N.Y. Comp. Codes R. & Regs. Tit. 10 § 415.26 - Organization and administration
A nursing home shall be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.
(a) Administration.
(1) No nursing home shall operate unless it is
under the supervision of an administrator who holds a currently valid nursing
home administrator's license and registration, or temporary license, issued
pursuant to article 28-D of the Public Health Law. The administrator shall set an
example for all staff members, consultants and others affiliated with the
facility which recognizes that the institution exists to serve the interests of
and the needs of the residents, which emphasizes the importance of a resident's
right to independence regarding all aspects of institutional life and encourages
residents to participate together with staff in resolving conflicts and problems
which frequently arise in a group residential setting. The administrator shall:
(i) be readily accessible to residents and
staff for consultations;
(ii) involve
the Resident Council in addressing the need to seek compromises between
conflicting resident and staff interests and needs;
(iii) encourage professional and respectful
behavior on the part of the staff toward residents; and
(iv) seek to involve staff at all levels in
developing and implementing an interdisciplinary approach to resident services,
in order to better serve the individual and group interests of
residents.
(2)
Administrator coverage.
(i) Nursing homes with
41 or more beds shall employ a full-time administrator.
(ii) Nursing homes with 40 beds or less shall
designate in writing a licensed and registered administrator for an amount of
time in accordance with the following:
(a) In
no event shall an administrator be employed for fewer than twelve hours per week;
such hours to be served during normal business hours of 7:00 a.m. to 5:30 p.m.
Monday thru Friday.
(b) The
department may require employment greater than 12 hours per week based on:
(1) the size of the facility;
(2) the history and nature of any operating
deficiencies; and
(3) any
investigations or other problems brought to the attention of the
commissioner.
(iii) The governing body shall designate in
writing a staff member to serve as alternate administrator for all hours that the
administrator of record is absent from duty to ensure that all shifts, 24 hours a
day, 7 days a week are covered by administrative supervision.
(iv) No person whose license to practice
nursing home administration has been forfeited, revoked, annulled, or placed on
inactive status or suspended shall be involved in the administration and
direction of a nursing home either on a full-time, part-time or acting
basis.
(3) When, by reason
of death, resignation, incapacity, illness or other reason, the nursing home does
not have a licensed and currently registered nursing home administrator capable
of carrying out such functions, the governing body shall immediately notify the
commissioner, assign such duties to a named individual acceptable to the
commissioner in accordance with that individual's training, experience and prior
record of work performance at the nursing home, and provide for supervision of
the nursing home by a licensed and currently registered nursing home
administrator in accordance with the following:
(i) A plan for the supervision of the
unlicensed acting nursing home administrator shall be submitted to the Department
which provides that:
(a) the nursing home is
making a bonafide effort to recruit a licensed and registered nursing home
administrator;
(b) there is no other
licensed and registered person in the facility available, capable and willing to
accept the position;
(c) the
supervising administrator will provide a minimum of four hours of onsite
supervision weekly during normal business hours unless the department determines
that more hours are necessary based on:
(1) the
quality of care in the facility;
(2)
the qualifications of the unlicensed acting administrator; and
(3) the on-site presence of qualified
administrative staff.
(ii) The unlicensed acting administrator shall
serve for a maximum of three months except that the nursing home may request and
receive from the department one additional three month extension upon a finding
that the unlicensed acting administrator has performed his or her duties
effectively and that the quality of resident care and services has not
deteriorated.
(4) In
addition to the other responsibilities delineated herein, the administrator
shall:
(i) report to the governing body at
regular intervals;
(ii) implement the
policies of the nursing home by making operating decisions, including but not
limited to general supervision, employing and discharging of staff, programming
and, where appropriate, integrating the services of the nursing home with the
community's health resources;
(iii)
assure that the residents' council:
(a) meets
as often as the membership deems necessary;
(b) is directed by the residents and is chaired
by a resident or another person elected by the membership; and
(c) may meet with any member of the supervisory
staff provided that reasonable notice of the council's request is given to such
staff;
(iv) agree to
assign a staff person in consultation with the resident council, acceptable to
such council, to act as advisor or coordinator, to facilitate the council in
holding regular meetings and to assist members in carrying out council
activities, including obtaining necessary information to become informed of
facility policies, exploring the solutions to problems and conveying to the
administrator issues and suggestions which require administrative
action;
(v) assure that any
complaints, problems or issues reported by the council to the designated staff
person or administration are addressed; and that a written report addressing the
problem, issues or suggestions is sent to the council when requested;
and
(vi) assure that except in
extraordinary circumstances such as health emergencies, the facility has visiting
hours encompassing at least 10 hours within a 24-hour period, including at least
two meal periods, and that a statement as to the visiting hours is posted in a
public place such as the main lobby or the residents' dining room.
(5) The facility shall provide such
secretarial, accounting, receptionist and other supportive personnel, and such
office equipment and supplies, as are needed for satisfactory administration of
the nursing home.
