Current through Register Vol. 41, No. 3, September 23, 2024
A. Each
assisted living facility shall retain a licensed health care professional who
has at least two years of experience as a health care professional in an adult
residential facility, adult day center, acute care facility, nursing home, or
licensed home care or hospice organization, either by direct employment or on a
contractual basis, to provide on-site health care oversight.
1. For residents who meet the criteria for
residential living care:
a. The licensed
health care professional, practicing within the scope of the health care
professional's profession, shall provide health care oversight at least every
six months, or more often if indicated, based on the health care professional's
professional judgment of the seriousness of a resident's needs or the stability
of a resident's condition; or
b. If
the facility employs a licensed health care professional who is on site on a
full-time basis, a licensed health care professional, practicing within the
scope of the health care professional's profession, shall provide health care
oversight at least annually, or more often if indicated, based on the health
care professional's professional judgment of the seriousness of a resident's
needs or stability of a resident's condition.
2. For residents who meet the criteria for
assisted living care:
a. The licensed health
care professional, practicing within the scope of the health care
professional's profession, shall provide health care oversight at least every
three months, or more often if indicated, based on the health care
professional's professional judgment of the seriousness of a resident's needs
or stability of a resident's condition; or
b. If the facility employs a licensed health
care professional who is on site on a full-time basis, a licensed health care
professional, practicing within the scope of the health care professional's
profession, shall provide health care oversight at least every six months, or
more often if indicated, based on the health care professional's professional
judgment of the seriousness of a resident's needs or stability of a resident's
condition.
3. All
residents shall be included at least annually in health care
oversight.
B. While on
site, as specified in subsection A of this section, the licensed health care
professional shall provide health care oversight of the following and make
recommendations for change as needed:
1.
Ascertain whether a resident's service plan appropriately addresses the current
health care needs of the resident.
2. Monitor direct care staff performance of
health-related activities.
3.
Evaluate the need for staff training.
4. Provide consultation and technical
assistance to staff as needed.
5.
Review documentation regarding health care services, including medication and
treatment records, to assess whether services are being provided in accordance
with physicians' or other prescribers' orders.
6. Monitor conformance to the facility's
medication management plan and the maintenance of required medication reference
materials.
7. Evaluate the ability
of residents who self-administer medications to continue to safely do
so.
8. Observe infection control
measures and consistency with the infection control program of the
facility.
C. For all
restrained residents, onsite health care oversight shall be provided by a
licensed health care professional at least every three months and include the
following:
1. The licensed health care
professional shall be, at a minimum, a registered nurse who meets the
experience requirements in subdivision A of this section.
2. The licensed health care professional
shall review the current condition and the records of restrained residents to
assess the appropriateness of the restraint and progress toward its reduction
or elimination.
3. The licensed
health care professional providing the oversight for this subdivision shall
also provide the oversight for subdivisions B 1 through B 8 of this section for
restrained residents.
4. The
oversight provided shall be a holistic review of the physical, emotional, and
mental health of the resident and identification of any unmet needs.
5. The oversight shall include review of
physician's orders for restraints to determine whether orders are no older than
three months, as required by
22VAC40-73-710 E 2.
6. The oversight shall include an evaluation
of whether direct care staff have received the restraint training required by
22VAC40-73-270 and whether the
facility is meeting the requirements of
22VAC40-73-710 regarding the use
of restraints.
7. The licensed
health care professional shall make recommendations for change as
needed.
D. The licensed
health care professional who provided the health care oversight shall certify
that the requirements of subsection B and, if applicable, C of this section
were met, including the dates of the health care oversight. The specific
residents for whom the oversight was provided must be identified. The
administrator shall be advised of the findings of the health care oversight and
any recommendations. All of the requirements of this subsection shall be (i) in
writing, (ii) signed and dated by the health care professional, (iii) provided
to the administrator within 10 days of the completion of the oversight, and
(iv) maintained in the facility files for at least two years, with any specific
recommendations regarding a particular resident also maintained in the
resident's record.
E. Action taken
in response to the recommendations noted in subsection D of this section shall
be documented in the resident's record if resident specific, and if otherwise,
in the facility files.
Statutory Authority: §§
63.2-217 and 63.2-1733 of the Code of
Virginia.
