in cooperation
with the executive director shall establish written admission policies clearly
stating who is eligible for the services of the home.
(b) Pre-placement procedures must be clearly
set forth. These must include providing an explanation of all agency policies,
regulations, and requirements prior to a resident's entry into the home and the
resident's written acknowledgment of having received this
information.
(c) Clients are to be
admitted for care only after an intake evaluation by social service staff
indicates that this is the most suitable plan for her.
(d) Commitment to a definite plan for the
child must not be a condition for admission. There must be a clear
understanding that the plan for the child rests with the client.
(e) Admission of a child from another state
shall be in accordance with the Interstate Compact on the Placement of
Children.
(f) The agency must not
admit any residents in excess of its licensed capacity.
(2) Discharge Policy
(a) The Board of Directors in cooperation
with the executive director shall establish written discharge
policies.
(b) Discharge policies
shall be interpreted to each client at the time of application or admission.
These policies must include a description for procedures for prepared
discharge.
(c) Normally residents
shall not be discharged without medical permission and a social service
plan.
(d) Residents who wish to
surrender their children for adoption shall be referred to a licensed
child-placing agency for this service.
(e) A written discharge statement shall be
signed by the resident's legal custodian or resident which relieves the agency
of further legal responsibility.
(3) Provision of Social Services
(a) Casework services shall be available
daily to every resident admitted to a maternity home, either through qualified
staff or by contract with a qualified agency or individual.
(b) Social Services must include:
1. Pre-admission evaluation to determine
whether group care is appropriate for a particular client.
2. Regular contact, individually and/or in
groups to:
(i) Help the resident resolve her
conflicts and handle the immediate problems;
(ii) Assist the resident in planning for her
child including options of marriage, single parenting or adoption;
(iii) Provide service to the resident's
parents and/or the father of the child, if this is possible and appropriate;
and
(iv) Prepare the resident for
the return to community life.
(c) Adequate records shall be maintained on
each applicant. The following information must be recorded:
1. Resident's full name, date of birth,
address, occupation, social security number and educational level;
2. Parents' name and address(es) (if
available);
3. Person to contact in
case of emergency;
4. Name and
address of alleged father, when available;
5. Date of entering the home;
6. Social history;
7. Report of physical examination;
8. Psychological evaluation, if available and
indicated;
9.
Correspondence;
10. Agreement for
services must be signed by the resident, and, if a minor, signed also by her
parents Consent for medical services signed by the resident and, if a minor,
signed by her parents or guardian;
11. Date of discharge and final plan for the
resident and her baby; and
12. At
discharge, combined medical, nursing, and social service records shall be
stored in a locked fire-resistant file and must be handled
confidentially.
(4) Health Services
(a) Each maternity home shall have a medical
advisor who is a licensed physician. He shall be available for individual case
consultation as needed. Medical consultants must also be available to establish
and periodically review standards for the provision of health services within
the agency.
(b) Each maternity home
shall have written health service policies covering such areas as storing and
administering prescription medication, provisions of medical service during the
absence of staff and for other emergencies, and other aspects of the total
health program.
(c) Medications
1. All medications including over the counter
drugs, attitude manipulators, tranquilizers, legend pain killers, barbiturates,
or amphetamines, must be safeguarded by a double entry medication system
whereby each medication is recorded as it comes into the agency. Administration
of all medications must be documented. Medications must be double-locked within
the agency.
2. The agency must not
have psychotrophic drugs as stock items. Such drugs must be individually
prescribed and kept in the original containers with the name of the patient,
drug, dosage, frequency of administration, and prescription number unless
filled directly by the physician.
3. Other prescribed medication may not be
administered without a specific order or standing order from a licensed
physician.
(d) Each
maternity home shall have the services of a registered nurse or a licensed
practical nurse. Their responsibilities will be to coordinate the total health
services provided each resident, maintain contact with the residents, in order
to recognize problems which may require medical follow-up, and implement
medical recommendations, special diets, and other routine procedures.
(e) Maternity homes using local hospitals and
clinics for prenatal care and/or delivery shall use only those hospitals and
clinics approved and licensed by the Tennessee Department of Health and
Environment.