(b)
Governing body. The nursing home shall have a governing body, or designated
persons functioning as a governing body, that is legally responsible for
establishing and implementing policies regarding the management and operation of
the facility. The governing body shall:
(1)
appoint an administrator who is eligible for such appointment and who functions
in accordance with subdivision (a) of this section;
(2) determine and establish written policies
consistent with the stated purposes of the facility, the program of services
provided, its physical structure and equipment, the number and qualifications of
staff members, and their job classifications and descriptions;
(3) be responsible for the operation of the
facility;
(4) be responsible for
providing or arranging services for residents as required in this
Subchapter;
(5) employ or otherwise
arrange for the services of such personnel as are required in this
Subchapter;
(6) assure that a method
is implemented to promptly deal with complaints and recommendations made by
residents or designated representatives which:
(i) enables complaints and recommendations to
be made orally or put in writing;
(ii) brings complaints and recommendations
promptly to the attention of the administration for review and
resolution;
(iii) responds to all
residents or designated representatives as to action taken or the reason why no
action was taken, as soon as possible and except under extraordinary
circumstances such as health or administrative emergencies, within 21 days after
the complaint or recommendation was made; and
(iv) provides for review and evaluation of the
effectiveness of the complaint process;
(7) assure that the complaint and
recommendation method is made known to:
(i) all
residents upon admission and their designated representatives; and
(ii) all nursing, social service and other
appropriate personnel, in order to assist residents who want to make a complaint
or recommendation;
(8)
assure that the facility establishes a residents' council;
(9) be responsible for compliance with all
provisions of this Subchapter;
(10)
(i) post in a public place a notice supplied by
the New York State Department of Health containing:
(a) the time and date the facility shall assess
residents to determine case mix intensity, pursuant to section
86-2.30
of this Title; and
(b) department
auditors will be in the facility to review the data submitted by the facility in
the patient review instrument for the current assessment period; and
(c) a statement that each resident and/or the
resident's designated representative has the right to know the specific
assignment to a patient classification category; and
(d) the person within the facility to contact
for this information;
(ii)
notify the resident and/or the resident's designated representative according to
the following procedures, that a process exists for reimbursement purposes to
assign residents to a patient classification category as contained in Appendix
13-A of this Title entitled "Patient Categories and Case Mix Indices Under
Resource Utilization Group (RUG-II) Classification System":
(a) upon admission to the facility, at the
initial resident assessment required pursuant to section
415.11
of this Part a designated professional staff member shall inform the resident
and/or resident's designated representative of this process and that further
information on the classification system is available upon request; and
(b) the process by which residents are
classified for reimbursement purposes into the RUG-II classification system shall
be, at least annually, an item for discussion on the agenda at a resident council
as required by paragraph (8) of this subdivision;
(11) furnish for the staff telephone services
consisting of at least one operational, unlocked, noncoin telephone installation
on each floor of the facility, for the use of professional staff in the
performance of their duties;
(12)
permit activities related only to the operation of the facility except that the
operator, subject to prior written approval of the commissioner, may, where such
arrangement will not result in any diminishment of resident care or services, or
adversely affect the cost of delivering nursing home services;
(i) enter into a written contract for the
purpose of leasing unneeded space and equipment on the premises of the facility
to a health care practitioner licensed by the State Education Department, or to a
provider licensed under the Public Health Law, Mental Hygiene Law, or Social
Services Law to provide health care services to residents or nonresidents, where
such arrangements will also promote needed health care services for residents;
or
(ii) prepare food for consumption
off-site as part of a nutrition program or make available service of meals,
nutrition education, and nutrition counseling for nonresidents on-site;
(13) notify the department
immediately of anticipated or actual termination of any service vital to the
continued safe operation of the facility or to the health and safety of its
residents and personnel, including but not limited to the anticipated or actual
termination of telephone, electric, gas, fuel, water, heat, air conditioning,
rodent or pest control, contract food, or contract laundry services, and the
services of key full- or part-time personnel such as the administrator, director
of nurses, consultant physician, consultant dietitian or others; and apply
remedial measures promptly and notify the department immediately regarding the
nature of results of such measures;
(14) transfer residents to another appropriate
facility only after consultation, as appropriate, with the resident, his or her
physician, and designated representative except in an emergency situation, in
which case the operator shall notify the physician and designated representative
immediately and record the reason for the transfer; and
(15) ensure that members of the governing body
make themselves available to hold meetings with representatives of the resident
council at least 3 times a year to discuss matters contained in a jointly
developed agenda.
(c)
Staff qualifications and personnel management. The nursing home shall employ on a
full-time, part-time or consultant basis a sufficient number of professional
staff members who are educated, oriented and qualified to carry out the
provisions of this Part and to assure the health, safety, proper care and
treatment of the residents.
(1) With regard to
personnel management, the facility shall:
(i)
provide personnel in accordance with paragraph (2) of this subdivision, with a
planned orientation to nursing home operation and resident care and such
on-the-job training as is necessary for each properly to perform his or her
individual job assignments;
(ii) have
on file and furnish each employee with a copy of written policies governing
conditions of employment, including the job description for his or her
position;
(iii) assure that each
part-time, full-time or private duty employee, consultant, volunteer, or other
person serving in any other capacity in the nursing home shall:
(a) receive an orientation which shall include
but not be limited to the following:
(1) a
review and explanation of relevant personnel policies and procedures, including
his or her job description;
(2) an
orientation to the facility's organization, its long-term care philosophy, the
roles of all personnel in the organization;
(3) an orientation to the physical plant,
infection control, quality assessment and assurance and the environmental aspects
of the facility;
(4) the facility
safety program, including fire safety, accident prevention, resident emergency
procedures, and facility operation during disruption of services;
(5) resident's rights; and
(6) resident abuse and neglect reporting
requirements as set forth in section
2803-d of the Public Health Law;
(b) be on duty, alert and
appropriately dressed during the entire tour of duty, part-time assignment,
consultation visit, volunteer work, private duty or other employment in the
nursing home;
(c) maintain personal
cleanliness and hygiene; and
(d)
conduct himself or herself in a professionally acceptable manner with all
residents, employees and guests, including refraining from abusive, immoral or
other unacceptable conduct, behavior or language and demonstrating respect for
each resident's dignity in full recognition of his or her
individuality;
(iv) assign
each employee duties consistent with his or her job description and with his or
her level of competence, education, preparation and experience; and
(v) develop and implement policies and
procedures which require:
(a) the provision for
a physical examination and recorded medical history for personnel including all
employees and members of the medical and dental staff. The examination shall be
of sufficient scope to ensure that, consistent with Federal and State statutes
prohibiting discrimination on the basis of disability or handicap, no person
shall assume his/her duties unless he/she is free from a health impairment that
would present a risk to the resident which cannot be reasonably accommodated, or
which might interfere with the performance of his/her duties, including the
habituation or addiction to depressants, stimulants, narcotics, alcohol or other
drugs or substances which may alter the individual's behavior. The nursing home
is required to provide such examination without cost for all employees. The
nursing home shall also conduct a health status assessment of all volunteers
whose activities are such that a health impairment would pose a risk to residents
or personnel, in order to determine that the health and well being of residents
and personnel are not jeopardized by the condition of such volunteers. The
nursing home shall require the following of all personnel as a condition of
employment or affiliation:
(1) for all
personnel prior to employment or affiliation, except for personnel with no
clinical or patient contact responsibilities who are located in a building or
site with no patient care services, an initial individual tuberculosis (TB) risk
assessment, symptom evaluation, and TB test (either tuberculin skin test or Food
and Drug Administration (FDA) approved blood assay for the detection of latent
tuberculosis infection), and annual assessments thereafter. Positive findings
shall require appropriate clinical follow-up. The medical staff shall develop and
implement policies regarding positive findings, including procedures for
facilitating and documenting treatment for latent TB infection where indicated.
