W. Va. Code R. § 69-9-9

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 69-9-9 - STAFFING

9.1. Medical Director.

9.1.a. The center shall designate, in writing, a physician accountable to the governing body to serve as medical director.

9.1.b. The center shall have a medical director to ensure medical care provided to patients is adequate and appropriate.

9.1.c. The medical director shall be certified by the American Academy of Pediatrics with a specialty in Pediatrics with at least three years of experience in the medical care of patients with neonatal abstinence syndrome.

9.1.d. The medical director is responsible for:

9.1.d.1. Reviewing policies, procedures, and guidelines to ensure adequate, comprehensive services;

9.1.d.2. Coordinating medical care provided in the center so it is adequate and appropriate;

9.1.d.3. Assisting in the evaluation of credentialing and re-credentialing of licensed practitioners to determine whether they will be authorized to practice within the organization by recommendation;

9.1.d.4. Approving in-service training programs; and

9.1.d.5. Reviewing and evaluating incident reports or summaries of incident reports, identifying hazards to health and safety, and making recommendations as needed.

9.2. Director of Nursing.

9.2.a. The neonatal abstinence syndrome center shall employ a Director of Nursing with the following minimum qualifications:

9.2.a.1. The Director of Nursing shall hold a current and unencumbered license from the West Virginia Board of Examiners for Registered Professional Nurses; and

9.2.a.2. The Director of Nursing shall have at least two years of experience in the medical care of neonatal or pediatric patients.

9.2.b. The Director of Nursing shall be responsible for:

9.2.b.1. Assisting in the development of performance evaluations for all staff reporting to the Director of Nursing;

9.2.b.2. Supervising day-to-day clinical operations of the center, including but not limited to practice standards and quality improvement;

9.2.b.3. Developing and implementing programs and related materials based on best practices in collaboration with the Medical Director;

9.2.b.4. Assure competency and consistency in care and guides clinical practice through resource development, educational opportunities, consultation and research;

9.2.b.5. Developing and monitoring benchmark standards and tools to evaluate and achieve success in clinical objectives;

9.2.b.6. Reviewing the effectiveness of practice modalities and develops performance measures and indicators to assess success.

9.2.b.7. Continuously monitoring outcomes and approaches to ensure quality performance and outcomes;

9.2.b.8. Assisting in the development of educational materials to address deficiencies in the operation of the center; and

9.2.b.9. Coordinating outreach and education to referring centers or entities.

9.3. Registered Professional Nurse.

9.3.a. The center shall employ registered professional nurses to oversee and manage the care of patients being assessed and treated for neonatal abstinence syndrome.

9.3.b. There shall be one registered professional nurse per every four patients at all times. There must be a minimum of two licensed nurses on each shift, one of which must be a registered professional nurse.

9.3.c. Registered professional nurses shall hold a current and unencumbered license from the West Virginia Board of Examiner's for Registered Professional Nurses.

9.3.d. Registered professional nurses shall have a current cardiopulmonary resuscitation (CPR) certification.

9.3.e. Registered professional nurses shall have a Neonatal Advanced Life Support (NALS) or S.T.A.B.L.E. certification (http://www.stableprogram.org) within one year of employment.

9.3.f. Registered professional nurses shall be responsible for:

9.3.f.1. Overseeing care and treatment of patients provided by personal care assistants;

9.3.f.2. Checking neonatal abstinence syndrome symptoms score once per shift, and as needed;

9.3.f.3. Participating in physician rounds for all assigned patients;

9.3.f.4. Administering medications according to physician's orders;

9.3.f.5. Verifying and documenting administration and dosage of all medications, including opiates, administered by another registered professional nurse;

9.3.f.6. Monitoring for adherence to feeding and treatment protocols;

9.3.f.7. Reporting all patient medical concerns to the physician;

9.3.f.8. Reporting all social concerns to the social worker;

9.3.f.9. Assuming care and treatment of patients requiring closer monitoring;

9.3.f.10. Communicating with parents and caregivers in a non-judgmental environment;

9.3.f.11. Maintaining confidentiality in all matters pertaining to patient and family care and treatment;

9.3.f.12. Providing education and support to parents and caregivers; and

9.3.f.13. Initiating and updating plan of care.

9.4. Social Worker.

9.4.a. Social worker educational requirements must hold an unencumbered and valid West Virginia Social Work license.

9.4.b. Social worker must have three years of experience in working with people with substance abuse disorders and/or patient welfare.

9.4.c. Social worker shall be responsible to:

9.4.c.1. Coordinate and collaborate with the social work departments at all admitting hospitals;

9.4.c.2. Visit with and provide information to parents about the center;

9.4.c.3. Coordinate and give tours of the center to parents;

9.4.c.4. Work with the registered professional nurse during the admission process;

9.4.c.5. Review the center rules with parents;

9.4.c.6. Work with families to identify the existing needs and strengths for providing care;

9.4.c.7. Introduce the family to the clinical team at the center;

9.4.c.8. Ensure all families receive necessary training;

9.4.c.9. Provide parent and family training for non-medical issues;

9.4.c.10. Gather and record information regarding the family and patient social status;

9.4.c.11. Be the liaison to Patient Protective Services;

9.4.c.12. Help identify patients who should be remanded into state custody;

9.4.c.13. Coordinate local substance abuse prevention programs;

9.4.c.14. Prepares and maintains records for the patient's chart regarding social and parental strengths and needs; and

9.4.c.15. Meet regularly with the Director of Nursing and registered professional nurses to discuss patient and family care needs.

