ML20149E669

Applicant Exhibit A-11,consisting of Rockingham Nursing Home Policies,Stds Rules & Regulations

ML20149E669
Person / Time
Site:	Seabrook
Issue date:	10/22/1987
From:	ROCKINGHAM COUNTY NURSING HOME, ROCKINGHAM COUNTY
To:
References
OL-A-011, OL-A-11, NUDOCS 8802110224
Download: ML20149E669 (76)

Text

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POLICIES,

" l STANDARDS, RULES AND REGULATIONS . j 1B 'FEB -2 A9 :27

12. _ FIRE, SAFETY AND DISASTER PROGRAM 1

gfFICE Of SEQ?E TAA f '

Since there is no Security Department at Rockingham NursinhajhahEVICE procedure must be set up and followed for turning the outside night lights on and off and locking and unlocking the outside doors. The Maintenance

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Department will be responsible for_ turning ~the lights on-and locking the- 5 doors in the evening or at. dusk. The Housekeeping Department will be

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3 responsible for turning the lights off and unlocking the doors in the I morning no later than 6 a.m.

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'The following is a list of the lights and doors that are to be checked: ] t Blaisdell Bldg. : 016: lights turned on and off - doors checked o- '[

B17:  !)

B14:

B12:

B24:

B4:

B2:

Mitchell Bldg.: M4: lights turned onn and offn - doorsn locked a

andn unlocked n

n n g7 .n Underhill Bldg.: U9: lights turned on and off - doors "

checked U13:

Fernald Bldg.: Fil: lights turned on" and off" - doors" checked Dishroom:

The Nursing Department will be responsible for locking anti unlocking the a door in the Fernald Sunporch (C-103) Also the doors in the Underhill 'i Bldg. U103, U109, U112, U114 should be locked at all times as well as the i door to the entrance way in the Mitchell Bldg. 4 The night switchboard operator will be responsible for locking the doors in the Main Lobby at 11:30 p.m. and unlocking them at 5:30 a.m. Should there i be a need to open them during these hours, the Nursing Supervisor should be paged to unlock them.

The keys to the doors and lights will be kept at the switchboard.  !

The flags are the responsibility of the Housekeeping Department. There are two sets of flags. One set is in front of the Blaisdell Bldg. and the other is in the Courtyard. They are to be put out each morning at 7 a.m. and taken down at 4:30 p.m. and kept at the switchboard, e 8802110224 871022 3 ,

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Revised: 10/6/78 ROCKlilGHAM fiURSING HOME POLICIES,  ;

STAT {DARDS, RULES Afl0 REGULATIONS ,

12. FIRE, SAFETY AND DISASTER PROGRAM:

A written program of fire, safety and disaster for the ,

entire complex is kept current with local state and federal laws .j applicable. A copy of the program is attached.  ;

e Regular meetings of the Safety Committee are held under a 5 Director, appointed by the Administrator, i A copy of the Incident or Accident Report form currently in use at the Rockingham Nursing Home is attached.

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RCdDC11AM OOU!CY t;URSDC llCtE l

D'PLOYEE DCIDDE REFORT f n

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DGLOYEG IUOT: TFIPiiONE 10.

DEPARB C E: JOB TITII:

DATE OF D CIDD C: TDE: A.M or Rt ij

!1 DGCT IICATION OF DCIDDE:

DECRIBE DCsCTLY MIAT HAPPDED DCLUDDG IU423 OF ALL PERSONS DNOLVED: -

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d LIST ALL DWIMCC DNOLVED:

STATE DE PART OF BODY DUUPID: -

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LIST U.'LL IU4ES OF win:HiSES: h

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o CATE: SIGNATURE OF DTIOYEE: g C DATE: DO C IATE SUPERVISOR :

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g g FIUm p BY SUPERVISOR [

d GS FIRST AID GIVDr? YES 10 By: q t

TYPE OF FIRST AID GIVD1: l DTICYEE Ru uGID TO FIriSICIRi? YES to (If YG ccrglete 1,2,3 )

1. DATE SED 1: MIERE:

2. FiriSICIR1'S 1742: ADDPISS:

3. FiriSICIN1'S FD;DDGS:

ADDITIONAL CottECS DCIJJDDG RECCtiC:DATIONS FOR PPr/DCION OF SDIILAR CCUJRRDCES: _ _

SUPERVISORS SIG::lGUPI: DATE:

WH:T E A v ., waton N C Lt 0.* Dm Meac 'PINm Sa'e's Commiss'ener 3

CKINGHAM NURSING 'HOME .h Redsed MM L

12. ORIENTATION POLICY - NEW EMPLOYEES - SECURITY DEPARTMENT f It is the policy.of the Security Department of the Rockingham l!ursing l 4.

.Home to orient new employees to their position, to acquaint them with }

the new environment, to introduce them to key personnel and to specify the responsibilities of their position. This orientation shall include 1 a presentation and discussion of the Rules &_ Regulations of the 1 Rockingham-Nursing Hone.

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1. All employees of the Security Department shall be made aware 4 of the following:  ;

a. Time clock and time card  ;

b. . Parking regulations 'I

.c. Fire regulations }

d. Dining room regulations and hours for meals j

e. Smoking rules 4

f. Personnel Policies a

g. Detex clock - for punch stations in addition to the above, there will be the following: l Eight-hour tour of duty with senior security man a.

4-15 shift preferred

b. Physical by M.D. M

c. If physically fit will join the next Scott Air Pak Class I

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3/T2/80'

- ROCKINGHAM NURSING HO"E

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c POLICY STATEMENT i i 4

Nursing Homes, because of their very nature, are-expected to be places of safety and it is our intent that Rockingham Nursing Home live up to this, reputation. -The first. step is to comply '

l with applicabl.e laws on fire, accident prevention, health, ~

3 and working conditions. These laws define minimum requireinents, h which we shall exceed whenever practical. .)

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The second step is incident prevention. Incidents involving our -

employees prevent efficient use of our resources and disrupt ' service 3 to patients. Incidents involving patients or visitors lead to com- , j plaints and loss of goodwill. Our policy will be to take all practical steps possible to safeguard our employees, patients and.

visitors from accidents.

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l ANNEX A If l:

1. In the event of an emergency situation, imediate notifications of local 3 f

emergency services (Fire, Police, Rescue and Civil Defense) is essential, A) Fire 642-5452 B) Police 679-2225  ;,

C) Ambulance 772-5912 h D) Civil Defense 778-8158 - work

2. Notify Administrator, Medical Director, Director of Nurses.

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A) Administrator N , Home - M F B) Medical Director - Home - m - Office it C) Director of M Nurses [

3. To recall off-duty personnel, notify local radio and television stations h t

and repeat the,following message:

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"Due to the emergency that exists, all personnel of the Rockingham County Nursing Home are requested to report to the ,

y facility as soon as possible."

Radio Stations Phone Television Stations Phone WERZ, Exeter (603) 772-4757 WBZ, Boston (617) 787-70C WOKQ Rye Beach (603) 964-6598 WCVB, Boston (617) 449-040 '

WHEB, Portsmouth (603) 436-7300 WNEV, Boston (617) 725-077 WBZ, Boston (617) 787-7000 WMUR, Manchester (603) 623-80fL WHDH, Boston (617) 267-1313 If tne Emergency Broadcast Systems has been activated by local government official, notify Civil Defense and repeat the above message.

