W. Va. Code R. § 64-13-8 - Quality of Care
8.1. Each
resident shall receive, and the nursing home shall provide, the necessary care
and services to attain or maintain the highest practicable physical, spiritual,
mental, and psychosocial well-being of the residents, in accordance with the
comprehensive assessment and plan of care.
8.2. Activities of Daily Living. Based on the
comprehensive assessment of a resident, the nursing home shall ensure that:
8.2.1. A resident's abilities in activities
of daily living do not diminish unless circumstances of the resident's clinical
condition demonstrate that diminution was unavoidable. Activities of daily
living include the resident's ability to:
8.2.1.a. Bathe, dress, and groom;
8.2.1.b. Transfer and ambulate;
8.2.1.c. Use the toilet;
8.2.1.d. Eat; and
8.2.1.e. Use speech, language, or other
functional communication systems.
8.2.2. A resident is given the appropriate
treatment and services to maintain or improve his or her abilities specified in
this rule.
8.2.2.a. Assistive devices. The
nursing home shall provide special eating equipment and utensils for residents
who need them.
8.2.2.b. The nursing
home shall evaluate residents having potential to benefit from the assistive
devices to assure that the assistive devices meet the resident's needs;
and
8.2.3. A resident
who is unable to carry out activities of daily living receives the necessary
services to maintain good nutrition, grooming, and personal and oral
hygiene.
8.3. Vision and
Hearing. To ensure that residents receive proper treatment and assistive
devices to maintain vision and hearing abilities, the nursing home shall, if
necessary, assist the resident:
8.3.1. In
making appointments; and
8.3.2. By
arranging for transportation to and from the office of a practitioner
specializing in the treatment of vision or hearing impairment or the office of
a professional specializing in the provision of vision or hearing assistive
devices.
8.4. Pressure
Sores. Based on the comprehensive assessment of a resident, the nursing home
shall ensure that:
8.4.1. A resident who
enters the nursing home without pressure sores does not develop pressure sores
unless the resident's clinical condition demonstrates that they were
unavoidable; and
8.4.2. A resident
having pressure sores receives necessary treatment and services to promote
healing, prevent infection, and prevent new sores from developing.
8.5. Urinary Incontinence. Based
on the resident's comprehensive assessment, the nursing home shall ensure that:
8.5.1. A resident who enters the nursing home
without an indwelling catheter is not catheterized unless the resident's
clinical condition demonstrates that catheterization is necessary;
8.5.2. A resident who has an in-dwelling
catheter has a documented medical reason for the catheter; and
8.5.3. A resident who is incontinent of
bladder receives appropriate treatment and services to prevent urinary tract
infections and to restore as much normal bladder function as possible, unless
the restoration of function is not possible due to the physical or cognitive
condition of the resident.
8.6. Range of Motion. Based on the
comprehensive assessment of a resident, the nursing home shall ensure that:
8.6.1. A resident who enters the nursing home
without a limited range of motion does not experience a reduction in range of
motion unless the resident's clinical condition demonstrates that a reduction
in range of motion is unavoidable; and
8.6.2. A resident with a limited range of
motion receives appropriate treatment and services to increase range of motion
or to prevent further decrease in a range of motion.
8.7. Mental and Psychosocial Functioning.
Based on the comprehensive assessment of a resident, the nursing home shall
ensure that:
8.7.1. A resident who displays
mental or psychosocial adjustment difficulty receives appropriate treatment and
services to correct the assessed problem; and
8.7.2. A resident whose assessment did not
reveal a mental or psychosocial adjustment difficulty does not display a
pattern of decreased social interaction or increased withdrawn, angry or
depressive behaviors, unless the resident's clinical condition demonstrates
that such a pattern is unavoidable.
8.8. Feeding Tubes. Based on the
comprehensive assessment of a resident, the nursing home shall ensure that:
8.8.1. A resident who has been able to eat
enough alone or with assistance is not fed by tube unless the resident's
clinical condition demonstrates that use of a feeding tube is unavoidable;
and
8.8.2. A resident who is fed
enterally receives the appropriate treatment and services to prevent secondary
complications such as reflux, aspiration, aspiration pneumonia, diarrhea,
vomiting, dehydration, and metabolic abnormalities, and to restore, if
possible, normal eating skills.
8.9. Accidents.
8.9.1. A nursing home shall provide an
environment that remains as free from accident hazards as possible.
