Utah Administrative Code
Topic - Health
Title R432 - Health Care Facility Licensing
Rule R432-200 - Small Health Care Facility - Four to Sixteen Beds
Section R432-200-16 - Nursing Care
Universal Citation: UT Admin Code R 432-200-16
Current through Bulletin 2024-06, March 15, 2024
(1) Each licensee shall provide nursing care services commensurate with the needs of the residents served.
(2) The licensee shall ensure that each licensed nursing staff member maintains a current Utah license to practice nursing.
(3) The health services supervisor as defined in Rule R432-1 shall:
(a) direct the implementation of physician's
orders;
(b) plan and direct the
delivery of nursing care, treatments, procedures, and other services to assure
that each resident's needs are met;
(c) review the health care needs of each
resident admitted to the facility and formulate with other professional staff a
resident care plan according to the attending physician's orders;
(d) review the medication system for
completeness of information, accuracy in the transcription of physician's
orders, and adherence to stop-order policies;
(e) ensure that nursing notes describe the
care provided, including the resident's response;
(f) instruct the staff on the legal
requirements of charting;
(g)
supervise clinical staff to assure they perform restorative measures in their
daily care of residents;
(h) teach
and coordinate habilitative and rehabilitative care to promote and maintain
optimal physical and mental functioning of the resident;
(i) keep the administrator and attending
physician informed of significant changes in the resident's health
status;
(j) plan with the
physician, family, and health-related agencies the care of the resident upon
discharge;
(k) coordinate resident
services through the quality assurance committees;
(l) assign qualified supervisory and
supportive staff throughout the day and night to assure that the health needs
of residents are met;
(m) develop
written job descriptions for any health service personnel and orient each new
personnel to the facility and their duties and responsibilities;
(n) evaluate and document the performance of
each member of the staff at least annually and ensure that the evaluation is
available for departmental review; and
(o) plan, conduct, and document orientation
and in-service training programs for staff.
(4) The licensee shall ensure that required staffing hours are compliant with the following:
(a) each licensee that provides nursing care
shall provide at least two hours of nursing staff coverage for each registered
nurse, licensed practical nurse and aide per resident per 24 hours, of which
20% or 24 minutes per resident shall be provided only by licensed staff;
and
(b) a licensee providing
rehabilitative or habilitative care shall:
(i)
provide adequate staff care and supervision to meet the resident's needs based
on the resident care plan;
(ii)
conform to the specific program requirements in the appropriate supplement;
and
(iii) ensure adequate coverage
with additional staff in the event of staff illness, turnover, sudden increase
in resident population, or similar event.
(5)
(a) The
licensee shall ensure that nursing and health care services are compliant with
this subsection.
(b) The health
services supervisor shall review and annually update the nursing and health
services procedure manual.
(c) The
licensee shall make the manual accessible to any clinical staff and available
for review by the department.
(d)
The nursing and health services procedures shall address the following:
(i) bathing;
(ii) positioning;
(iii) enema administration;
(iv) decubitus prevention and care;
(v) bed making;
(vi) isolation procedures;
(vii) clinical test procedures;
(viii) laboratory requisitions;
(ix) telephone orders;
(x) charting;
(xi) rehabilitative nursing;
(xii) diets and feeding residents;
(xiii) oral hygiene and denture care;
and
(xiv) nasogastric tube
insertion and care is done only by a registered nurse, a licensed practical
nurse, with appropriate training, or a physician.
(6)
(a) The licensee shall implement measures to
prevent and reduce incontinence for each resident in compliance with this
subsection.
(b) A licensed nurse
shall provide a written assessment to determine the resident's ability to
participate in a bowel and bladder management program.
(c) An individualized plan for each
incontinent resident shall begin within two weeks of the initial nurse's
assessment.
(d) A licensed nurse
shall record a weekly evaluation of the resident's performance in the bowel or
bladder management program.
(e) A
licensed nurse shall record fluid intake and output for each resident as
ordered by the physician or charge nurse.
(f) A licensed nurse shall evaluate intake
and output records at least weekly and record each evaluation in the resident's
record.
(g) A physician or nurse
shall periodically reevaluate any physician's or nurse's orders.
(7)
(a) The licensee shall ensure nursing
personnel receive rehabilitative nursing training and that any rehabilitative
nursing services comply with this subsection.
(b) Nursing personnel shall perform and
document rehabilitative nursing services daily for residents who require such
services.
(c) Nursing personnel
shall provide rehabilitative services to maintain the resident's level of
functioning or to improve the resident's ability to carry out the activities of
daily living.
(d) Rehabilitative
nursing services shall include the following:
(i) turning and positioning of
residents;
(ii) assisting residents
to ambulate;
(iii) improving
resident's range of motion;
(iv)
restorative feeding;
(v) bowel and
bladder retraining;
(vi) teaching
residents' self-care skills;
(vii)
teaching residents transferring skills;
(viii) teaching residents self-administration
of medications, as appropriate; and
(ix) taking measures to prevent secondary
disabilities such as contractions and decubitus ulcers.
Disclaimer: These regulations may not be the most recent version. Utah 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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