4 Off-duty personnel will refrain from contacting the facility during an emergency..

If in These phones will be in use in the emergency and should not be tied up.

doubt, report to the facility directly. ' ' lour assistance will be needed.

5. The facility'has access to a radio to receive up-3-date Civil Defense informatig and instructions on the Energency Broadcast System.

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O O Rev.10nSnS 4 ROCKINGHAM COUf;TY fiURSING HOME i

12. FIRE, SAFETY, DISASTER PROGRAM I

J ADMlft!STRATOR l 6

{ Mr. William F. Sturtevant Ext. WIN Home f Ext. M Office [

h DIRECTOR OF ADMINISTRATIVE SERVICES j Mrs, fiancy Lang M Home  !

N Ext. W Office  !

i l i SAFETY COMMITTEE  ;

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) Mr. William F. Sturtevant Ext. Home i j 6 Ext. J Mrs. Nancy Lang M Home  !

! M Ext. W Office i Mrs. Janet Schur M Homa j 6 Ext. W Office l

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Miss Marlene Skorupski M Home l M Ext. W Office i i

Mrs. Norma Dodge N Home l l M Ext. W Office j i

4 Mrs. Marilyn Winget M Home 6 Ext. W Office l

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i Mrs. Evalyn Tree M Home ,  !

j N Ext. anla Office r Mrs. Louise Haley M Home i 6 Ext. M Office ll 4

l Mr. Greg Ginchereau M Home Office i

Ext. W j i

• Mrs. Wendy Lombardo M Home l

Ext. M Office 1

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, , Rev. 7-24-86 ,,

l * . ROCKINGHA'l 'NTY NURSING HOME 1* FIFE. SAFETY, DISASTER PROGRAM 4

ADMINISTRATION }

i Miss Phyllis Rogers M Grandparents 4 m Ext. WWER Office l

4 Miss Mary Jane Toth M Home j Ext M Office  ;.

Mrs. Elaine Twombley M Home Ext. M Office I.

Mr. Perley Twombley M Homa.

Operator Office Mrs. Janet Jenks M  !!ome M Operator Office CHAPLAIN Rev. Dennis Marasco M Home  ;

Ext. M Office l

FARM j n

Robert Bartlet,; . Ext. M Hoce f M Ext. M Office

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t TOOD SERVICE j Y

Mrs. Linda Andrzejewski M Home Ext M Office [

Mr. Charles Studrance M Home i M Ext. M Office L

Mr. Brian Cheney M Home  ;

W Ext. M Office l]

i Brain Estelle M Hoce f M Ext. M Office l

HOUSEKEEPING Mrs. Louise Haley M Home g 6 Ext. M Office  !

l Mrs. Jean Sweeney M Home 6 Ext. M Office

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Rev. 7/24/66 ,

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• i ROCKlfi HAM COUNTY f;URSING HOMr l

12. FIRE, SAFETY, DISASTER PROGRAM h i, .

fiURSING [

b El Director of Nursing: g.

Mrs. florma Dodge R.H. M Home 0

m Ext. M Office Il I

Assistant Director of flursing:

Mrs. Marilyn Winget, R.N. Home f 6 Ext. M Office f X.

Supervis,r 7-3:

Mrs. Patricia Rouillard, R.N. 2nd Floor M Home i m Ext. M Office l Mrs. Joan Skinner, R.fl. 1st Floor M Ext. M Office .

Mrs. Janet Schur, R.M. In-Service M Home f

6 Ext. M Office j Mrs. Sandra Brown, R.N. M Home M Ext. M ' Office i I

Supervisor 3-11: $

k Mrs. Irene Crosby, R.N. M Home ti m Ext. M Office 'Il u

Mrs. Holly Gilbert, R.fl. M Home

}j Ext. M Office r.

Mrs. Virginia McKinley M Home- Y Ext. M Office h M w Supervisor 11-7: fj n

Mrs. Margaret Byrne, R.fl. M Home Office f

M Ext. M g Mrs. Mari ta L.owell , R.fl. M Home !i M Ext. M Office [

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o Rev. 10/25/85 ROCKitiGHAM C00iiTY i;URSit;G HOME O

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12. FIRE, SAFETY, DISASTER PROGRAM L

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i Mrs. Wendy Lombardo M Home k Ext. M Office f Miss Laura Clark M Home Ext. W Office f PJ f Miss Marlene Skorupski M Home f Txt. M Office l t

a Mrs. Debbie Doucette M Home N Ext. M Office ,k r

PHARMACY f I.

Mr. Gilbert Hoss M Home [

6 Ext. M Office y Mrs. Sandra Shute M Home 6 Ext. M Office g i

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SOCIAL SERVICE )

! Miss Lorraine Carter M Home I m Ext. M S Office f; f

Miss Cindy Hurlburt M Home 3 6 Ext. M Office i

ADULT MEDICAL DAY CARE }j i Greg Ginchereau Home Ext. Office [

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Kathleen Costello M Home j l M Ext. M Office ]

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• Rev: 3/1/80 f F0Cl;INGilAM NURSING HO"l: 1 FI P.1: . SAFETY, DISASTER PRE RA", 1 i

Policies, Standards, Rules and Regulations

12. DIS ASTER PL/u'; )

1. THIS PLL'1 TO BE I"ITI ATED IN TI)E OF A DISASTER r

1. All staff subject to call in an emergency. )

. 2. Switchboard Ope'rator to netify staff as ordered by Administrator in charge.

3. Employees report to the head of their Department or Charge person.

4. Administrater and Direc tor of Nursing should be notified ic=ediately if i I

not on duty.

l II. CH/.IN OF COSCIAND j

1. Administrator

2. Directer of Nursing i i

3. Assistant Director 4

4 Supervisor 7-3, 3-11, 11-7 Persen en duty at time of disaster will be relieved of charge when next y higher person in the chain of cec.and arrives en the scene. j III. ADMINISTRATIVE DETAIL )

1. Ascertain type of emergency h

a. Decide scope <

b. Acount of staff needed ".D's - Nurses - Aides- Orderlies - Volunteers - l Maintenance - liousekeeping - Dietary. 3

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IV. NOTIn* THE SEDICAL DIRECTOR {

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1. Call rest of Staff Doctors as needed. j V. TRIAGE TEA.'t

1. (1) Nurse Practitlener (Adult) - :!aintenance - (2) Aides - Clerk - f stationed at the ambulance entrance - casualties will be screened and -

sent to respective area for treatment.

2. First Aid will be given ir. mediately to prevent lo s t. of life then sent to -

an active hespital.

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3. Field type O.R. - X-Ray and simular posts could be set up in 0.T. and P.T. areas.

4. Cots set up in Auditorium - post surgery. (

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VI. EyACUATIO';

1. Medical Director decisien Discharge or transfer of patients. Extra beds could be placed in certain areas, t

2. Ambulatory patients could be sent here for a time or to other Nursing Homes. .

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Rev: 3/1/80 1 E0Cl:INGHAM NURSING HO"!: {

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TI nt:. SAFETY, DISASTER PROGRAM j Policies, Standards, Rules and Regulattens

12. DISASTER PLAN l 6

1. THIS PLAN TO BE INITI ATED IN TIME OF A DISASTER 4 s

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1. All staff subject to call in an e crgency. y

. 2. Switchboard Operator to notify staff as ordered by Administrator in charge. 4

3. Employees report to the head of their Department or Charge person. l

4. Administrator and Director of Nursing should be notified immediately if 4 not on duty.

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II. CfD.IN OF COSMAND j f

1. Administrator

2. Director of Nursing j

3. Assistant Director ]'

4 Supervisor 7-3, 3-11, 11-7 Persen en duty at time of disaster will be relieved of charge when next a higher person in the chain of comr.and arrivec cn the scene. <

III. AD!CNISTRATIVE DETAIL ,

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1. Ascertain type of emergency ]J

a. Decide scope

b. Amount of staff needed- MD's - Nurses - Aides- Orderlies - Volunteers - 3 2

Maintenance - Housekeeping - Dietary.

