제안 텍스트
이 장에서 사용되는 다음 단어와 용어는 문맥상 달리 명시되지 않는 한 다음과 같은 의미를 갖습니다:
"학대(" )란 개인(보호자 포함)이 고의로 신체적 상해, 부당한 감금, 협박, 또는 신체적 고통이나 정신적 고통을 초래하는 처벌을 가하거나, 신체적, 정신적, 심리사회적 안녕을 유지하거나 달성하기 위해 필요한 물품이나 서비스를 박탈하는 행위를 의미합니다. 이에는 언어적, 성적, 신체적 또는 정신적 학대가 포함됩니다.
"관리자" 는 버지니아주 장기요양관리자 위원회에서 면허를 취득하고 요양 시설 관리에 필요한 권한과 책임을 가진 개인을 의미합니다.
"입학(" )은 오리엔테이션, 규칙 및 요구 사항, 적절한 직원 배정 등 요양 시설에 입소하는 절차를 의미합니다. 일시적 결석 후 시설에 재입소하는 것은 입소에 포함되지 않습니다.
"사전 의료 지시서" 는 (i) 버지니아주 법령 § 54 의 요건에 따라 신고자가 자발적으로 작성한 증인이 있는 서면 문서(1-2983 ) 또는 (ii) 신고자가 말기 질환을 앓고 있다고 진단받은 시점 이후에 작성하고 § 54 의 규정에 따른 증인이 있는 구두 진술서(1-2983 )를 의미합니다.
"평가(" )는 서비스의 기반이 되는 프로필을 개발하기 위해 레지던트를 평가하는 과정을 의미합니다. 평가에는 여러 분야의 직원이 거주자의 치료 필요성을 판단하는 데 도움을 주기 위해 초기 및 지속적으로 정보를 수집하고 거주자별 데이터를 수집 및 검토하는 작업이 포함됩니다.
"주치의" 는 현재 버지니아주 의사회에서 면허를 취득하고 레지던트 또는 법정 대리인이 레지던트의 의료 서비스 제공을 결정하는 데 주된 책임이 있는 것으로 확인된 의사를 의미합니다.
"장애물 범죄" 는 버지니아주법 § 19-2-392-02 의 장애물 범죄 정의 조항 (i)에 명시된 모든 위반 행위를 의미합니다.
"이사회" 는 보건위원회를 의미합니다.
"칸나비디올 오일" 은 버지니아주 법령의 § 54 의 하위 섹션 A 에 정의된 용어와 동일한 의미입니다.1-3408-3.
"공인 간호조무사" 는 버지니아주 간호위원회에서 정의한 인증 요건을 충족하고 간호조무사 등록부에 등재된 개인만 사용할 수 있는 직함을 의미합니다.
"화학적 구속(" )이란 개인이 최고 수준의 기능에 도달하지 못하게 하는 의학적 증상이나 정신 질환 또는 정신 지체의 증상을 치료하는 데 필요하지 않고 훈육이나 편의를 위해 사용되는 정신약물(기분, 정신 상태 또는 행동을 조절하기 위해 처방되는 약물)을 의미합니다.
"임상 기록" 은 직접 또는 간접적인 거주자-제공자 간 상호작용을 통해 제공되는 신체적 또는 정신적 의료 서비스에 대한 문서를 의미합니다. 의사 및 기타 의료 전문가가 검사 결과, 약품, 진행 상황 메모를 포함한 평가 및 치료 세부 정보 등 다양한 거주자 건강 정보를 수집한 계정입니다.
"커미셔너" 는 주 보건국장을 의미합니다.
"불만" 은 시설 직원이 신고한 사건을 제외하고 보건부에 접수된 모든 신고를 의미합니다. 이러한 혐의에는 학대, 방치, 착취 또는 주 또는 연방 법률 또는 규정 위반이 포함됩니다.
"종합 치료 계획(" )이란 평가 데이터를 기반으로 거주자의 임상 및 심리사회적 필요, 이러한 필요를 충족하기 위한 개입, 측정 가능한 치료 목표를 식별하고 명시된 목표를 달성하기 위한 거주자의 진행 상황을 문서화한 서면 실행 계획을 의미합니다.
"건설(" )은 새로운 요양 시설의 건설 또는 기존 요양 시설의 확장, 리모델링 또는 변경을 의미하며, 시설의 초기 및 후속 장비를 포함합니다.
"범죄 기록 보고서" 는 금지 범죄에 대한 유죄 판결 또는 버지니아 주 경찰청의 중앙 범죄 기록 교환소의 범죄 이력 기록에 관한 범죄 기록 클리어런스를 의미합니다.
"부서" 는 버지니아주 보건부를 의미합니다.
"존엄성" 은 직원이 거주자와의 상호작용에서 거주자의 자존감과 자존감을 유지하고 향상시키는 데 도움이 되는 활동을 수행한다는 의미입니다.
"퇴원(" )이란 요양 시설에서 제공한 거주자의 서비스가 종료되는 절차를 의미합니다.
"퇴원 요약서" 는 요양 시설 퇴원 시 제공된 서비스, 달성한 목표, 퇴원 후 계획 또는 최종 처분에 대한 최종 서면 요약서를 의미합니다. 퇴원 요약은 임상 기록의 일부가 됩니다.
"의약품(" )이란 (i) 미국 공식 "의약품" 약전 또는 미국 공식 동종요법 약전 또는 이에 대한 보충서에서 인정된 물품 또는 물질, (ii) 사람 또는 다른 동물의 질병 진단, 치료, 완화, 치료 또는 예방에 사용하기 위한 물품 또는 물질을 의미합니다; (iii) 사람 또는 다른 동물의 신체 구조 또는 기능에 영향을 미치기 위한 식품 이외의 물품 또는 물질; (iv) (i), (ii) 또는 (iii)항에 명시된 물품의 구성 요소로 사용하기 위한 물품 또는 물질. 여기에는 기기나 그 구성 요소, 부품 또는 액세서리는 포함되지 않습니다.
"전자 모니터링(" )이란 거주자의 방에 설치된 오디오 기능이 있거나 없는 무인 비디오 녹화 시스템을 의미합니다.
"비상 대비 계획" 은 요양 시설의 치료 제공 능력을 방해하는 자연 재해 또는 기타 비상 사태의 결과를 관리하기 위해 고안된 요양 시설의 안전 관리 프로그램의 구성 요소를 의미합니다.
"직원" 은 풀타임 또는 파트타임으로 금전적 보수를 받고 특정 직무를 수행하는 사람을 의미합니다.
"Facility-managed" means an electronic monitoring system that is installed, controlled, and maintained by the nursing facility with the knowledge of the resident or resident's responsible party legal representative in accordance with the facility's policies.
"풀타임(" )이란 요양 시설에서 주당 최소 35 시간 이상 근무하는 것을 의미합니다.
"Guardian" means a person legally invested with the authority and charged with the duty of taking care of the resident, managing his property, and protecting the rights of the resident who has been declared by the circuit court to be incapacitated and incapable of administering his own affairs. The powers and duties of the guardian are defined by the court and are limited to matters within the areas where the resident in need of a guardian has been determined to be incapacitated.
