Rules & Regulations of the State of Tennessee
Title 0720 - Health Facilities Commission
Chapter 0720-37 - Standards for Adult Care Homes - Level 2
Section 0720-37-.06 - SERVICES PROVIDED
Universal Citation: TN Comp Rules and Regs 0720-37-.06
Current through April 3, 2024
(1) Medical Services. Each ACH shall provide twenty-four (24) hour nursing services furnished or supervised by the adult care home provider, resident manager or substitute caregiver. Licensed registered nurses and licensed practical nurses may provide all prescribed medical services that are within the scope of the nurse's professional license.
(2) Medical services in an ACH shall be provided by:
(a) Appropriately licensed staff of an
ACH;
(b) Appropriately licensed or
qualified contractors of an ACH;
(c) A licensed home care organization;
or
(d) Another appropriately
licensed entity.
(3) Standards for Medication Administration. An ACH shall:
(a) Ensure that all drugs and biologicals
shall be administered by a licensed professional operating within the scope of
the professional license and according to the resident's plan of care;
and
(b) Ensure that all medications
are kept in a locked, central location, separate from medications of the
staff.
(c) Self-administration of
Medication. Residents must have a physician or nurse practitioner's written
order of approval to self-medicate. Residents able to handle their own medical
regimen may keep medications in their own room in a locked storage
container.
(d) Injections.
Subcutaneous, intramuscular, and intravenous injections may be
self-administered by the resident or by a licensed professional operating
within the scope of the professional license.
(4) An ACH shall dispose of medications as follows:
(a) Upon discharge of a resident,
unused prescription medication shall be released to the resident, the
resident's family member, or the resident's legal representative, unless
specifically prohibited by the attending physician.
(b) Upon the death of a resident, unused
prescription medication must be destroyed in the manner outlined and by the
individuals designated in the facility's medication disposal policy, unless
otherwise requested by the resident's family member or the resident's legal
representative and accompanied by a written order by a physician. The ACH's
medication disposal policy shall be written in accordance with current FDA or
current DEA medication disposal guidelines.
(c) The ACH shall properly dispose of
prescription medication administered by the facility in accordance with the
facility's medication disposal policy, which shall be written in accordance
with current FDA or current DEA medication disposal guidelines.
(d) The ACH may dispose of prescription
medication that is self-administered by the resident according to the
facility's medication disposal policy, which shall be written in accordance
with current FDA or current DEA medication disposal guidelines, or the facility
may provide information to the resident's family member or the resident's legal
representative regarding the proper method to dispose of the
medication.
(e) If the resident is
a hospice patient, hospice shall be responsible for disposing of the
prescription medication upon death of the resident.
(f) The ACH's medication disposal policy
shall also address the disposal of scheduled drugs, non-scheduled drugs, and
devices that are misbranded, expired, deteriorated, not kept under proper
conditions, and kept in containers with illegible or missing labels.
(5) An ACH shall provide personal services as follows:
(a) Each ACH shall
provide each resident with at least the following personal services:
1. Protective care;
2. Safety when in the ACH;
3. Daily awareness of the individual's
whereabouts;
4. The ability and
readiness to intervene if crises arise;
5. Room and board; and
6. Non-medical living assistance with
activities of daily living.
(b) Recreational Services. An ACH shall
provide to residents a daily regime of activities commensurate with the
resident's needs, as identified through the assessment developed by the
facility and specified in the resident's plan of care.
(c) Laundry services. An ACH shall:
1. Provide arrangements for laundry of ACH
linens and residents' clothing;
2.
Provide appropriate separate storage areas for soiled linens and residents'
clothing; and
3. Maintain clean
linens in sufficient quantity to provide for the needs of the residents. Linens
shall be changed whenever necessary.
(d) Dietary services.
1. An adult care home provider shall provide
three (3) nutritionally balanced meals per day or shall make arrangements for
meals on an as needed basis. The food must be adapted to the habits,
preferences and physical abilities of the residents. Additional nourishment
and/or snacks shall be provided to residents with special dietary needs or upon
request.
2. There shall be no more
than fourteen (14) hours between the evening and morning meals.
3. All food served to the residents shall be
of good quality and variety, sufficient quantity, attractive and at safe
temperatures. Prepared foods shall be kept hot (140ºF or above) or cold
(41ºF or less) as appropriate.
4. Meal planning and preparation shall take
into consideration any special dietary needs of the resident, as prescribed by
the resident's physician.
5. An ACH
shall designate a person responsible for the food service, including the
purchasing of adequate food supplies and the maintenance of sanitary practices
in food storage, preparation and distribution. Sufficient arrangements or
employees shall be maintained to cook and serve the food.
6. An ACH may contract with an outside food
management company if the company has a dietitian who serves the ACH on a
full-time, part-time, or consultant basis, and if the company maintains at
least the minimum standards specified in this section while providing for
constant liaison with the ACH for recommendations on dietetic policies
affecting resident treatment.
7. An
ACH shall have a current therapeutic diet manual approved by a dietitian
readily available to all ACH personnel.
8. Menus shall be planned one week in advance
and posted in a location accessible to residents and families.
9. An ACH shall:
(i) Provide sufficient food provision
capabilities and dining space;
(ii)
Maintain and properly store a forty-eight (48) hour food supply at all
times;
(iii) Provide appropriate,
properly-repaired equipment and utensils for cooking and serving food to serve
all residents;
(iv) Maintain a
clean and sanitary kitchen; and
(v)
Ensure employees shall wash and sanitize equipment, utensils and dishes after
each use.
Authority: T.C.A. §§ 68-11-206, 68-11-209, and 68-11-270.
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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.