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IV. NOTIET THE MEDICAL DIRECTOR 1

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1. Call rest of Staff Doctors as needed.  !

V. TRIAGE TEAM .

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1. (1) Nurse Practitioner ( Adult) - Maintenance - (2) Aldes - Clerk - N statiened at the ambulance entrance - casualties will be screened and sent to respective area for treatment. .

2. First Aid will be given it. mediately to prevent lo s t. of life then sent to an active hospital.

3. Field type 0 R. - X-Ray and simular posts could be set up in 0.T. and .

P.T. areas. {

4. Cots set up in Auditorium - post surgery. (

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V1. EVACUATION

1. Medical Director decisien Discharge or transfer of patients. Extra beds could be placed in certain areas.  !

2. Ambulatory patients could be sont home for a time or to other Nursing Homes.

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Revt3/1/80 i ROCKINGRAM NURSING HOME FIRE, SAFETY, DISASTER PROGRAM '

12. EXTINGUISHER LOCATIONS BUILDING FLOOR ROOM QUANTITY EXTINGUISHER TYPE FERNALD BASDENT CORRIDOR 2 ABC .

FEMALD BASEMDiT CORRIDOR 1 FIRE BLANKET TEMALD EASEMDiT KITCHEN 4 CO2 k FEMALD BASEMENT KITCHEN 2 PRESSURIZED WATER )

FEMALD B AS EMENT KITCHEN 3 ABC J TEMALD BAS RENT MECHANICAL RM. 2 -ABC  ;

FERNALD FIRST CORRIDOR 5 PRESSURIZED WATER FERNALD FIRST CORRIDOR 1 FIRE BLANKET TEMALD FIRST KITCHDi 1 ABC FEMALD SECOND CORRIDOR 4 PRESSURIZED WATER T r.MALD SECOND CORRIDOR 1 FIRE BLANKET T 2.'JiALD SECOND KITCHDi 1 ABC 7ERNALD SECOND LOBBY I PRESSURIZED WATER TERNALD SECOND LOBBY l FIRE BLANKET LIJ.IEDELL BASUZNT E. CORRIDOR ~ -1 PRESSURIZED WATER OLAISDELL BASEMCiT LOBBY 1 ABC SMISDELL BASDIDiT W. CORRIDOR 2 PRESSURIZED WATER '

' ' Lt.I S DELL BASDENT W. CORRIDOR 1 FIRE BIANKET L'. A!S DELL BASDENT AUDITORIUM 1 PRFSSURIZED WATER U.AISDELL BASDENT O.T. 1 ABC utnISDELL BASEMD;T 0.T. 1 CO2 $

. ilSDELL BASDENT P.T. 1 ABC dLAISDELL BASEMDiT P.T. 1 FIRE BLANKET {

ELAISDELL BASEMDIT BFXPC. 1 ABC 2LAISDELL FIRST E. CORRIDOR 2 PRESSURIZED WATER )

BLAISDELL FIRST E. CORRIDOR 1 FIRE BLANKET i dLAISDELL FIRST KITCHEN 1 ABC i 3LAISDELL FIRST W. CORRIDOR 1 PRESSURIZED WATER i 4

BLAISDELL 'SECOND E. CORRIDOR '2 PRESSURIZED WATER 1 DLAISDELL SEC0!iD E. CORRIDOR 1 FIPI BLANKET )

BLAISDELL SECOND KITCHEN 1 ABC BLAISDELL SEC0!iD W. CORRIDOR 1 PRESSURIZED WATER FERNALD 1 & 2 AND BLAISDELL 1 & 2 - (2) SCOTT AIR PACS EACH. ,

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12. E.UINCUISHER LOCATIONS f SUILDING FLOOR ROOM OUANTITY EXTINGUISHER TYPE TEMALD BASEME'iT l

CORRIDOR 2 ABC  ?

FERNALD BASEMENT CORRIDOR 1 FIRE BLMiKET j FERNALD BASEMCIT KITCHEN 4 CO2 4 FEMALD BASDINT KITCHEN 2 PPISSURIZED WATER FERNALD 2 AS EMENT KITCHDI 3 ABC FERNALD BAS DENT MECHANICAL RM. 2 ABC t

FERNALD FIRST CORRIDOR S PRESSURIP.ED WATER FERNALD FIRST CORRIDOR 1 FIRE ELANKET I FERNALD FIRST KITCHDi 1 ABC

]

FEMALD SECOND CORRIDOR 4 PRESSURIZED WATER d 5

FERNALD SECOND CORRIDOR 1 FIRE BLANKET T 2.MiALD SECOND KITCRDi 1 ABC 7EP.*iALD SECOND LOBBY 1 PRESSURIZED WATER }

TERNALD SECOND LOBBY 1 FIRE BLANKET EL*.IS DELL BASE! INT E. CORRIDOR -1 PRESSURIZED WATER OLAISDELL BASEMCiT LOBBY 1 ABC 51AISPILL BASDENT W. CORRIDOR 2 PPISSURIZED WATER

" l.I S DELL

- BASDENT W. CORRIDOR 1 FIRE BLANKET ,

SLAISDELL B ASE* T.NT AUDITORIUM 1 PRESSURIZED WATER I .*1SDELL

. BASDENT 0.T. 1 ABC L.IS DELL BASEMENT 0.T. 1 CO2

- ilSDELL BASDENT P.T. 1 ABC dLAISDU.L BASE!ENT P.T. 1 FIRE BLANKET

.LAISDELL BASEMDiT BKFPC. 1 ABC 2LAISDELL FIRST E. CORRIDOR 2 PRESSURIZED WATER BLAISDELL FIRST E. CORRIDOR 1 FIRE BLANKET sLAISDELL FIRST KITCHEN 1 ABC LLAISDELL FIRST W. CORRIDOR 1 PRESSURIZED WATER )

BLAISDELL SECOND E. CORRIDOR 2 PRESSURIZED WATER 1 ELAISDELL S EC0!iD E. CORRIDOR 1 FIPI BLANKET )

BLAISDELL SECOND KITCHEN 1 ABC .

BLAISDELL SECOND W. CORRIDOR 1 PRESSURIZED WATER  !

FERNALD 1 & 2 AND BLAISDELL 1 & 2 - (2) SCOTT AIR PACS EACH. .