"법정대리인" 이란 거주자의 업무 수행을 위해 거주자를 대리하거나 거주자를 대신할 법적 책임이 있는 사람을 의미합니다. 여기에는 후견인, 후견인, 영구 위임장에 따른 사실상의 대리인, 수탁자 또는 관할 법원 또는 거주자가 대리인의 대리권 범위를 명시한 법적 문서에서 대리인으로 명시적으로 지정한 기타 사람이 포함될 수 있습니다. 법정 대리인은 법적 권한이 있는 직무에 대해서만 거주자를 대리하거나 거주자를 대신할 수 있습니다.
"약물" 은 처방약 또는 일반 의약품을 포함하여 경구 복용하거나 주사, 삽입, 국소 도포 또는 기타 방식으로 투여하는 모든 물질을 의미합니다.
"방임(" )이란 거주자의 건강, 안전 또는 안락함을 얻거나 유지하는 데 필요한 서비스, 치료 또는 돌봄을 적시에 일관되게 제공하지 않거나 신체적 상해, 정신적 고통 또는 정신 질환을 피하는 데 필요한 재화와 서비스를 적시에 일관되게 제공하지 않는 것을 의미합니다.
"요양 시설" 은 버지니아주 법령의 § 32-1-123 에 정의된 모든 요양원을 의미합니다.
"OLC" 는 버지니아주 보건부의 면허 및 인증 사무소를 의미합니다.
"Person" means any individual, corporation, partnership, association, trust, or other legal entity, whether governmental or private, owning, managing, or operating a nursing facility.
"신체적 구속(" )이란 거주자의 신체에 부착되거나 인접하여 개인이 쉽게 제거할 수 없는 수동적 방법 또는 물리적 또는 기계적 장치, 재료 또는 장비로 이동의 자유 또는 신체에 대한 정상적인 접근을 제한하는 것을 의미합니다.
"정책" 이란 요양 시설의 활동, 절차 및 운영에 대한 원칙과 지침을 설명하고 규율하는 서면 진술서를 의미합니다.
"절차" 는 프로그램 목표 또는 정책을 구현하기 위해 고안된 일련의 활동을 의미하며, 이 장의 특정 요구사항에 따라 작성될 수도 있고 작성되지 않을 수도 있습니다. 검사 목적상 절차가 실제로 이행되었다는 증거가 있어야 합니다.
"경과 기록(" )은 치료를 제공하는 사람이 서명하고 날짜를 기입한 서면 진술서를 의미하며, 거주자의 치료에 대한 관련성 있는 시간순 보고서로 구성됩니다. 진행 상황 노트는 임상 기록의 구성 요소입니다.
"자격을 갖춘" 이란 버지니아주에서 면허, 등록 또는 인증에 대한 현행 법적 요건을 충족하고, 할당된 책임에 상응하는 적절한 교육 및 경험을 보유하고 있거나, 전문가를 지칭하는 경우 적절한 학위를 소지하거나 문서화된 동등한 교육, 훈련 또는 경험을 보유하고 있는 것을 의미합니다.
"의료 질 관리(" )는 서비스 배정 및 기간의 적절성, 활용 시설 및 자원의 적절성, 제공된 치료의 적절성 및 임상적 건전성 등과 관련하여 임상 진료가 지정된 기준과 가치를 충족하는 정도를 판단하기 위해 수행되는 체계적인 활동을 의미합니다. 이러한 활동은 또한 허용된 기준에 부합하지 않는 관행의 변화를 보장해야 합니다. 품질 보증 활동의 예로는 시설 전체의 거주자 케어 목표 설정, 목표 달성을 위해 사용된 절차 평가, 목표 달성 시 발생하는 문제에 대한 해결책 제안 등이 있습니다.
"재입원" 이란 입원, 외부 방문 또는 치료 휴가를 위한 일시적 결근 후 요양 시설로 복귀하거나 이전 입원을 종료하는 공식 퇴원 후 재입원 또는 감금하는 것을 의미합니다.
"거주자" 는 고객, 소비자, 환자 또는 기타 용어에 관계없이 요양 시설에 입원한 주 서비스 수혜자를 의미합니다.
"거주자 관리형" 이란 거주자가 요양 시설에 대한 지식을 가지고 설치, 제어 및 유지 관리하는 전자 모니터링 시스템을 의미합니다.
"책임자 또는 당사자" 는 거주자로부터 공식 대리인 또는 대리인으로 지정되어 그 사람을 대신하여 행동할 권한을 부여받은 개인을 의미합니다. 책임자는 보호자, 수취인, 가족 구성원 또는 거주자의 돌봄을arranged하고 이 책임을 맡은 기타 개인일 수 있습니다. 책임자 또는 책임 당사자는 거주자와 관련이 있을 수도 있고 없을 수도 있습니다. 법원이 지정하지 않는 한, 책임 있는 개인 또는 단체는 법정 후견인이 아닙니다.
"슈퍼비전(" )이란 감독 대상 개인의 기술, 역량 및 성과를 모니터링하고 정기적인 대면 지도 및 교육을 제공하는 지속적인 프로세스를 의미합니다.
"선서 공개(" )란 요양 시설에 대한 보상 고용 신청자가 연방 내 또는 연방 외의 모든 형사 유죄 판결 또는 계류 중인 형사 고발을 공개하는 서면 진술서 또는 확인서를 의미합니다.
"THC-A 오일" 은 버지니아주 법규의 § 54-1-3408-3 의 하위 섹션 A에 정의된 용어와 동일한 의미입니다.
"자원봉사자" 는 금전적 보상 없이 요양 시설에 서비스를 제공하는 사람을 의미합니다.
A. This chapter is not applicable to:
1. Those entities listed in § 32.1-124 of the Code of Virginia; and
2. 버지니아주 법령 § 321-128 에 따라 종교적 교리를 실천하기 위해 설립 또는 운영되는 시설(단, 해당 시설은 환경 보호 및 생활 안전에 관한 법령 및 규정을 준수해야 함).
B. A license to operate a nursing facility is issued to a person or organization. An organization may be a partnership, association, corporation, or public entity.
비. C. Each license and renewal thereof shall be issued for one year. A nursing facility shall operate within the terms of its license, which include the:
1. Name of the nursing facility;
2. 운영자의 이름입니다;
3. 요양 시설의 물리적 위치;
4. Maximum number of beds allowed; and
5. 라이선스가 만료되는 날짜입니다.
C. D. A separate license shall be required for nursing facilities maintained on separate premises, even though they are owned or are operated under the same management.
D. E. Every nursing facility shall be designated by a permanent and appropriate unique name. The name shall not be changed without first notifying the OLC.
E. F. The number of resident beds allowed in a nursing facility shall be determined by the department. Requests to increase beds must be made in writing and must include an approved Certificate of Public Need, except as provided in 12VAC5-371-40 J G.
F. G. Nursing facility units located in and operated by hospitals shall be licensed under Regulations for the Licensure of Hospitals in Virginia (12VAC5-410). Approval for such units shall be included on the annual license issued to each hospital.
지. H. Any person establishing, conducting, maintaining, or operating a nursing facility without a license shall be guilty of a Class 6 felony.
