Inspection results are reported by the Department in writing to the agencies within two weeks of the survey. A resident admitted for long-term rehabilitation shall be a person who has suffered a traumatic brain injury with structural non-degenerative brain damage, is medically stable, is not in a persistent vegetative state, demonstrates potential for physical, behavioral and cognitive rehabilitation and may evidence moderate to severe behavior abnormalities. Assist licensed nursing personnel ( RNs, LPN, and Nurse Aides) in obtaining in-service training to keep their license current and in accordance with state law. (iii) Notice of certain balances. (2) The facility shall not enter into any contract or agreement with the resident, next of kin and/or sponsor for life care of the resident. 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. In 2021, if the applicant is single, countable assets must be no higher than $2,000. (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. (1) The facility shall not charge a resident or his or her designated representative for any item or service not requested by the resident or the designated representative. (3) The facility shall issue a certificate of completion to each individual who successfully completes the state-approved feeding assistant training program. If married with a spouse remaining at home (community spouse), countable assets can reach $148,620. At the time of admission, a written copy of the following basic services must be made available to all residents: the daily, weekly or monthly rate; board, including therapeutic or modified diets, as prescribed by a doctor; (1) basic nutritional requirements for foods and fluids; (ii) feeding the resident who needs assistance; and. (6) Nurse aide recertification. (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. ; 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. (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. (i) The nurse aide training program shall include classroom and clinical training which enhances both skills and knowledge and, when combined, shall be of at least 100 hours' duration. The administrator shall set an example for all staff members, consultants and others affiliated with the facility which recognizes that the institution exists to serve the interests of and the needs of the residents, which emphasizes the importance of a resident's right to independence regarding all aspects of institutional life and encourages residents to participate together with staff in resolving conflicts and problems which frequently arise in a group residential setting. (a) any payment of cash or transfer of other assets by a facility directly or indirectly to or for the benefit of its operator or owner; and. 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. (3) The nursing home shall advise each potential resident or designated representative that he or she may seek a second opinion if he or she disagrees with the diagnosis or treatment being provided, and may call in a specialist selected by the resident or designated representative for medical consultation. Nursing home abuse is a serious problem in the United States. 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. 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. They must work under the supervision of a licensed occupational therapist or a licensed physician to assist in providing occupational therapy services. Copies of such statues are also available for public inspection and copying at the Records Access Office, Department of Health, Tower Building, Empire State Plaza, Albany, NY 12237. Section 441.317 - Sub-acute care services. (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. Nursing Homes. 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. (h) Financial Policies. (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. In order to maintain your certification with the Peace Officer Standards and Training Commission annual in-service training must be completed on or before June 30, 2023. (vi) Limitation on charges to personal funds. In pooled accounts, there shall be a separate accounting for each resident's share. (iv) In reviewing an application for withdrawal, the commissioner shall consider: (b) whether such withdrawal would impair the facility's ability to render quality care; (c) any expense which such withdrawal would generate; and. Published: May 2021. Section 441.317 - Sub-acute care services. The nursing home shall employ on a full time, part time or consultant basis a sufficient number of professional staff members who are educated, oriented and qualified to carry out the provisions of this Part and to assure the health, safety, proper care and treatment of the residents. The training program shall be supervised by a Program Coordinator who meets the definition specified in subparagraph (i) of paragraph (1) of this subdivision and conducted by the Primary Instructor who meets the definition specified in subparagraph (ii) of paragraph (1) of this subdivision. Scheduled short term nursing home care provided on a temporary basis to an individual who needs this level of care, but who is normally cared for in the community. 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. (iii) carry out staff drills in accordance with the written plan at least twice a year. (v) Assurance of financial security. This week's Ftag of the Week is F947 Required In-Service Training for Nurse Aides, which is part of the Training Requirements regulatory group. 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. Fiscal Year. Most people think the danger from fire is the flames, however, it is the smoke that can travel quickly to areas far from the fire. The facility shall employ a qualified dietitian either full-time, part-time or on a consultant basis who shall . Sorry, you need to enable JavaScript to visit this website. Dimensions: 8.5" X 11" spiral. 2:2 NURSING HOME RESIDENT'S RIGHTS DIGNITY AND RESPECT The resident has the right to: be treated with dignity, respect and consideration at all times; privacy in the treatment and care of your personal needs; choose activities, schedules and health care consistent with your interests and plan of care; communicate with and have access to people and services inside Preventive care practices. In terms of income, patients pay a share of cost based on an income after deduction for health insurance premiums and other expenses. Occupational therapists provide these services on the referral or prescription of a physician, physician assistant, or nurse practitioner. Residents shall be assessed as to their ability to be discharged to home or to a home-like setting with or without supportive services. Any brief statement not exceeding 150 words by the nurse aide disputing the findings shall also be included in the report, provided that any such statement containing the names of any resident or complainant shall be returned to the submitting individual and shall not be reported to the registry. (d) the financial condition of the facility in general. (vi) notify the Department within 72 hours of receipt of the notice that such referral