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Rov:3/1/80 ROCKINCHAM NURSING HOFI FIRE, SAFETY, DISASTER PROGRAM

12. EXTINGUISHER LOCATIONS BUILDING FLOOR ROOM OUANTITY EXTINGUISHER TYPE ,,

i MITCHELL B AS E".ENT CORRIDOR 1 PRESSURIZED WATER MITCHELL PRIhr PJf. 1 PRESSURIZED WATER MITCHELL FIRST PJf. 4 1 ABC MITCHELL FIRST CORRIDOR 2 PRESSURIZED WATER MITCHELL FIRST CORRIDOR 1 FIRE BIANKET MITCHELL FIRST KITCHEN 1 ABC -

MITCHELL FIRST STAIRWELL 2 PPISSURIZED WATER j MITCEELL SECOND PJf. 26 1 ABC MITCHELL SECOND CORRIDOR 2 PRESSURIZED WATER MITCHELL SECOND CORRIDOR 1 FIRE BLANKET MITCHELL SECOND KITCHEN 1 ABC MITCHELL SECOND STAIRWELL 2 PPISSURIZED WATER UNDERHILL BASEMENT CORRID3R 2 TRESSURIZED WATER UNDEPRILL BASEMENT CORRIDOR 1 ABC UNDEPRILL BASEMENT STORE PJ!. ,1 PPISSURIZED WATER UNDERHILL FIRST CORRIDOR 7 PRESSURIZED WATER UNDERilILL FIRST PORCH 1 PRESSURIZED WATER UNDERHILL TIRST PORCH 1 ABC UNDERHILL FIRST BY PORCH 1 FIRE BLANFlT UNDERHILL FIRST KITCHEN 1 ABC UNDERHILL SECOND CORRIDOR 7 PPISSURIZED WATER UNDERHILL SECOND PORCH 1 PRESSURIZED WATER UNDERHILL SEC0!iD PORCH 1 AEC .

l UNDERHILL SECOND BY PORCH 1 FIPI BLANKET $

UNDEPJIILL SECOND KITCHEN 1 ABC ]

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FIRE, SATETY, DISASTER PROGP>.M g 2

12. DISASTER RESPONSIBILITIES:

NURSING: I

1. Charge Nurse - (2) Aides remain at their station, all other 'l Personnel will take lounge chairs and wheel chairs and go )

down to ambulance entrance. Fernald and Blaisdell elevators - a

vill be down, Mitchell elevator up. <

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2. Central Supply Aide - Maintain supplies in emergency room and 3 c First Aide Station & Cast Room - Supply Room that has running water.

In the event of Field Station Hospital - RN and LPN in charge.

3. Operating Room - Scrub Nurse - RN or LPN with surgical training plus RN or LPN - Floor Nurse, Anesthetis t - MD or RN <

CAST - RN or LPN with 1 - 2 Aides. b

4. Emergency - All other staff vill be assigned to areas to carry out assigned duties. Help transport patients after triage officer sees them. Help inspect - bandage - or give solace to patients.

ADMISSION: ,

1. Of fice Manager will be in char e. or senior staff member on duty.

2. Switchboard to be manned at all times. /

3. To place. emergency tags correctly on ad=issions.

4. Recording of transfer or discharge of entients to where and when.  ;

5. Liaisons between home and relatives. .

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HOUSEY.EEPING: l.

1. Keep linen supply available. I j 2. Clean areas when necessary. [

3. All staf f vill report to Housekeeping Of fice to be sent where needed. [

j 4. Laundry - vork to keep linens available.

. PRARMACY: l l 1. Send supplies to area requesting them, i:

2. Order supplies from outside source to prevent shortage.

DIETARY:

1. Provide e=ergency food supply. -

2. Utilite staff for 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> coverage.

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MAINTDiANCE:

1. Transfer and set up of equipeent. *

2. Repair of equip =ent.

3. Keep traffic lanes open. ,

4. Utilize staff for 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> coverage.

P.T.: vill assist Nursing in transporting.

0.T.: will recieve, patients into Auditorium - keep calm. y i

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R3v 3/1/80 3 ROCKINGHAM NURSING HOME E FIRE, SAFETY, DISASTER PROGRAM L

12. NURSING: j Supervisor to disaster area.

Head Nurses

1. See that ward is being secured- vindows, doors closed.

2. Kardex - bed check as required. -

3. Calm and attend patients, d

4. Telephone to be manned - avait orders to evacuate. ) ,

5. Assign staff to detail.

6. When ordered by senior staff me:ber on duty - Send Scott Air y Pac trained personnel to den equipnent. -

Non-Disaster Building: I Divide staff into Group I & II using coffee break Group I - 1st. coffee Remain on floor, closing doors and windows. Help to cale patients, d Avait orders to evacuate.

f Group II - 2nd coffee Seeare your duty area until instructed to do otherwise.

1. Report to disaster area. '

2. Help move patients from im=ediate disaster area using L.

honizontal and vertical evacua. ion. (

3. Walking patients - vrap in blanket. $

4. Bed patients - vrap in blanke*., drag by head of blanket. .

Avait Orders To Evacuate.

i 7-3 Special Detail EMERGENCY ROOM - Manned by: Supply room - Supervisor of supplies Drug roce. - Pharmacist.

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. '" Rev: 3/1/80 ROCKINGHM1 liURSING liOME .

FIRE, SAFETY, DISASTER PROCFAM i

12. -

a OCCUPATIONAL THERAPY: l F11'I PROCEDURES

l. CLOSE WINDOWS AND DOORS. j

2. SHUT OFF ALL ELECTRICi.L EQUIT!ENT. L

3. Il0LD ALL PATIENTS IN THE AFIA - LIST ALL PATIENTS.

4. IF ON ELEVATOR, BRING TO GROUND FLOOR. LIST ALL PATIENTS.

5. ORDERS WILL BE A';N0U'!CED OVER P. A. SYSTD! IF WORKING, IF NOT THERE -;

WILL BE A VISSCiGER. l f.. TO EVACUATE BUILDING WILL COME AS A DIRECT ORDEn. .

7. REPORT TO AUDITORIUM Wu.EN ORDER IS GIVC'. f

- i PHYSICAL THERAPY: l FIRE PROCEDURES

1. CLOSE WINDOWS AND LOOFS.

[

g l 2. SHUT OFF ALL ELECTRICAL EQUIPMENT. )

3. HOLD ALL PATIC;TS IN THE APIA - LIST ALL PATICITS. g i 4. IF ON ELEVATOR, BRING TO GROUND FLODR. LOCK. LIST ALL PATID!TS.

j 5. ORDERS WILL BE A2.NOUNCED OVEF P. A. SYSTR! IT WOPJING, IF NOT THEPI WILL BE A MESSCiGER.

6. TO E7ACUATE BUILDING WILL COME AS A DIFICT ORDER.

7. THYSICAL THEPA?Y AIDES WILL BE USED FOR TRA1;SPORTATION IN AliY DISASTER. }

I HALRDFISSER: }

FIRE PROCEDUFIS {

1. KEEP PATIENTS IN YOUR E00M, LIST ALL PATID;TS. .

2. TFX1 SPORTING, MOVE PATIENTS INTO A SAFETY OR HOLDING AFIA.

PATIDiTS IN SMOKING AREA SHOULD MOVE INTO MITCHELL BUIIDING OR h HAIRDFISSING ROOM.

AEMINISTRATION: I FIPI PROCEDUPIS f

1. CLOSE WINDOWS AND DOORS. F

2. SHUT OFF ALL ELECTRICAL EQUIPMD;T. [

3. STAFF REMAINS IN THE API.A. f

a. Assist telephone cperator.  ;,

b. Act as cessengers. {

c. Act as clerks; infor:s; ion center. [

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Rev:3/1/00 51 $,' -

ROCKINGHAM NURSING HOME '

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v'" FIRE, SAFETY, DISASTER PROGRAM

' 12 . - MIN 7EN1NCE 4 _5 .

. , 1. In the event % E a fire in the Nursing Home or the Brentwood complex, the .

