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: (3) Personal comfort items, including smoking materials, notions and novelties, and confections. 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. . Facility discharge planning staff shall arrange for any home modifications, equipment or assistance expected to be required of the resident in the new setting. (c) Items and services that may be charged to residents' funds. 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. Nursing home abuse is a serious problem in the United States. Nurse aides assist nursing home residents in bathing, dressing, eating, toileting, and other tasks. Title: Part 415 - Nursing Homes - Minimum Standards Effective Date 01/26/2023 Part 415 - Nursing Homes - Minimum Standards GENERAL RESIDENTIAL RIGHTS AND SERVICES CLINICAL SERVICES ADMINISTRATIVE OPTIONAL SERVICES Statutory Authority Public Health Law, Sections 2803 (2), 2803 (6), 2803-c and 2803-h Volume VOLUME C (Title 10) up The resident may be completely unresponsive to any stimuli or may exhibit a generalized response by reacting inconsistently and non-purposefully to stimuli in a nonspecific manner. Clinical laboratory means a facility for the microbiological, immunological, chemical, hematological, biophysical, cytological, pathological, genetic or other examination of materials derived from the human body, for the purpose of obtaining information for the diagnosis, prevention or treatment of disease, or the assessment of a health condition, or for identification purposes. Nursing homes and adult care facilities must facilitate vaccinations for all residents. 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. Terminal illness is defined as a medical life expectancy of six months or less if the illness runs its normal course. 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. 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. (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. (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; or, (ii) a document indicating one dose of live virus rubella vaccine was administered on or after the age of twelve 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 (i) or (ii) of this subclause, which comes from a previous employer or the school which the employee attended as a student; and. When this service is provided, the operator shall ensure that: the radiographic procedures requiring the use of contrast media or fluoroscopic interpretation and control are performed with the active participation of a qualified specialist in diagnostic radiology or a physician qualified in a medical specialty related to the radiographic procedure. Occupational therapists provide these services on the referral or prescription of a physician, physician assistant, or nurse practitioner. (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. (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. Such reimbursement shall be on a pro rata basis based on the length of subsequent employment as an RHCF nurse aide in the RHCF. The facility shall provide comprehensive and coordinated health services and the operator must provide or make arrangements for: case management services; substance abuse services, if appropriate; mental health services; HIV prevention and counseling services; pastoral counseling; TB screening and on-going follow up, and specialized medical services including gynecology, as needed. 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. All personnel making such report shall be referred to an appropriate health care professional for assessment of the risk to residents and personnel. (1) basic nutritional requirements for foods and fluids; (ii) feeding the resident who needs assistance; 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. Most of the daily care furnished to nursing home residents is rendered by the nearly 696,000 nurse aides employed by nursing homes. 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. Safety in the Community Materials Test Infection Control Materials Test Adult and Child Abuse Materials Test Fire Safety Materials Test 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. (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. (b) Funds less than $50. (b) Governing Body. (xii) maintain a centralized log on the receipt and disposition by the facility of persons referred for admission. (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. 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. 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. To certify a SNF or NF, a state surveyor completes at least a Life Safety Code (LSC) survey, and a Standard Survey. (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. (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. In order to establish eligibility for hospice care, the patient's physician and the hospice medical director must certify that the patient is terminally ill, the patient or authorized representative must elect the hospice benefit in writing, and a hospice plan of care must be established. 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. (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. (5) methods of reducing the effects of cognitive impairments. (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. 17,000 nursing homes, and in Fiscal Year 2000, Medicare and Medicaid paid more than $45 billion to nursing homes. (v) Assurance of financial security. Schedules for scheduled short term care are generally pre-arranged and shall be limited to one or more periods of from one to 30 days and shall not exceed 42 days in any one year except in extraordinary circumstances, such as sudden illness of the primary caregiver or temporary unfitness of the individual's principal residence. Positive findings shall require appropriate clinical follow-up. The trainee shall have three opportunities to pass the clinical skills examination; and. 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. 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. 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. Staff are trained to manage behavior and promote effective care of dementia patients by arranging the environment in ways that produce positive outcomes for patients. Residents shall be assessed as to their ability to be weaned from their ventilatory dependence. The goal of scheduled short term care is to provide relief for the caregiver(s) while providing nursing home care for the individual. (c) Staff qualifications and personnel management. (a) The system shall preclude any commingling of resident funds with facility funds or with the funds of any person other than another resident. 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. Nursing Home Profiles provides useful information about every nursing home in New York State. 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. 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. (k) Observing and reporting signs and symptoms of disability and illness: (i) determination of temperature, pulse, respiration; (3) recognizing and reporting abnormal signs and symptoms of common diseases and conditions, including but not limited to: (xv) foul-smelling or concentrated urine; and. The facility shall not be required to bear the expense of such visit. Licensed Professions: Nursing. 