A. 요청이 있는 경우 OLC는 라이선스 취득에 관한 정보를 원하는 사람에게 상담을 제공합니다. 이러한 상담의 목적은 다음과 같습니다:
1. 표준 및 라이선스 프로세스에 대해 설명합니다;
2. 다른 정보 출처를 찾는 데 도움을 제공합니다;
3. 잠재적 신청자가 제안한 프로그램 계획, 양식 및 기타 문서가 표준과 관련이 있는지 검토합니다.
4. 해당되는 경우 소방 및 건축법, 환경 보건 기준 등 기타 주 및 지역 조례를 준수해야 할 필요성에 대해 잠재적 신청자에게 알립니다.
B. Upon request, the OLC will provide an application form for a license to operate a nursing facility. Licensees and applicants shall obtain licensure applications from the OLC.
C. OLC는 요청된 모든 정보와 신청 수수료가 필요한 양식과 함께 제출되면 신청이 완료된 것으로 간주합니다. OLC가 신청서가 불완전하다고 판단하면 신청자에게 불완전한 신청서를 접수했다는 알림을 보냅니다.
D. 신청자는 OLC가 신청서를 처리할 시간을 확보할 수 있도록 개강 예정일 최소 10일 전에 초기 신청서를 작성하여 OLC에 제출해야 합니다( 30 ). 라이선스 신청은 언제든지 철회할 수 있습니다.
E. A nursing facility may not be licensed without first complying with the requirements for a Certificate of Public Need as required by Article 1.1. (§ 32.1-102.1 et seq.) of Chapter 4 of Title 32.1 of the Code of Virginia.
1. Application for initial license of a nursing facility shall include a statement of any agreement made with the commissioner as a condition for Certificate of Public Need approval to provide a level of care at a reduced rate to indigents or accept patients requiring specialized care.
2. Any initial license issued to any nursing facility that made such agreement as a condition of its Certificate of Public Need approval shall not be renewed without demonstrating prior to or at the time of applying for renewal that it is substantially complying with its agreement.
F. The renewal of a nursing facility license shall be conditioned upon the up-to-date payment of any civil penalties owed as a result of willful refusal, failure, or neglect to honor certain conditions established in their award of a Certificate of Public Need pursuant to § 32.1-102.4 F B of the Code of Virginia.
G. Prior to changes in operation which would affect the terms of the license, the licensee must secure a modification to the terms of the license from the OLC.
H. Requests to modify a license must be submitted in writing, 30 working days in advance of any proposed changes, to the Director of the Office of Licensure and Certification.
I. The license shall be returned to the OLC following a correction or reissuance when there has been a change in:
1. 주소;
2. 연산자;
3. Name; or
4. 침대 용량.
J. G. Nursing facilities shall be exempt, for a period of no more than 30 days, from the requirement to obtain a license to add temporary beds when the commissioner has determined that a natural or man-made disaster has caused the evacuation of a hospital or nursing home and that a public health emergency exists due to a shortage of hospital or nursing home beds.
K. The OLC will evaluate written information about any planned changes in operation which would affect either the terms of the license or the continuing eligibility for a license. A licensing representative may visit the facility during the process of evaluating a proposed modification.
L. If a modification can be granted, the OLC shall respond in writing with a modified license. In the event a new application is needed, the licensee will receive written notification. When the modification cannot be granted, the licensee shall be advised by letter.
M. The department shall send an application for renewal of the license to the licensee prior to the expiration date of the current license.
N. H. The licensee shall submit the completed renewal application form along with any required attachments and the application fee by the date indicated in the cover letter.
O. I. It is the licensee's responsibility to complete and return the application to assure timely processing. Should a current license expire before a new license is issued, the current license shall remain in effect provided the complete and accurate application was filed on time.
A. The licensing representative shall make unannounced on-site inspections of the nursing facility. The licensee shall be responsible for correcting any deficiencies found during any on-site inspection. Compliance with all standards will be determined by the OLC.
B. The licensee shall make available to the licensing representative any necessary records.
C. 또한 라이선스 사용자는 라이선스 담당자가 대리인, 직원, 거주자, 가족 및 자신의 관리, 통제, 지시 또는 감독을 받는 모든 사람을 면담할 수 있도록 허용해야 합니다.
D. After the on-site inspection, the licensing representative shall discuss the findings of the inspection with the administrator of record or designee.
E. As applicable, the administrator of record shall submit an acceptable plan for correcting any deficiencies found during an on-site inspection.
F. The administrator of record will be notified whenever any item in the plan of correction is determined to be unacceptable.
G. The administrator of record shall be responsible for assuring the plan of correction is implemented and monitored so that compliance is maintained.
A. The OLC has the responsibility to investigate any complaints regarding alleged violations of the standards or statutes and complaints of the abuse or neglect of persons in care. The Department of Social Services and the State Ombudsman are notified of complaints received.
B. Complaints may be received in written or oral form and may be anonymous.
C. 조사가 완료되면 라이선스 사용자와 신고자(알려진 경우)에게 조사 결과가 통보됩니다.
D. As applicable, the facility's administrator of record shall submit an acceptable plan for correcting any deficiencies found during a complaint investigation.
E. The administrator of record will be notified whenever any item in the plan of correction is determined to be unacceptable.
F. The administrator of record shall be responsible for assuring the plan of correction is implemented and monitored so that compliance is maintained.
A. A nursing facility may not hire for compensated employment a person who has been convicted of a barrier crime, unless:
1. The person has been convicted of a single barrier crime punishable as a misdemeanor;
2. The conviction does not involve abuse or neglect; and
3. Five years have elapsed since the conviction.
B. A nursing facility shall:
1. Obtain from an applicant for compensated employment a sworn disclosure; and
2. Attach the sworn disclosure to and file it with the criminal record report.
3. Obtain a criminal record report on applicants for compensated employment from the Virginia Department of State Police no more than 30 calendar days after employment begins.
C. A nursing facility may not accept:
1. A criminal record report dated more than 90 calendar days prior to the start date of employment;
2. Duplicates or copies of the original criminal record report, except as provided in subsection D of this section.
D. If a nursing facility uses a temporary staffing agency for substitute staff, a nursing facility shall obtain a letter from the temporary staffing agency that includes:
1. 대체 직원의 이름입니다;
2. 임시 인력 파견 기관의 고용 날짜; 그리고
3. A statement verifying that the criminal record report:
a. Has been obtained within 30 calendar days of employment at the temporary staffing agency;
b. Is on file at the temporary staffing agency; and
c. Does not contain a conviction for a barrier crime, or indicates the substitute staffing person has been convicted of a single barrier crime punishable as a misdemeanor that does not involve abuse or neglect and five years have elapsed since the conviction.
E. A nursing facility may not permit a compensated employee to work in a position that involves direct contact with a patient until an original criminal record report has been received by the nursing facility or temporary staffing agency, unless the employee works under the direct supervision of another compensated employee for whom a background check has been completed in accordance with subsection B of this section.
F. A nursing facility shall obtain a new criminal record report and a new sworn disclosure if an individual:
1. Terminates compensated employment at one nursing facility and begins compensated employment at another nursing facility, unless the nursing facilities are owned by the same entity. The employee's file shall contain a statement indicating the original criminal record report has been transferred or forwarded to the new work location; or
2. Takes a leave of absence exceeding six consecutive months.
G. A nursing facility shall provide a copy of the criminal record report to an applicant denied compensated employment because of convictions appearing on his criminal record report.