Annual TB assessment shall include education, individual risk assessment, and
follow-up tests as indicated; and
(2)
a certificate of immunization against rubella which means:
(i) a document prepared by a physician,
physician's assistant, specialist's assistant, nurse practitioner, licensed
midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58
of this Title, demonstrating serologic evidence of rubella antibodies;
(ii) a document indicating one dose of live
virus rubella vaccine was administered on or after the age of 12 months, showing
the product administered and the date of administration, and prepared by the
health practitioner who administered the immunization; or
(iii) a copy of a document described in item
(i) or (ii) of this subclause, which comes from a previous employer or the school
which the employee attended as a student; and
(3) a certificate of immunization against
measles, for all personnel born on or after January 1, 1957, which means:
(i) a document prepared by a physician,
physician's assistant, specialist's assistant, nurse practitioner, licensed
midwife or a laboratory possessing a laboratory permit issued pursuant to Part 58
of this Title, demonstrating serologic evidence of measles antibodies;
(ii) a document indicating two doses of live
virus measles vaccine were administered with the first dose administered on or
after the age of 12 months and the second dose administered more than 30 days
after the first dose but after 15 months of age showing the product administered
and the date of administration, and prepared by the health practitioner who
administered the immunization;
(iii)
a document, indicating a diagnosis of the employee as having had measles disease,
prepared by the physician, physician's assistant/specialist's assistant, licensed
midwife or nurse practitioner who diagnosed the employee's measles; or
(iv) a copy of a document described in item
(i), (ii) or (iii) of this subclause which comes from a previous employer or the
school which the employee attended as a student;
(4) if any licensed physician, physician's
assistant/specialist's assistant, licensed midwife or nurse practitioner
certifies that immunization with measles and/or rubella vaccine may be
detrimental to the employee's health, the requirements of subclause (2) and/or
(3) of this clause relating to measles and/or rubella immunization shall be
inapplicable until such immunization is found no longer to be detrimental to such
employee's health. The nature and duration of the medical exemption must be
stated in the employee's employment medical record and must be in accordance with
generally accepted medical standards, (see, for example, the recommendations of
the American Academy of Pediatrics and the Immunization Practices Advisory
Committee of the U.S. Department of Health and Human Services);
(b) the reassessment of the health
status of all personnel as frequently as necessary, but no less than annually, to
ensure that personnel are free from health impairments which pose a risk to
residents or personnel which cannot be reasonably accommodated or which may
interfere with the performance of duties;
(c) that all personnel report immediately to
their supervisor or the administrator any signs or symptoms of personal illness.
All personnel making such report shall be referred to an appropriate health care
professional for assessment of the risk to residents and personnel. Based on this
assessment, the nursing home shall authorize appropriate measures to be taken,
including but not limited to removal, reassignment or return to duty.
(2) For all personnel,
the facility shall provide planned orientation and staff development programs,
including but not limited to:
(i) an orientation
for each new employee prior to or within one week of employment;
(ii) on-the-job skill training as is necessary
for each to properly perform his or her job;
(iii) continuous staff development programs to
increase knowledge, skills and understanding of problems and ways of dealing with
problems associated with residents needing nursing home care including knowledge
of the quality assurance and assessment program in the facility; and
(iv) maintenance of records of these
activities, including the methods used and an evaluation on their
effectiveness.
(3) For all
personnel who provide services in the nursing home, for whom licensure,
registration or certification is required, the facility shall obtain and retain
verification of license number or certification with expiration date of
same.
(4) For all services and
departments, the facility shall maintain:
(i)
an organization chart;
(ii) a master
plan for staffing; and
(iii) policies
and procedure manuals.
(d) Nurse aide certification and training.
(1) Definitions. The following terms used in
this section shall be defined as follows:
(i)
Nurse aide training program coordinator shall mean a person who is assigned the
administrative responsibility and accountability for the RHCF nurse aide training
program. The program coordinator (PC) shall be a registered professional nurse
with at least two years experience in a nursing home and demonstrated competency
to teach adult learners as evidenced and documented by at least one of the
following:
(a) completion of a professionally
recognized course in teaching adult learners or New York State Education
Department teacher certification;
(b)
two years of experience teaching nursing or nursing related programs to adults in
an academic setting approved by the State Education Department or other
recognized accrediting body; or
(c)
two years of experience teaching nurse aides in a residential health care
facility.
(ii) Instructor
shall mean the person who is assigned the educational responsibility for the
nursing home nurse aide training program. This person shall have the day-to-day
responsibility for implementing the facility's training program in accordance
with the facility's policies and procedures and State and Federal requirements.
The instructor shall be a registered professional nurse with at least one year of
experience in a nursing home who has demonstrated ability to teach adult learners
as evidenced and documented by at least one of the following:
(a) completion of a professionally recognized
course in teaching adult learners or New York State Education Department teacher
certification;
(b) two years of
experience teaching nursing or nursing related programs to adults in an academic
setting approved by the State Education Department or other recognized
accrediting body; or
(c) two years of
experience teaching nurse aides in a residential health care facility.
(iii) Clinical skills evaluator or
nurse aide evaluator shall mean a person who administers part or all of the State
authorized residential health care facility nurse aide competency examinations.
This person shall be a registered professional nurse who has one year of nursing
home experience and has successfully completed the State approved clinical
evaluator or nurse aide evaluator program. Effective July 1, 1992 only
individuals possessing nurse aide evaluator designation may administer the State
RHCF nurse aide competency examinations.
(2) Nurse aide certification. In order to
obtain nurse aide certification and be listed in the New York State RHCF Nurse
Aide Registry as described in section
415.31
of this Part, an individual must successfully complete a State approved
residential health care facility nurse aide training program as described in
paragraph (2) of this subdivision and pass the State authorized clinical skills
competency examination and written or oral competency examination as described in
paragraph (3) of this subdivision.
(i) The
residential health care facility nurse aide training program shall be reviewed
and approved by the department prior to implementation as to the requirements
contained in this section.
(ii) The
facility shall be notified by the department within 90 days of the submission of
the program whether the program has been approved, disapproved or additional
information is required.
(iii)
Program approval will be granted for a term not to exceed two years and is
subject to on-site review for the purpose of determining compliance with
applicable State and Federal requirements during the course of all facility
surveys.
(iv) Approved programs must
notify the department, in the form and manner described by the department, and
may be subject to review, whenever substantive changes are made to the
program.
(v) Approval to provide
training by or in the facility will be withdrawn by the department for up to two
years each time the facility:
(a) fails to
permit unannounced visits;
(b) fails
to meet all of the applicable Federal and State requirements for nurse aide
training and competency evaluation;
(c) is subjected to an extended or partial
extended survey;
(d) is assessed a
civil monetary penalty of $5,000 or more;
(e) has a temporary manager, receiver or
caretaker appointed; or
(f) is
subjected to a ban on admissions or a denial of payment under either the title
XVIII or title XIX programs.
(3) Nurse aide training program. The training
program shall be supervised by a program coordinator who meets the definition
specified in subparagraph (1)(i) of this subdivision and conducted by the
instructor who meets the definition specified in subparagraph (1)(ii) of this
subdivision. The program coordinator may be the director of nursing services
provided that the director of nursing services does not perform the actual
training. Additional health care personnel may supplement the instructor to
provide specialized training provided that such supplemental trainers have at
least one year of experience in their field of expertise.