8.9.2. A nursing home shall provide an
environment where each resident receives adequate supervision and assistive
devices to prevent accidents.
8.9.3. The nursing home shall complete a
written report of any incident or accident in which a resident is involved,
either inside or outside of the nursing home.
8.9.4. The report shall include the:
8.9.4.a. Date of the occurrence;
8.9.4.b. Time of the occurrence;
8.9.4.c. Place of the occurrence;
8.9.4.d. Details of the occurrence;
and
8.9.4.e. Date and signature of
the reviewing physician.
8.9.5. The report shall be written and signed
by the person who is responsible for the resident at the time that the accident
or incident occurred.
8.10. Nutrition. Based on a resident's
comprehensive assessment, the nursing home shall ensure that a resident:
8.10.1. Maintains acceptable parameters of
nutritional status, unless the resident's clinical condition demonstrates that
this is not possible;
8.10.2.
Receives a therapeutic diet when there is a nutritional problem; and
8.10.3. Who has an unplanned weight loss or
gradual progressive unexplained weight loss shall have a thorough nutritional
assessment, including appropriate laboratory studies. The unplanned or
unexplained weight loss shall be assessed by the following parameters:
8.10.3.a. A significant weight loss of five
percent or a severe weight loss of greater than five percent in a one month
interval;
8.10.3.b. A significant
weight loss of seven and a half percent or a severe weight loss of greater than
seven and a half percent in a three month interval;
8.10.3.c. A significant weight loss of 10
percent or a severe weight loss of greater than 10 percent in a six month
interval.
8.11. Hydration. A nursing home shall provide
each resident with sufficient fluid intake to maintain proper hydration and
health.
8.12. Special Needs. A
nursing home shall ensure that residents receive proper treatment and care for
the following special needs:
8.12.1.
Injections;
8.12.2. Parenteral and
enteral fluids;
8.12.3. Colostomy,
ureterostomy, or ileostomy care;
8.12.4. Tracheostomy care;
8.12.5. Tracheal suctioning;
8.12.6. Respiratory care;
8.12.7. Foot care;
8.12.8. Prostheses; and
8.12.9. Skin conditions.
8.13. Medications and Drugs.
8.13.1. Each resident's drug regimen shall be
free from unnecessary drugs. An unnecessary drug is any drug used in any of the
following circumstances or combinations of circumstances:
8.13.1.a. In excessive doses (including
duplicate therapy);
8.13.1.b. For
excessive duration;
8.13.1.c.
Without adequate monitoring;
8.13.1.d. Without adequate indications for
its use; or
8.13.1.e. In the
presence of adverse consequences that indicate the dose should be reduced or
discontinued.
8.13.2.
Antipsychotic Drugs. Based on a comprehensive assessment of a resident, the
nursing home shall ensure that:
8.13.2.a.
Residents who have not used antipsychotic drugs are not given these drugs
unless antipsychotic drug therapy is necessary to treat a specific condition as
diagnosed and documented in the clinical record;
8.13.2.b. Residents who use antipsychotic
drugs receive gradual dose reductions and behavioral interventions, unless
clinically contraindicated, in an effort to discontinue these drugs;
8.13.2.c. Residents do not receive
antipsychotic drugs pursuant to a PRN order unless that medication is necessary
to treat a diagnosed specific condition that is documented in the clinical
record.
8.13.2.d. PRN orders for
antipsychotic drugs are limited to 14 days. Except as provided in subdivision
8.13.2.e. of this rule, if the attending physician or prescribing practitioner
believes that it is appropriate for the PRN order to be extended beyond 14
days, he or she should document their rationale in the resident's medical
record and indicate the duration for the PRN order;
8.13.2.e. PRN orders for antipsychotic drugs
are limited to 14 days and cannot be renewed unless the attending physician or
prescribing practitioner evaluates the resident for the appropriateness of that
medication;
8.13.2.f. Residents,
and the resident's legal representative in the case of incapacity to make
health care decisions, receive a full explanation of the reasons for using the
psychotropic drug, including the benefits and risks of the psychotropic drug;
and
8.13.2.g. Residents, and the
resident's legal representative in the case of incapacity to make health care
decisions, provide written consent to the use of the psychotropic drug. The
nursing home shall maintain documentation of the information provided and
consent received in the resident's medical record.
8.13.3. Medication Errors. The nursing home
shall ensure that:
8.13.3.a. It is free of
medication error rates of five percent or greater; and
8.13.3.b. Residents are free of any
significant medication errors.