9.5. Personal Care Assistants.

9.5.a. The facility may employ personal care assistants to care for patients, including bathing, feeding, diapering, therapeutic handling and scoring neonatal abstinence syndrome symptoms that do not require an assessment.

9.5.b. Personal care assistants shall not be assigned to more than three patients.

9.5.c. Personal care assistants shall meet the following educational requirements:

9.5.c.1. A high school diploma, or equivalent; and

9.5.c.2. A current Neonatal Advanced Life Support (NALS) or S.T.A.B.L.E. certification within one year of employment.

9.5.d. The center shall provide a comprehensive orientation to each personal care assistants to at a minimum to:

9.5.d.1. Provide an in-depth understanding of all policies and procedures of the center;

9.5.d.2. Report allegations abuse, neglect, misappropriation and fraud;

9.5.d.3. Report drug diversion concerns;

9.5.d.4. Become proficient in therapeutic handling; and

9.5.d.5. Become proficient in neonatal abstinence syndrome symptom scoring.

9.5.e. Personal care assistants shall be responsible for:

9.5.e.1. Caring for patients with neonatal abstinence syndrome under direct supervision of a registered professional nurse;

9.5.e.2. Providing general patient care including, vital signs, bathing, feeding, and diapering.

9.5.e.3. Maintaining low stimulus environment at all times;

9.5.e.4. Scoring patients using a neonatal abstinence syndrome scoring method;

9.5.e.5. Using therapeutic handling to comfort and decrease stimulus;

9.5.e.6. Directing any concerns to the registered professional nurse immediately;

9.5.e.7. Maintaining confidentiality in all matters pertaining to patient and family care and treatment;

9.5.e.8. Documenting care provided in the patient's chart; and

9.5.e.9. Reporting end of shift status to the registered professional nurse.

9.6. Volunteers.

9.6.a. All volunteers are subject to the criminal background check requirements under the provisions of this rule.

9.6.b. No one under the age of 18 may volunteer.

9.6.c. Each volunteer shall receive training in therapeutic handling and the characteristics of neonatal abstinence syndrome.

9.6.d. Volunteers may only perform tasks related to therapeutic handling, housekeeping, and clerical duties.

9.7. Staffing Ratios.

9.7.a. The center shall maintain a personal care assistant staffing ratio to meet the needs of the patients.

9.7.b. Employees assigned to provide care to patients on a specified unit, including nursing staff, may be included in the employee to patient ratio.

9.7.c. Employees assigned to supervisory duties, including nursing supervisor, or those duties that cause them to be away from the unit may not be included in the count.

9.7.d. There shall be one registered professional nurse per every four patients at all times. There must be a minimum of two licensed nurses on each shift, one of which must be a registered professional nurse, with the ability to increase the ratio when needed.

9.8. Staff Training and Development.

9.8.a. The center shall ensure all patient care employees are specifically trained to meet the needs of the patients with neonatal abstinence syndrome.

9.8.b. All patient care employees shall be trained within the first 30 days of employment on basic patient care, and on an ongoing annual basis.

9.8.c. At a minimum, all patient care employees shall be trained in:

9.8.c.1. Patient development;

9.8.c.2. Neonatal Advanced Life Support (NALS) or S.T.A.B.L.E. within one year of employment;

9.8.c.3. First aid;

9.8.c.4. Basic patient care; and

9.8.c.5. The effects of neonatal abstinence syndrome on the patient.

9.8.d. Prior to completion of the training, the new patient care employees shall be scheduled to work with only fully trained employees.

9.9. Personnel Records.

9.9.a. The center shall maintain a confidential personnel record for each employee containing the following information:

9.9.a.1. A dated application;

9.9.a.2. Reference verification;

9.9.a.3. Evaluations of work performance;

9.9.a.4. Tuberculosis screening prior to hire and every five years;

9.9.a.5. Current license, registration, or certification status if applicable to the job;

9.9.a.6. A summary of the employee's in-service training for the previous two years;

9.9.a.7. Any center specific required forms;

9.9.a.8. A job description signed by the employee; and

9.9.a.9. Records required to be retained for criminal background checks as defined by the provisions of this rule.

9.9.b. The center shall maintain a confidential personnel record for each volunteer containing the following information:

9.9.b.1. A dated application;

9.9.b.2. Reference verification;

9.9.b.3. Evaluations of work performance;

9.9.b.4. Tuberculosis screening prior to hire and every five years;

9.9.b.5. Current license, registration, or certification status, if applicable to the job;

9.9.b.6. A summary of the volunteer's in-service training for the previous two years;

9.9.b.7. Any center specific required forms;

9.9.b.8. A job description signed by the volunteer; and

9.9.b.9. Records required to be retained for criminal background checks as defined by the provisions of this rule.

9.10. Criminal Background Checks. The neonatal abstinence center shall be subject to the provisions of the Article 49, Chapter 16 of the W. Va. Code, or the West Virginia Clearance for Access: Registry and Employment Screening Act, and subsequent promulgated rules.

W. Va. Code R. § 69-9-9