(i) The nurse aide training program shall
include classroom and clinical training which enhances both skills and knowledge
and, when combined, shall be of at least 100 hours' duration. The clinical
training shall as a minimum include at least 30 hours of supervised practical
experience in a nursing home. The nurse aide training program shall include
stated goals, objectives, and measurable performance criteria specific to the
curriculum subject material, the resident population and the purpose of the
facility, and shall be consistent with the curriculum outlined below. This
curriculum shall be taught at a fourth to sixth grade English literacy level.
Facilities with special populations shall supplement the curriculum to address
the needs of such populations accordingly. The curriculum shall otherwise
include, but not be limited to the following:
(a) normal aging:
(1) anatomical changes;
(2) physiological changes;
(3) psychosocial aspects:
(i) role changes;
(ii) cultural changes;
(iii) spiritual needs; and
(iv) psychological and cognitive changes;
and
(4) concept of
wellness and rehabilitation.
(b) psychological needs of the resident:
(1) adjustment to institutional
living;
(2) working with resident and
family during admission/transfer/discharge;
(3) residents' rights:
(i) respect and dignity;
(ii) confidentiality;
(iii) privacy; and
(iv) self-determination; and
(4) sexual adjustments in relation
to illness, physical handicaps and institutional living;
(c) communication in health care facilities:
(1) relating to residents, families, visitors,
and staff;
(2) methods of
communication in overcoming the barriers of language and cultural-differences;
and
(3) communicating with residents
who have sensory loss, memory, cognitive or perceptual impairment;
(d) personal care needs:
(1) care of the skin, mouth, hair, ears and
nails; and
(2) dressing and
grooming;
(e) resident
unit and equipment:
(1) bed-making;
and
(2) care of personal belongings
such as clothing, dentures, eyeglasses, hearing aids and prostheses;
(f) nutritional needs:
(1) basic nutritional requirements for foods
and fluids;
(2) special
diets;
(3) meal services;
(4) assistance with eating:
(i) use of adaptive equipment; and
(ii) feeding the resident who needs assistance;
and
(5) measuring and
recording fluid and food intake;
(g) elimination needs:
(1) physiology of bowel and bladder continence:
(i) maintaining bowel regularity; and
(ii) physical, psychosocial and environmental
causes of incontinence;
(2) nursing care for the resident with urinary
and/or bowel incontinence:
(i) toileting
programs;
(ii) care of urinary
drainage equipment;
(iii) use of
protective clothing; and
(iv)
enemas;
(3) measuring
urinary output;
(4) bowel and bladder
training programs; and
(5) care of
ostomies including but not limited to colostomy and ileostomy;
(h) mobility needs:
(1) effects of immobility; and
(2) ambulation and transfer techniques:
(i) use of assistive devices;
(ii) use of wheelchairs; and
(iii) use of mechanical lifters;
(i) sleep and rest needs:
(1) activity, exercise and rest; and
(2) sleep patterns and disturbances;
(j) nursing care programs for the
prevention of contractures and decubitus ulcers (pressure sores);
(1) body alignment, turning and
positioning;
(2) individualized
exercise programs;
(3) special skin
care procedures;
(4) use of special
aids; and
(5) maintenance of
individualized range of motion;
(k) observing and reporting signs and symptoms
of disability and illness:
(1) physical signs
and symptoms:
(i) determination of temperature,
pulse, respiration;
(ii) testing
urine;
(iii) measuring height and
weight;
(2) behavioral
changes; and
(3) recognizing and
reporting abnormal signs and symptoms of common diseases and conditions,
including but not limited to:
(i) shortness of
breath;
(ii) rapid
respirations;
(iii) coughs;
(iv) chills;
(v) pain and pains in chest or
abdomen;
(vi) blue color to
lips;
(vii) nausea;
(viii) vomiting;
(ix) drowsiness;
(x) excessive thirst;
(xi) sweating;
(xii) pus;
(xiii) blood or sediment in urine;
(xiv) difficult or painful urination;
(xv) foul-smelling or concentrated urine;
and
(xvi) urinary
frequency;
(l)
infection control:
(1) medical
asepsis;
(2) handwashing;
and
(3) care of residents in
isolation;
(m) resident
safety:
(1) environmental hazards;
(2) smoking;
(3) oxygen safety; and
(4) use of restraints;
(n) nursing care needs of resident with special
needs due to medical conditions such as but not limited to:
(1) stroke;
(2) respiratory problems;
(3) seizure disorders;
(4) cardiovascular disorders;
(5) sensory loss and deficits;
(6) pain management;
(7) mentally impairing conditions:
(i) associated behavior disorders;
and
(ii) characteristics of residents
such as wandering, agitation, physical and verbal abuse, sleep disorders, and
appetite changes;
(o) mental health and social service needs:
(1) self care according to the resident's
capabilities;
(2) modifying behavior
in response to the behavior of others;
(3) developmental tasks associated with the
aging process; and
(4) utilizing the
resident's family as a source of emotional support;
(p) resident rights; and
(q) care of the dying resident including care
of the body and personal effects after death.
(r) care of cognitively impaired residents:
(1) techniques for addressing the unique needs
and behaviors of individuals with dementia;
(2) communicating with cognitively impaired
residents;
(3) understanding the
behaviors of cognitively impaired residents;
(4) appropriate responses to the behaviors of
cognitively impaired residents; and
(5) methods of reducing the effects of
cognitive impairments.
(ii) The training program shall maintain a
performance record of the major duties and skills taught each nurse aide trainee.
At the end of the training program, a copy of the performance record shall be
given to the trainee and the trainee's employer, if different from the training
facility. As a minimum, the performance record shall include the following;
(a) a listing of the measurable performance
criteria for each duty and skill expected to be learned in the program;
(b) an entry showing satisfactory or
unsatisfactory performance;
(c) the
date of the performance; and
(d) the
name of the instructor supervising the performance.
(4) Nurse aide competency
evaluation. Subsequent to the completion of the nurse aide training program
including the satisfactory performance of all duties and skills listed in the
performance record, the facility shall arrange for the nurse aide trainee to take
and pass the State authorized residential health care facility nurse aide
clinical skills competency examination and the written or oral competency
examination as follows:
(i) the clinical skills
competency examination shall be given by a licensed registered nurse, who meets
the definition of the clinical skills evaluator until June 30, 1992 and effective
July 1, 1992 the nurse aide evaluator specified in subparagraph (1)(iii) of this
subdivision and who is not otherwise associated with the facility employing
and/or training the nurse aide trainee. The trainee shall have three
opportunities to pass the clinical skills examination; and
(ii) after passing the clinical skills
examination, the trainee shall have three opportunities to pass the written or
oral competency examination. The nurse aide trainee will obtain certification and
be listed in the Registry upon passing the written or oral examination.
(5) The operator shall not charge a
fee to any individual for the costs of training, including textbooks and
materials, or for the costs of the competency examinations.