8.13.4. Controlled Drugs Policy. The nursing
home shall have policies and procedures regarding the procurement, storage,
dispensing, administration, and disposition of controlled substances that
conforms to the Uniform Controlled Substances Act, W. Va. Code §§
60A-1-101, et
seq. federal regulations and the rules of the West Virginia Board of
Pharmacy.
8.14. Nursing
Services Staffing.
8.14.1. A nursing home
shall have sufficient nursing personnel to provide nursing and related services
to attain or maintain the highest practicable physical, mental, and
psychosocial well-being of each resident, as determined by resident assessments
and individual plans of care. Staffing shall not, other than during short
unforeseeable emergencies, be less than an average of 2.25 hours of nursing
personnel time per resident per day.
8.14.a.1. Minimum hours of resident care
personnel to residents are outlined in Table 64-13.A. of this rule.
8.14.a.2. Facilities with fewer than 51 beds
are staffed at higher hours as outlined in table 64-13.A. of this
rule.
8.14.2. A nursing
home shall provide services by sufficient numbers of each of the following
types of personnel on a 24-hour basis to provide nursing care to all residents
in accordance with resident care plans:
8.14.2.a. Licensed nurses; and
8.14.2.b. Other nursing personnel. Based on
the residents' needs and the nursing home services, the nursing home may
determine the combination of licensed nurse time and nurse aide time if the
total meets the minimum 2.25 hours nursing personnel time
requirement.
8.14.3.
Charge Nurse. A nursing home shall designate a licensed nurse to serve as a
charge nurse on each shift;
8.14.4.
Registered Nurse. A nursing home shall have a registered nurse on duty in the
facility for at least eight consecutive hours, seven days a week. In facilities
with fewer than 60 beds, the director of nursing may serve to meet this
requirement.
8.14.5. Nurse on Call.
If there is not a registered professional nurse on duty, there shall be a
registered professional nurse on call.
8.14.6. Director of Nursing. A nursing home
shall designate in writing a registered nurse to serve as the director of
nursing services on a full-time basis, who shall be on duty at least five days
a week, eight hours a day during the day shift.
8.14.7. The director may require staffing
ratios above the specified minimum ratios if necessary to meet the residents'
needs.
8.14.8. Paid Feeding
Assistants. Paid feeding assistants are authorized to feed residents who have
no feeding complications, under the direct supervision of a registered
professional nurse (RN) or a licensed practical nurse (LPN).
8.14.8.a. Paid feeding assistants may set up
a resident's meal tray for dining, assist in feeding the resident, and record
the resident's intake at the meal.
8.14.8.b. Paid feeding assistants are to be
used in accordance with the West Virginia Department of Health and Human
Resources Office of Health Facility Licensure and Certification Guidelines for
Paid Feeding Assistants which can be located at ohflac.wvdhhr.org.
8.14.9. Posting of Nurse Staffing
Information. The nursing home shall post the following information on a daily
basis.
8.14.9.a. The current date, resident
census, and the total number and actual hours worked by the following
categories of licensed and unlicensed nursing staff directly responsible for
resident care per shift, including:
8.14.9.a.1. Registered nurses;
8.14.9.a.2. Licensed practice nurses;
and
8.14.9.a.3. Registered nurse
aides.
8.14.9.b. The
nursing home must post this information in a clear and readable document; and
in a prominent place readily accessible to residents and visitors.
8.14.9.c. The nursing home shall, upon oral
or written request, make the nurse staffing data available to the public for
review. Copies of the nurse staffing data is subject to a charge not to exceed
25 cents per page.
8.14.9.d. The
nursing home shall maintain the posted nurse staffing data for a minimum of 18
months.
8.15.
Dietary Services.
8.15.1. Dietary Staffing.
8.15.1.a. Dietitian. A nursing home shall
employ a qualified dietitian either full-time, part-time, or on a consultant
basis.
8.15.1.a.1. A qualified dietitian is
one who is registered by the Commission on Dietetic Registration and licensed
by the West Virginia Board of Licensed Dietitians; or
8.15.1.a.2. Is qualified as defined by the
West Virginia Board of Licensed Dietitians, and is licensed by that board to
provide professional nutritional services in West Virginia.
8.15.1.a.3. Consultation shall be based upon
the residents' needs and shall occur at intervals of no less than 37 days and
for no less than eight hours.