resulted in conviction of an individual who was involved in misappropriation of resident property. The operator shall implement nurse aide recertification in accordance with the following: (i) The required documentation shall be provided in the form indicated by the Department to each nurse aide who either currently works for or last worked for compensation as a nurse aide in the facility; (ii) A fee shall not be charged by the operator to any nurse aide for any cost associated with recertification; (iii) The recertification fee for each nurse aide who either currently works for or last worked for compensation as a nurse aide in the facility shall be paid by the operator except that the nurse aide staffing agency or employment organization which currently employs the nurse aide may pay this fee; and. (11) Specially prepared or alternative food requested instead of the food generally prepared by the facility, if it is documented that the requested food costs more than food provided to other residents, except that food provided under paragraph (6) of subdivision (f) of section 415.3 of this Title shall not be charged to residents' funds. Special activities are offered to the residents with the goal of maintaining and promoting autonomy and decision making on the part of dementia patients. Examine nursing performance through a set of metrics that look at: Quality of care received. Potential residents whose personal attending physician or dentist is not approved to provide services to the resident after admission shall be duly notified prior to or at the time of admission. Such transfer agreements shall: (1) comply with the provisions of section 400.9 of this Title; (2) ensure that residents are admitted to the general hospital on a timely basis when such transfer is medically appropriate as determined by the attending physician or other approved practitioner; and. (3) Nurse aide training program. (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. 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. (8) No facility shall enter into a real property mortgage or lease transaction without 30 days' prior notice in writing to the commissioner. No charges shall be made to residents for those services. These tests may be taken online and electronically submitted to Home Health Specialists. Home Health Specialists requires all employees to complete the following mandatory inservices annually. The facility shall maintain a resident's personal funds that do not exceed $50 in a non-interest bearing account or petty cash fund. (j) Nursing care programs for the prevention of contractures and decubitus ulcers (pressure sores); (1) body alignment, turning and positioning; (5) maintenance of individualized range of motion. The curriculum shall otherwise include but not be limited to the following: (iv) psychological and cognitive changes; and. Such reimbursement shall be on a pro rata basis based on the length of subsequent employment as an RHCF nurse aide in the RHCF. [1] Sufficient nursing staff is universally recognized as a key requirement for making high quality of care possible and available for residents. 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 application shall contain a verified current balance sheet and a description of the facility's cash position, including as cash such cash equivalents as certificates of deposit and treasury bills. If it chooses to provide these items and services, they shall be included as covered Medicare or Medicaid services and reimbursed under those program benefits. The federal Nursing Home Reform law requires nursing facilities to have "sufficient" staff to meet their residents' needs. (vi) assure that except in extraordinary circumstances such as health emergencies, the facility has visiting hours encompassing at least 10 hours within a 24 hour period, including at least two meal periods, and that a statement as to the visiting hours is posted in a public place such as the main lobby or the residents' dining room. (i) upon receiving prepayment or advance money for the purpose of being applied to payments in satisfaction of or as security for the performance of facility responsibilities, deposit such money, which shall continue to be the money of the person making the prepayment, in an interest-bearing account in a bank or with a financial agent; (ii) not be required to deposit prepayment in an interest-bearing account where such money is to be applied to payments when due, until 61 days after such prepayment or advanced money is made; (iii) notify in writing each of the persons making such prepayment of the name and address of the bank or financial agent with which the deposit is made and the amount of such deposit. 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 report identifies each rule that is violated, along with a description of the evidence to support the finding. Rehabilitation services shall be made available, only at the direction of a physician, to eligible persons as medically needed and as an integral part of a comprehensive medical care program. (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. (g) Transfer Agreements. (q) Care of the dying resident including care of the body and personal effects after death; and. 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. 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. All personnel making such report shall be referred to an appropriate health care professional for assessment of the risk to residents and personnel. Box No. Such records shall include, but not be limited to: (i) the full name of the feeding assistant, facility-issued trainee or employee ID number, name and address of the facility, dates on which each content area of the feeding assistant training program was delivered and successfully completed, the date on which the individual successfully completed the feeding assistant training program, and the name, title and signature of the training program instructor. (4) utilizing the resident's family as a source of emotional support. 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. Agencies are required to provide orientation for new staff (including aides) employed by the agency prior to provision of care. 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. (j) Misappropriation of resident property. Revisions to Guidance - The Centers for Medicare & Medicaid Services (CMS) have revised the guidance to surveyors in Appendix PP under F155 to clarify a facility's obligation to provide CPR. 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. 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 . The facility shall notify the resident when the amount in the account of a resident who receives Medicaid benefits reaches $200 less than the SSI resource limit for one person, specified in section 1611(a)(3)(B) of the Social Security Act, and that, if the amount in the account, in addition to the value of the resident's other nonexempt resources, should reach the SSI resource limit for one person, the resident may lose eligibility for Medicaid or SSI; (iv) Conveyance upon death. 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