Section 146.230 Services

Section 146

Section 146.230  Services

a)         An SLF must combine housing, personal and health related

services in response to the individual needs of residents who need help in

activities of daily living.  Supportive services shall be available 24 hours

per day to meet scheduled and unscheduled needs in a way that promotes resident

self-direction and participation in decisions that emphasize independence,

individuality, privacy, dignity and autonomy in a residential setting.

b)         Nursing Services

1)         The SLF shall conduct a comprehensive resident assessment and

service plan for each SLF resident as required under Section 146.245.

2)         When a resident is unable to administer his or her own

medications, a licensed nurse shall administer the medications.

3)         Nursing services shall include medication set-up (such as

preparing weekly pill caddies with that week's medication) and follow-up care,

and shall be conducted by a licensed nurse.

4)         Other nursing services include episodic and intermittent

health promotion or disease prevention counseling and teaching self-care in

meeting routine and special health care needs that can be done by other staff

under the supervision of a registered nurse.

5)         All nursing services shall be provided in accordance with the Nurse

Practice Act [225 ILCS 65].

c)         Personal Care

1)         The SLF shall provide personal care services for residents,

including but not limited to assistance with bathing, eating, dressing,

personal hygiene, grooming, toileting, ambulation and transfer.

2)         Personal care services shall be delivered by certified nursing

assistants who meet the qualifications described in Section 146.235(f)(1)

ct [225 ILCS 65].

c)         Personal Care

1)         The SLF shall provide personal care services for residents,

including but not limited to assistance with bathing, eating, dressing,

personal hygiene, grooming, toileting, ambulation and transfer.

2)         Personal care services shall be delivered by certified nursing

assistants who meet the qualifications described in Section 146.235(f)(1).

d)         Medication Administration, Oversight and Assistance in

Self-Administration

1)         The SLF shall provide the following:

A)        Reminding

the resident to take his or her medications;

B)        Taking medication from where it is stored in the apartment and

handing it to the resident when requested to do so by the resident;

C)        Opening or uncapping medication containers for residents; and

D)        Assisting residents in the removal of the medication from the

container and assisting the resident in consuming or applying the medication

when requested to do so by the resident (i.e., placing a dose in a container

and placing the container to the mouth of the resident).

2)         The services identified in subsection (d)(1)(D) shall only be

delivered by a licensed nurse.

3)         Medication

administration shall be documented according to the needs of each resident.

Documentation for medication administration shall include, but not be limited

to, the following:

A)        Name

of resident;

B)        Name

of medication, dosage, directions and route of administration;

C)        Date

and time medication is scheduled to be administered;

D)        Date

and time medication was administered; and

E)        Signature

or initials of employee administering the medication.

4)         Medication

oversight shall be documented according to the needs of each resident

Name

of resident;

B)        Name

of medication, dosage, directions and route of administration;

C)        Date

and time medication is scheduled to be administered;

D)        Date

and time medication was administered; and

E)        Signature

or initials of employee administering the medication.

4)         Medication

oversight shall be documented according to the needs of each resident.

Documentation for medication oversight shall include, but not be limited to,

the following:

A)        Name

of resident;

B)        Name

of medication, dosage, directions and route of administration;

C)        Type

of oversight needed; i.e., reminders, assisting with opening container, etc.;

D)        Date

and time medication is scheduled to be taken;

E)        Documentation

showing that resident has taken, or refused to take, the medication; and

F)         Signature

or initials of employee providing oversight.

e)         Meals

1)         The SLF shall provide three meals per day, or two meals per

day (noon and evening meals) and a breakfast bar.  The menu shall include food

choices that allow a resident to choose foods that will meet the requirements

of a therapeutic diet as ordered by a resident's physician.  The menu for each

resident shall meet the basic food pattern for a general diet for an adult

following the recommendations of the Food and Nutrition Board, National Academy

of Sciences.

2)         The SLF shall make available beverages, including coffee,

fruit juice and snack foods, at no cost to the residents.

3)         The SLF shall offer the same menu options to all residents

regardless of payment source.

4)         The SLF shall keep all menus served on file for not less than six

months.

5)         The SLF shall maintain on the premises supplies of staple

foods for a minimum of a one week period and of perishable foods for a minimum

of a two day period. Supplies shall be appropriate to meet the requirements of

the menu

offer the same menu options to all residents

regardless of payment source.

4)         The SLF shall keep all menus served on file for not less than six

months.

5)         The SLF shall maintain on the premises supplies of staple

foods for a minimum of a one week period and of perishable foods for a minimum

of a two day period. Supplies shall be appropriate to meet the requirements of

the menu.

6)         The SLF shall keep records of all food purchased on file for

not less than six months.

7)         The SLF shall store, prepare, distribute and serve food in a

manner to protect against contaminants and spoilage and to insure the preparation

and serving of food at safe and palatable temperatures.

8)         The SLF shall provide and maintain clean and sanitary central

kitchen and dining areas.  The SLF shall ensure a sanitary and adequate supply

of eating and drinking utensils and pots and pans for preparing food in the

central kitchen and dining areas.

9)         The SLF shall provide residents with written information about

menu plans. Menu cycles shall not be repeated within a one week time frame.

There shall be an established mechanism for residents to provide input into the

selection and preparation of food served.

10)        The SLF shall allow residents to obtain, prepare and store

food in residential apartments if doing so does not represent a health or

safety hazard to others.