8.15.1.b. A dietary manager shall be employed
if a dietitian is not employed full-time and shall be one of the following:
8.15.1.b.1. A dietetic technician, registered
by the Academy of Nutrition and Dietetics;
8.15.1.b.2. A certified dietary manager, as
certified by the Association of Nutrition and Food service
Professionals;
8.15.1.b.3. A
graduate of an associate or baccalaureate degree program in foods and nutrition
or food service management; or
8.15.1.b.4. A person enrolled in an approved
program to become a certified dietary manager within 60 days of accepting
responsibility for the position. This person shall successfully complete the
program within the specific timeframes outlined by the enrolled program and
shall successfully pass the Certified Dietary Manager (CDM) examination within
no more than two months of completing the approved program.
8.15.1.c. The dietary manager,
under the direction of the dietitian, is responsible for the daily operation of
the dietetic service;
8.15.2. Sufficient staff. A nursing home
shall employ sufficient support personnel competent to carry out the functions
of the dietary service.
8.15.3.
Menus and Nutritional Adequacy. A nursing home shall meet the nutritional needs
of residents in accordance with the Reference Dietary Intake (RDI) of the Food
and Nutrition Board of the National Research Council, National Academy of
Sciences.
8.15.4. Food. A nursing
home shall provide each resident with:
8.15.4.a. Food prepared by methods that
conserve nutritive value, flavor, and appearance;
8.15.4.b. Meals shall be prepared and served
the same day;
8.15.4.c. Food that
is palatable, attractive, and at the proper temperature;
8.15.4.d. At the time of receipt by the
resident, foods shall be at a temperature of no less than 120 F for hot foods
and at no more than 50 F for cold foods;
8.15.4.e. Food prepared in a form designed to
meet individual needs;
8.15.4.f.
Food substitutes of similar nutritive value for food the resident
refuses;
8.15.4.g. Food prepared
with seasoning, unless contraindicated by a physician's order; and
8.15.4.h. Iodized salt, if used.
8.15.5. Diets including regular
diets. All residents shall have a physician's order for the specific type of
diet he or she is to receive as set forth in the nursing home's diet manual.
8.15.5.a. Therapeutic and texture modified
diets shall be served to residents in accordance with physician's
orders.
8.15.5.b. Nursing personnel
shall advise food service in writing of each resident's diet order, and a copy
of the order shall be kept on file for at least one year.
8.15.5.c. Therapeutic Diets. Therapeutic
diets shall be prescribed by the attending physician. A current therapeutic
diet manual that is not more than five years old and is approved by the
dietitian shall be available for nursing personnel and physicians.
8.15.5.d. Recognizing that the resident has
the right to refuse medical treatment, all residents have the right to request
substitute foods even when this violates the physician's orders.
8.15.5.d.1. A nursing home shall provide
education to the resident regarding the benefits of the prescribed diet and
consequences of his or her refusal to eat the prescribed diet.
8.15.5.d.2. A nursing home shall document the
informed decision in the resident's clinical record.
8.15.6. Frequency of meals.
8.15.6.a. A nursing home shall provide at
least three meals daily at regular times, or in accordance with residents'
preferences and customary routines.
8.15.6.b. No more than 14 hours shall elapse
between a substantial evening meal and breakfast the following day. Breakfast
shall not be served before 7:00 a.m., unless by a resident's request.
8.15.6.c. A nursing home shall offer a
nourishing snack at bedtime daily, as determined by the resident's needs.
8.15.6.c.1. The amount of the snacks consumed
by the resident shall be recorded in the resident's medical record.
8.15.6.c.2. The amount of supplement consumed
by the resident shall be recorded in the resident's medical record.
8.15.7. Sanitary
conditions. A nursing home shall:
8.15.7.a.
Procure food from sources approved or considered satisfactory by federal,
state, or local authorities;
8.15.7.b. Store, prepare, distribute, and
serve food under sanitary conditions;
8.15.7.b.1. Hold hot foods at or above 135 F
and cold foods at or below 40 F, or the current Food and Drug Administration
Food Code located at www.fda.gov.
8.15.7.b.2. Temperatures of foods are taken
and documented prior to placement in the hot or cold food holding
area.
8.15.7.c. Dispose
of garbage and refuse properly.
8.15.8. Emergency supplies.
8.15.8.a. A nursing home shall have a planned
three day disaster menu that correlates with the emergency food
supply.
