N.H. Admin. Code § He-P 805.16

Current through Register No. 50, December 12, 2024

Section He-P 805.16 - Required Services

(a) The licensee shall provide administrative services that include the appointment of a full-time, on-site administrator who:

(1) Is responsible for the day-to-day operations of the SRHCF;

(2) Works no less than 35 hours per week at the SRHCF, which may include day, evening, night and weekend hours;

(3) Meets the requirements of He-P 805.18(g) and (h); and

(4) Designates, in writing, an alternate administrator who shall assume the responsibilities of the administrator in his or her absence.

(b) At the time of application for admission, the licensee shall provide the resident and legal agent, if any or personal representative, a written copy of the residential service agreement pursuant to RSA 161-J, except that a copy of the residential service agreement shall not be required if the facility admission contract includes all of the provisions of a residential service agreement.

(c) In addition to (b) above, at the time of admission, the licensee shall provide a written copy to the resident and legal agent, if any, or personal representative, and receive written verification of receipt for the following:

(1) An admissions contract including the following information:

a. The basic daily, weekly and monthly fee;

b. A list of the core services required by He-P 805.14(b) that are covered by the basic fee;

c. Information regarding the timing and frequency of cost of care increases;

d. The time period covered by the admissions contract;

e. The SRHCF's house rules;

f. The reasons a resident may be transferred or discharged in accordance with RSA 151:5-a, II, or RSA 151:21, V;

g. The SRHCF's responsibility for resident discharge planning;

h. Information regarding nursing, other health care services or supplies not provided in the core services, to include:

1. The availability of services;

2. The SRHCF's responsibility for arranging services; and

3. The fee and payment for services, if known;

i. The licensee's policy regarding:

1. Arranging for the provision of transportation;

2. Arranging for the provision of third party services, such as a hairdresser or cable television;

3. Acting as a billing agent for third party services;

4. Monitoring third party services contracted directly by the resident and provided on the SRHCF premises;

5. Handling of resident funds pursuant to RSA 151:24 and He-P 805.14(q);

6. Bed hold, in compliance with RSA 151:25;

7. Storage and loss of the resident's personal property; and

8. Smoking;

j. If the facility is not constructed to meet the health care occupancy chapter of NFPA 101, the admission agreement shall note that the resident may need to be discharged or transferred when the facility can no longer meet the resident's evacuation needs as required by the approved fire safety and emergency plan approved by the local fire department;

k. The licensee's medication management services and associated costs; and

l. The list of grooming and personal hygiene supplies provided by the SRHCF as part of the basic daily, weekly or monthly rate;

(2) A copy of the most current version of the patients' bill of rights under RSA 151:21 and the SRHCF's policy and procedure for implementing the bill of rights pursuant to RSA 151:20, II;

(3) A copy of the resident's right to appeal an involuntary transfer or discharge under RSA 151:26, II(5);

(4) The SRHCF's policy and procedure for handling reports of abuse, neglect or exploitation which shall be in accordance with RSA 161-F:46 and RSA 169-C:29;

(5) Information on accessing the long-term care ombudsman;

(6) Information on advanced directives;

(7) Whether or not personnel are trained in cardiopulmonary resuscitation (CPR), first aid or both; and

(8) Whether or not the facility has an AED onsite and available for use in an emergency.

(d) The SRHCF shall assess each resident's needs using the "Care Assessment for Residential Services Tool" (April 2022)."

(e) All personnel who administer the RAT shall be trained to complete the RAT by the department or entities listed in RSA 151:5-c, III.

(f) The assessment described in (d) above shall:

(1) Be completed no more than 30 days prior to admission to the SRHCF;

(2) Be completed in consultation with the resident and guardian or agent, if any; and

(3) Be repeated every 6 months or after any significant change as defined in He-P 805.03(br).

(g) The facility shall have documented evidence that the resident and guardian or agent, if any, has had an opportunity to review the RAT.

(h) If the RAT identifies the need for a nursing assessment, the nursing assessment shall be completed within 72 hours of the completion of the RAT.

(i) If the RAT identifies a need for a care plan, the care plan shall be:

(1) Completed within 24 hours of the resident's admission for the initial RAT and within 24 hours of the completion of all subsequent RATs;

(2) Made available to personnel who assist residents;

(3) Be completed in consultation with the resident and guardian or agent, if any; and

(4) If the resident and guardian or agent are unable or unwilling to participate as required by (3) above, it shall be documented in the resident record.

(j) The care plan identified in (i) above shall include on an ongoing basis:

(1) The date the problem or need was identified;

(2) A description of the problem or need;

(3) The goal or objective of the plan;

(4) The action or approach to be taken;

(5) The responsible person(s) or position; and

(6) The date of reevaluation, review, or resolution.

(k) All care plans shall be reviewed at least every 6 months to determine if:

(1) The care plan will be continued for another 6 months;

(2) The care plan will be revised to meet the needs of the resident; and/or

(3) The care plan will be discontinued because the plan is no longer needed.

(l) Progress notes shall be written at least every 90 days and include, at a minimum:

(1) Care plan outcomes if a care plan was developed as identified by the RAT;

(2) The resident's physical, functional and mental abilities; and

(3) Changes in behavior, such as eating habits, sleeping pattern, and relationships.

(m) At the time of a resident's admission, the licensee shall obtain written and signed orders from a licensed practitioner for medications, treatment, and special diet.

(n) The licensee shall have each resident obtain a health assessment by a licensed practitioner within one year prior to admission or within 72 hours following admission to the SRHCF.

(o) The health assessment referenced in (n) above shall include:

(1) Diagnoses, if any;

(2) The medical history;

(3) A list of current medications including over-the-counter medications, treatments and special diets, if applicable; and

(4) Allergies.

(p) Each resident shall have at least one health assessment every 12 months, unless the primary care licensed practitioner determines annually that a health assessment is not necessary and specifies in writing an alternative time frame, or the resident annually refuses in writing.

(q) A resident may refuse all care and services.

(r) When a resident refuses care or services that could result in a threat to their health, safety or well-being, or that of others, the licensee or their designee shall:

(1) Inform the resident of the potential results of their refusal;

(2) Notify the licensed practitioner and guardian, if any, of the resident's refusal of care; and

(3) Document in the resident's record the refusal of care and the resident's reason for the refusal.

(s) The licensee shall maintain an information data sheet in the resident's record and promptly give a copy to emergency medical personnel in the event of an emergency transfer to another medical facility.

(t) The information data sheet referenced in (s) above shall include:

(1) Full name and the name the resident prefers, if different;

(2) Name, address and telephone number of the resident's next of kin, guardian or agent, if any;

(3) Diagnosis;

(4) Medications, including last dose taken and when the next dose is due;

(5) Allergies;

(6) Functional limitations;

(7) Date of birth;

(8) Insurance information;

(9) Advanced directives; and

(10) Any other pertinent information not specified in (1)-(9) above.

N.H. Admin. Code § He-P 805.16

#8746, eff 10-25-06

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

Amended by Volume XLII Number 6, Filed February 10, 2022, Proposed by #13333, Effective 1/25/2022, Expires 1/25/2032

The amended version of this section by New Hampshire Register Volume 42, Number 19, eff. 4/20/2022 is not yet available.