11)        The SLF shall provide residents with meal service in their

apartments as a time limited service during periods of documented illness.

f)         Laundry

1)         If requested by a resident, the SLF shall provide laundry

services at least weekly at no charge to the resident.

2)         The SLF shall provide for the appropriate handling, cleaning,

and storage of routine personal laundry, laundry soiled with body secretions

and all other laundry.  This includes all detergent and fabric softeners

required to perform normal routine laundry service at no cost to the resident

resident, the SLF shall provide laundry

services at least weekly at no charge to the resident.

2)         The SLF shall provide for the appropriate handling, cleaning,

and storage of routine personal laundry, laundry soiled with body secretions

and all other laundry.  This includes all detergent and fabric softeners

required to perform normal routine laundry service at no cost to the resident.

3)         The SLF shall provide on-site laundry equipment for resident

use in accordance with Section 146.210.

4)         Laundry service does not include dry cleaning services.

g)         Housekeeping

1)         The SLF shall provide for general housekeeping services at

least weekly (house cleaning, bed making, changing of linens, dusting and

vacuuming).

2)         The SLF shall take into account individual habits and

lifestyle preferences when providing all housekeeping services in residential

apartments.

3)         The SLF shall maintain all public areas in a clean and orderly

condition.

4)         The SLF shall maintain all common bathing rooms in a clean and

orderly condition.

h)         Maintenance

1)         The SLF shall maintain all residential apartments  in good

repair.

2)         The SLF shall keep the building and grounds  clean and free of

hazards, with all systems maintained in good working order.

i)          Social and Recreational Programming

1)         The SLF shall facilitate the involvement of individual and

community volunteer activities with and for residents.

2)         The SLF shall provide programs at least twice weekly, which

include on-site programs as well as off-site trips, allowing for social and

recreational programs for the residents.  Transportation shall be provided or

arranged at no cost to the resident by the SLF for scheduled activities

off-site.

3)         The SLF shall provide access to opportunities for scheduled

and unscheduled individual and group socialization within the SLF and in the

larger community

de on-site programs as well as off-site trips, allowing for social and

recreational programs for the residents.  Transportation shall be provided or

arranged at no cost to the resident by the SLF for scheduled activities

off-site.

3)         The SLF shall provide access to opportunities for scheduled

and unscheduled individual and group socialization within the SLF and in the

larger community.

4)         The

SLF shall make available to each resident information about community resources

and make community integration part of the SLF's recreational, socialization

and vocational activities.

j)          Ancillary Services

1)         The SLF shall provide or arrange transportation, at no charge

to the residents, for scheduled shopping, community and social activities. The

community outings shall reflect the interests, choices and needs of the

residents and be scheduled on a regular basis and be reflected in the

residents' calendar.

2)         The SLF shall assist a resident in obtaining needed and

preferred services offered outside the SLF at his or her request. Upon request

by a resident, the SLF shall assist in making medical appointments and

arranging for transportation to and from the source of medical treatment

(payment for medical transportation shall be made in accordance with 89 Ill.

Adm. Code 140.490 through 140.492).

3)         The SLF shall provide shopping assistance when a resident is

temporarily unable to shop.

k)         24 Hour Response/Security Staff

1)         The SLF shall have response/security staff awake and  available

on the premises 24 hours a day to respond to scheduled or unpredictable needs

and emergency calls from residents.  Staff shall possess certification in

emergency resuscitation.  The SLF shall provide no fewer than one staff person

for facilities with one to 75 residents, a second staff person for facilities

with 76 to l50 residents, and a third staff person for facilities with 151 or

more residents

premises 24 hours a day to respond to scheduled or unpredictable needs

and emergency calls from residents.  Staff shall possess certification in

emergency resuscitation.  The SLF shall provide no fewer than one staff person

for facilities with one to 75 residents, a second staff person for facilities

with 76 to l50 residents, and a third staff person for facilities with 151 or

more residents. In determining the number of staff, the SLF shall consider the

number of floors in the building, and the medical needs of the residents.  At

least one certified nursing assistant shall be on-site 24 hours a day to

respond to resident needs.

2)         The SLF shall provide security 24 hours a day, including

lockable entrances (accessibility controlled by SLF staff for security purposes

during overnight hours) and on-site personnel.  All residents shall have 24

hour access.

3)         Rehabilitated nursing facilities shall have separate staff

on-site in the SLF.

l)          Health Promotion and Exercise Programming

1)         The SLF shall offer and encourage the use of health promotion

and exercise programs for its residents.

2)         The SLF shall develop programs to be held not less frequently

than three times per week geared toward promoting better health and fitness of

the residents.  These programs are in addition to the social and recreational

programming described in this Section.

m)        Emergency Call System

1)         The SLF shall ensure that at least two electronic devices are

available in each apartment to enable the resident to secure help in an

emergency.  At least one device shall be located in each bathroom. The

requirement for additional devices shall be met with a device located in each

bedroom or through a portable emergency home response system.

2)         The SLF shall have electronic devices available in each common

area, each public restroom, each common bathing room and each resident laundry

room to enable residents to secure help in an emergency

e device shall be located in each bathroom. The

requirement for additional devices shall be met with a device located in each

bedroom or through a portable emergency home response system.

2)         The SLF shall have electronic devices available in each common

area, each public restroom, each common bathing room and each resident laundry

room to enable residents to secure help in an emergency.

3)         The emergency call system shall be capable of direct and

immediate notification to staff or shall be manned by personnel 24 hours a day

for transmission to available staff for assistance.

n)         Daily

Check

The SLF shall

implement a system to check on the welfare of each resident daily.