N.H. Admin. Code § He-P 805.14

Current through Register No. 45, November 7, 2024

Section He-P 805.14 - Duties and Responsibilities of the Licensee

(a) The licensee shall comply with all relevant federal, state and local laws, rules, codes and ordinances as applicable.

(b) The licensee shall provide the following core services:

(1) The presence of staff whenever a resident is in the facility;

(2) Health and safety services to all residents to minimize the likelihood of accident or injury, with protective care and oversight provided 24 hours a day regarding:

a. The residents' functioning, safety and whereabouts; and

b. The residents' health status, including the provision of intervention as necessary or required;

(3) Emergency response and crisis intervention;

(4) Assistance with taking and ordering medications as determined by a resident's ability or inability to safely manage medications as determined by the Resident Assessment Tool (RAT);

(5) The provision of 3 nutritious meals and snacks unless the resident chooses other options according to their residential service agreement;

(6) Housekeeping, laundry and maintenance services in accordance with the residential service agreement;

(7) The availability of on-site activities, for which the facility shall make reasonable accommodation for residents with disabilities, to include, but not be limited to television, radio, internet, games, newspapers, visitors and music, designed to sustain and promote physical, intellectual, social and spiritual well-being of all residents in accordance with the residential service agreement;

(8) Assistance in arranging medical and dental appointments, including assistance in arranging transportation to and from such appointments and reminding the residents of the appointments; and

(9) Personal supervision of residents when necessary to offset cognitive deficits that might pose a risk to the safety of self or others if the resident is not supervised.

(c) The licensee shall provide access, as necessary, to the following services pursuant to RSA 151:2, IV and RSA 151:9, VII(a) (2):

(1) Nursing services, in accordance with RSA 326-B, including supervision and instruction of direct care personnel, relative to the delivery of nursing care;

(2) Rehabilitation services, including documentation of the licensed practitioner's order for the service, such as physical therapy, occupational therapy, and speech therapy; and

(3) Behavioral health care services.

(d) The licensee shall assist with arranging transportation to community programs, such as religious services and cultural, social, educational and recreational activities according to the availability of such services in the surrounding communities.

(e) The licensee shall:

(1) Provide basic supplies necessary for residents to maintain grooming and personal hygiene, such as soap, shampoo, toothpaste, toothbrush and toilet paper;

(2) Not be responsible for the cost of purchasing a specific brand of product at a resident's request;

(3) Ensure that sufficient numbers of qualified personnel are present in the SRHCF to meet the needs of residents at all times;

(4) Ensure that demonstrated competencies required by the "qualified personnel" referenced in (3) above are documented in the employee personnel file; and

(5) Require any paid provider of direct care, other than an employee, providing health care related services to provide a brief written, signed, and dated note describing the reason for the service(s), and the next planned visit, if known.

(f) The use of chemical or physical restraints as defined under He-P 805.03(m) and (ax) , respectively, shall only be permitted as allowed by RSA 151:21.

(g) After the use of a physical of chemical restraint, the facility shall make the following notifications:

(1) To the resident's guardian or agent, if any, as soon as is practicable and in no case longer than 24 hours; and

(2) To the health facilities licensing unit within 48 hours by fax, at (603) 271-5574, or by electronic means.

(h) The use of mechanical restraints, limited to locked, secured and/or alarmed SRHCFs or units within an SRHCF, or anklets, bracelets or similar devices that cause a door to automatically lock when approached, thereby preventing a resident from freely exiting the SRHCF or unit within as permitted by the fire code, shall be allowed.

(i) The following methods of mechanical restraints shall be prohibited:

(1) Full bed rails;

(2) Gates, if they prohibit a resident's free movement throughout the living areas of the SRHCF;

(3) Half doors, if they prohibit a resident's free movement throughout the living areas of the SRHCF;

(4) Geri chairs, when used in a manner that prevents or restricts a resident from getting out of the chair at will;

(5) Wrist or ankle restraints;

(6) Vests or pelvic restraints; or

(7) Other similar devices that prevent a resident's free movement.

(j) For reportable incidents, the licensees shall have responsibility for:

(1) Faxing to 271-5574 or, if a fax machine is not available, conveying by electronic or regular mail, the following information to the department within 48 hours of a reportable incident as defined in He-P 805.03(bf) :

a. The SRHCF name;

b. A description of the incident, including identification of injuries, if applicable;

c. The name of the licensee(s) or personnel involved in, witnessing, or responding to the unusual incident;

d. The name of resident(s) involved in the reportable incident;

e. The date and time of the reportable incident;

f. The action taken in direct response to the reportable incident;

g. If medical intervention was required, by whom and the date and time;

h. When the resident's guardian or agent, if any, or personal representative, or emergency contact person was notified;

i. The signature of the person reporting the reportable incident; and

j. The date and time the residents licensed practitioner was notified, if applicable;

(2) As soon as practicable, notifying the local police department, the department and the guardian, agent, or personal representative, if any, when a resident has an elopement or unexplained absence and the licensee has searched the building and the grounds of the SRHCF without finding the resident; and

(3) Notifying the department with a written report within 5 days describing the actions taken by personnel, the final outcome or continuation of the reportable incident and actions taken to prevent a reoccurrence if it was not submitted in the initial report.

(k) The licensee shall comply with the patient's bill of rights as set forth in RSA 151.

(l) The licensee shall not exceed the maximum number of residents or beds licensed by the department, unless authorized by the department, such as during an emergency.

(m) The licensee shall give a resident a written notice as follows:

(1) Thirty days advance notice for an increase in the cost or fees for SRHCF services unless the increase of cost or fees is due to a change in the resident's condition and service needs; or

(2) Fourteen days advance notice for an involuntary change in room or bed location, unless the change is required to protect the health, safety and well-being of the resident or other residents, in such case the notice shall be as soon as practicable.

(n) In addition to the posting requirements specified in RSA 151:29, the licensee shall post the following documents in a public and conspicuous area:

(1) The current license certificate issued in accordance with RSA 151:2;

(2) The most recent inspection report as specified in RSA 151:6-a;

(3) A copy of the patient's bill of rights specified by RSA 151:21;

(4) A copy of the licensee's complaint procedure, including a statement that complaints may be submitted, in writing, to The Department of Health and Human Services, Health Facilities Administration, 129 Pleasant Street, Concord, N.H. 03301 or by calling 1-800-852-3345, and information on how to contact the office of the long-term care ombudsman; and

(5) The licensee's evacuation floor plan identifying the location of, and access to all fire exits.

(o) The licensee shall determine the smoking status of the SRHCF.

(p) If smoking is to be allowed, the licensee shall develop and implement smoking policies and designate smoking areas in accordance with RSA 155:66, RSA 155:68 and RSA 155:69 and He-P 805.25(f) .

(q) The licensee may hold or manage a resident's funds or possessions only when the facility receives written authorization in accordance with RSA 151:24 and RSA 151:21, VII, and such funds shall not be used for the benefit of the licensee, other residents or other household members.

(r) The licensee shall not falsify any documentation required by law or provide false or misleading information to the department.

N.H. Admin. Code § He-P 805.14

#8746, eff 10-25-06

Amended byVolume XXXV Number 18, Filed May 7, 2015, Proposed by #10813, Effective 4/21/2015, Expires4/21/2025.