Section He-P 811.15 - Required Services(a) The licensee shall provide administrative services that include the appointment of a full time administrator who: (1) Meets one of the following requirements: a. Has a bachelor's degree in business administration or a health related field; orb. Is a registered nurse currently licensed in the state of New Hampshire with at least 12 months experience in clinical nursing with 6 months of the experience being in the care of clients with nephrology disorders;(2) Is responsible for the day-to-day operations of the ESRDDC; (3) Delegates, in writing, an alternate onsite, qualified designee who shall assume the responsibilities of the administrator in his or her absence; and(4) May hold more than one position within the facility if qualified.(b) The licensee shall credential licensed practitioners involved in the direct care of clients as follows: (1) The licensee shall establish a credentialing committee composed of, at a minimum, the medical director, the administrator, and the director of nursing; and(2) The credentialing committee shall be responsible for: a. Establishing the education and experience requirements of each direct-care position; b. Establishing a system for determining that the person being credentialed is: 1.Licensed or certified to practice health care in New Hampshire; and
2.Qualified by education and experience to meet the requirements of the position in a. above;
c. Approving, and documenting the approval of, the duties that may be performed by the person being credentialed;d. Establishing a procedure for updating the approvals in b. above as necessary; and e. The annual review of all credentialed personnel. (c) The licensee shall provide medical services that meet the guidelines in the Association for the Advancement of Medical Instrumentation (AAMI) 's "American National Standard for Dialysate for Hemodialysis" (RD 52:2009 edition), available as noted in Appendix A for: (1) Water quality requirements and testing; and(2) The reuse of hemodialyzers and other dialysis supplies.(d) The licensee shall provide instructions and education to clients, including but not limited to medical needs, nutrition, hygiene, medical emergencies, community support and resources.(e) The licensee shall appoint a medical director who:(1) Is a physician licensed in the state of New Hampshire; (2) Is board certified in internal medicine or pediatrics; (3) Has completed a board-approved training program in nephrology; (4) Has at least 12 months experience providing care to patients receiving dialysis; and(5) Shall perform the following duties: a. Participate in the ESRDDC's quality assurance program;b. Participate in the implementation of corrective action plans in affected problem areas;c. Participate in the credentialing process for all licensed health care practitioners;d. Act as a liaison between the licensed practitioners and the client;e. Be available to consult with the client's licensed practitioner, as needed;f. Participate in the development of medical emergency procedures and all standing orders; g. Be available to respond to the center by phone or in person in the case of an emergency or shall ensure that a physician meeting the qualifications of the medical director is available; andh. Review and approve all patient care policies including infection control for the ESRDDC.(f) The licensee shall provide nursing services that include: (1) A department of nursing that is under the supervision of a director of nursing;(2) The appointment of a full time director of nursing who:a. Is a registered nurse currently licensed in the state of New Hampshire;b. Has at least one year of experience as a registered nurse caring for clients with nephrology disorders; andc. Shall perform the following duties: 1.Provide nursing direction, supervision, and staff evaluations to promote quality nursing care;
2.Be a member of the ESRDDC's quality improvement committee; and
3.Participate in the development nursing protocols and procedures; and
(3) Sufficient staff to meet the dialysis needs of clients at all times while in the care of the facility.(g) The licensee shall provide dialysis technician services that include the employment of dialysis technicians who are qualified through education and technical training as required by the center's policies and procedures.(h) The licensee shall not be required to have a separate collection station license, pursuant to He-P 817 to collect patient samples for laboratory testing from clients of its dialysis services. (i) The ESRDDC must obtain a lab license in accordance with He-P 808 if it performs laboratory testing unless the ESRDDC limits the testing preformed to point of care waived glucose testing.(j) The licensee shall not be required to have a separate home health license, pursuant to He-P 809, to provide staff-assisted home dialysis in a client's place of residence.(k) The licensee shall provide social work services, including the employment of a sufficient number of social workers to meet the needs of their clients and who: (1) Have at least a master's degree in social work; or(2) Have a bachelor's degree in a health or human services field, plus: a. Two years experience as a social worker; andb. Have established a consultative relationship with a person holding a master's degree in social work.(l) The licensee shall provide dietary services, including the employment of a sufficient number of dietitians to meet the needs of clients and who: (1) Are registered by the American Dietetic Association and have one year of experience in clinical nutrition; or(2) Have a baccalaureate or advanced degree with major studies in food and nutrition or dietitian and one year of experience in clinical nutrition.N.H. Admin. Code § He-P 811.15
Amended by Volume XXXIX Number 32, Filed August 8, 2019, Proposed by #12827, Effective 7/20/2019, Expires 1/16/2020.Amended by Volume XL Number 7, Filed February 13, 2020, Proposed by # 12985, Effective 1/29/2020, Expires 1/29/2030.