Maintenance L66artnent will be responsible for the following*

w 4 Tra::sf erL and -set-up of equipment as required. l

!!) !!3intain and rr. pair of essential equipment fccilities and utilities. f C) Insure that 'tlhe traf fic lanes are open.

2. All personnel (cxcept as designated) will report to the Maintetance control k.

y point. Maintenance control will insure 3 7

a- A) That' tha fire pump station is manned and in operating condition. This 3

\

g

^

ste':ioa vill be transfered to the control of the Fire Chief or his -

p.;

'L representitive upon their arrival. ' 3 J

'- B)' Rat all electrict:1 systens and plants are ope able, disconnect as m ;? Aequired. .

is canned and all unessential f

C) 3 at the. - boiler anc' n ewer plant

[

equipment be shut down.

D) Inaure thgt. the water supply system is manned and in operating condition.

E) Insure that all trucks:. tractors, and hec.vy equipment is readily  ;

available at:.d pooled . 1

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4. The-Maintenanco Supervisor, forerau , and fire klara sy stem technician will s

ik respond to ths fire scene. Deter:ainationwill be madc st t.ha t time of require-ments for additional manpod e and/pr~ equipment._ .

9

5. All the Maintenance personnel will always asst *me total r'esponsibility to k insure that the fire plan is followed and coerdinate the activities until y '

r,elieved by the fire chief or fire carshall.

6.bnlyafterthefirechieforfiremarshallhasdeclaredtheemergency k over, will Maintenance operations be returned to normal. p f

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Rev 3/1/80 ROCKINGilMi NURSING 110ME 3 I FIRE, SAFETY, DISASTER PROGRAM .,

,{

12. EVACUATION ROUTE p I

UNDERilILL 1 P

1. When alart: sounds, residents should be kept calm, doors and windows y p

are to be shut.

7

2. Residents should be moved horizontally away f rom fire scene, provide a blanket.

3. Vertical evacuation, when ordered, shall be out t: following exits; -j t

Exit 1 - West Rooms }

Exit 2 - South Rooms j Exit 3 - North Rooms kA Exit 3 - Wheelchairs if possible. I N

D0 NOT MOVE BEDS IN CORRIDOR. A 1

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UNDERHILL 2

1. When alarm sounds, residents should be kept calm, doors and windows are to be shut. g

2. Residents should be moved horizontally away f rom fire. scene, provide a blanket. ,

3. Vertical evacuation, when ordered, shall be down the fire escape.

DO NOT MOVE BEDS IN CORRIDOR.

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Rev: 3/1/80 g i-

" ROCKING! LAM N11RSING HOME E FIRE, SAFETY. DISASTER PROGRAM 3

12. EVACUATION ROUTE i

FERNALD 1 & 2 1

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1. When alarm sounds, residents should be-kept calm, doors and windows

~

--are to be shut.

t

2. Residents should be moved horizontally, away from fire scene, beyond -

]

.y fire doors. Provide a blanket. $

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3. Vertical evacuation, when ordered, shall be down stairwell designated

]

by senior staff. member. 4 k

DO NOT MOVE BEDS IN CORRIDOR. _

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MITCHr.LL 1 & 2

- .h

1. When alarm sounds, residents should be kept calm, doors and windows -

j are to be shut.

i r

2. Residents should be moved horizontally. away f rom fire scene, beyond' fire doors. Provide a blanket.

3. Vertical evacuation, when ordered, shall be down fire escape off sunporch.

DO NOT MOVE BEDS IN CORRIDOR.

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Rev: 3/1/80-ROCKINGHAM NURSING HOMC

. FIRE, SAFETY. DISASTER PROGRAM -

12. EVAC'lATION ROUTE

~BLAISDELL 1 1.,When alatu sounds, residents should be kept calm, doors and win' dows

'are to-be shut.

l

2. Residents should be moved horizontally, away from fire scene, beyond l fire doors. Provide a blanket. J

3. Vertical evacuation when ordered, shall be out the following exits:

B1-A - East Stbirs B1-B - West Stairs DO NOT MOVE BEDS IN CORRIDOR.

BLAISDELL 2

1. When alarm sounds, residents should be kept calm, doors and windows are to be shut.

2. Residents should be moved horizontailf, away from fire scene, beyond ,

' fire doors. Provide a blanket. ,

)

3.. Vertical evacuation, when ordered, shall be out the following exits: -

32-A - East S tairs 'I B2-B - West' Stairs DO NOT MOVE BEDS IN CORRIDOR.

A GROUND FLOORS

1. Hove residents horizontally away from fire scene.

2. If evacuation is ordered, residents should be moved out nearest exit.

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ROCKINGHAM NURSING HOME FIRE, SAFETY, DISASTER PROGRAM ft

12. ,

STAIRWELLS DIERGENCY -USE Upstairs Traffic:

FERNALD'- South Stairs /\

MITCHELL - West S tairs '

UNDERHILL - East Stairs BLAISDELL - Center Stairs Downstairs Traffic:

FERNALD - North S tairs MITCHELL - Fire Escape UNDERHILL - Fire Escape BLAISDELL - Eas t Stairs BLAISDELL - West Stairs \/

Nursing staf f shall remain in or return to their duty area until ordere.d to do otherwise. ,

Ground level emergencies shall be handled by the following personnel: 4 Fernald, Mitchell, Underhill Basements - Dietary, Ho'usekeeping, 4 Storeroom employees.

Blaisdell Basement - Administration, Physical Therapy, & Occupational Therapy enployees.

Evacuation of ward or building shall be ordered by senior s'taff member on duty.

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I ROCKI!!GHAM 1."JRSING HCME F IPI , SAFETY, DISASTER PR'OGRAM

. 12. DIETARY SERVICES Table of chlorinr* solution for disinfecting water from "Basic Course in Duergency Feeding":

Quantity of Water Clear Water Cloudy Water ff 1 gallon 10 drops 20 drops 5 gallons teaspoon 1 teaspoon 1,500 gallons 1 quart 2 quarts Dose the water with chlorine solution, stir and let stand for 30 minutes. If the smell of chlorine in the water has disappeared after 30 minutes, the water should be considered still unsafe to use. More chlorine solution should be added to the water and stirred. Wait 30 more minutes. The water may taste of chlorine, but it is not harmful.

Radioactive fallout cannot be removed by any of these disinfection methods.

Special methods are reqaired for treating such water. Food or water exposed to radioactivity must not be used until it has been declared safe'by radiological personnel or qualified civil defense officials.

NO SAFE WATER NO PIFRIGEPATION NO COOKING OR SERVING FACILITIES - In the event that thera is no safe water, refrigeration or cooking or serving facilities, the following steps should be followed:

1. Rely on canned and package foods, eaten cold, directly from the container or paper plates. Save tin cans for possible future use j as eating utensils.  !

2. Use juices from canned fruits and vegetables as substitutes for f water. Gingerales, soft drinks, or fruit juices may be used as e substitutes for water.

3. Serve foods that can be held in the hand.

4. Check the disaster plan menu that is attached to this plan for meals.

SAFE WATER l

IMPROVISED COOKINJ FACILITIES .

SAFE RECEPTACLES FOR FOOD AND BEVERAGE SUCH AS TIN CANS , OR PAPER CUPS AND DISHES - In the event that the above situation exists, the following steps l

! should be followed:

1. Serve a simple hot soup, stew, bread, or crackers, and a hot beverage.

2. If water for cooking is rationed, use vegetable juices and canned

• soups as liquids for cooking.

