W. Va. Code R. § 64-75-12 - Requirements Related to the Provision of Limited and Intermittent Nursing

12.1. Standard Requirements.

12.1.a. The licensee of a residential care community which provides limited and intermittent nursing care shall arrange for a registered professional nurse to assume responsibility for the oversight of nursing care and services. The licensee shall enter into a written agreement with the registered professional nurse which specifies the responsibilities of the registered professional nurse and the licensee. Arrangements for nursing services may be made by contract with an individual or a nursing service with a management entity; or the residential care community may employ a registered nurse; or the administrator of the residential care community may act in this capacity, if he or she is a licensed registered professional nurse. Arrangements with a home care agency providing only direct care does not satisfy the requirements for nursing management over-sight of all residents. (Class I)

12.1.b. Nursing support staff shall be under the supervision of the registered professional nurse who has assumed the overall responsibility for the oversight and care provided to the residents. (Class I)

12.1.c. The licensee shall implement, within reasonable expectation, the recommendations of the registered nurse regarding care, services and staff training intended to protect the residents. (Class II)

12.1.d. The licensee shall provide written notice to each resident regarding the availability of nursing services at the time of admission, or, for current residents, within thirty (30) days of the effective date of this rule. (Class III)

12.1.e. All physician's orders shall be reviewed every thirty (30) days for accuracy by the registered professional nurse or other lawfully authorized professional, unless there is a medical condition requiring a more frequent review as determined by the resident's physician. (Class II)

12.1.f. A physician or a consultant pharmacist shall conduct quarterly pharmacy reviews on all residents receiving limited or intermittent nursing services. (Class III)

12.1.g. The licensee shall assure that the registered professional nurse maintains a general record with a complete signature for each entry which shall include at least the following:

12.1.g.1. The date, time in and time out for each visit (unless the registered professional nurse is employed by the residential care community at least thirty-five (35) hours per week); (Class III)

12.1.g.2. A list of duties performed by the registered nurse during each visit; (Class III) and

12.1.g.3. A brief statement regarding identified concerns and recommended actions taken to resolve them. (Class III)

12.1.h. The licensee shall develop a system that provides for twenty-four (24) hour accessibility between the residential care community, the registered professional nurse, and/or other emergency personnel. (Class I)

12.2. Nursing Services.

12.2.a. A registered professional nurse shall document the following in each resident's individual case record using a complete signature or initials with a complete signature on each page of the record:

12.2.a.1. A monthly progress note in the resident's record as indicated by the needs of the resident to document the status of the resident and any changes in his or her health or welfare;

(Class II)

12.2.a.2. Any significant temporary or permanent changes in condition including changes resulting from incidents or accidents; (Class II) and

12.2.a.3. Any verbal or written orders received from a licensed health care professional. (Class I)

12.2.b. The registered professional nurse shall:

12.2.b.1. Provide oversight of the nursing care and services through contact with the licensee and residential care community staff as necessary to ensure appropriate resident care. Visits to the residential care community shall occur at least weekly and be of sufficient duration to perform all required duties; (Class I)

12.2.b.2. Provide overall supervision of the provision of nursing services to residents by ensuring that the services established within the resident's service plan are met and that the resident's physical, mental and social well-being are not compromised; (Class I)

12.2.b.3. Complete a written nursing assessment for each resident with nursing needs within twenty-four (24) hours following admission, and update the assessment at the time of any significant temporary or permanent change in the resident's condition. In the absence of a significant temporary or permanent change in condition, the residential care community shall review the assessment quarterly; (Class I)

12.2.b.4. Coordinate the development of a component of the service plan to meet any identified nursing and medical needs of the resident with the resident and the attending physician or other licensed health care professional. This component shall be completed within seven (7) days after admission and shall be reviewed by the registered nurse at least quarterly or at the time of a significant temporary or permanent change in condition; (Class I)

12.2.b.5. Review training needs of residential care community staff members; (Class II)

12.2.b.6. Provide needed training or recommend to the residential care community appropriate training for staff; (Class II)

12.2.b.7. Provide to the licensee a written record of training provided by the registered nurse to individuals or groups with an outline of the items discussed, the date and time of the session, and signatures of individuals involved in the training; (Class II)

12.2.b.8. Provide overall supervision of medication storage, dispensing systems and disposition; (Class I) and

12.2.b.9. Coordinate admission and discharge planning as it relates to the medical component of resident care.(Class II)

Notes

W. Va. Code R. § 64-75-12