Current through Register Vol. 24-18, September 15, 2024
Nothing in this section applies to an RTF in its licensed
capacity to provide pediatric transitional care services according to this
chapter.
(1) The licensee must
establish and implement policies and procedures that:
(a) Describe how the licensee meets the
residents' health care needs by satisfying the requirements of this section;
and
(b) Are reviewed and approved
by a health care pre-scriber at least biennially.
(2) The licensee must:
(a) Limit admission, transfer, discharge, and
referral processes to residents for whom the RTF is qualified by staff,
services, equipment, building design and occupancy to give safe care;
(b) Conduct or accept a current health care
screening of each resident upon admission including a tuberculosis risk
assessment and symptom screening;
(c) Refer residents for health care provided
outside of the RTF as needed such as, but not limited to, laboratory, dental,
ambulatory care or specialty services as needed;
(d) Assist residents in following all
prescribed treatments, modified diets, activities or activity
limitations;
(e) Assist residents
to keep health care appointments;
(f) Provide access to a health assessment by
a health care prescriber any time a resident exhibits signs or symptoms of an
injury, illness or abnormality for which a medical diagnosis and treatment are
indicated;
(g) Provide access to
tuberculosis testing if the resident is high-risk or symptomatic of
tuberculosis;
(h) Address serious
illness, medical emergencies, or threat to life, to include:
(i) Criteria for determining the degree of
medical stability of residents;
(ii) Observing residents for signs and
symptoms of illness or trauma;
(iii) Reporting abnormal signs and symptoms
according to an established protocol;
(iv) Criteria requiring a resident's
immediate transfer to a hospital;
(v) How staff transmits the resident's
medical and related data in the event of a transfer;
(vi) How to notify the parent or guardian,
personal representative or next of kin in the event of an emergency, threat to
life, serious change in the resident's condition, transfer of a resident to
another facility, or death; and
(vii) When to consult with internal or
external resource agencies or entities such as poison control, fire department
or police.
(i) Provide
access to emergency and prenatal care for pregnant residents, and postnatal
care services for residents and infants; and
(j) Assure provisions of each resident's
personal care items and durable medical equipment including storing and
labeling each resident's personal care items separately, preventing
contamination, and preventing access by other residents.
(3)
(a)
RTFs performing the following duties must meet the staffing requirements in (b)
of this subsection:
(i) Have a health care
prescriber initiate or adjust medication that is administered by staff
according to the resident's individual service plan;
(ii) Otherwise administer medications to the
resident; or
(iii) Use restraint or
seclusion.
(b) RTFs
performing any duties described in (a) of this subsection must meet the
following staffing requirements:
(i) A
registered nurse, licensed practical nurse, or pre-scriber must be available
on-site during medication administration or while restraint or seclusion is
being used, and otherwise available by phone twenty-four hours per day, seven
days per week; and
(ii) A
prescriber or registered nurse who is responsible for the supervision of
resident care and nursing services must be available on-site at least four
hours per calendar week.
(4) RTFs which do not perform any duties
described in subsection (3)(a) of this section but have a health care
pre-scriber initiate or adjust medication for residents to self-administer
according to the resident's individual service plan must have a registered
nurse or licensed practical nurse available at least by phone twenty-four hours
per day, seven days per week.
(5)
RTFs which meet the conditions in subsection (3) or (4) of this section must:
(a) Perform a health assessment for each
resident. A pre-scriber or licensed nurse operating within their scope of
practice shall conduct and complete the assessment following the resident's
admission to the RTF unless a health assessment was performed within the past
three months and is available to the RTF upon admission; and
(b) Develop and implement the policies and
procedures explaining how nursing staff will be used including:
(i) Scheduling of hours on-site and
availability by phone;
(ii)
Supervision, assessment, and training of other staff;
(iii) Delegation to other staff;
(iv) Medication management;
(v) Treatment planning;
(vi) Health screenings;
(vii) Health assessments; and
(viii) If applicable, restraint or
seclusion.
Statutory Authority: Chapter 71.12 RCW. 05-15-157, §
246-337-080, filed 7/20/05, effective
8/20/05.