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. In-service requirements: State and federal in-service education mandates include 12 hours per year for home health aides (HHAs) and 6 hours per year for personal care aides (PCAs). The Nursing Home Profiles quality data for all . The program coordinator may be the director of nursing services provided that the director of nursing services does not perform the actual training. (1) physiology of bowel and bladder continence: (ii) physical, psychosocial and environmental causes of incontinence; (2) nursing care for the resident with urinary and/or bowel incontinence: (4) bowel and bladder training programs; and. (iv) a copy of a document described in (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. Half of all nursing home attendants have admitted abusing or neglecting elderly patients at some point in their careers, according to research from 2010.The elderly are some of the most vulnerable members of our society, and the law has certain safeguards in place in order to help prevent such abuses. (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. Facilities with special populations shall supplement the curriculum to address the needs of such populations accordingly. No charges shall be made to residents for those services. The required training and in-services for nursing home employees are grouped into several categories: General requirements, abuse prevention and reporting requirements, safety requirements, infection control and prevention requirements, and specialized requirements for identified employees. (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. A physical therapist assistant is a licensed health care professional who provides treatment according to a plan developed by and under the supervision of a licensed physical therapist to assist in providing physical therapy services. (ii) Accounting and records. (c) The facility shall assure that each nurse aide receives at least twelve hours of formal in-service education each year. Quality of life achieved. Residents shall be assessed as to their ability to be discharged to home or to a home-like setting with or without supportive services. (iv) maintenance of records of these activities, including the methods used and an evaluation on their effectiveness. The curriculum shall otherwise include but not be limited to the following: (iv) psychological and cognitive changes; and. (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. 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. Those services included in the daily rate. (2) working with resident and family during admission/transfer/discharge; (4) sexual adjustments in relation to illness, physical handicaps and institutional living. (ii) After passing the clinical skills examination, the trainee shall have three opportunities to pass the written or oral competency examination. 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. 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. The facility shall employ a qualified dietitian either full-time, part-time or on a consultant basis who shall . Initiation of CPR - Prior to the arrival of emergency medical services (EMS), nursing homes must provide basic life support . (4) Nurse aide competency evaluation. (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. (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 section, 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. Training conducted for purposes of orienting new aides does not count toward meeting the annual 6 or 12-hour aide in-service requirement. The state Department of Health (DOH) has issued guidance to address the in-service training requirements for personal care aides (PCAs) and home health aides (HHAs) during the COVID-19 pandemic. (b) Optional covered items and services. 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. 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; (5) routine personal hygiene items and services. (ii) The training program shall maintain a performance record of the major duties and skills taught each nurse aide trainee. 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. 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. (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. The population served shall consist primarily of individuals with traumatically acquired, non-degenerative, structural brain damage resulting in residual deficits and disability. (4) For all services and departments, the facility shall maintain: (d) Nurse aide certification and training. (1) The facility shall: (i) specify its refund policies in writing to each resident, next of kin and/or sponsor prior to admission; and. Section 441.317 - Sub-acute care services. A resident admitted for coma management shall be a person who has suffered a traumatic brain injury with structural non-degenerative brain damage, and is in a coma. (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; (6) resident abuse and neglect reporting requirements as set forth in section 2803-d of the Public Health Law. Require supervision, monitoring, preventive, diagnostic, therapeutic, rehabilitative or palliative care or services but do not require continuous 24-hour-a-day inpatient care and services to maintain their health status and enable them to remain in the community. You may see these icons in your state requirements below: Renew during Compliance Period Renew in Specified Time Retake 8hr for Missed Renewal Non-Resident Supplement Required Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts (3) communicating with residents who have sensory loss, memory, cognitive or perceptual impairment. The facility may charge the resident for requested services that are more expensive than or in excess of covered services. 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. (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. (a) Direction. (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. (j) Misappropriation of resident property. (ii) Nursing homes with 40 beds or fewer 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. 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. (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. In order to work as a certified nurse aide (CNA) in New York State, a person must successfully complete a nurse aide training program (NATP) delivered only by a program approved by NYSED or NYSDOH. 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. In-service education may be obtained through web-based training programs. 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. (a) Services included in Medicare or Medicaid payment. Fiscal Year. 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.. (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. (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. 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. (iii) carry out staff drills in accordance with the written plan at least twice a year. 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