ML20247H153
| ML20247H153 | |
| Person / Time | |
|---|---|
| Site: | Seabrook  |
| Issue date: | 05/16/1989 |
| From: | MASSACHUSETTS, COMMONWEALTH OF |
| To: | |
| References | |
| OL-I-MAG-087, OL-I-MAG-87, NUDOCS 8905310172 | |
| Download: ML20247H153 (4) | |
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105 CMR: DEPARTMENT OF PUBLIC HEALTH ig era /yp q
L 105 CMR 150.000: LICENSING OF LONC-TERM CARE FACILITIES i
'89 MAY 23 P6 'll l
1 Section 150.001: Definitions 150.002: Administration -
hCh$Iibio I,, I I
M 150.003: Adnussions. Transfers and Discharges Epn "
l 150.004: Patient Care Policies i
150.005: Physician Services 150.000: Other Picfessional Services and Diagnostic Services 150.007:. Nursing Services 150.000: Pharmaceutical Services and Medications.
150.009: Dietary Service 150.010: Restorative Therapy Services (Physical Therapy, Occupational Therapy and Speech. Hearing and Language Therapy) 150.011: Social Services -
Activities and Recreation 150.012:~
150.013: Clinical and Related Records.
150.014: Utilization Review 150.015: Patient Comfort. Safety. Accommodations and Equipment 150.015: Environmental Health and Housekeeping l
150.017: Construction and Equipment.
(150.018: Reserved) 150.019: Education Services (SNCFC) 150.020: Supplement A: Limited Nursing Care in Certain LevelIV Units 150.021: Support Service Plan for LevelIV Community Support Facilities PREAMBLE j
The Department of Public Health is charged with the responsibility of ensuring that the Commonwealth's long tetm care facilities provide good quality care.' quality of life and safety for facility residents. In keeping with this responsibility, the Department has developed rest home regulations intended mainly to address the unmet needs of residents with mental health problems through the establishment of a new facility type referred to as Community Support Facility (CSF). The CSF is required te provide special services. staffing, and medication administration safeguards.
' After the effective date of these regulations only CSFs w.li be permitted to admit new residents from private or public psychiatric institutions. Commum ty Support Residents (CSRs) below the age of 50 and residing in Level IV facilities or in Level!V units in rnulti-level facilities prior to the effective date of these regulations shall not be discharged or transferred due to their age from such facilities or units without their consent (if they are competent to give such C
consent) or the consent of their guardian (if they are not competent). Such residents are also eligible for all services provided in a CSF as set out in these 3
regulations. Th6 Departre. int will consider and approve waiver requests for admission of resicents with mental health probleins to non-CSF facilities when special circumstances arise. Special circumstances which may require a waiver request might include: - a married couple which desires not to be separated and a resident who would be geographically separated from his/her family, or community supports (eg., church, medical carel.
Rest home residents shall have the followmg rights as set forth in these regulations:
1.
The right to refuse a social services plan and a support services plan.
-2.
The right to give signed consent for admission and services in a Community Support Facility (if he/she is competent to give such consent) nr the written consent of his/her guardian (if he/sne is not competenti.
3.
The right to resident projections against arbitran transfers ne discharges related to the change m a facility's designation as a CSF nr non-CSF: and 4.
The nght to refuse antipsychotics medications.
The Department will monitor the implementation and effect of these regulations on residents and on Level IV facilities. Level IV units and Commumty Support Facilities, and by July t.1988 will provide a report to the Public Health Council with appmpnate recommendations. An opporturuty will be offered for interested parties to comment on the implementation of these regulations through a public rneeting, which will be held prior to the Department's report to the Public Health Council.
7/1/87 8905310172 890516
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4 105 CMR: DEPARTMENT OF PUBLIC HEALTH 4
150.001: Definitions (A) Lons-Term Care Facility shall mean any institution whether conducted for chanty or profit which is advertised, announced or maintained for the express or irpplied purpose of providing three or more individuals' admitted thereto with long-term resident, nursing, convalescent or rehabilitative care; supet<ision and care incident to old age for ambulatory persons; or retirement home care for elderly persons. Long-term care facilitly shall include convalescent or nursmg homes, rest homes, mfirmaries. maintained in towns and charitable homes for the aged. " Facility" as used herein, shall mean a long-term care facility or unit thereof.
(1) Institution shall mean an establishment housed in a single building or in two or more adiacent buildings.
(2) Identifiable Unit shall mean a section of a facility such as a wing. floor or ward and shall include adiacent naoms where acceptable to the Department. For all facilities constructed af ter March 19,1968 and for all new construction, additions, conversions or alterations, an identifiable unit shall correspond to the definition of a unit as stated in the currently applicable construction standards of the Department, Fea facilities constructed prior to March 19, 1968, an identifiable unit shall mean approximately 40 beds in facilities that provide Level !! care, and not more l
than 60 beds in facilities that provide Level 111 or IV care.
(3) Convalescent or Nursing Home. Rest Home, infirmary Maintained in a Town, and Chantable Home for the Aged shall have the same meanmgs as those tesms defined in General Laws, chapter 111. section 71.