(i) If within 12 months of completing a State
approved RHCF nurse aide training program, an individual is employed or is given
an offer of employment by a facility, the facility must arrange, in a form and
manner indicated by the department, for the individual to receive reimbursement
from the State for the amount of the costs, up to the CAP established by the
State, incurred by the individual for the training. Such reimbursement shall be
on a pro rata basis based on the length of subsequent employment as an RHCF nurse
aide in the RHCF.
(ii) If within 12
months of completing the State approved RHCF nurse aide competency evaluation
program, an individual is employed or is given an offer of employment by a
facility, the facility must arrange, in a form and manner indicated by the
department, for the individual to receive reimbursement from the State for the
acceptable amount of the costs, up to the CAP established by the State, incurred
by the individual for the examinations. Such reimbursement shall be on a pro rata
basis based on the length of subsequent employment as an RHCF nurse aide in the
RHCF.
(6) Nurse aide
recertification. The certified nurse aide shall be recertified every two years no
later than the last day of the month in which certification was received. To
obtain recertification the certified nurse aide shall demonstrate in the form
indicated by the department that he/she has worked at least seven hours for
compensation as a health care nurse aide during the previous 24-month period. The
operator shall implement nurse aide recertification in accordance with the
following:
(i) the required documentation shall
be provided in the form indicated by the department to each nurse aide who either
currently works for or last worked for compensation as a nurse aide in the
facility;
(ii) a fee shall not be
charged by the operator to any nurse aide for any cost associated with
recertification;
(iii) the
recertification fee for each nurse aide who either currently works for or last
worked for compensation as a nurse aide in the facility shall be paid by the
operator except that the nurse aide staffing agency or employment organization
which currently employs the nurse aide may pay this fee; and
(iv) after any period of 24 consecutive months
during which the certified nurse aide did not provide nurse aide care for
compensation in a residential health care facility, such nurse aide shall be
required to requalify as specified in the following clause (a) or (b) of this
subparagraph to be listed in the New York State RHCF Nurse Aide Registry:
(a) nurse aides who, on or after July 1, 1989,
successfully completed a State-approved nurse aide training program in accordance
with applicable Federal and State requirements, must pass the State-authorized
residential health care facility nurse aide clinical skills competency
examination and the written or oral competency examination; and
(b) all other nurse aides must successfully
complete a State-approved nurse aide training program and pass the
State-authorized residential health care facility nurse aide clinical skills
competency examination and the written or oral competency examination.
(7) The operator shall
complete a performance review of each nurse aide at least once every 12 months.
(i) Written records shall be maintained which
indicate the content of and attendance at each inservice training
program.
(ii) Each nurse aide trainee
and certified nurse aide shall attend and be compensated for at least six hours
of inservice education in every six-month period.
(8) The operator shall ensure that the
certified nurse aide regularly attends inservice education programs provided for
all personnel and that the programs shall include the following:
(i) a portion of each individual's annual
inservice education as required by subparagraph (iv) of this paragraph shall be
based upon the outcome of the individual's annual performance review as specified
in paragraph (7) of this subdivision, and address the areas of weakness in the
individual's performance;
(ii)
inservice education must also address the special needs of the residents in the
facility, including the care of the cognitively impaired;
(iii) written records shall be maintained which
indicate the content of and attendance at each inservice training program and the
outcomes of the performance review; and
(iv) each certified nurse aide shall attend and
be compensated for inservice education sufficient to ensure the continuing
competence of the nurse aide of not less than six hours of inservice education in
every six-month period.
(e) Use of outside resources. If the nursing
home does not employ a qualified professional person to furnish a specific
service to be provided by the facility, the nursing home shall have that service
furnished to residents by a qualified person or agency outside the facility in
accordance with the following:
(1) The operator
shall enter into written agreement with the outside resource which shall comply
with the provisions of this section and section
400.4 of this Title and
shall:
(i) specify that the operator retains
professional and administrative responsibility for obtaining services that meet
professional standards and principles that apply to professionals providing
services in such a facility;
(ii)
require that such services are provided on a timely basis;
(iii) set forth the responsibilities, function,
objectives and terms of the agreement, including financial arrangements and
charges of each such outside resource; and
(iv) be signed by an authorized representative
of the facility and the person or the agency providing the service.
(2) The outside resource, when
acting as a consultant, shall apprise the administrator of recommendations, plans
for implementation and continuing assessment in his or her areas of
responsibility through dated, signed reports which shall be retained by the
administrator for follow-up action and evaluation of performance.
(f) Disaster and emergency
preparedness.
(1) The nursing home shall have a
written plan, updated at least twice a year, with procedures to be followed for
the proper care of residents and personnel, and for the reception and treatment
of mass casualty victims, in the event of an internal or external emergency
resulting from natural or man-made causes including but not limited to
earthquake, severe weather, flood, bomb threat, chemical spills, strike,
interruption of utility services, nuclear accidents, fire or similar
occurrences.
(2) The nursing home
shall develop and implement written policies concerning missing
residents.
(3) The nursing home
shall:
(i) train all employees in emergency
procedures when they begin to work for the facility;
(ii) periodically, but at least annually review
the written plan with existing staff; and
(iii) carry out staff drills in accordance with
the written plan at least twice a year.
(g) Transfer agreements. Nursing homes shall
have in effect a written transfer agreement with one or more general hospitals as
required to meet the medical care needs of residents. Such transfer agreements
shall:
(1) comply with the provisions of
section
400.9
of this Title;
(2) ensure that
residents are admitted to the general hospital on a timely basis when such
transfer is medically appropriate as determined by the attending physician or
other approved practitioner; and
(3)
provide for the transfer of medical and other information needed for care and
treatment of residents, when the transferring facility deems it
appropriate.
(h) Financial
policies.
(1) The facility shall:
(i) specify its refund policies in writing to
each resident, next of kin and/or sponsor prior to admission; and
(ii) refund promptly any amount or proportion
of prepayment in excess of the amount or proportion thereof obligated for
services already furnished in the event the resident leaves the nursing home
prior to the end of the prepayment period for reasons beyond the control of the
resident, next of kin and/or sponsor. In the event that the resident leaves for
reasons within his or her control, or that of the next of kin and/or sponsor, the
facility shall not retain from the prepayment or charge in the absence of a
prepayment, an amount in excess of one day's basic rate in addition to any amount
obligated for services already furnished.
(2) The facility shall not enter into any
contract or agreement with the resident, next of kin and/or sponsor for life care
of the resident.
(3) No facility or
agent, consultant, employee or representative thereof shall:
(i) pay any commission, bonus, rebate or
gratuity to any organization, agency, physician, employee or other person for
referral of any resident to the nursing home;
(ii) request and/or accept any remuneration,
tip or gratuity in any form from a resident, next of kin and/or sponsor for any
services provided or arranged or for denial of services by the nursing home other
than specified fees ordinarily paid for care, excluding donations, gifts and
legacies given in behalf of the facility; or
(iii) accept any remuneration, rebate, gift,
benefit or advantage of any form from any vendor or other supplier because of the
purchase, rental or loan of equipment, supplies or services for the facility or
resident, excluding normal business practices.
