Current through Bulletin 2024-06, March 15, 2024
(1) For an
immediate care facility, the licensee:
(a)
shall provide 24-hour licensed nursing services;
(b) shall ensure nursing staff are present on
the premises 24 hours a day to meet the needs of residents;
(c) shall provide at least one registered
nurse either by direct employ or by contract to provide direction to nursing
services;
(d) may employ a licensed
practical nurse to act as the health services supervisor instead of a director
of nursing if a registered nurse consultant meets regularly with the health
services supervisor; and
(e) shall
provide at least the following:
(i) medical
supervision;
(ii) dietary
services;
(iii) social services;
and
(iv) recreational
therapy.
(2)
The licensee shall provide the following services as required in the resident
care plan:
(a) physical therapy;
(b) occupational therapy;
(c) speech therapy;
(d) respiratory therapy; and
(e) other therapies as ordered by the
licensed practitioner.
(3) For a skilled level of care nursing
facility, the licensee shall:
(a) provide
24-hour licensed nursing services;
(b) ensure nursing staff are present on the
premises 24 hours a day to meet the needs of residents;
(c) ensure a licensed charge nurse is present
on each shift;
(d) employ a
registered nurse for at least eight consecutive hours a day, seven days a
week;
(e) designate a registered
nurse to serve as the director of nursing on a full-time basis;
(f) not permit a person to concurrently serve
as the director of nursing and as a charge nurse; and
(g) provide services to the residents that
preserve current capabilities and prevent further deterioration including the
following:
(i) medical supervision;
(ii) dietary services;
(iii) physical therapy;
(iv) social services;
(v) recreation therapy;
(vi) dental services; and
(vii) pharmacy services.
(4) The licensee shall provide the
following services as required by the resident care plan:
(a) respiratory;
(b) occupational therapy; and
(c) speech therapy.
(5)
(a) The
licensee shall ensure any respite services comply with this
subsection.
(b) The licensee may
provide respite services at an hourly rate or daily rate, but may not exceed 14
days for any single respite stay. A respite stay that exceeds 14 days is
considered a nursing facility admission and is subject to the requirements of
this rule applicable to non-respite residents.
(c) The licensee shall coordinate the
delivery of respite services with the recipient, the case manager, if
applicable, and the family member, or primary caretaker.
(d) The licensee shall document and
coordinate with each provider agency to ensure uninterrupted service
delivery.
(6) The
licensee shall complete:
(a) a Level 1
Pre-admission Screening upon the persons admission for respite
services;
(b) a record for each
person receiving respite services;
(c) a service agreement to serve as the plan
of care, that identifies the prescribed medications, physician treatment
orders, need for assistance with activities of daily living, and diet orders;
and
(d) written respite care
policies and procedures that are available to staff.
(7) The licensee shall ensure respite care
policies and procedures address the following:
(a) medication administration;
(b) notification of a responsible person in
the case of an emergency;
(c)
service agreement and admission criteria;
(d) behavior management
interventions;
(e) philosophy of
respite services;
(f) post-service
summary;
(g) training and
in-service requirement for employees; and (h) handling personal
funds.
(8) The licensee
shall ensure the individual receiving respite services receives a copy of the
resident rights documents upon admission.
(9) The licensee shall ensure respite records
contain the following:
(a) the service
agreement;
(b) resident demographic
information;
(c) nursing
notes;
(d) physician treatment
orders;
(e) daily staff
notes;
(f) accident and injury
reports;
(g) a post-service
summary; and
(h) an advanced
directive, if available.
(10) The licensee shall ensure retention and
storage of respite records complies with Subsection
R432-150-25(3).
(11) The licensee shall ensure
confidentiality and release of information complies with Subsection
R432-150-25(4).
(12) Hospice care may only be arranged and
provided by a licensed hospice agency in accordance with Rule
R432-750.
(13) A nursing care
facility may provide terminal care.