H. A nursing facility shall maintain the confidentiality of criminal record reports and store criminal record reports in locked files accessible only to the administrator or designee.
I. A nursing facility may not disseminate the criminal record report and sworn disclosure except to a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.
A. The OLC can commissioner may authorize variances only to its own licensing standards, not to regulations of another agency or to any requirements in federal, state, or local laws.
B. A nursing facility may request a variance to a particular standard or requirement contained in this chapter when the standard or requirement poses a special hardship and when a variance to it would not endanger the safety or well-being of residents, employees, or the public.
C. Upon finding that the enforcement of one or more of the standards would be clearly impractical, the OLC commissioner shall have the authority to waive, either temporarily or permanently, the enforcement of one or more of these standards, provided safety, resident care and services are not adversely affected.
D. The OLC commissioner may rescind or modify a variance if (i) conditions change; (ii) additional information becomes known which alters the basis for the original decision; (iii) the nursing facility fails to meet any conditions attached to the variance; or (iv) results of the variance jeopardize the safety, comfort, or well-being of residents, employees and the public.
E. Consideration of a variance is initiated when a written request is submitted to the Director director of the Office of Licensure and Certification OLC. The OLC may provide consultation in the development of the written request and throughout the variance process.
F. The request for a variance must describe the special hardship to the existing program or to a planned innovative or pilot program caused by the enforcement of the requirements. When possible, the request should include proposed alternatives to meet the purpose of the requirements which will ensure the protection and well-being of residents, employees, and the public.
G. The OLC shall notify the nursing facility of the receipt of the request for a variance. The OLC commissioner may attach conditions to the granting of the variance in order to protect persons in care.
H. When the decision is to deny a request for a variance, the reason shall be provided in writing to the licensee.
I. When a variance is denied, expires, or is rescinded, routine enforcement of the standard or portion of the standard shall be resumed. The nursing facility may at any time withdraw a request for a variance.
A. 누구든지 면허를 취득하지 않고는 버지니아주 법령 § 32-1-123 에 정의된 요양 시설을 소유, 설립, 운영, 유지, 관리 또는 운영할 수 없습니다.
B. 요양 시설은 다음 사항을 준수해야 합니다:
1. 이 규정(12VAC5-371);
2. 기타 해당 연방, 주 또는 지역 법률 및 규정
3. 자체 정책 및 절차.
C. 요양 시설은 본 규정 및 관련 법령의 준수를 입증하는 데 필요한 보고서 및 정보를 제출하거나 제공해야 합니다.
D. 요양 시설은 OLC의 결정에 따라 적시에 서면 조치 계획을 제출하고, 점검 중에 확인된 규정 미준수 사항을 시정하기 위한 서면 계획을 이행해야 합니다. 계획에는 다음이 포함되어야 합니다:
1. 시정 조치 또는 취해야 할 조치에 대한 설명;
2. 각 작업의 완료 날짜
3. 운영 책임자의 서명.
E. The nursing facility shall permit representatives from the OLC to conduct inspections to:
1. 애플리케이션 정보를 확인합니다;
2. 이 장의 준수 여부를 결정합니다;
3. 필요한 기록 검토
4. 불만 사항을 조사합니다.
F. The current license from the department shall be posted in a place clearly visible to the general public. A nursing facility shall give written notification 30 calendar days in advance of implementation of changes affecting the accuracy of the license. Changes affecting the accuracy of the license are:
1. 주소;
2. 연산자;
3. 요양 시설의 이름입니다;
4. 요양 시설 운영을 위한 관리 계약 또는 임대 계약의 변경 제안;
5. 면허가 필요한지 여부에 관계없이 요양 시설 서비스의 제안된 추가, 삭제 또는 변경 사항을 구현합니다;
6. 소유권 변경, 또는
7. 침대 용량.
통지는 OLC의 책임자에게 발송되어야 합니다.
G. The nursing facility shall not operate more resident beds than the number for which it is licensed The current license from the commissioner shall be posted in a place clearly visible to the general public.
H. The nursing facility shall fully disclose its admission policies, including any preferences given, to applicants for admission.
I. The nursing facility shall identify its operating elements and programs, the internal relationship among these elements and programs, and the management or leadership structure.
J. The nursing facility shall provide, or arrange for, the administration to its residents of an annual influenza vaccination and a pneumonia vaccination according to the most recent recommendations for "Prevention and Control of Influenza" (www.cdc.gov/mmwr/preview/mmwrhtml/rr5306a1.htm), MMWR 53 (RR06), "Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2020–21 Influenza Season" and "Guidelines for Preventing Health Care-Associated Pneumonia, 2003" (www.cdc.gov/mmwr/preview/mmwrhtml/rr5303a1.htm), MMWR 53 (RR03), of "Guidelines for Preventing Health-Care-Associated Pneumonia" from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, unless the vaccination is medically contraindicated or the resident declines the vaccination offer.
K. Upon request of the nursing facility's family council, the nursing facility shall send notices and information about the family council mutually developed by the family council and the administration of the nursing home facility, and provided to the nursing facility for such purpose, to the listed responsible party legal representative or a contact person of the resident's choice up to six times a year. Such notices may be included together with a monthly billing statement or other regular communication. Notices and information shall also be posted in a designated location within the nursing facility.
A. The nursing facility shall have a governing body that is legally responsible for the management of the operation.
B. The governing body shall adopt written bylaws that describe the organizational structure and establish authority and responsibility in accordance with applicable laws, including a:
1. Statement of purpose;
2. Description of the functions of the governing body members, officers and committees;
3. Description of the method of adoption, implementation, and periodic review of policies and procedures; and
4. Description of the methods to be utilized to assure compliance with this chapter.
C. The governing body shall disclose the names and addresses of any individual or entity that holds 5.0% or more ownership interest in the operation of the nursing facility.
D. When the governing body is not the owner of the physical plant, the governing body shall disclose the name and address of the individual or entity responsible for the alterations, modifications, maintenance and repairs to the building.
E. The governing body shall notify the OLC in writing 30 days in advance of changes affecting the accuracy of the license. Changes affecting the accuracy of the license are:
1. 요양 시설 운영을 위한 관리 계약 또는 임대 계약의 변경 제안;
2. 면허가 필요한지 여부에 관계없이 요양 시설 서비스의 제안된 추가, 삭제 또는 변경 사항을 구현합니다;
3. Selling the facility; or
4. A change in ownership.
A. The governing body shall appoint an individual, on a full-time basis, to serve as its on-site agent, responsible for the day-to-day administration and management.
B. The governing body shall provide the OLC with evidence that the individual appointed as administrator is:
1. Currently licensed by the Virginia Board of Long-Term Care Administrators; or
2. Holds a current administrator's license in another state and has filed an application for license with the Virginia Board of Long-Term Care Administrators.
C. Within five working days of the effective date of termination of the administrator's employment, the governing body shall notify the OLC, in writing, of the name and qualifications of the replacement administrator of record or the acting administrator.
D. The governing body shall appoint a qualified administrator within 90 days of the effective date of the termination of the previously qualified administrator, and shall provide the OLC with written notification of the administrator's name, license number, and effective date of employment.
An additional 30-day extension may be granted if a written request provides documentation that the individual designated as administrator is awaiting the final licensing decision of the Virginia Board of Long-Term Care Administrators.