(4) Lons-Term Care shall mean care of significant duration as distintnushed from acute short-term care provided in a general hospital.
l There stall be three Levels of long-term care facilities under these i
cegulatici s.
j (B) Levels of Long-Tenn Care Facilities or Units. With the Conditions of Participation for Extended Care Facilities under Title XVI!! of the Social Secunty Act of 1965 (P.L 89-97) and provide r:are for patients as pra... bed ther.ein.
j' (1) S_ killed Nursing Care Facilities (LevelII) shall mean a facility or units thereof that provide contmuous skilled nursing care and
- meamngful l
availability of restorative services and other therapeutic services in addition to the minimum. basic care and services required in these rules and regulations for patients who show potential for improvement or restoration to a stabilized condition or wno have a deterioratmg condition requinng skilled care. Such facilities may but need not comply.
(a) Skilled Nursing Care Facilities for Children (SNCFCI fleve: fil shall mean a facility or umt/s thereof that provides skilled nursmg care services and/or inter.sive supportive nursing care services together with therapeutic treatment and habilitative services to multiply handicapped individuals, birth to twenty-two (22) years of age, who exhibit medical /nursmg needs requinng intervention, observation and supervision by a multi-disciplinary team of professionals. Individuals requiring these services who are aged fifteen (15) to twenty (22) or who do not meet the definition of " multiply handicapped" may be admitted to adult llevel !!
or Level !!!) umts with pnar approval from the Department's Medical Review Team (MRT) and the Department's licensing agency. A SNCFC is not an appropnate facility or umt for individuals requinns long-term custodial care.
(b) Respite Care in a Skilled Nursme Care Pacility for Children (SNCFC) shall mean temporary, snort term care of a muittply handicapped individual birth to twenty-two (22) years of age in order to provide relief to a family / primary care-giver.
(2) Supportive Nursma Care Facilities (Level till shall mean a facility or units thereof that provide routme nuestng services and penodic availability of skilled nursmg, restorative and other therapeutic services as indicated.
in addition to the miminum, basic care and services required in these rules I
i 7/7/87 596 EMERCENCY H
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- 105 CMR:. DEPARTMENT OF. PUBLIC HEALTil
' d 150.001i continued >
and' regulations for patients whose condition is stabill ed to the point that they need only supportive nursmg care, supervision and observation. -
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,(3) A^t Care Facilities (Level IV) shall mean a' facility or units theseof that provides or arranges to provide in addition to the minimum bes6c care and services required in these rules and regulations, a supervised l.
supportive and protective living environment and support services for elderly ambulatory residents 50 years of age and older having difficulty in
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1 carms for themselves and who do not require Level 1/11 or III nursmg care or other medically related services on a routine beeis. This facility's services and programs seek to foster personal well-being '- Mim.an optimal level of psychosocial. functioning. : and integration of residents into community living. Exception: Individuals below the age of 50 residing in Level IV facilities or in Level IV units in multi-level facilities petor to July j
1,1937 shall not be discharged or transferred due tb their age from such i
facilities or units without their consent (if they are competent to stve such consent) or the consent of their guardian (if they are not competenO.
(4) C-sty Suocott Facilities (CSF) shall mean a type of Resident Care
(
Facility or umta thereof which provides or makes arrangements to provide j
-l sppsopriate mental health services.. including follow-up, diagnoses.
treatment, monitoring, and crisis intervention, in addition to the minimum basic care and services required in these rules and regulations for Resident j
L'
. Care Facilities. The central purpose.of the CSF shall be to enable its i
k rendents to cope with daily, living outside a mental health institutional settmg by seeking to prevent their remstitutionalisation ' and thus assist them in their transition and integration into commumty living. For the
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purpose,s of licensure designation, a CSF shall mean any -resident care facility in which the Department determines that fifty percent (50%) or
.A more of the facility's residents are Commuruty Support Residents.
(C) : Sinste Level Facility shall mean a facility that provides only one level of care in one or more identifiable units.
q (D) Multiole Level Facility shall'mean a facility that provides two or three.
i-levels of care m one or more identifiable units for each level of care.
j (E) Minimum. Basic Rouirements for Care and Services shall mean the least
. quantity of personnel and services allowable for each level of care for licensure
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as prescribed in these rules and regulations. This is not to preclude the fact i
that additional staff and services will be necessary in certain facilit.es to meet
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patient needs.
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(F) D_e_partment shall mean the Department of. Public Health of the Commonwealth of Massachusetts.
j (C) Medical Care shall mean setvices provided by a physician or physician-nurse practitioner team or physician-physician assistant taam includlag: physical exammation and diagnosts; orders for treatments.
medications, diets, and associated semcas: emergency care: periodic supervision and review; and determmation of appropriateness of care and placement.
(H) Organ!gd Medical Staff shall mean an organized group of physicians as defined by the joint Commission on Accreditation of Hospitals.
II). physician shall mean a doctor of medicine or doctor of osteopathy who is registered te practice medicme in Massachusetts pursuant to General Laws, chapter 112. section 2.
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t11 Pediatrician shall mean a physictan licensed to practice medicme m Massachusetts who is certified or eligtole for certification by the American Board of Pediatrics.
(O Advisory phvsician shall mean a physician who advises on the conduct of medicai.mo meatcally related services m a facility. Advisory obvsician :n a j
.ino SNCF,C. snait mean a pediatriciast wiio suvises on the conouct of r.eotcat medically telated services m a f actitty.
EMERGENCY 7/7/87 397 f
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