3. Use ration water for coffee and tea as well as for plain drinhing water.

l 4.,, Follow the disaster plan menu that is attached to this plan for l meals.

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Rev:3/1/80 ROCKINGHAM I.'URSING HOME FIRE, SATETY , DISASTER PROGRAM

12. DIETARY SERVICES. (cont 'd)

SOME WATER NO UTILITIES ELECTRIC, LP GAS AVAILABLE.- In.the event that the above situation exists, the following f steps should be followed: .

1. Move the tray line operation to the staff dining room, making 3 use of the dining room serving line which is operated with gas.  ?

2. Serve sandwiches with fillings not subject to quick spoilage [

- and easily handled beverage.

3. Follow the disastar plan menu that is attached to this plan for {~

meals.

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k; ROCKINGilA}! NURSING HOME FIRE, SAFETY, DISASTER PROGRA}!

t.

DISASTER PLAN MENU f "12. DIETARY SERVICES r

1st Day } g.

F"AKFAST Calories 4 oz.- Orange Juice 40 80 f

I cup Dry Cereal .

4 oz. Evaporated Milk . 173 2 pkg. Sugar 40 8 oz. Instant Coffee '

333 LUNCH 6 oz. Cream Celery Soup '60 s Cheese Sandwich 146 .

2 oz.

136 3 2 slice .(on bread) 4 1 pat Oleo 45 Carrot Sticks 40 5-6 80 f'[ '

4 oz. Canned Pear & Juice

• 4 ea. Crackers . .

68 8 oz. Mf'.h (made from non-fati dry milk) . 80 .

?

8 oz. C-ffee or Tea 20 1 pkg. Sugaz 675 j SUPPER 3

. Chicken Rice. Soup 85 6 oz. 3 Peanut Butter' Sandwich 146.

2 oz.

136 fi 2 slice (on bread) 4 ea. ' Crackers 68 i Fruit Mix & Juice 80 4 oz.

, 8 oz. Milk (made from non-fat dry milk) 80 8 oz. Coffee or Tea .

Sugar 20 f I phs. l

+

615 i

1,623 ,'

TOTAL FOR DAY 2%

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1 ROCKINCilAM NURSING HOME 1

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FIRE, S AFETY, DISASTER PROGRAM i

12. DIETARY SERVICES DISASTER PLAN MENU

-2nd Day

_ BREAKFAST Calories ,

4 oz. Orange Juice .

40 k I cup Dry Cereal 80 L 4 oz. Evaporated Milk 173 le 2 pkg. Sugar 40 [

8 oz. Instant Coffee 333 h 5

LUNCil . j; I.

2 ea. Franks 210 15 cup Baked Beans (canned) 140 Relish 20 4 oz. Peaches 80 2 slice Bread 136 y 2 pat Oleo 90 20

[D 1 pkg. Sugar .

8 oz. Milk (made from non-fat dry milk)

Coffee or Tea 80 [

8 oz.

776 b

SUPPER 1 cup Tuna Salad 250

, 4 ea. Crackers 68 1 pat Oleo 45 2 slice Bread 136 2 ea. Cookies 100 4 oz. Sliced Pineapple 80 8 oz. Milk (made from non-fat dry milk) 80 1 pkg. Sugar 20 8 oz. Coffee or Tea 779 i

TOTAL FOR DAY 1,888

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Rev: 3/1/80 r.N If, ROCKINGHAM NURSING HOME J' C+

FIRE, S AFETY , DIS ASTER PROGRAM

12. DIETARY SERVICES DISASTER PLAN MENU [.

3rd Day

'i BREAXFAST Calories  ;

a 4 oz. Orange Juice 40 80

[ 5, 1 cup Dry Cereal 173  ;

4 oz. Evaporated Milk ,;

Sugar 40 2 pkg.

8 oz. Instant Cof f ee 333

[

LUNCH h

85 g 6 oz. Vegetable Beef Soup 4 en. Crackers 68 g Cranberry Juice

• 80 4 oz. 136 p(

2 slice Bread '

Oleo 90 2 pat 80 4 oz. . Apricots

• 80 8 oz. Hilk (made from non-f at dry milk) ,

f.,

8 oz. Coffee or Tea '

Sugar 2O_ T' i pkg. 639 SUPPER ,

Chicken Vegetable Soup 85 6 oz. 68 Q

4 ea. Crackers 2 slice Bread 136 f9 Oleo 90 2 pat 100 j 2 ea. Cookies V 80 4 oz. Applesauce 8 oz. Milk (made from non-fat dry milk) 80 3 Sugar 20 F 1 pkg. f, 8 oz. Cof f ee or Tea '

I 659

! t, TOTAL FOR DAY 1,631 I

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ADMINISTRATOR ADMINISTRATIVE ASSISTAtlT SAFETY COORDINATOR l

l SAFETY & LOSS CONTROL COMMITTEE BRENTWOOD FIRE CHIEF Administrator, Chairperson Maintenance -

Nursing Housekeeping .

Food Service EMERGENCY SERVICE GROUP FIRE EQUIP. INSP. COMMITTEE--~

0.T.

P.T. Brentwood Fire Chief Brentwood Fire Chief Inservice Maintenance Personnel Maintenance Personnel AMDC Other designated employees l

3UILDING & PREMISES EMPLOYEE TRAINING &

INSPECTION COMMITTEE RETRAINING COMMITTEE Representive of Administrator h Safety & Loss Control Comm. R.P.T.

Department Heads In-Service Coordinator i

1 to N

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'A' fs q Revised: 11/8/85 L

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(_) V t ROCKINGHAM COUNTY NURSING HOME 2

SAFETY AND LOSS CONTROL COMMITTEE ORGANIZATION The safety and Loss. Control Committee has the responsibility and authority as delegated by the Administrator to organize, direct, and control the Safety and 3

, Loss Control Program.for all Nursing-Home operations and activities involving g the. safety and welfare of residents, clients, members of the public, employees. [

and professional staff.

Its basic activities are as follows:

1. . Review the incider.t analyses as prepared by the Representative Insurance Agency to determine the effectiveness of the, Safety and Loss Control Program. F

~2. Review and investigate all incidents particularly those in which time loss or Q injury has resulted. Make recommendations for corrective action when required. p

3. Review Inspections Reports and check the action taken to remcVe or control the hazardous conditions or practices reported, g

4. Plan Safety and Loss Control Training Programs (including fire) for all 4 b

personnel.

5. Institute a program for handling patients and members of the public under emergency conditions. g vi

6. Develop and assist in the use of educational materials, including visual [j aids, which should be a part of the Nursing Home's personnel training  ;

programs. ,

p

7. Develop Safety and Loss Control educational material, which includes j Off-The-Job safety, for posting within departments and for general T d

distribution to all employees, d

MEMBERSHIP g II r

Each Department Head is responsible for representation of at least one member to serve on the Safety and Loss Control Comittee. Each appointment will be reviewed at least annually by the Department Head and the Safety and Loss ,

Control Committee.

MEETINGS The committee meets every 2nd & 4th Tuesday of each month at 1:45 pm. Special meetings may be called by the Chairperson, Members must designate an alternate ,f to attend ma tings in their absence.

