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; and. 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. Every law enforcement officer in Massachusetts is required to complete the annual in-service training as prescribed in Chapter 253 of the Acts of 2020, Section 22. Residents shall be assessed as to their ability to be discharged to home or to a home-like setting with or without supportive services. (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. 04/09/1997. This program is intended to serve long-term ventilator dependent residents. (3) Nurse aide training program. (3) provide for the transfer of medical and other information needed for care and treatment of residents, when the transferring facility deems it appropriate. 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. 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. Skilled nursing facilities (SNFs) and nursing facilities (NFs) are required to be in compliance with the requirements in 42 CFR Part 483, Subpart B, to receive payment under the Medicare or Medicaid programs. (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. (1) The facility shall: (i) specify its refund policies in writing to each resident, next of kin and/or sponsor prior to admission; and. ; 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; hospital gowns or pajamas as required by the clinical condition of the resident, unless the resident, family member or designated representative elects to furnish them, and laundry services for these and other launderable personal clothing items; general household medicine cabinet supplies, including but not limited nonprescription medications, materials for routine skin care, dental hygiene, care of hair, etc., except when specific items are medically indicated and prescribed for exceptional use for a specific resident; assistance and/or supervision, when required, with activities of daily living, including but not limited to toileting, bathing, feeding and assistance with getting from place to place; services, in the daily performance of their assigned duties, by members of the nursing home staff assigned to resident care; 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 items are prescribed by a doctor for regular and sole use by a specific resident; 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; provision of optician and optometrist services; physical therapy, occupational therapy, speech pathology services, audiology services and dental services, on either a staff or fee-for-services basis, as prescribed by a doctor, administered by or under the direct supervision of a licensed and currently registered physical therapist, occupational therapist, speech pathologist, qualified audiologist or registered dentist. Inspection results are reported by the Department in writing to the agencies within two weeks of the survey. (e) written admission policies which specifically state the criteria used in making admission decisions. (5) If a resident authorizes the facility in writing to manage his or her personal finances in accordance with 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: (a) Funds in excess of $50. Minimum Qualifications A valid New York State license and current registration to practice as a Registered Professional Nurse in New York State; and Holds, or obtains through facility orientation, a valid and current certification in Basic Life Support (BLS) through the American Heart Association (AHA); and A Master's Degree in Nursing, or a . (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. (d) the person within the facility to contact for this information. Federal legislation (the Omnibus Budget Reconciliation Act of 1987) and associated regulations (42 CFR 483.152) require that Medicare- and Medicaid-certified nursing homes employ nurse aides who are trained and evaluated through training programs approved by their states. Such services include not only service to the patient but also instructions to responsible members of the family in follow-up procedures necessary for the care of the patient. (c) two years of experience teaching nurse aides in a residential health care facility. Occupation therapy is provided by an occupational therapist that is a licensed rehabilitation care professional, which works to restore or improve physical abilities, promote behavioral changes, adapt surroundings, and teaches new skills; the goal is to have the individual achieve her or his best physical and/or mental functioning in daily life tasks. Safety of residents. (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. (ii) Negative net worth shall be calculated without regard to any surplus created by reevaluation of assets. (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. (d) the financial condition of the facility in general. To obtain recertification the certified nurse aide shall demonstrate in the form indicated by the Department that he/she has worked at least 7 hours for compensation as a health care nurse aide during the previous 24 month period. Services shall be directed at restoring each resident to his or her optimal level of functioning and assisting each resident to achieve maximum independence from mechanical ventilation. ADHC program provides the health care services and activities provided to a group of persons, who are not residents of a residential health care facility, but are functionally impaired and not homebound. Such laws include, but need not be limited to, the applicable