E. The governing body shall assure that administrative direction is provided at all times. The governing body, the administrator, or the chief executive officer shall designate, in writing, a qualified individual to act as the alternate nursing home administrator in the absence of the administrator of record.
A. 요양 시설은 관리 기관의 승인을 받은 서면 정책 및 절차를 이행해야 합니다.
B. 모든 정책과 절차는 적어도 매년 검토되어야 하며, 권장되는 변경 사항은 승인을 위해 운영위원회에 제출해야 합니다.
C. 최소한 검토 날짜, 참석자, 권고 사항 및 관리 기관의 조치 날짜가 포함된 연간 정책 검토에 대한 서면 기록이 유지되어야 합니다.
D. Administrative and operational policies and procedures shall include, but are not limited to:
1. 관리 기록;
2. 입학, 전학 및 퇴원;
3. 의료 지시 및 의사 서비스;
4. 간호 방향 및 간호 서비스;
5. 요양 시설 외부에서 구매한 의약품을 포함한 의약품 서비스;
6. 식단 서비스;
7. 사회복지 서비스;
8. 활동 서비스;
9. 회복 및 재활 거주자 서비스;
10. 계약 서비스;
11. 임상 기록;
12. 입주자 권리 및 불만 사항;
13. 품질 보증 및 감염 관리 및 예방;
14. 안전 및 비상 대비 절차
15. 직업 및 임상 윤리를 포함합니다:
a. 거주자 정보의 기밀 유지;
b. 주민과의 진실한 소통;
c. 사전 동의 및 치료 거부에 대한 적절한 기준 준수; 그리고
d. 노인, 인지 장애자 및 임종자의 필요에 특별한 주의를 기울여 거주자의 존엄성을 보존합니다.
16. Facility Nursing facility security.
E. Personnel policies and procedures shall include, but are not limited to:
1. 각 직무 분류에 대한 권한, 책임, 자격을 명시한 직무 설명서를 작성합니다;
2. 직원 오리엔테이션, 직원 개발, 현업 교육 및 지속적인 교육에 대한 지속적인 계획;
3. 각 직원에 대한 정확하고 완전한 인사 기록:
a. 현재 전문 자격증, 등록증 또는 수료증 또는 필수 공인 교육 과정 이수 확인;
b. 범죄 기록 확인;
c. 직원이 직무 설명서를 검토했거나 사본을 수령했음을 확인합니다;
d. 요양 시설, 해당 정책, 부여된 직책 및 직무에 대한 오리엔테이션;
e. 연례 성과 평가 결과에 따라 직원에 대해 승인된 평생 교육 프로그램을 이수한 경우;
f. 연간 직원 성과 평가
g. 징계 조치
4. 직원 건강 관련 정보는 인사 파일과 분리된 파일에 보관합니다.
F. Financial policies and procedures shall include, but not be limited to:
1. 입학 동의;
2. 청구 방법:
a. 기본 일일 또는 월간 요금에 포함되지 않은 서비스;
b. 요양 시설의 계약자가 제공하는 서비스, 그리고
c. 타사 결제자;
3. 수수료 및 요금 변경에 대한 거주자 또는 지정 대리인 통지;
4. 청구 오류 수정 및 환불 정책;
5. 체납된 거주자 계정 수금, 그리고
6. 상주 자금 처리.
G. Policies shall be made available for review, upon request, to residents and their designated representatives.
H. 정책과 절차는 직원이 항상 쉽게 이용할 수 있어야 합니다.
A. 요양 시설은 버지니아주 법령(§§ 32.1-138 및 32.1-138.1 )에 정의된 대로 거주자의 권리를 보장하는 정책과 절차를 개발하고 시행해야 합니다.
B. 절차는 다음과 같습니다:
1. 거주자가 법률에 따라 갖는 권리를 제한하지 않습니다;
2. 거주자의 권리 이행을 위한 직원 교육 제공.
3. 고충 처리 절차를 포함하세요.
C. OLC의 불만 처리 담당자의 이름과 전화번호, 성인 보호 서비스 무료 전화번호, 주 옴부즈맨의 무료 전화번호는 공공장소에 눈에 잘 띄게 게시해야 합니다.
D. Copies of resident rights shall be given to residents upon admittance to the nursing facility and made available to residents currently in residence, to any guardians legal representatives, next of kin, or sponsoring agency or agencies, and to the public.
E. The nursing facility shall have a plan to review resident rights with each resident annually, or with the responsible family member or responsible agent legal representative at least annually, and have a plan to advise each staff member at least annually.
F.1요양 시설은 면허 발급 또는 갱신 조건으로 거주자의 권리와 관련하여 버지니아주 법령의 §§ 32 -138 및 32 -1138 1 조항을 준수하고 있음을 서면으로 증명해야 합니다.
G. The nursing facility shall register with the Department of State Police to receive notice of the registration or reregistration of any sex offender within the same or a contiguous zip code area in which the nursing facility is located pursuant to § 9.1-914 of the Code of Virginia.
H. 각 요양시설은 잠재적 거주자의 체류 기간이 예상되는 경우 입원 전에 잠재적 거주자가 등록된 성범죄자인지 여부를 판단해야 합니다:
1. 3일 이상 또는
2. 실제로 3일 이상 체류합니다.
I. The nursing facility shall not restrict the rights of a nursing home resident's family and resident's legal representative to meet in the nursing facility with the families and legal representatives of other residents of the facility.
A. All financial records, including resident funds, shall be kept according to generally accepted accounting principles (GAAP).
B. Each nursing facility shall maintain liability insurance coverage in a minimum of $1 million and professional liability coverage in an amount at least equal to the recovery limit set forth in § 8.01-581.15 of the Code of Virginia to compensate residents or individuals for injuries and losses resulting from the negligent or criminal acts of the nursing facility. Failure to maintain minimum insurance shall result in revocation of the nursing facility's license.
C. Nursing facilities choosing to handle resident funds shall:
1. Comply with § 32.1-138 A 7 of the Code of Virginia regarding resident funds;
2. Purchase a surety bond or otherwise provide assurance for the security of all personal funds deposited with the nursing facility; and
3. Provide for separate accounting for resident funds.
D. In the event the nursing facility is sold, the nursing facility shall provide written verification that all resident funds have been transferred and shall obtain a signed receipt from the new owner. Upon receipt, the new owner shall provide an accounting of resident funds.
E. Each nursing facility shall be required to provide a full refund of any unexpended patient funds on deposit with the nursing facility following the discharge or death of a patient, other than entrance related fees, within 30 days of a written request for such funds by the discharged patient or, in the case of the death of a patient, the person administering the patient's estate in accordance with the Virginia Small Estate Act (§ 64.2-600 et seq. of the Code of Virginia).
A. The nursing facility shall maintain a quality assessment and assurance committee consisting of at least the following individuals:
1. The director of nursing services;
2. A physician designated by the nursing facility; and
3. At least three other members of the nursing facility staff, one of whom demonstrates an ability to represent the rights and concerns of residents.