8.15.8.b. The emergency
food supply shall be maintained on the premises with non-perishable foods and
disposable supplies to meet all resident needs for three days.
8.15.8.c. The emergency food supply may be
incorporated with the regular stock of food supplies.
8.15.9. A nursing home shall maintain a
dietetic service that is organized either directly by a nursing home or through
a written agreement with a contractor who complies with the standards of this
rule.
8.15.10. The dietetic service
shall be in substantial compliance with the Department of Health and Human
Resources' Legislative Rule, Food Establishments, W. Va. Code R. §§
64-17-1, et seq.
8.16. Physician and Physician Extender
Services.
8.16.1. A physician shall personally
approve in writing a recommendation that a person be admitted to a nursing
home. Each resident shall remain under the care of a physician.
8.16.2. Physician supervision. A nursing home
shall ensure that:
8.16.2.a. The medical care
of each resident is supervised by a physician; and
8.16.2.b. Another physician supervises the
medical care of residents when their attending physician is
unavailable.
8.16.3.
Physician visits. The physician shall:
8.16.3.a. Review the resident's total program
of care, including medications and treatments, and examine the resident
personally at each visit required under the provisions of this rule;
8.16.3.b. Write, sign, and date progress
notes at each visit; and
8.16.3.c.
Sign and date all orders.
8.16.4. Frequency of physician visits. The
resident shall be seen face-to-face by a physician:
8.16.4.a. Within five days prior to admission
or within 72 hours following admission; and
8.16.4.b. At least every 30 days for the
first 90 days after admission, and as the resident's condition warrants. A
nursing home shall assure that physician visits occur as clinically indicated
for the resident.
8.16.4.c. After
the 90 day requirement has expired, the physician shall visit every 60 days and
as the resident's condition warrants.
8.16.5. Except as provided under the
provisions of this rule, all required physician visits shall be made by the
physician personally.
8.16.6. After
the initial visit, at the option of the physician, the required visit every 60
days may be alternated between personal visits by the physician and visits by a
physician's assistant, nurse practitioner, or clinical nurse specialist under
the provisions of this rule.
8.16.7. Availability of physicians for
emergency care. A nursing home shall provide or arrange for the provision of
physician services 24 hours a day, in case of an emergency.
8.16.8. Physician delegation of tasks. Except
as specified under the provisions of this rule, a physician may delegate tasks
to a physician assistant, nurse practitioner, or clinical nurse specialist who:
8.16.8.a. Is licensed by the state;
8.16.8.b. Is acting within the scope of
practice as defined by W. Va. Code §§
30-3-1
et seq.; and
8.16.8.c. Is under the supervision of the
physician.
8.17. Specialized Rehabilitative Services.
8.17.1. Provision of services. If specialized
rehabilitative services such as, but not limited to, physical therapy,
speech-language pathology, occupational therapy, and psychological or
psychiatric rehabilitative services, are required in the resident's
comprehensive plan of care, a nursing home shall:
8.17.1.a. Provide the required services;
or
8.17.1.b. Obtain the required
services from an outside resource, in accordance with subsection 10.7. of this
rule, from a provider of specialized rehabilitative services.
8.17.2. Qualifications.
Specialized rehabilitative services shall be provided under the written order
of a physician by qualified personnel as determined by licensing boards of
those personnel.
8.18.
Dental Services.
8.18.1. A nursing home shall
provide, or obtain from an outside resource in accordance with subsection 10.7.
of this rule, the following dental services to meet the needs of each resident:
8.18.1.a. Routine dental services, to the
extent the resident is covered under the State Medicaid Plan; and
8.18.1.b. Emergency dental services 24 hours
a day.
8.18.2. A nursing
home shall assist a resident in need of dental services by:
8.18.2.a. Making dental
appointments;
8.18.2.b. Arranging
for transportation to and from the dentist's office; and
8.18.2.c. Referring residents with lost or
damaged dentures to a dentist.
8.19. Pharmacy Services.
8.19.1. A nursing home shall provide routine
and emergency drugs and biologicals to its residents, or obtain them under an
agreement described under the provisions of this rule.
8.19.2. All drugs shall be provided in
conformance with the requirements of federal, state, and local laws,
regulations, and rules.
8.19.3.
Procedures. A nursing home shall provide pharmaceutical services, including
procedures that assure the accurate acquiring, receiving, dispensing, and
administering of all drugs and biologicals, to meet the needs of each
resident.
