C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-46, subsec. 144-101-II-46.13

Current through 2024-51, December 18, 2024

Subsection 144-101-II-46.13 - INSPECTIONS OF CARE

A team, whose composition is specified at 46.13-1, will inspect at least annually the care and services provided to each member receiving inpatient services in the hospital. No hospital shall be notified of the time of inspection more than forty-eight (48) hours before the scheduled arrival of the team.

46.13-1Team Composition

The Inspection Team shall consist of one or more psychiatric nurse consultants, a medical social work consultant, MSW level social worker and a psychiatrist or physician knowledgeable about inpatient services in psychiatric hospitals.

46.13-2Personal Contact With And Observation Of Members And Review Of Records

The Team's inspections must include review of each member's record.

A. For members under age twenty one (21) receiving inpatient services, the inspections must also include personal contact with and observation of each member.

B. For members age sixty five (65) or older receiving inpatient services, if the record does not contain complete periodic assessments described at 46.10, or if the Team deems such reports inadequate, the inspection will also include personal contact with and observation of the member.

46.13-3Determination By Team

The team must determine in its inspection that:

A. The services available in the hospital are adequate to:

1. Meet the health needs of each member and

2. Promote each member's maximum physical, mental, and psychosocial functioning.

B. It is necessary and desirable for the member to continue to receive inpatient services within the hospital;

C. It is not feasible to meet the member's health needs through alternative institutional services; and

D. Each member under age twenty one (21) is receiving active treatment as defined at 46.01-3.

46.13-4Basis for Determinations

In making the determinations on adequacy of services and related matters for each member under 46.13-3, above, the team may consider such items as whether or not:

A. The medical evaluation, social and psychological evaluation, and the plan of care are complete and current;

B. The plans of care are followed and all ordered services, including dietary orders, are provided and properly recorded;

C. The attending physician reviews prescribed medications at least every thirty (30) days;

D. Tests or observations of each member indicated by his medication regimen are made at appropriate times and properly recorded;

E. Physician, nurse, and other professional progress notes are made as required and appear to be consistent with the observed condition of the member;

F. The member receives adequate services, based on observations such as

1. Cleanliness;

2. Absence of bed sores;

3. Absence of signs of malnutrition or dehydration; and

4. Apparent maintenance of maximum physical, mental, and psychosocial functions;

G. The member needs any service that is not furnished by the hospital or through arrangements with others;

H. The member needs continued placement in the hospital or there is an appropriate plan to transfer the member to an alternate method of care.

I. Whether certification or recertification has been timely and properly documented.

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-46, subsec. 144-101-II-46.13