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t ROCKlftGHAM COUllTY f40RSING HOME  ;

L E

SAFETY AllD LOSS CONTROL COMMITTEE h

The Safety and Loss Control Committee reports directly to the Administrator l on all matters pertaining to the Safety and Loss Control Program, and has the responsiblity to: ((

t i

Assist the Department Heads and Supervisors in carrying out their 1.

responsibilities in accident prevention and fire protection. j Keep records of all incidents involving injury or time loss. From the k

2. I, incident repcrts, prepare analyses for management and for Committee personnel showing types, trends, causes, problem areas, etc. [

3. Conduct quarterly safety inspections with the Department Heads as out-lined under "Building and Premises Inspection Committee", and follow $e up the recommendations until satisfactorily completed.

4. Follow up with the Fire Chief until the recommendations of the Fire W Equipment Inspection Comittee are successfully completed. (

5. Administer the Safety Training Programs developed by the Employee Training and Retraining Committee for all personnel. L[

6. Supervise the posting and distribution .of Safety and Loss Control Educational material. f

7. Integrate flursing Home Safety and Less Control Activities with the I' latest developments in accident prevention.

8. Transmit to the Administrator any Safety and Loss Coatrol recommendations [b that require approval by the Administrator or the S ard for Comissioners ,lf before such recomendations may by put into effec Devise and recommend forms to be used in all the phases of Safety and I.I 9.

Loss Control activities to promote adequate documentation.  ;

Submit written reports to the Administrator on the progress of the Safety }

10.

and Loss Control activities. I V

11. Conduct and monitor regular fire drills.

Assist in training all flursing Home personnel in sounding the alarm and lj 12.

using emergency fire-fighting equipment. [.

k

13. Develop in cooperation with the local public fire department a fire '

emergency and evacuation program.

~

14. See that periodic inspections by the Fire Equipment Inspection Committee are made of all fire-protection and fire-fighting equipment. Assure that h remedial action is taken to correct unsatisfactory findings and that i reports are submitted promptly to the Safety and Loss Control Committee. j

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ROCKINGHAM COUNTY flVRSING HOME E

.e ADMINISTRATOR l The Administrator will serve as Chairperson to review the Safety and Loss Control program and initate necessary changes to keep'the program effective and current.

The. Administrator shall take proper action to motivate all Department Heads in ,

developing a proper attitude toward Safety and Loss Control. J

(

OEPARTMENT' HEADS, SUPERVISORS AND ANY PERSON IN' LEADERSHIP ROLE p{

Responsibilities are to: ,'

1. Enforce the safety rules and regulations of the Nursing Home and promptly [

report any violations. to the Safety and Loss Comittee. g i

2. Make quarterly inspections of their departments and initiate the corrective ,I actions needed. Submit a written inspection report to the Safety and loss

{

Control Commit?.ee.

3. Require that all incidents in each department be reported immediately. f Submit a copy of the incident report to an officer of.the Safety and loss #

Committee within 72 hours8.333333e-4 days <br />0.02 hours <br />1.190476e-4 weeks <br />2.7396e-5 months <br />. .

4. Require that all employees in each department be trained in safe work 9 practices, especially body mechanics and fire safety. g in

5. Require that all employees in each department be familiar with the }

emergency evacuation program and actively participate in fire drills. [4 b

6. Be constantly on the alert to detect unsafe conditions and practices,

[

and take steps to eliminate them, f c

[

7. Require that all new eraployees read the Safety Booklet upon employment

.and annually thereafter during Fire Safety Week (October). Employees are to submit to their Department Head a signed form stating that he/she A L

has read the booklet. This is to be filed in their personnel record. p B

8. Keep accurate records of attendance at Safety training programs of [

l employees in each department. g EMPLOYEE TRAINING COMMITTEE l The Employee Trainina and Retraining Committee is composed of the Administrator, Director of P.T. , anu the In-Service Coordinator. j i

The Committee has the responsiblity for planning, organizing, and evaluating j l

training programs:

1. In the use of first aid and fire equipment. j h

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L --- - - - - _ . - _ - = . - _ _ _

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9' ROCKINGHAM COUtlTY NURSil1G HOME l EMPLOYEE TRAINING COMMITTEE (Con't) >

2. In the use of good body mechanics and the safe movement of residents. t

3. In the techniques used to investigate the causes of incidents.

4. In safe work practices and environments. i BUILDING AND PREMISES INSPECT 10ll COMMITTEE W

ORGAll!IATION I The Comittee is composed of a representative from the Safety and Loss Control Comittee and a representative of Maintenance personnel. While an area or department is being inspected, the Department Head or Supervisor becomes a e' temporary member of the Inspection Comittee. )

-The Committee performs the following duties:

Inspection of all departments and work and storage areas quarterly h or more frequently if considered necessary. There will be an immediate i inspection of any area where new hazards or incidents are reported.

Findings and recommendations of the Committee are reported on the inspection '(

forms provided. A copy of each inspection report is given to the department head or supervisor concerned, so that any necessary corrective action within E the supervisor's area of responsibility may be started immediately. A second [

copy is retained by the secretary of the Safety and Loss' Control Comittee. .p f'

for followup purposes. A third is forwarded to the Administrater. g 1 -d FIRE EQUIPMENT INSPECTION COMMITTEE g

.ff, ORGAllIZATION p o

The Comittee is composed of a representative from the Safety and Loss Control 9 Committee, Brentwood Fire Chief, and two members of the Maintenance Department. ,

i The duties of the Committee are to make periodic inspections of all fire -

protection and fire-fighting equipment on a frequency determined by the h Fire Chief. g

(

Findings and recommendations of the Committee are reported on inspection forms F

provided. A copy of each inspection report is retained by the Secretary from ..

the Safety and Loss Contiol Committee for discussion at the Safety and Loss Control Committee meetings and for followup purposes. A copy of each inspec-tion report is also forwarded to the Administrator.

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ROCKlf1GHAM COUNTY flVRSING tiOME EMERGENCY SERVICE GROUP f.;

c

. ORGANIZATION )

- . l':

The Emergency Service Group is composed of the' Fire Chief, Maintenance Personnel,

~,

and designated employees of various departments and consists of enough members

~.to provide an immediate response of at least 'four members to any emergency. There should be a Group for all three shifts. The activities of the Group should be ,

supervised by the Fire Chief and monitored by the Safety and Loss Control j Committee as needed. .. t

?

The Emergency Service Group responds immediately to any emergency. {

r MEMBERS. [ .

The members are selected by the Fire Chief and the Safety and Loss Control 1 Committee with consideration given to the following qualifications: }l

(

1. Physical condition and interest in the fire emergency and evacuation program.: g

2. Availability to answer alarms and attend training sessions. P.

k.

