Section 340.1500 Medical Care Policies

Section 340

Section 340.1500  Medical

Care Policies

a)         The facility shall have a written program of medical services

approved in writing by the advisory physician, which reflects the philosophy of

care provided, the policies relating to this philosophy, and the procedures for

implementation of the services.  The program shall include the entire complex

of services provided by the facility and the arrangements to effect transfer to

other facilities as promptly as needed.  The written program of medical

services shall be followed in the operation of the facility.

b)         Each resident admitted shall have a physical examination,

within five days prior to admission or within 72 hours after admission.  The

examination report shall include at a minimum each of the following:

1)         An evaluation of the resident's condition, including height

and weight, diagnoses, plan of treatment, recommendations, treatment orders,

personal care needs, and permission for participation in activity programs as

appropriate.

2)         Documentation of the presence or absence of tuberculosis

infection by tuberculin skin test in accordance with Section 340.1520.

3)         Documentation of the presence or absence of incipient or

manifest decubitus ulcers (commonly known as bed sores), with grade, size and

location specified, and orders for treatment, if present.  (A photograph of

incipient or manifest decubitus ulcers is recommended on admission.)

4)         Orders from the physician regarding weighing of the resident,

and the frequency of such weighing, if ordered.

c)         The facility shall notify the resident's physician of any

accident, injury, or significant change in a resident's condition that

threatens the health, safety or welfare of a resident, including, but not

limited to, the presence of incipient or manifest decubitus ulcers or a weight

loss or gain of five percent or more within a period of 30 days

frequency of such weighing, if ordered.

c)         The facility shall notify the resident's physician of any

accident, injury, or significant change in a resident's condition that

threatens the health, safety or welfare of a resident, including, but not

limited to, the presence of incipient or manifest decubitus ulcers or a weight

loss or gain of five percent or more within a period of 30 days.  The facility

shall obtain and record the physician's plan of care for the care or treatment

of such accident, injury or change in condition at the time of notification.

d)         At the time of an accident or injury, immediate treatment

shall be provided by personnel trained in first aid procedures.

e)

All medical treatment and procedures shall be administered

as ordered by a physician.  All new physician orders shall be reviewed by the

facility's director of nursing or charge nurse designee within 24 hours after

such orders have been issued to assure facility compliance with such orders.

(Section 2-104(b) of the Act)

f)

Every resident shall be permitted to refuse medical

treatment and to know the consequences of such action, unless such refusal

would be harmful to the health and safety of others and such harm is documented

by a physician in the resident's clinical record.

(Section 2-104(c) of the

Act)

g)         All

residents shall be permitted to participate in the

planning of their total care and medical treatment to the extent that their

condition permits.

(Section 2-104(a) of the Act)

h)

No resident shall be subjected to experimental research or

treatment without first obtaining

the resident's

informed, written

consent.  The conduct of any experimental research or treatment shall be

authorized and monitored by an institutional review board appointed by the

Director.

Any facility desiring to conduct an experimental program or do

research that is in conflict with this Part shall submit a written request to

the Department and secure prior approval

ithout first obtaining

the resident's

informed, written

consent.  The conduct of any experimental research or treatment shall be

authorized and monitored by an institutional review board appointed by the

Director.

Any facility desiring to conduct an experimental program or do

research that is in conflict with this Part shall submit a written request to

the Department and secure prior approval.  Such approval will be granted only

if the request will not create an unnecessary and unusual threat to the health,

welfare, safety or rights of residents or staff.  (Section 2-104(a) of the Act)

i)          All residents

shall be permitted respect and privacy in

their medical and personal care program.  Every resident's case discussion,

consultation, examination and treatment shall be confidential and shall be

conducted discreetly, and those persons not directly involved in the resident's

care must have the resident's permission to be present.

(Section 2-105 of

the Act)

j)

An identification wristlet may be employed for any resident

upon a physician's order, which shall document the need for the identification

wristlet in the resident's clinical record.  A facility may require a resident

residing in an Alzheimer's disease unit with a history of wandering to wear an

identification wristlet, unless the resident's guardian or power of attorney

directs that the wristlet be removed.  All identification wristlets shall

include, at a minimum, the resident's name and the name, telephone number, and

address of the facility issuing the identification wristlet.

(Section

2-106a of the Act)

k)

A facility

shall

not refer a patient or the family

of a patient to a

home health agency, home nursing agency, or home services

agency

unless the agency is licensed under

the

Act.

A facility

shall request a copy of an agency's license prior to making a referral to that

agency.  (Sec 3.8 of the Home Health, Home Services, and Home Nursing Agency

Licensing Act)