8.19.4. Service
consultation. A nursing home shall employ or obtain the services of a licensed
pharmacist who:
8.19.4.a. Provides
consultation on all aspects of the provision of pharmacy services in the
nursing home;
8.19.4.b. Establishes
a system of records of receipt and disposition of all controlled drugs in
sufficient detail to enable an accurate reconciliation; and
8.19.4.c. Determines that drug records are in
order and that an account of all controlled drugs is maintained and
periodically reconciled.
8.19.5. Drug regimen review.
8.19.5.a. The drug regimen of each resident
shall be reviewed, by a licensed pharmacist, at least every 37 days.
8.19.5.b. The drug regimen review shall
include substances that are regarded as herbal products or dietary
supplements.
8.19.6. The
nursing home shall conduct a drug regimen review on the premises.
8.19.7. The pharmacist shall report any
irregularities in the drug regimen review to the attending physician and the
director of nursing, who shall act upon these reports.
8.19.8. Labeling of drugs and biologicals.
Drugs and biologicals used in the nursing home shall be labeled in accordance
with currently accepted professional principles, and include the appropriate
accessory and cautionary instructions, with the expiration date when
applicable.
8.19.9. Storage of
drugs and biologicals.
8.19.9.a. In accordance
with state and federal laws, the nursing home shall store all drugs and
biologicals in locked compartments under proper temperature controls and permit
only authorized personnel to have access to the keys.
8.19.9.b. A nursing home shall provide
separately locked, permanently affixed compartments for the storage of
controlled drugs listed in Schedule II of the Comprehensive Drug Abuse
Prevention and Control Act of 1970, 42 U.S.C. § 812, and other drugs
subject to abuse, except when the nursing home uses single unit package drug
distribution systems in which the quantity stored is minimal and a missing dose
can be readily detected.
8.20. Infection Control.
8.20.1. A nursing home shall establish and
maintain an infection control program designed to provide a safe, sanitary, and
comfortable environment and to help prevent the development and transmission of
disease and infection.
8.20.2.
Infection control program. A nursing home shall establish and implement an
infection control program under which it:
8.20.2.a. Investigates, controls, and
prevents infections in the nursing home;
8.20.2.b. Determines what procedures, such as
isolation, shall be applied to a resident and isolates only to the extent that
is required to protect the resident and others; and
8.20.2.c. Maintains a record of incidents,
investigations, and corrective actions related to infections. The records shall
provide for analysis of causal factors and identification of preventative
actions to be implemented.
8.20.3. Preventing spread of infection.
8.20.3.a. Policies and Procedures. A nursing
home shall establish and implement policies and procedures consistent with
current accepted standards of practice regarding the administration of
pneumococcal vaccine, influenza vaccine, and screening for
tuberculosis.
8.20.3.b. Isolation.
When the nursing home staff determines by means of the infection control
program that a resident needs isolation to prevent the spread of infection, the
nursing home shall isolate the resident or make arrangements to have the
resident transferred to a nursing home which can better meet the needs of the
resident if the nursing home is unable to provide the required degree of
isolation.
8.20.3.c. A resident who
is transferred under the provisions of this rule and desires to return to the
original nursing home shall be readmitted immediately to the first available
bed in a semi-private room when the need for isolation has abated, provided
that the resident still requires the care provided by the original nursing home
and that nursing home is able to meet the resident's needs.
8.20.3.d. Employee restrictions. A nursing
home shall prohibit employees with a communicable disease or infected skin
lesions from direct contact with residents or their food, if direct contact
will transmit the disease.
8.20.3.e. Hand-washing. A nursing home shall
require staff to wash their hands after each direct resident contact and after
engaging in any activity for which hand washing is indicated by accepted
standards of professional practice.
8.20.4. Linens. Personnel shall handle,
store, process, and transport linens in order to prevent the spread of
infection.
8.21.
Trauma-informed care. The nursing home shall ensure that residents who are
trauma survivors receive culturally competent, trauma-informed care in
accordance with professional standards of practice and accounting for
residents' experiences and preferences in order to eliminate or mitigate
triggers that may cause re-traumatization of the resident.
8.22. Pain management. The facility must
ensure that pain management is provided to residents who require such services,
consistent with professional standards of practice, the comprehensive
personcentered care plan, and the resident's goals and
preferences.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.