(4) In the event that the operator of the
facility and the consulting physician or any other professional provider of
services are one and the same person, he or she shall not reimburse himself or
herself as consultant for such services provided to the facility or directly to
any resident other than for services provided in an emergency.
(5) If a resident authorizes the facility in
writing to manage his or her personal finances in accordance with section
415.3(g)(1)
of this Part, the facility shall hold, safeguard, manage and account for personal
funds of the resident deposited with the facility in accordance with the
following:
(i) Deposit of funds.
(a) Funds in excess of $50. The facility shall
deposit any resident's personal funds in excess of $50 in an interest bearing
account (or accounts) that is separate from any of the facility's operating
accounts, and that credits all interest earned on the resident's funds to his or
her account. In pooled accounts, there shall be a separate accounting for each
resident's share.
(b) Funds less than
$50. The facility shall maintain a resident's personal funds that do not exceed
$50 in a non-interest bearing account or petty cash fund.
(ii) Accounting and records. The facility shall
establish and maintain a system that assures a full and complete and separate
accounting, according to generally accepted accounting principles, of each
resident's personal funds entrusted to the facility on the resident's behalf. The
system shall contain, as a minimum, the resident's name, Medicaid case number
where applicable, date of admission, date and amount of each withdrawal or
deposit, and balance at each transaction.
(a)
The system shall preclude any commingling of resident funds with facility funds
or with the funds of any person other than another resident.
(b) The individual financial record shall be
available within one business day of a request, to the resident or his or her
designated representative.
(c) The
individual financial record shall document each deposit or withdrawal of funds
including the signature of the resident or the resident's designated
representative for each transaction.
(iii) Notice of certain balances. The facility
shall notify the resident when the amount in the account of a resident who
receives Medicaid benefits reaches $200 less than the SSI resource limit for one
person, specified in section 1611(a)(3)(B) of the Social Security Act, and that,
if the amount in the account, in addition to the value of the resident's other
nonexempt resources, should reach the SSI resource limit for one person, the
resident may lose eligibility for Medicaid or SSI.
(iv) Conveyance upon death. Upon the death of a
resident with a personal fund deposited with the facility, the facility shall
convey within 30 days the resident's funds, and a final accounting of those
funds, to the individual or probate jurisdiction administering the resident's
estate.
(v) Assurance of financial
security. The facility shall purchase a surety bond, or provide self-insurance,
to assure the security of all personal funds of residents deposited with the
facility.
(vi) Limitation on charges
to personal funds. The facility shall not impose a charge against the personal
funds of a resident for any item or service for which payment is made under
Medicaid or Medicare (except for applicable deductible and coinsurance amounts).
The facility may charge the resident for requested services that are more
expensive than or in excess of covered services.
(a) Services included in Medicare or Medicaid
payment. During the course of a covered Medicare or Medicaid stay, the facilities
shall not charge a resident for the following items and services:
(1) nursing services and specialized
rehabilitative services;
(2) dietary
services;
(3) an activities
program;
(4) room/bed maintenance
services; and
(5) routine personal
hygiene items and services.
(b) Optional covered items and services. A
facility may choose to provide residents with supplies, equipment and
transportation essential to the activities program required by section
415.5(g)
of this Title. If it chooses to provide these items and services, they shall be
included as covered Medicare or Medicaid services and reimbursed under those
program benefits. No charges shall be made to residents for those
services.
(c) Items and services that
may be charged to residents' funds. Listed below are general categories and
examples of items and services that the facility may charge to residents' funds
if they are requested by a resident and payment is not made by Medicare or
Medicaid:
(1) telephone;
(2) television/radio for personal
use;
(3) personal comfort items,
including smoking materials, notions and novelties, and confections;
(4) cosmetic and grooming items and services,
in excess of those for which payment is made under Medicaid or
Medicare;
(5) personal
clothing;
(6) personal reading
matter;
(7) gifts purchased on behalf
of a resident;
(8) flowers and
plants;
(9) social events and
entertainment offered off the premises and outside the scope of the activities
program, provided under section
415.5(g)
of this Part;
(10) noncovered special
care services such as private duty nurses consistent with Medicare and Medicaid
rules and regulations for residents who are beneficiaries of these programs;
and
(11) specially prepared or
alternative food requested instead of the food generally prepared by the
facility, if it is documented that the requested food costs more than food
provided to other residents, except that food provided under section
415.3(f)(6)
of this Part shall not be charged to residents' funds.
(d) Requests for items and services.
(1) The facility shall not charge a resident or
his or her designated representative for any item or service not requested by the
resident or the designated representative.
(2) The facility shall not require a resident
or his or her designated representative to request any item or service as a
condition of admission or continued stay.
(3) The facility shall inform the resident or
his or her designated representative requesting an item or service for which a
charge will be made that there will be a charge for the item or service and what
the charge will be.
(6) The facility shall:
(i) upon receiving prepayment or advance money
for the purpose of being applied to payments in satisfaction of or as security
for the performance of facility responsibilities, deposit such money, which shall
continue to be the money of the person making the prepayment, in an
interest-bearing account in a bank or with a financial agent;
(ii) not be required to deposit prepayment in
an interest-bearing account where such money is to be applied to payments when
due, until 61 days after such prepayment or advanced money is made;
(iii) notify in writing each of the persons
making such prepayment of the name and address of the bank or financial agent
with which the deposit is made and the amount of such deposit;
(iv) be entitled to receive an administrative
expense equivalent to one percent per annum upon the prepayment money deposited,
which shall be in lieu of all other administrative expenses;
(v) inform any person making prepayment as
security for the performance of facility responsibilities that waivers of the
provisions of this paragraph are void.
(7) Equity withdrawal. No facility or governing
body may withdraw or reduce a facility's equity so as to create or increase a
negative net worth by means of a withdrawal without the prior approval of the
commissioner.
(i) The term withdrawal shall
mean:
(a) any payment of cash or transfer of
other assets by a facility directly or indirectly to or for the benefit of its
operator or owner; and
(b) any
liability or contingent liability incurred within any period of 12 consecutive
months by a facility or its operator by reason of a mortgage, lease, borrowing or
other transaction relating to such facility that exceeds, in the aggregate,
$25,000.
(ii) Negative net
worth shall be calculated without regard to any surplus created by reevaluation
of assets.
(iii) An application for
approval shall be submitted in writing at least 60 days prior to the proposed
withdrawal and shall specify the purpose of the withdrawal and the details
concerning such withdrawal including, where applicable, such items as the
principal amount, interest rate, repayment terms, conditions of default, remedies
upon default and obligee of any transaction to be consummated in a proposed
withdrawal. The application shall contain a verified current balance sheet and a
description of the facility's cash position, including as cash such cash
equivalents as certificates of deposit and treasury bills.
