Ariz. Admin. Code § R9-10-427 - Quality Rating
A. As required
in A.R.S. §
36-425.02(A),
the Department shall issue a quality rating to each licensed nursing care
institution based on the results of a compliance inspection.
B. The following quality ratings are
established:
1. A quality rating of "A" for
excellent is issued if the nursing care institution achieves a score of 90 to
100 points,
2. A quality rating of
"B" is issued if the nursing care institution achieves a score of 80 to 89
points,
3. A quality rating of "C"
is issued if the nursing care institution achieves a score of 70 to 79 points,
and
4. A quality rating of "D" is
issued if the nursing care institution achieves a score of 69 or fewer
points.
C. The quality
rating is determined by the total number of points awarded based on the
following criteria:
1. Nursing Services:
a. 15 points: The nursing care institution is
implementing a system that ensures residents are provided nursing services to
maintain the resident's highest practicable physical, mental, and psychosocial
well-being according to the resident's comprehensive assessment and care
plan.
b. 5 points: The nursing care
institution ensures that each resident is free from medication errors that
resulted in actual harm.
c. 5
points: The nursing care institution ensures the resident's representative is
notified and the resident's attending physician is consulted if a resident has
a significant change in condition or if the resident is in an incident that
requires medical services.
2. Resident Rights:
a. 10 points: The nursing care institution is
implementing a system that ensures a resident's privacy needs are
met.
b. 10 points: The nursing care
institution ensures that a resident is free from physical and chemical
restraints for purposes other than to treat the resident's medical
condition.
c. 5 points: The nursing
care institution ensures that a resident or the resident's representative is
allowed to participate in the planning of, or decisions concerning treatment
including the right to refuse treatment and to formulate a health care
directive.
3.
Administration:
a. 10 points: The nursing care
institution has no repeat deficiencies that resulted in actual harm or
immediate jeopardy to residents that were cited during the last compliance
inspection or a complaint investigation conducted between the last compliance
inspection and the current compliance inspection.
b. 5 points: The nursing care institution is
implementing a system to prevent abuse of a resident and misappropriation of
resident property, investigate each allegation of abuse of a resident and
misappropriation of resident's property, and report each allegation of abuse of
a resident and misappropriation of resident's property to the Department and as
required by A.R.S. §
46-454.
c. 5 points: The nursing care institution is
implementing a quality management program that addresses nursing care
institution services provided to residents, resident complaints, and resident
concerns, and documents actions taken for response, resolution, or correction
of issues about nursing care institution services provided to residents,
resident complaints, and resident concerns.
d. 1 point: The nursing care institution is
implementing a system to provide social services and a program of ongoing
recreational activities to meet the resident's needs based on the resident's
comprehensive assessment.
e. 1
point: The nursing care institution is implementing a system to ensure that
records documenting freedom from infectious pulmonary tuberculosis are
maintained for each personnel member, volunteer, and resident.
f. 2 points: The nursing care institution is
implementing a system to ensure that a resident is free from unnecessary
drugs.
g. 1 point: The nursing care
institution is implementing a system to ensure a personnel member attends
in-service education according to policies and procedures.
4. Environment and Infection Control:
a. 5 points: The nursing care institution
environment is free from a condition or situation within the nursing care
institution's control that may cause a resident injury.
b. 1 point: The nursing care institution
establishes and maintains a pest control program that complies with A.A.C.
R3-8-201(C)(4).
c. 1 point: The
nursing care institution develops a written disaster plan that includes
procedures for protecting the health and safety of residents.
d. 1 point: The nursing care institution
ensures orientation to the disaster plan for each personnel member is completed
within the first scheduled week of employment.
e. 1 point: The nursing care institution
maintains a clean and sanitary environment.
f. 5 points: The nursing care institution is
implementing a system to prevent and control infection.
g. 1 point: An employee cleans the employee's
hands after each direct resident contact or when hand cleaning is indicated to
prevent the spread of infection.
5. Food Services:
a. 1 point: The nursing care institution
complies with 9 A.A.C. 8, Article 1, for food preparation, storage and handling
as evidenced by a current food establishment license.
b. 3 points: The nursing care institution
provides each resident with food that meets the resident's needs as specified
in the resident's comprehensive assessment and care plan.
c. 2 points: The nursing care institution
obtains input from each resident or the resident's representative and
implements recommendations for meal planning and food choices consistent with
the resident's dietary needs.
d. 2
points: The nursing care institution provides assistance to a resident who
needs help in eating so that the resident's nutritional, physical, and social
needs are met.
e. 1 point: The
nursing care institution prepares menus at least one week in advance,
conspicuously posts each menu, and adheres to each planned menu unless an
uncontrollable situation such as food spoilage or non-delivery of a specified
food requires substitution.
f. 1
point: The nursing care institution provides food substitution of similar
nutritive value for residents who refuse the food served or who request a
substitution.
D. A nursing care institution's quality
rating remains in effect until a subsequent compliance inspection or complaint
investigation is conducted by the Department except as provided in subsection
(E).
E. If the Department issues a
provisional license, the current quality rating is terminated. A provisional
licensee may submit an application for a substantial compliance inspection. If
the Department determines that, as a result of a substantial compliance
inspection, the nursing care institution is in substantial compliance, the
Department shall issue a new quality rating according to subsection
(C).
F. The issuance of a quality
rating does not preclude the Department from seeking a civil penalty as
provided in A.R.S. §
36-431.01,
or suspension or revocation of a license as provided in A.R.S. §
36-427.
Notes
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