3. . Specific abilities related to the need's of the Group (electrician, plumber, i' truck driver, etc.) {

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r ROCKINGHAM COUNTY NURSING HOME b

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. SAFETY AND LOSS CONTROL PROGRAM ,

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MOTOR VEHICLE CONTROL i

The-purpose'of_this program is.to establish requirements for the safe operation 1 of motor vehicles owned and leased by the Rockingham County Nursing Home. (

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1. All individuals selected to operate motor vehicles must possess a valid current driver's license from the State fo New Hampshire. Selection'to  :

operate will be made by the individual supervisor and submitted in writing 2 k

to the appropriate department head. Both physical and mental conditions must be considered by the supervisor before recommending a person. (

2. The Rockingham County Maintenance Department will maintain a current listing k of all individuals authorized to operate motor vehicles-(name, address, ,

license number) for the purpose of insurance information. [t

3. Pre-operation Inspection of Vehicles:

a. Check for physical damage prior to start y

b. Check oil, water, tires Check and, adjust mirrors (side and rear view) r c.

d. Check and adjust safety belts , { 1, -

Note all _ damage or questionable areas and report them to the Maintenance f' Department as soon as possible. 00 NOT OPERATE A VEHICLE IF AN UNSAFE CONDITION EXISTS. h 6

During operation of the vehicle the operator should be aware of all the y

4. p safety and warning devices within the vehicle (low oil, low water and C generatorwarninglights). Operator must always observeDriving all posted driving speads and drive in a' safe and prudent manner. the [

l-vehicles of the Nursing Home complex requires that All Drivers De Alert For Elderly Residents who may be walking around the area, fl

5. Post Operation Requirements of Vehicles:

I j'

a. Insure that parked vehicles are properly braked '(har.d brake on).

p If the vehicle has automatic transmission, insure tnat it is placed in the "PARK" postition. If the vehicle is standard f transmission, place the transmission in gear (first or reverse)

+

b. Check vehicle for damages.

c. Refuel the vehicle after every use.

L 6. Maintenance and Repairs:

/

a. Preventive maintenance and repairs will normally be performed i

by the Maintenance Department. All work will be attempted to i

! be accomplished on a scheduled basis,

b. Repairs or emergency service that may occur on the road are to j be accomplished as required after consultation with the l Maintenance Department.

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1 ROCKINGHAM COUNTY l1VRSING HOME [

t SAFETY AND LOSS C0!4 TROL PROGRAM t L

L MOTOR VEHICLE CONTROL (con't)

8. Accidents ..... Should you become involved in a motor vehicle accident, h the following must be done: [.

h

a. Do Not leave the scene of an accident. r

b. If you have passengers on board, check to see if any are injured. f.

Perform first aid as required, and call for help. 6

c. If you are involved with another vehicle, get all the information of that vehicle and driver: k 5

1. Name & Address (driver and witnesses)

2. Vehicle type and number j

3. Insurance company of other driver  ;

4. Notify police J, o

5. Fill out accident report

d. All accidents are to be reported to your supervisor and the k Maintenance Department is to be notified. Accident report E must be filed with the insurance company and the State of 1.

New Hampshire with 5 days.- .

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ROCKINGHAM COUNTY NURSING HOME 1

[

INCIDENTS INVESTIGATIONS [

s It is the policy of Rocki.ngham County Nursing Home to perform inc.ident A investigations as a means to prevent similar or more serious incidents. i-The Safety and loss Control Committee will investigate and review as f needed, any ano all-incidents particularly those involving: g

a. the use' of improper body mechanics and/or lifing techniques, i the improper use of equipment, and any incident resulting in time loss or a medical claim. (!

Investigations shall be conducted by designated members of the Safety D and Loss Control Committee including the supervisor or Department ' l

. Head of the area where the incident occurred. { .

PROCEDURE:

1. Source of referrals for investigation will include incident 3 reports, resident complaints, employee concern for potential .h injury or time loss, and general trends and individual incident patterns as evidenced by HIL report or records of the Safety and f

p1 Loss Control Committee. ,

2. An investigation of an incident will be initiated within 72 hours8.333333e-4 days <br />0.02 hours <br />1.190476e-4 weeks <br />2.7396e-5 months <br /> and a preliminary report submitted to the Safety and Loss Control (*

Committee within 2 weeks. @

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-?

3. The investigation report shall include a description of the incident, names of employees and/or witnesses related to the incident, ,i) indentified causes, statements from individuals involved in the c incident including the witnesses, action taken to prevent recurrence, the date of the report, and the signatures of investigators. f(

B The Safety and Loss Control Committee shallreview all investigation y 4.

reports at regularly scheduled or special meetings and make recommen-dations regarding need for any further action to be taken, including p

disciplinary measures. 4

5. Any employee involved in an incident investigation shall be notified

' of the review date scheduled with the Safety and Loss Control rom. kE The employee may exercise the opi.f on of being present at the l

ittee.

review session to provide input to the committee. I3

6. The Safety and Loss Control Cemittee will meet in a closed session (

to make decisions ar.d vote on reconnendations regarding each L investigation reviewed, f Recommedations of each investigation reviewed will be submitted to k 7.

the Administrator within one week of review date, including written h documentation for disciplinary action. [o Y

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! 40 [

ROC)[lii HAM C0v!CY fiUR$! fig HOME liC10EffT IlESTIGATIO!;S (con't)

8. It shall be the responsiblity of the department head to present to the employee any written documentation for disciplinary action upon approval of the Administrator. <

9. All reports and documentation will be kept on file by the Secretary of the Safety and Loss Control Committee. Copies will be placed in an involved employee's personnel . folder.

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1.~ BUSINESS OUtCE 3. M8 tic ARta$ NOT <

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2. MSif0RSLOUNGE S A1157 ACTORf SA $8&OTOFY

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. 'C?.*MENDATIONS AND OR E1PLAfi ATION OF UNS ATISF ACTOAY ITU.*S: ,-

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Centrifuges Covered

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14. 2 Z #'Cpe- Soe:imen & '.*ed cation Identification Coatainer .

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me nt 13. _ If'ciderts Properly Investigated a-d Preper Follow up

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LtS E & C,ASUA4,TV

g. M AINTEN ANCE -

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FCP lfeStJRED $ U$f ONLY

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General Howselee p.ag

' " D ~j $ ] N S Bede, Cronks, $ de Rolls, CA s- "S I' , F. ]s ~NS Piscement of Used Needles

' D., ]s U N s F winie ur e, lacludens F oct !vools G QS ._lNS Prorer Specirren oad

1. . ]5 CNS S:th, Call Light, Tub Handle s, Vedicction Ide ntific siion -

?, Solety $ trips on Twbs ons ihowers H. ~ s ~NS Me dication Admin;s tration F. ]S ]NS Csygen Tent.pornsag 559 4 Electrie [ Procedures Observed Betrer, er Cord Remo,ed From Area J. ~.;s Dus Cabinets, Storage . Hercotics Locked, wnere ongen is Being Used Nest and Orderly Sioroge

7. *0ERICOC S _ $T AlQ w AV S Location 4 UTILIT Y DOOMS A. ]5 CNS E i. 5:g ns ' A. [s [Ns Floors

3. -]$ CNs Elevator Entrances B. ]5 [NS H ow se ke e pin 2 C. ]5 CNS Corridor & Stroke Doors Closee , C. [s ONs Portable Ladders D. ]1 CNS 5teroge of Portsb8e Eqwip-ent D. [s ]Ns Flammehle Storese C. [s ONS Floors, warning Signs In Floce \ E. ~ 5 CNS Moentenance Eowip. & Storage Dwring f loor Meiatenance F. ]5 ]NS I V Solwrions Seperated

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.- 5. C E NE R A L

3. ds CNs Chwie Doors Closed (Lowndry, Tresh) A.-

H. -ti Ct4 5 'teirwors, Trod s, Handr ails, = : $ _- ; N 5 Smoking Rules Erforced

!N5 Persernel t'no- Ereergency Plen B. i north road

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SHOP 6 .O STOP E i O O O i..  !

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FENCE Q - BUILDING ACCESS PolNTS i 120 got dels.1 twel ini,d e V : :,; .u- UN D E R GROU N D T U N N E LS (

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SEWAGE

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