(iv) In reviewing an application for
withdrawal, the commissioner shall consider:
(a) the necessity for the withdrawal;
(b) whether such withdrawal would impair the
facility's ability to render quality care;
(c) any expense which such withdrawal would
generate; and
(d) the financial
condition of the facility in general.
(8) No facility shall enter into a real
property mortgage or lease transaction without 30 days' prior notice in writing
to the commissioner.
(i)
Admission policies and practices.
(1) The
nursing home shall:
(i) admit a resident only
on physician's orders and in accordance with the resident assessment criteria and
standards as promulgated and published by the department, and specified in
sections
86-2.30(i)
and
400.12 of
this Title, which shall include, as a minimum:
(a) an assessment, performed prior to admission
by or on behalf of the agency or person seeking admission for the resident of the
resident's level of care needs according to the resident assessment criteria and
standards promulgated and published by the department (and specified in sections
86-2.30[i]
and
400.12 of
this Title);
(b) for those residents
failing to meet the criteria and standards for admission to the nursing home (as
indicated in New York State criteria for level of care, specified in section
400.12 of
this Title), a certification signed by a physician member of the transferring
facility's utilization review agent or signed by the responsible social services
district's local Medicaid medical director or designee, indicating the reason(s)
the resident requires nursing home level of care; and
(c) for residents in general hospitals and
residing in the community, the SCREEN, as specified in section
400.12 of
this Title, performed prior to admission to the nursing home shall not be
completed by personnel of a residential health care facility, except where a
certified home health agency or other appropriate community-based assessor has
been contacted by the resident or the resident's designated representative, for
the purpose of completing the SCREEN, and has not completed the SCREEN within 48
hours;
(ii) accept and
retain only those nursing home residents for whom it can provide adequate
care;
(iii) admit each resident only
after a pre-admission personal interview with the resident's physician, the
resident, his or her next of kin and/or sponsor, as appropriate, except that a
telephone interview may be substituted when a personal interview is not feasible,
and a summary of all interviews shall be recorded on the resident's chart or
other appropriate record;
(iv)
maintain a written record of all financial arrangements with the resident, his or
her next of kin and/or sponsor, with copies executed by and furnished to each
party;
(v) make no arrangement for
prepayment for basic services exceeding three months;
(vi) assess no additional charges, expenses or
other financial liabilities in excess of the daily, weekly or monthly basic rate
except:
(a) upon express written approval and
authority of the resident, next of kin or sponsor;
(b) upon express written orders of the
resident's personal, alternate or staff physician stipulating specific services
and supplies not included as basic services;
(c) upon 30 days' prior written notice to the
resident or designated representative, of additional charges, expenses or other
financial liabilities due to the increased cost of maintenance and/or operation
of the nursing home; and, upon request of the resident, designated representative
or of the department, financial and statistical supportive evidence sufficient to
reflect such change in economic status shall be provided; or
(d) in the event of a health emergency
involving the resident and requiring immediate special services or supplies to be
furnished during the period of the emergency;
(vii) provide to each resident or designated
representative at the time of admission, a written copy of the following
information and services which shall be considered as basic information and
services to be made available to all residents:
(a) the daily, weekly or monthly
rate;
(b) board, including
therapeutic or modified diets, as prescribed by a physician;
(c) lodging; a clean, healthful, sheltered
environment, properly outfitted;
(d)
24 hours-per-day nursing care;
(e)
the use of all equipment, medical supplies and modalities, notwithstanding the
quantity usually used in the everyday care of nursing home residents, including
but not limited to catheters, hypodermic syringes and needles, irrigation
outfits, dressings and pads, and so forth;
(f) fresh bed linen, as required, changed at
least twice weekly, including sufficient quantities of necessary bed linen or
appropriate substitutes changed as often as required for incontinent
residents;
(g) hospital gowns or
pajamas as required by the clinical condition of the resident, unless the
resident, next of kin or sponsor elects to furnish them, and laundry services for
these and other launderable personal clothing items;
(h) general household medicine cabinet
supplies, including but not limited to non-prescription medications, materials
for routine skin care, oral hygiene, care of hair, and so forth, except when
specific items are medically indicated and prescribed for exceptional use for a
specific resident;
(i) assistance
and/or supervision, when required, with activities of daily living, including but
not limited to toilet, bathing, feeding and ambulation assistance;
(j) services, in the daily performance of their
assigned duties, by members of the nursing home staff concerned with resident
care;
(k) use of customarily stocked
equipment, including but not limited to crutches, walkers, wheelchairs or other
supportive equipment, including training in their use when necessary, unless such
item is prescribed by a physician for regular and sole use-by a specific
resident;
(l) activities program,
including but not limited to a planned schedule of recreational, motivational,
social and other activities, together with the necessary materials and supplies
to make the resident's life more meaningful;
(m) social services as needed;
(n) physical therapy, on either a staff or
fee-for-service basis, as prescribed by a physician, administered by or under the
direct supervision of a licensed and currently registered physical
therapist;
(o) occupational therapy,
on either a staff or fee-for-service basis, as prescribed by a physician,
administered by or under the supervision of a qualified occupational
therapist;
(p) speech pathology
services, on either a staff or fee-for-service basis, as prescribed by a
physician, administered by a qualified speech pathologist;
(q) audiology services, on either a staff or
fee-for-service basis, as prescribed by a physician, administered by a qualified
audiologist; and
(r) dental services,
on either a staff or fee-for-service basis, as administered by or under either
the personal or general supervision of a licensed and currently registered
dentist;
(viii) apply the
following restrictions to the admission and retention of residents:
(a) residents under 16 years of age shall be
admitted only to a nursing home area approved for such occupancy by the
department and separate and apart from adult residents;
(b) prenatal, intrapartum or postpartum, and
maternity patients shall not be admitted;
(c) residents identified and assessed to need
nursing home care shall not be barred from admission or retention solely on the
basis that they are also maintained on alcohol or substance abuse treatment
programs; and
(d) a resident
suffering from a communicable disease shall not be admitted or retained unless a
physician certifies in writing that transmissibility is negligible, and poses no
danger to other residents, or the facility is staffed and equipped to manage such
cases without endangering the health of other residents;
(ix) not discriminate because of race, color,
blindness, sexual preference or sponsorship in admission, retention and care of
residents;
(x) establish and
implement written policies and procedures governing the admission process which
ensure compliance with State and Federal anti-discrimination laws which apply to
the governing body. Such laws include, but need not be limited to, the applicable
provisions of this Part; Public Health Law, section 280a(9); the New York State
Civil Rights Law, sections 40 and 40-c; article 15 (Human Rights Law) of the
State Executive Law, sections 291, 292 and 296 and title 42 of the United States
Code, sections 1981, 2000a, 2000a-2, 2000d, 3602, 3604 and 3607. Copies of the
cited State and federal statues are available from West Publishing Company, P.O.