provisions of this Part; Public Health Law, section 2801-a(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 Unites States Code, sections 1981, 2000a, 2000a-2, 2000d, 3602, 3604 and 3607. (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. (2) working with resident and family during admission/transfer/discharge; (4) sexual adjustments in relation to illness, physical handicaps and institutional living. When such potential is identified, the facility shall initiate an active program of therapy and other supportive services designed to assist the resident in the transition to the new setting. (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. Facility discharge planning staff shall arrange for any home modifications, equipment or assistance expected to be required of the resident in the new setting. Such examinations shall include procedures to determine, measure, or otherwise describe the presence or absence of various substances, components or organisms in the human body. (iv) maintenance of records of these activities, including the methods used and an evaluation on their effectiveness. In-service education may be obtained through web-based training programs. (c) Staff qualifications and personnel management. As a follow up to its October 13, 2020 guidance, DOH is extending its "enforcement discretion" for surveys involving PCA in-service training . (j) Misappropriation of resident property. New residents arrive continually, and employees leave; turnover among nursing staffs in nursing homes is extraordinarily high, an annual average of 128 percent, a new study has found.. Physical therapy is provided by a physical therapist that is a licensed health care professional, which examines and evaluates a patient's condition and then plans and administers treatments to promote optimal health. The curriculum shall otherwise include but not be limited to the following: (iv) psychological and cognitive changes; and. 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. Physical therapists seek to relieve pain, improve the body's movement and function, maintain cardiopulmonary function, restore, maintain and promote optimal physical function; and limit disabilities resulting from injury or disease. (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 or kin and/or sponsor. The Centers for Medicare & Medicaid Services (CMS) issued the mandate in 2016 and gave facilities three years to become compliant. 280 or by faxing 518-474-3398.; The State Education Department is not responsible for any fees paid to an outside testing or credentials . 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. The Nursing Home Profiles quality data for all . Inspections and complaint information. board, including therapeutic or modified diets, as prescribed by a doctor; lodging - a clean, healthful, sheltered environment, properly outfitted; the use of all equipment, medical supplies and modalities used in the care of nursing home residents, including but not limited to catheters, hypodermic syringes and needles, irrigation outfits, dressings and pads, etc. Hospice shall mean a coordinated program of home and inpatient care which treats the terminally ill patient and family as a unit, employing an interdisciplinary team acting under the direction of an autonomous hospice administration. Occupational therapy assistants provide treatment according to a plan developed by or in collaboration with a licensed occupational therapist. Nursing Homes provide 24 hour a day nursing care, case management, health monitoring, personal care, nutritional meals and special diets, physical, occupational, and speech therapy, social activities and respite care for those who are ill or physically infirm. 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. 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. Nursing Homes. Nursing homes and adult care facilities must facilitate vaccinations for all residents. 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. Section 441.317 - Sub-acute care services. Those residents who are assessed as potentially able to be weaned from dependence on support with mechanical ventilation or whose daily use of ventilator support may be reduced shall receive an active program of therapy and other supportive services designed for that resident to reduce or eliminate his or her need for use of a ventilator. The head-injury program shall be designed specifically to serve medically stable, traumatically brain-injured individuals with an expected length of stay from 3 to 12 months. Initiation of CPR - Prior to the arrival of emergency medical services (EMS), nursing homes must provide basic life support . (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. (iii) Program approval will be granted for a term not to exceed 2 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. Each approved adult day health care session must operate for a minimum of five hours duration, not including time spent in transportation. (2) care of personal belongings such as clothing, dentures, eyeglasses, hearing aids and prostheses. (5) care of ostomies, including but not limited to colostomy and ileostomy. ISBN: 978-1-64535-132-. The goal of scheduled short term care is to provide relief for the caregiver(s) while providing nursing home care for the individual. (q) Care of the dying resident including care of the body and personal effects after death; and. This poster is available from the State Division of Human Rights, 55 West 125 Street, New York, NY 10027. Individuals who withdraw their licensure application may be entitled to a partial refund.. For the procedure to withdraw your application, contact the Nurse Unit by e-mailing opunit4@nysed.gov or by calling 518-474-3817 ext. (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. The report identifies each rule that is violated, along with a description of the evidence to support the finding. The certified nurse aide shall be recertifed every two years no later than the last day of the month in which certification was received. The federal Nursing Home Reform law requires nursing facilities to have "sufficient" staff to meet their residents' needs. 