(a) The building(s) of the Nursing Care Facility shall be constructed, arranged and maintained to ensure the health and welfare of all residents. - (i) An employee shall be designated responsible for services and for the establishment of policies and procedures in each of the following areas:
- (B) Laundry operations; and
- (C) General housekeeping.
- (ii) There shall be written rules and regulations governing the handling and storing of oxygen, and maintenance of oxygen equipment. Only labeled Medical Grade USP Oxygen shall be used.
- (iii) Approved incineration facilities shall be provided and maintained or other approved procedures shall be used for disposal of resident wastes, as well as sanitary disposal of all other wastes.
- (A) These facilities, location and methods shall be in accordance with recommendations of the Centers for Disease Control and Prevention, the National Institutes of Health and in compliance with air pollution standards.
- (iv) Shower/bath and resident lavatories shall be set to provide water of a temperature not to exceed 110 degrees Fahrenheit.
- (v) The water source of an emergency potable supply shall be identified and shall be sufficient in volume to meet facility needs.
(b) Sanitary Environment. The Nursing Care Facility shall establish policies and procedures for investigating, controlling and preventing infections. - (i) Policies, procedures, and techniques shall be regularly reviewed, particularly those concerning food service, laundry practices, and the disposal of environmental and resident wastes.
- (ii) A facility policy shall be developed for reporting and monitoring employees with an infection that could be transmitted through usual job duties to residents, their food or laundry.
- (iii) The facility shall report the required diseases/conditions to the Wyoming Department of Health, Epidemiology Unit as per W.S. § 35-4-107. In addition, those conditions classified as nosocomial where two (2) or more persons, either residents or employees, are affected shall be reported immediately to the State Health Officer, the County Health Officer, and the Licensing Division. The Nursing Care Facility Administrator or his/her designated representative shall furnish all available pertinent information related to such disease or condition to the Licensing Division.
- (iv) Inservice education shall be provided for all employees. This shall include the practice of aseptic techniques, such as: handwashing/universal precautions, proper grooming, masking and gowning procedures (for isolation), disinfection and sterilizing techniques, and the handling and storage of resident care equipment and supplies plus decontamination methods.
- (A) Continuing education shall be provided to all employees on the cause, effect, transmission, prevention and elimination of infections.
- (v) Animals, birds, and other pets shall be allowed in the Nursing Care Facility with the approval of the resident council and:
- (A) The pet has had an examination prior to entering the Nursing Care Facility and annually thereafter, or more frequently if required by the pets health condition;
- (B) The pets vaccinations are current;
- (C) The pet is not allowed in the residents dining room during dining hours or in any food preparation area; and,
- (D) Someone must be designated as the primary caretaker of the pet, other than a resident of the facility.
- (E) Aquariums and enclosed aviaries are excluded from the above requirements provided they are properly secured and are maintained in an approved sanitary manner. Aquariums must be protected to prevent spillage or breakage.
- (vi) Humidifiers and all oxygen equipment shall be maintained according to the manufacturers recommendations and acceptable standards of practice.
(c) Dietary Facilities. Food shall be stored, prepared, distributed, and served under proper sanitary conditions. - (i) Non-dietary personnel shall be excluded from the dietary area and the traffic pattern shall be strictly controlled;
- (ii) Employees shall not eat or use tobacco products in any food preparation area;
- (iii) A written policy shall be developed and adhered to for the cleaning and sanitizing of all ice machines; and
- (iv) Equipment and work areas shall be clean and orderly. Effective procedures for cleaning all equipment and work areas shall be followed consistently to safeguard residents health.
(d) Laundry. - (i) All soiled linens shall be transported in closed bags. Isolation linen shall be handled according to current acceptable standards of practice.
- (ii) There shall be separate carts (with a positive designation) or methods for transportation of clean and soiled linen. Carts for clean linen transport shall be labeled, cleaned and sanitized daily prior to such usage.
(e) General Facilities. - (i) Sewage disposal, when not on a municipal system, shall be approved by the Wyoming Department of Environmental Quality.
- (ii) Water supply, when not on a municipal system, shall be approved by the Wyoming Department of Environmental Quality.
- (iii) Measures shall be taken to prevent and control insects, rodents and other environmental hazards affecting the residents and the premises.
048-11 Wyo. Code R. § 11-6