Virginia Administrative Code
Title 12 - HEALTH
Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
Chapter 60 - STANDARDS ESTABLISHED AND METHODS USED TO ASSURE HIGH QUALITY CARE
Section 12VAC30-60-320 - Adult ventilation/tracheostomy specialized care criteria
Universal Citation: 2 VA Admin Code 30-60-320
Current through Register Vol. 41, No. 3, September 23, 2024
A. General description. The resident must have long-term health conditions requiring close medical supervision, 24 hour licensed nursing care, and specialized services or equipment.
B. The targeted adult population requiring specialized care includes individuals requiring mechanical ventilation and individuals with a complex tracheostomy who require comprehensive respiratory therapy services.
C. Criteria.
1. The individual must require at a minimum:
a. Physician visits at least once weekly. The
initial physician visit must be made by the physician personally and subsequent
required physician visits after the initial visit may alternate between
personal visits by the physician and visits by a physician assistant or nurse
practitioner.
b. Skilled nursing
services 24 hours a day. A registered nurse must be on the nursing unit on
which the resident resides, 24 hours a day, whose sole responsibility is the
designated unit.
c. Respiratory
services provided by a licensed board-certified respiratory therapist (these
services must be available 24 hours a day).
d. Coordinated multidisciplinary team
approach to meet needs.
2. In addition, the individual must meet one
of the following two requirements:
a. Require
a mechanical ventilator; or
b. Have
a complex tracheostomy that meets all of the following criteria. The individual
must:
(1) Have a tracheostomy, with the
potential for weaning off of it, or documentation of attempts to wean, with
subsequent inability to wean;
(2)
Require nebulizer treatments followed by chest PT (physiotherapy) at least four
times per day or nebulizer treatments at least four times a day, which must be
provided by a licensed nurse or licensed respiratory therapist;
(3) Require pulse oximetery monitoring at
least every shift due to demonstrated unstable oxygen saturation
levels;
(4) Require respiratory
assessment and documentation every shift by licensed respiratory therapist or
trained nurse;
(5) Have a
physician's order for oxygen therapy with documented usage;
(6) Require tracheostomy care at least
daily;
(7) Have a physician's order
for suctioning as needed; and
(8)
Be deemed to be at risk of requiring subsequent mechanical
ventilation.
Statutory Authority
§§ 32.1-324 and 32.1-325 of the Code of Virginia and Item 325 LLL of Chapter 1042 of the 2003 Acts of Assembly.
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