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. Section 441.320 - Teaching program (approved), Section 441.321 - Teaching program (nonapproved), Part 442 - Reporting Principles And Concepts, Section 442.12 - Matching of revenue and expenses, Section 442.13 - Deductions from operating revenue, Section 442.15 - Long-term security investments, Section 442.18 - Accounting for property, plant and equipment, Section 442.23 - Debt financing for plant replacement and expansion purposes, Section 442.24 - Direct assignment of costs, Section 442.25 - Hospital research and education costs, Section 442.26 - In-service education--nursing, Section 442.27 - In-service education--nonnursing, Section 442.29 - Periodic interim payments, Section 443.2 - Functional and responsibility concepts, Section 443.4 - Listing of accounts--balance sheet, Section 443.5 - Listing of accounts--income statement, Section 443.6 - Small hospital reduced reporting requirements, Section 443.7 - Natural classification of revenue, Section 443.8 - Natural classification of expense, Section 444.2 - Unrestricted Fund assets, Section 444.4 - Unrestricted fund liabilities, Section 444.5 - Restricted fund liabilities, Section 444.8 - Operating revenue accounts--general, Section 444.9 - Operating revenue--daily hospital services, Section 444.10 - Operating revenue--ambulatory services, Section 444.11 - Operating revenue--ancillary services, Section 444.12 - Operating revenue--other operating revenue, Section 444.13 - Operating revenue--deductions from revenue, Section 444.14 - Patient revenue account descriptions, Section 444.15 - Other operating revenue account descriptions, Section 444.16 - Deductions from revenue account descriptions, Section 444.17 - Operating expenses--general, Section 444.18 - Daily hospital services expenses description, Section 444.19 - Ambulatory services expenses description, Section 444.20 - Ancillary services expenses description, Section 444.21 - Other operating expenses description, Section 444.22 - Non-operating revenue and expenses description, Section 444.23 - Natural classification of expense, Section 445.2 - Job titles by natural classification index, Section 445.3 - Supplies and services by natural expense classification index, Section 446.2 - Reclassification for reporting purposes, Section 446.3 - Reclassification for cost finding purposes, Section 446.4 - Alternative cost allocation bases--sequence of allocation, Section 446.5 - Recommended cost allocation bases--listing, Section 446.6 - Definitions and sources of statistics for Medicaid cost allocation, Section 446.7 - Description of other New York State supplemental data, Section 446.8 - Definitions and sources of statistics for Medicaid cost allocation, Section 446.9 - Expense detail reporting, Section 446.10 - Identification of supplemental data, Section 446.12 - Accommodation classification, Section 446.14 - Changes in certified bed capacity, Section 446.16 - Source of payment defined, Section 446.17 - Gross charges by source of payment, Section 446.18 - Patient days by source of payment, Section 446.19 - Discharges by source of payment, Section 446.20 - Ambulatory visits by source of payment, Section 446.21 - Direct admissions from emergency room, Section 446.22 - Inpatient care statistics by unit, Section 446.23 - Ambulatory care statistics, Section 446.25 - Home medical care program, Section 446.26 - Organized Drug Addiction Program, Section 446.27 - Organized alcoholic treatment program, Section 446.28 - Selected special service statistics, Section 446.30 - Cost allocation adjustments, Section 446.36 - Supplemental data for both upstate and downstate Blue Cross plans, Section 446.37 - Cost allocation adjustments, Section 446.38 - Funded depreciation calculation, Section 446.39 - Funded depreciation waiver, Section 446.41 - Hospital-based home health agencies, Section 446.44 - Program services for supplemental data, Part 447 - Standard Unit Of Measure References, Section 447.3 - Neurology--Diagnostic Services, Section 447.4 - Physical therapy services, Section 447.5 - Occupational Therapy Services, Section 448.1 - Specifications for cost reporting periods beginning in 1980, Title: Part 415 - Nursing Homes - Minimum Standards. (b) The individual financial record shall be available within one business day of a request, to the resident or his or her designated representative. The program provides palliative and supportive care to meet the special needs arising out of physical, psychological, spiritual, social and economic stresses which are experienced during the final stages of illness, and during dying and bereavement. (7) Equity withdrawal. (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. (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. 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