Ohio Admin. Code 5122-30-25 - Skilled nursing care and changes in a resident's health status
(A)
A class two or class three facility may not provide
physical health care activities for the treatment of a serious illness or
disease, defined as skilled nursing care in accordance with section
3721.01 of the Revised Code.
Skilled nursing care shall be considered to be provided by a residential
facility if it is provided by a person employed by or associated with the
facility, including a home healthcare company owned by or associated with the
owner/operator, or by another person pursuant to an agreement to which neither
the resident who receives the services nor their custodian or legal guardian is
a party. In the event of such serious illness or disease, the resident may make
arrangements for necessary home health, visiting nurse, or similar services. If
the resident need assistance in making arrangements, staff of a class 2
facility shall assist the resident in making these arrangements or assure
another entity is available to provide the assistance.
"Skilled nursing care" means procedures that require technical skills and knowledge beyond those the untrained person possesses and that are commonly employed in providing for the physical, mental, and emotional needs of the ill or otherwise incapacitated. "Skilled nursing care" includes, but is not limited to, the following:
(1)
Irrigations,
parameterizations, application of dressings, and supervision of special
diets;
(2)
Objective observation of changes in the patient's
condition as a means of analyzing and determining the nursing care required and
the need for further medical diagnosis and treatment;
(3)
Special
procedures contributing to rehabilitation;
(4)
Administration of
medication by any method ordered by a physician, such as hypodermically,
rectally, or orally, including observation of the patient after receipt of the
medication;
(5)
Administering tube or syringe feedings or parenteral
nutrition;
(6)
Carrying out other treatments prescribed by the
physician that involve a similar level of complexity and skill in
administration.
(B)
No class two facility shall admit or retain any
resident in need of skilled nursing care unless the care will be provided on a
part-time, intermittent basis; consisting of fewer than eight hours in a
twenty-four hour day, or fewer than forty hours in a seven day period, and not
more than a total of one hundred twenty days in any twelve-month period. The
skilled nursing care must be provided by an appropriately licensed employee or
contract employee of one or more of the following:
(1)
A home health
agency certified under Title XVIII of the "Social Security Act," 49 Stat. 620
(1935),
42 U.S.C.
301, as amended.
(2)
A hospice care
program licensed under Chapter 3712. of the Revised Code.
(3)
A mental health
or substance use treatment provider, or board.
(C)
In class two
facilities, the facility shall monitor and report changes in the health status
of residents that would require a change in facility type or referral for
skilled nursing care or licensed health professional intervention and contact
the resident's physician, source of medical care, or case manager with in
twenty-four hours. When a resident is observed to have difficulty in
self-administering medication, a new assessment of the resident's capacity to
self-administer the medications prescribed for them with or without assistance
must be obtained. If an updated assessment determines that the resident is no
longer capable of self-administering medication, the facility must provide a
discharge or transfer notice to the resident in accordance with rule
5122-30-27 of the Administrative
Code. An operator may not transfer such a resident to another class two
residential facility.
(D)
Class two facilities shall in the event of acute
illness, accident, nursing facility admission, or hospitalization of a
resident, contact the resident's physician or source of medical care
immediately. The operator shall also notify any emergency contact
pre-designated by the resident, and the resident's case manager, if applicable,
as soon as possible, but not later than twenty-four hours after the emergency
occurs. The operator shall document the occurrence and contacts in the
resident's record.
(E)
A resident in a class three facility may retain and
utilize a visiting nurse, home health nurse or any other needed medical
services.
Replaces: 5122-30-25
Notes
Promulgated Under: 119.03
Statutory Authority: 5119.34
Rule Amplifies: 5119.34
Prior Effective Dates: 5/10/79, 5/1/81, 1/1/00, 8/1/02
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