B. The quality assessment and assurance committee shall:
1. Meet at least quarterly to identify issues which would improve quality of care and services provided to residents; and
2. Develop and implement appropriate plans of action to correct identified deficiencies.
C. The nursing facility shall document compliance with these requirements.
A. 요양 시설은 안전하고 위생적이며 쾌적한 환경을 제공하고 질병 및 감염의 발생과 전파를 예방하기 위해 고안된 감염 관리 프로그램을 수립하고 유지해야 합니다.
B. 감염 관리 프로그램은 전체 물리적 시설과 모든 서비스를 포괄해야 합니다.
C. The infection control program addressing the surveillance, prevention and control of facility wide infections in the nursing facility shall include:
1. 감염된 유기체를 격리하는 절차;
2. 직원을 위한 손씻기 장비 이용;
3. 교차 오염을 방지하기 위해 허용된 전문 표준에 따라 올바른 손씻기 기술을 직원에게 교육합니다;
4. 직접 상주하는 의료진이 보편적 예방 조치를 시행합니다;
5. 전염성 질병이나 감염이 있는 직원은 직접 접촉으로 질병이 전염될 수 있는 경우 거주자 또는 거주자의 음식과 직접 접촉하지 못하도록 금지합니다;
6. 감염 관리 관행에 대한 직원 성과 모니터링
7. 감염 확산을 방지하는 방식으로 침구, 용품 및 장비를 취급, 보관, 처리 및 운송합니다;
8. 관련 규정에 따라 규제 대상 의료 폐기물을 취급, 보관, 처리 및 운송합니다;
9. 효과적인 해충 방제 프로그램 유지, 그리고
10. 감염 위험 감소 행동에 관한 직원 교육.
D. The nursing facility shall report promptly to its local health department diseases designated as "reportable" according to 12VAC5-90-80 when such cases are admitted to or are diagnosed in the nursing facility and shall report any outbreak of infectious disease as required by 12VAC5-90. An outbreak is defined as an increase in incidence of any infectious disease above the usual incidence at the nursing facility.
A. A written emergency preparedness plan shall be developed, reviewed, and implemented when needed. The plan shall address responses to natural disasters, as well as fire or other emergency which disrupts the normal course of operations. The plan shall address provisions for relocating residents and also address staff responsibilities for:
1. 긴급 구조대원에게 알리고 경보를 울리는 것;
2. Implementing evacuation procedures including the evacuation of residents with special needs;
3. 비상 장비의 사용, 유지 관리 및 작동
4. Accessing resident emergency medical information; and
5. 지역 사회 지원 서비스 활용.
B. 모든 직원은 정기적인 비상 대비 교육에 참여해야 합니다.
C. 직원은 비상 상황 발생 시 비상 대비 계획에 대한 문서화된 지식을 갖추고 이를 실행할 준비가 되어 있어야 합니다.
D. At least one telephone shall be available in each area to which residents are admitted and additional telephones or extensions as are necessary to ensure availability in case of need.
E. In the event of a disaster, fire, emergency or any other condition that may jeopardize the health, safety and well-being of residents, the organization nursing facility shall notify the OLC of the conditions and status of the residents and the licensed facility physical plant as soon as possible.
F. The nursing facility shall have a policy on smoking.
A. All requests for electronic monitoring shall be made in writing and signed by the resident or the resident's responsible party legal representative if the resident has been properly assessed incapable of requesting and authorizing the monitoring.
B. 이 조항에 따라 전자 감시만 허용됩니다.
C. A nursing facility shall not refuse to admit an individual and shall not discharge or transfer a resident due to a request to conduct authorized electronic monitoring.
D. Family members cannot obtain electronic monitoring over the objections of the resident, the resident's roommate, or the resident's responsible party legal representative. No equipment may be installed pursuant to subsection Q of this section over the objections of the resident, or if the resident is incapable, the resident's responsible party or legal representative. Facilities Nursing facilities shall not use monitoring equipment in violation of the law based solely on a family member's request or approval.
E. 전자 감시에 대한 동의서는 거주자의 의료 기록에 보관되어야 합니다.
F. Facilities Nursing facilities shall designate one staff person to be responsible for managing the electronic monitoring program.
G. Facilities Nursing facilities may designate custodial ownership of any recordings from monitoring devices to the resident or the resident's responsible party legal representative. Facility Nursing facility retained recordings shall be considered part of the resident's medical record and shall be retained for no less than two years or as required by state and federal laws.
H. If a nursing facility chooses to retain ownership of recordings, the nursing facility shall not permit viewings of recordings without consent of the resident or the resident's responsible party legal representative except to the extent that disclosure is required by law through a court order or pursuant to a lawful subpoena duces tecum. Should a the resident or a resident's responsible party legal representative approve viewing, the nursing facility shall accommodate viewing of any recordings in a timely manner, including providing:
1. 적절한 재생 또는 시청 장비;
2. 시청 중 개인정보 보호; 및
3. Viewing times convenient to the resident or the resident's responsible party legal representative.
If unauthorized viewing is discovered, the nursing facility shall report any such violation to the Office of Long-Term Care Ombudsman and to the OLC.
I. A nursing facility shall require its staff to report any incidents regarding safety or quality of care discovered as a result of viewing a recording immediately to the facility administrator and to the OLC. Facilities Nursing facilities shall instruct the resident or the resident's responsible party legal representative of this reporting requirement and shall provide the resident or the resident's responsible party legal representative with the OLC's complaint hotline telephone number.
J. A nursing facility shall have no obligation to seek access to a recording in its possession or to have knowledge of a recording's content, unless the nursing facility is aware of a recorded incident of suspected abuse, neglect, accident, or injury, or the resident, the resident's responsible party legal representative, or a government agency seeks to use a recording. Facilities Nursing facilities shall immediately report suspected abuse and neglect discovered as a result of using monitoring devices, as required by law.
K. A nursing facility may require the resident or the resident's responsible party legal representative to be responsible for all aspects of the operation of the monitoring equipment, including the removal and replacement of recordings; adherence to local, state, and federal privacy laws; and for firewall protections to prevent images that would violate obscenity laws from being inadvertently shown on the Internet.
L. A nursing facility shall prohibit assigned staff from refusing to enter a resident's room solely because of electronic monitoring.
M. 전자 감시 장비는 거주자, 직원 또는 거주자의 방을 이동하는 방문객의 안전을 보장하는 방식으로 설치되어야 합니다.
N. A nursing facility shall make reasonable physical accommodation for monitoring equipment, including:
1. 장치를 안전하게 설치할 수 있는 합리적인 공간을 제공하는 것; 및
2. 장치에 전원 공급원을 제공하는 것.
O. A nursing facility may require a resident or a resident's responsible party legal representative to pay for all costs, other than the cost of electricity, associated with installing electronic monitoring equipment. Such costs shall be reasonable and may include equipment, recording media and installation, compliance with life safety and building and electrical codes, maintenance or removal of the equipment, posting and removal of any public notices, or structural repairs to the building resulting from the removal of the equipment. Facilities Nursing facilities shall give 45 days' notice of an increase in monthly monitoring fees.
P. 거주자의 방을 감시하기 위해 설치된 모든 장비는 고정되어 있으며 회전할 수 없어야 합니다.
Q. The informed consent of all residents, or if a resident is incapable, a resident's responsible party, or residents' legal representatives assigned to the monitored room shall be obtained prior to any electronic monitoring equipment being installed.
