N.H. Admin. Code § He-P 807.16

Current through Register No. 50, December 12, 2024

Section He-P 807.16 - 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 RTRF;

(2) Meets the requirements of He-P 807.18(k) and (l) ;

(3) Designates, in writing, an alternate administrator who shall assume the responsibilities of the administrator in his or her absence; and

(4) In the event the administrator will be absent for a period to exceed 30 consecutive days, the facility shall notify the department who the interim administrator will be and submit credentials to verify he or she meets the requirements of (2) above.

(b) At the time of application for admission, the licensee shall provide the client a written copy of the clientele service agreement pursuant to RSA 161-J:4.

(c) In addition to (b) above, at the time of admission, the licensee shall provide a written copy to the client and the guardian or 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, or monthly fee;

b. A list of the core services required by He-P 807.14 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 RTRF's house rules;

f. The grounds for immediate termination of the agreement, pursuant to RSA 151:21, V;

g. The RTRF's responsibility for client 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 RTRF's responsibility for arranging services; and

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

i. The licensee's policies and procedures 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 client and provided on the RTRF premises;

5. Handling of client funds pursuant to RSA 151:24 and He-P 807.14(t) ;

6. Storage and loss of the client's personal property; and

7. Smoking;

j. The licensee's medication management services; and

k. The list of grooming and personal hygiene supplies provided by the RTRF 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 RTRF's policy and procedure for implementing the bill of rights pursuant to RSA 151:20, II;

(3) The RTRF'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; and

(4) Information on advanced directives.

(d) The RTRF shall perform a preliminary assessment of each client's needs and develop a preliminary care plan upon admission or within 24 hours following admission.

(e) A comprehensive evaluation shall be completed within 30 days for neuro-rehabilitation facilities.

(f) The evaluation required by (e) above shall:

(1) Be completed in consultation with the client's licensed practitioner, as applicable, and guardian or agent, if any;

(2) Be reviewed every 6 months or after any significant change as defined in He-P 807.03(bl) ;

(3) Include a medication review;

(4) Include a review of the client's clinical and treatment record; and

(5) Include an assessment for pain, vital signs, physical, cognitive, mental, and behavioral status, as well as an assessment as to how the client is psychologically adapting to his or her social environment.

(g) A care plan or treatment plan shall be written and shall include the date the problem or need was identified, the client goal or treatment to be taken, the date of re-evaluation, and responsible person(s), as applicable.

(h) The care plan or treatment plan shall:

(1) Be completed within 24 hours of the comprehensive evaluation;

(2) Be updated following the completion of each future assessment;

(3) Be made available to personnel who assist clients in the implementation of the plan; and

(4) Address the needs identified by the comprehensive evaluation in (e) above.

(i) The care plan or treatment plan as defined in He-P 807.03(k) and required by (g) above, shall include:

(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.

(j) Progress notes shall be written at least monthly and include at a minimum:

(1) Treatment care plan outcomes;

(2) Changes in the client's physical, functional, and mental abilities;

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

(4) Summary of protective care that has been provided.

(k) At the time of a client's admission, the licensee shall ensure that orders from a licensed practitioner are obtained for medications, and that special dietary requirements are documented.

(l) All personnel shall follow the orders of the licensed practitioner for each client and encourage clients to follow the practitioner's orders.

(m) The licensee shall have each client obtain a health examination by a licensed practitioner within 30 days prior to admission or within 72 hours following admission to the RTRF.

(n) The health examination in (m) above shall include:

(1) Diagnoses, if any;

(2) The medical history;

(3) Medical findings, including the presence or absence of communicable disease;

(4) Vital signs;

(5) Prescribed and over-the-counter medications;

(6) Allergies;

(7) Dietary needs; and

(8) Pain assessment for neuro-rehabilitation clients.

(o) Each client shall have at least one health examination every 12 months, unless the licensed practitioner determines that an annual physical examination is not necessary and specifies in writing an alternative time frame, or the client refuses in writing.

(p) A client may refuse all care and services.

(q) When a client 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 client and guardian of the potential results of their refusal;

(2) Notify the licensed practitioner of the client's refusal of care; and

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

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

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

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

(2) Name, address, and telephone number of the client'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 807.16

#9873-A, eff 2-24-11

Amended by Volume XXXIX Number 10, Filed March 7, 2019, Proposed by #12727, Effective 2/20/2019, Expires 8/19/2019.

Derived from Volume XL Number 2, Filed January 9, 2020, Proposed by #12962, Effective 12/31/2019, Expires 12/31/2029.