(f) Delivery and
nursery services for newborn infants, if operated by a maternity home, shall be
licensed by the Tennessee Department of Health and Environment.
(g) Prenatal Care
1. A medical and obstetric history shall be
obtained at the time of admission.
2. Within two weeks following admission a
complete examination and pelvic measurement shall be made. The admission
examination shall include blood pressure determination, weight urinalysis,
laboratory tests for syphilis, gonorrhea, Hepatitis B Virus and Herpes 11,
tuberculin skin test, determination of hemoglobin, red and white blood cell
counts, and any other special studies that may be indicated.
3. The physician shall examine the patient at
least once a month in the first six (6) months of pregnancy twice a month in
the seventh and eight months, weekly during the ninth month, and more often if
indicated.
(h)
Postpartum
1. Every patient shall be given
close medical nursing supervision, and allowed an adequate period for
recovery.
2. Adequate diet shall be
provided in accordance with the needs of the patient and on the recommendation
of the physician.
3. The length of
the recovery period and the continued limitation of activity shall be
determined by the attending physician.
4. A postpartum examination shall be made by
the physician before discharge from the home.
(i) Medical and nursing records shall be kept
by the appropriate staff members.
(j) At the time of the resident's discharge
from the home, the medical and nursing records shall be placed in the folder
with the running case record, and the complete document placed in the closed
files.
(k) Psychiatric and
Psychological Services
Psychiatrists serving maternity homes shall be board certified, or have successfully completed the requirements of a residency in psychiatry, or be currently participating in a psychiatric residency program.
1. Psychologists serving
maternity homes shall have at least a Master's degree in psychology from an
accredited university.
2.
Psychiatric and psychological services, if needed, shall include consultation
for social service staff and group or individual services for residents under
care.
(1) Clinic
If prenatal supervision is given by a physician in the residence, there shall be a room for medical examination.
(5) Basic and Informal Education
(a) Accredited academic
instructions shall be available for the mandatory school-age residents whose
education has been interrupted. Arrangements must be made through the local
school board to be certain that a certified teacher is used and that credits
are given for work completed. Safeguards are necessary to be certain that
information about the resident is handled confidentially when credits are
transferred.
(b) Health education
shall be available including:
1. Sound hygiene
practices;
2. Preparation for
childbirth;
3. Infant and child
care;
4. Drug and-alcohol use and
abuse;
5. Family
planning;
6. Sex
education;
7. Parenting education;
and
8. Sexually transmitted
diseases.
(6) The atmosphere prevailing in the home must be such as to foster the spiritual growth of the resident in her daily living. Residents shall be provided the opportunity to participate in religious activities as they desire.
(7) Recreational Activities
(a) Appropriate recreational activities shall
be provided.
(b) The participation
of individual residents in strenuous recreational activities shall be approved
by the staff physician.
(8) Food Services
(a) All maternity home facilities located in
counties or municipalities which have an adopted food service code, ordinance,
or regulation, must comply with such code, ordinance or regulation.
(b) Food of adequate quality and quantity
shall be served. The most currently recommended nutritional requirements for
the expectant mother as defined by the medical consultant shall be
provided.
(c) Three meals and
snacks shall be provided daily.
(d)
All special diets and diets of infants shall be prepared as prescribed by the
physician. For feeding suggestions for infants, copies of "Food for Infants"
can be obtained from the Tennessee Department of Health and
Environment.
(e) Denial of
nutritionally adequate diet shall not be used as a punishment.
(f) When a qualified nutritionist or a
dietitian is not on the staff, the person responsible for meal planning shall
request consultation, at least twice a year, from a qualified nutritionist or
dietitian. These services may be requested from the Department of Health and
Environment, local colleges, universities, or hospitals, etc.
(g) Menus for the week shall be prepared and
posted, in advance. These menus shall be followed, although reasonable
substitutions are permissible if the substituted food contains approximately
the same nutrients.
Authority: T.C.A. §§ 4-5-226(b)(2);37-5-101; 37-5-105; 37-5-106; 37-5-112(a); 71-1-105; 71-3-501 through 71-3-531 and 71-1-504(E).
Disclaimer: These regulations may not be the most recent version. Tennessee 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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