R. A copy of any signed consent form shall be kept in the resident's medical record as well as on file with the nursing facility's designated electronic monitoring coordinator.
S. Any resident or the resident's responsible party legal representative of a resident of a monitored room may condition consent for use of monitoring devices. Such conditions may include pointing the camera away or limiting or prohibiting the use of certain devices. If conditions are placed on consent, then electronic monitoring shall be conducted according to those conditions.
T. The nursing facility shall conspicuously post and maintain a notice at the entrance to the resident's room stating that an electronic monitoring device is in operation.
U. Facilities Nursing facilities shall notify all staff and their the long-term care division of the OLC Long-Term Care Supervisor that electronic monitoring is in use.
V. A nursing facility shall prohibit staff from covert monitoring in violation of this chapter. Facilities Nursing facilities shall instruct the resident or the resident's responsible party legal representative of this prohibition and shall provide the resident or the resident's responsible party legal representative with the OLC's complaint hotline telephone number.
W. If covert monitoring is discovered, the nursing facility shall report any such violation to the Office of Long-Term Care Ombudsman and OLC, and the nursing facility may require a resident or a resident's responsible party legal representative to meet all the requirements for authorized monitoring, if permitted by the nursing facility.
X. 각 요양 시설(전자 감시를 제공하지 않기로 선택한 시설을 포함하여)은 전자 감시를 위한 정책 및 절차를 수립하여야 합니다. 이 정책 및 절차는 본 절의 모든 요소를 포함하여 규정합니다.
Y. A nursing facility shall prohibit staff from tampering with electronic monitoring in violation of this chapter. Facilities Nursing facilities shall instruct the resident or the resident's responsible party legal representative of this prohibition and shall provide the resident or the resident's responsible party legal representative with the OLC's complaint hotline telephone number.
A. A nursing supervisor, designated by the director of nursing, shall be responsible for all nursing activities in the nursing facility, or in the section to which assigned, including:
1. Making daily visits to determine resident physical, mental, and emotional status and implementing any required nursing intervention;
2. Reviewing medication records for completeness, accuracy in the transcription of physician orders, and adherence to stop-order policies;
3. Reviewing resident plans of care for appropriate goals and approaches, and making revisions based on individual needs;
4. Assigning to the nursing staff responsibility for nursing care;
5. Supervising and evaluating performance of all nursing personnel on the unit; and
6. Keeping the director of nursing services, or director of nursing designee, informed of the status of residents and other related matters.
B. The nursing facility shall provide qualified nurses and certified nurse aides on all shifts, seven days per week, in sufficient number to meet the assessed nursing care needs of all residents.
C. Nursing personnel, including registered nurses, licensed practical nurses, and certified nurse aides shall be assigned duties consistent with their education, training and experience.
D. Weekly time schedules shall be maintained and shall indicate the number and classification of nursing personnel who worked on each unit for each shift. Schedules shall be retained for one year.
E. All nursing services shall be directly provided by an appropriately qualified registered nurse or licensed practical nurse, except for those nursing tasks that may be delegated by a registered nurse according to 18VAC90-20-420 through 18VAC90-20-460 Part IV (18VAC19-20-240 et seq.) of the regulation of the Virginia Board Regulations Governing the Practice of Nursing and with a plan developed and implemented by the nursing facility.
F. Before allowing a nurse aide to perform resident care duties, the nursing facility shall verify that the individual is:
1. A certified nurse aide in good standing;
2. Enrolled full-time in a nurse aide education program approved by the Virginia Board of Nursing; or
3. Has completed a nurse aide education program or competency testing, but has not yet been placed on the nurse aide registry.
G. Any person employed to perform the duties of a nurse aide on a permanent full-time, part-time, hourly, or contractual basis must be registered as a certified nurse aide within 120 days of employment.
H. Nurse aides employed or provided by a temporary personnel agency shall be certified to deliver nurse aide services.
I. The services provided or arranged with a temporary personnel agency shall meet professional standards of practice and be provided by qualified staff according to each resident's comprehensive plan of care.
A. All full-time, part-time, and temporary personnel shall receive orientation to the nursing facility commensurate with their function or job-specific responsibilities.
B. All resident care staff shall receive annual inservice training commensurate with their function or job-specific responsibilities in at least the following:
1. Special needs of residents as determined by the nursing facility staff;
2. Prevention and control of infections;
3. Fire prevention or control and emergency preparedness;
4. Safety and accident prevention;
5. Restraint use, including alternatives to physical and chemical restraints;
6. Confidentiality of resident information;
7. Understanding the needs of the aged and disabled;
8. Resident rights, including personal rights, property rights and the protection of privacy, and procedures for handling complaints;
9. Care of the cognitively impaired;
10. Basic principles of cardiopulmonary resuscitation for licensed nursing staff and the Heimlich maneuver for nurse aides; and
11. Prevention and treatment of pressure sores.
C. The nursing facility shall have an ongoing training program that is planned and conducted for the development and improvement of skills of all personnel.
D. The nursing facility shall maintain written records indicating the content of and attendance at each orientation and inservice training program.
E. The nursing facility shall provide inservice programs, based on the outcome of annual performance evaluations, for nurse aides.
F. Nurse aide inservice training shall consist of at least 12 hours per anniversary year.
G. The nursing facility shall provide training on the requirements for reporting adult abuse, neglect, or exploitation and the consequences for failing to make such a required report to all its employees who are licensed to practice medicine or any of the healing arts, serving as a hospital resident or intern, engaged in the nursing profession, working as a social worker, mental health professional or law-enforcement officer and any other individual working with residents of the nursing facility.
A. 의약품 및 기타 약국 제품의 조달, 보관, 조제 및 회계는 18VAC110-20 에 따라 제공되어야 합니다. 이는 외부 약국과의 협의를 통해 이루어질 수 있지만, 반드시 24-시간 응급 서비스에 대한 조항이 포함되어야 합니다.
B. Each nursing facility shall develop and implement policies and procedures for the handling of drugs and biologicals, including procurement, storage, administration, self-administration, and disposal of drugs.
C. Each nursing facility shall have a written agreement with a qualified pharmacist to provide consultation on all aspects of the provision of pharmacy services in the nursing facility.
D. 자문 약사는 계약의 기능을 수행하기에 충분한 시간 동안 최소한 매월 정기적으로 요양 시설을 방문해야 합니다.
E. Excluding cannabidiol oil and THC-A oil, no drug or medication shall be administered to any resident without a valid verbal order or a written, dated and signed order from a physician, dentist, podiatrist, nurse practitioner, or physician assistant, licensed in Virginia.
F. Nursing facility employees who are authorized to possess, distribute, or administer medications to residents may store, dispense, or administer cannabidiol oil or THC-A oil to a resident who has:
1. Been issued a valid written certification for the use of cannabidiol oil or THC-A oil in accordance with subsection B of § 54.1-3408.3 of the Code of Virginia; and
2. 약사회에 등록되어 있습니다.