Box No. 64526, St. Paul, MN 55164-0526, the publisher of McKinney's Consolidated
Laws of New York annotated and the United States Code annotated. Copies of such
statues are also available for public inspection and copying at the Records
Access Office, Department of Health, Tower Building, Empire State Plaza, Albany,
NY 12237. The policies and procedures shall include but not be limited to the
following:
(a) the prominent inclusion in
admission application forms and policy statements of a legend summarizing the
applicable federal and State anti-discrimination laws;
(b) the prominent display in the admissions
office of the New York State Division of Human Rights nondiscrimination
regulatory poster. This poster is available from the State Division of Human
Rights, 55 West 125 Street, New York, NY 10027. A copy of this poster is also
available for public inspection and copying at the Department of Health's Records
Access Office at the address set forth above;
(c) explicit advice to potential patients of
their right to nondiscriminatory treatment in admissions;
(d) the training of admission personnel in the
requirements of federal and State anti-discrimination laws listed above;
and
(e) written admission policies
which specifically state the criteria used in making admission decisions. If a
waiting list is used in making admission decisions, the list shall be maintained
in written form including the date of each application. The operation and
utilization of the waiting list shall be described in the written admission
policies;
(xi) furnish to
all hospitals within the long-term care planning area and to any hospital,
referral agency, or individual upon request a copy of the facility's admission
policies; and
(xii) maintain a
centralized log on the receipt and disposition by the facility of persons
referred for admission. For the purposes of this subdivision, receipt by the
facility of a completed hospital/community patient review instrument for a person
needing nursing home care shall constitute a patient referral. The log shall
contain for each referral a patient identifier, and indicate the race, sex,
color, national origin of the referral, the date of referral, referring hospital
or agency, and date and type of disposition of referral by the facility. Records
of such log shall be retained for 18 months from date of entry. In lieu of a log,
a facility may meet the requirements of this subdivision by retaining the
completed hospital/community patient review instrument forms received by the
facility for 18 months from receipt in a central place organized by date of
receipt and marked by date and type of disposition.
(2) The nursing home shall advise each
potential resident or designated representative prior to or at the time of
admission, that all medical and dental services which are provided by the
facility will be provided by practitioners who have an affiliation with the
facility. Potential residents whose personal attending physician or dentist is
not approved to provide services to the resident after admission shall be duly
notified prior to or at the time of admission. The facility shall promptly
receive and evaluate requests by such personal attending physician or dentist, to
be approved to attend to such prospective resident consistent with resident care
policies and procedures of the facility.
(3) The nursing home shall advise each
potential resident or designated representative that he or she may seek a second
opinion if he or she disagrees with the diagnosis or treatment being provided,
and may call in a specialist selected by the resident or designated
representative for medical consultation. The facility shall not be required to
bear the expense of such visit.
(j) Misappropriation of resident property. The
nursing home shall establish and implement policies and procedures for the
receipt, review and investigation of allegations of misappropriation of resident
property by individuals in the employ of and/or whose services are utilized by
the facility. Such policies and procedures shall be coordinated with the process
governing the handling of complaints as set forth in section
415.3 of this
Part.
(1) For purposes of this subdivision,
misappropriation of resident property shall mean the theft, unauthorized use or
removal, embezzlement or intentional destruction of the resident's personal
property including but not limited to money, clothing, furniture, appliances,
jewelry, works of art, and such other possessions and articles belonging to the
resident regardless of monetary value.
(2) In accordance with policies and procedures
governing misappropriation of resident property, the nursing home shall:
(i) ensure that upon receipt of an allegation
of misappropriation as submitted by the resident, designated representative,
other individual or source, an investigation of the matter shall be undertaken
not later than 48 hours after receipt;
(ii) maintain a log containing information
regarding the receipt, review, investigation, and disposition of every allegation
of misappropriation of resident's property including the name of the complainant
and the resident, a description of the personal property involved, and staff
designated to conduct the review and investigation;
(iii) notify the resident and complainant in
writing as to the findings upon disposition of the allegation;
(iv) notify the appropriate police agency when
the results of the investigation indicate there is reasonable cause to believe
that a resident's personal property valued at more than $250 has been
misappropriated or may elect to make such notification when the resident's
personal property is valued at less than that amount;
(v) monitor the status of all referrals to a
police agency on a regular basis but not less often than quarterly; and
(vi) notify the department within 72 hours of
receipt of the notice that such referral resulted in conviction of an individual
who was involved in misappropriation of resident property.
(3) Upon receipt of such notice of criminal
conviction involving misappropriation of property by a nurse aide and after the
department has provided to the individual an opportunity to be heard to dispute
the allegations and conviction resulting from misappropriation of resident
property, the department shall, pursuant to Public Health Law, section
2803-d, as amended by chapter 717 of the
Laws of 1989, report such finding to the New York State RHCF Nurse Aide Registry
established in accordance with Public Health Law, section
2803-j, as amended by such chapter. Any
brief statement not exceeding 150 words by the nurse aide disputing the findings
shall also be included in the report, provided that any such statement containing
the names of any resident or complainant shall be returned to the submitting
individual and shall not be reported to the registry.
(k) Feeding assistant training course.
(1) The feeding assistant training program
shall consist of a minimum of 15 hours of education and training and must include
all of the topics and lessons specified in the State-approved feeding assistant
training program curriculum.
(2) The
State-approved feeding assistant training program shall include, but not be
limited to, training in the following content areas:
(i) resident rights;
(ii) infection control;
(iii) safety and emergency procedures,
including Heimlich Maneuver;
(iv)
communications and interpersonal skills;
(v) changes in resident's condition;
(vi) appropriate response to resident
behavior;
(vii) assistance with
eating and hydration; and
(viii)
feeding techniques.
(3)
The facility shall issue a certificate of completion to each individual who
successfully completes the State-approved feeding assistant training program. The
certificate shall include the full name of the feeding assistant and the
facility-issued trainee or employee ID number, signature of feeding assistant,
name and address of the facility, date the individual successfully completed the
feeding assistant training program, name, title and signature of the training
program instructor, and name and signature of the nursing home
administrator.
(4) The facility shall
retain records of each individual who completes their State-approved feeding
assistant program. Such records shall include, but not be limited to:
(i) the full name of the feeding assistant,
facility-issued trainee or employee ID number, name and address of the facility,
dates on which each content area of the feeding assistant training program was
delivered and successfully completed, the date on which the individual
successfully completed the feeding assistant training program, and the name,
title and signature of the training program instructor.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.