Section 300.610 Resident Care Policies

Section 300

Section 300.610  Resident

Care Policies

a)         The facility shall have written policies and procedures

governing all services provided by the facility.  The written policies and

procedures shall be formulated by a Resident Care Policy Committee consisting

of at least the administrator, the advisory physician or the medical advisory

committee, and representatives of nursing and other services in the facility.  The

policies shall comply with the Act and this Part.  The written policies shall

be followed in operating the facility and shall be reviewed at least annually

by this committee, documented by written, signed and dated minutes of the

meeting.

b)         All of the information contained in the policies shall be

available to the public, staff and residents, and for review by the Department.

c)         The written policies shall include, at a minimum the following

provisions:

1)         Admission, transfer and discharge of residents, including

categories of residents accepted and not accepted, residents that will be

transferred or discharged, transfers within the facility from one room to

another, and other types of transfers;

2)         Resident care services, including physician services,

emergency services, personal care and nursing services, restorative services,

activity services, pharmaceutical services, dietary services, social services,

clinical records, dental services, and diagnostic services (including

laboratory and x-ray);

3)         A policy prohibiting blood transfusions, unless the facility

is hospital based and appropriate services are available in case of an adverse

reaction to the transfusions; and

4)

A policy to identify, assess, and develop strategies to

control risk of injury to residents and nurses and other health care workers

associated with the lifting, transferring, repositioning, or movement of a

resident

A policy prohibiting blood transfusions, unless the facility

is hospital based and appropriate services are available in case of an adverse

reaction to the transfusions; and

4)

A policy to identify, assess, and develop strategies to

control risk of injury to residents and nurses and other health care workers

associated with the lifting, transferring, repositioning, or movement of a

resident. The policy shall establish a process that, at a minimum, includes all

of the following:

A)

Analysis of the risk of injury to residents and nurses and

other health care workers taking into account the resident handling needs of

the resident populations served by the facility and the physical environment in

which the resident handling and movement occurs;

B)

Education of nurses in the identification, assessment, and

control of risks of injury to residents and nurses and other health care

workers during resident handling;

C)

Evaluation of alternative ways to reduce risks associated

with resident handling, including evaluation of equipment and the environment;

D)

Restriction, to the extent feasible with existing equipment

and aids, of manual resident handling or movement of all or most of a

resident's weight, except for emergency, life-threatening, or otherwise

exceptional circumstances;

E)

Procedures for a nurse to refuse to perform or be involved

in resident handling or movement that the nurse, in good faith, believes will

expose a resident or nurse or other health care worker to an unacceptable risk

of injury;

F)

Development of strategies to control risk of injury to

residents and nurses and other health care workers associated with the lifting,

transferring, repositioning, or movement of a resident; and

G)

Consideration of the feasibility of incorporating resident

handling equipment or the physical space and construction design needed to

incorporate that equipment when developing architectural plans for construction

or remodeling of a facility or unit of a facility in which resident handling

and move

ers associated with the lifting,

transferring, repositioning, or movement of a resident; and

G)

Consideration of the feasibility of incorporating resident

handling equipment or the physical space and construction design needed to

incorporate that equipment when developing architectural plans for construction

or remodeling of a facility or unit of a facility in which resident handling

and movement occurs.

(Section 3-206.05 of the Act)

d)         For the purposes of subsection (c)(4):

1)

"Health care worker" means an individual

providing direct resident care services who may be required to lift, transfer,

reposition, or move a resident.

2)

"Nurse" means an advanced practice nurse, a

registered nurse, or a licensed practical nurse licensed under the Nurse

Practice Act.

(Section 3-206.05 of the Act)

e)         The facility shall have a written agreement with one or more

hospitals to provide diagnostic, emergency and acute care hospital services.  The

Department will waive this requirement if the facility can document that it is

unable to meet the requirement because of its remote location or refusal of

local hospitals to enter an agreement. The services shall include:

1)         Emergency admissions;

2)         Admission of facility residents who are in need of hospital

care;

3)         Diagnostic services; and

4)         Any other hospital-based services needed by the resident.