G. Verbal orders for drugs or medications shall only be given to a licensed nurse, pharmacist, or physician.
H. 주문 시 복용 시간이나 횟수에 제한이 없는 약물 및 약품은 요양 시설의 서면 정책에 따라 자동으로 중단되어야 하며 주치의에게 통보해야 합니다.
I. 각 거주자의 투약 요법은 버지니아주 약사회에서 면허를 취득한 약사가 검토해야 합니다. 약사가 확인한 모든 이상 징후는 의사와 간호 책임자에게 보고하고 이에 대한 대응을 문서화해야 합니다.
J. 약물 처방은 주치의, 전문간호사 또는 의사 보조원이 최소 60 일마다 검토해야 합니다.
K. Prescription and nonprescription drugs and medications may be brought into the nursing facility by a resident's family, friend, or other person provided:
1. 약품 및 의약품을 배달하는 개인은 요양 시설의 서면 정책에 따라 적시에 약품을 배달하여 거주자의 처방된 치료 계획에 차질이 없도록 합니다;
2. 각 약품 또는 의약품은 개별 용기에 담겨 있습니다.
3. 개별 거주자에게 직접 배송할 수 없습니다.
또한 처방약은 법에서 요구하는 대로 처방전을 발급받아 라벨을 부착해야 합니다.
A. A resident shall be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident's medical symptoms.
B. Restraints shall only be used:
1. In accordance with the comprehensive assessment and plan of care, which includes a schedule or plan of rehabilitation training enabling the progressive removal or the progressive use of less restrictive restraints when appropriate; and
2. As a last resort, after completing, implementing, and evaluating the resident's comprehensive assessment and plan of care, when the nursing facility has determined that less restrictive means have failed.
C. If a restraint is used in a nonemergency, the nursing facility shall:
1. Explain the use of the restraint, including potential negative outcomes of restraint use, to the resident or his legal representative, as appropriate;
2. Explain the resident's right to refuse the restraint;
3. Obtain written consent of the resident. If the resident has been legally declared incompetent, obtain written consent from the legal representative; and
4. Include the use of restraint in the plan of care.
D. Restraints shall not be ordered on a standing or PRN basis.
E. Restraints shall be applied only by staff trained in their use.
F. At a minimum, for a resident placed in a restraint, the nursing facility shall:
1. Check the resident at least every 30 minutes;
2. Provide an opportunity for motion, exercise and elimination for not less than 10 minutes each hour in which a restraint is administered; and
3. Document restraint usage, including outcomes, in accordance with nursing facility policy.
G. Emergency orders for restraints shall not be in effect for longer than 24 hours and must be confirmed by a physician within one hour of administration. Each application of emergency restraint shall be considered a single event and shall require a separate physician's order.
H. Temporary restraints may be used for a brief period to allow a medical or surgical procedure, but shall not be used to impose a medical or surgical procedure which the resident has previously refused.
I. The nursing facility shall notify a resident's legal representative, if any, or designated family member as soon as practicable, but no later than 12 hours after administration of a restraint.
J. Chemical restraint shall only be ordered in an emergency situation when necessary to ensure the physical safety of the resident or other individuals.
K. Orders for chemical restraint shall be in writing, signed by a physician, specifying the dose, frequency, duration and circumstances under which the chemical restraint is to be used. Verbal orders for chemical restraints shall be implemented when an emergency necessitates parenteral administration of psychopharmacologic drugs, but only until a written order can reasonably be obtained.
L. Emergency orders for chemical restraints shall:
1. Not be in effect for more than 24 hours; and
2. Be administered only if the resident is monitored continually for the first 15 minutes after each parenteral administration (or 30 minutes for nonparenteral administration) and every 15 minutes thereafter, for the first hour, and hourly for the next eight hours to ensure that any adverse side effects will be noticed and appropriate action taken as soon as possible.
A. The nursing facility shall maintain an organized clinical record system in accordance with recognized professional practices. Written policies and procedures shall be established specifying content and completion of clinical records.
B. Clinical records shall be confidential. Only authorized personnel shall have access as specified in §§ 8.01-413 and 32.1-127.1:03 of the Code of Virginia.
C. Records shall be safeguarded against destruction, fire, loss, or unauthorized use.
D. Overall supervisory responsibility for assuring that clinical records are maintained, completed and preserved shall be assigned to an employee of the nursing facility. The individual shall have work experience or training which that is consistent with the nature and complexity of the record system and be capable of effectively carrying out the functions of the job.
E. An accurate and complete clinical record shall be maintained for each resident and shall include, but not be limited to:
1. Resident identification;
2. Designation of attending physician;
3. Admitting information, including resident medical history, physical examination, and diagnosis;
4. Physician orders, including all medications, treatments, diets, restorative, and special medical procedures required;
5. Progress notes written at the time of each visit;
6. Documented evidence of assessment of resident's needs, establishment of an appropriate treatment plan, and interdisciplinary plan of care;
7. Nurse's notes written in chronological order and signed by the individual making the entry;
8. All symptoms and other indications of illness or injury, including date, time, and action taken on each shift;
9. Medication and treatment record, including all medications, treatments and special procedures performed;
10. Copies of radiology, laboratory and other consultant reports; and
11. Discharge summary.
F. Verbal orders shall be immediately documented in the clinical record by the individual authorized to accept the orders, and shall be countersigned.
G. Clinical records of discharged residents shall be completed within 30 days of discharge.
H. Clinical records shall be kept for a minimum of five years after discharge or death, unless otherwise specified by state or federal law.
I. Permanent information kept on each resident shall include:
1. Name;
2. 사회보장번호;
3. 출생일;
4. Date of admission and discharge; and
5. Name and address of guardian legal representative, if any.
J. Clinical records shall be available to residents and legal representatives, if they wish to see them.
K. When a nursing facility closes, the owners shall make provisions for the safekeeping and confidentiality of all clinical records.
A. A quantity of linens shall be available at all times to provide for proper care and comfort of residents.
B. Linens and other laundry must be handled, stored, and processed to control the spread of infection.
C. Clean linen shall be stored in a clean and dry area accessible to the nursing unit.
D. Soiled linen shall be stored in covered containers in separate, well ventilated areas and shall not accumulate in the nursing facility.
E. Soiled linen shall not be sorted, laundered, rinsed, or stored in bathrooms, resident rooms, kitchens, or food storage areas.
F. Soiled linen shall not be placed on the floor.
G. Arrangement for laundering resident's personal clothing shall be provided. If laundry facilities are not provided on premises, commercial laundry services shall be utilized.
A. Provisions shall be made to obtain appropriate transportation in cases of emergency.
B. The nursing facility shall assist in obtaining transportation when it is necessary to obtain medical, psychiatric, dental, diagnostic or other services outside the nursing facility.
A. All unique design solutions shall be described with outcome measures. This shall be reviewed in cooperation with the OLC.
B. The description and outcome measures shall be a part of the material used to review the design solution at the time of the facility survey.
C. All unique design solutions, unless specifically excluded by contract, shall comply with Parts II (12VAC5-371-110 et seq.) and III (12VAC5-371-200 et seq.) of this chapter.
Guidelines for Design and Construction of Health Care Facilities, Facilities Guideline Institute (formerly of the American Institute of Architects Academy of Architecture), 2010 Edition.
Guidelines for Preventing Health Care-Associated Pneumonia, 2003, MMWR 53 (RR03), Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention.
의료 관련 폐렴 예방 가이드라인, 2003, MMWR 53 (RR-3), 질병관리본부 예방접종실무자문위원회.
Prevention and Control of Influenza, MMWR 53 (RR06), Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention.