6 Colo. Code Regs. § 1011-1 Chapter 08 Part 15

Current through Register Vol. 47, No. 11, June 10, 2024

Part 15 - Medical Services, Therapeutic Services, and Equipment, Supplies, and Assistive Technology

15.1 The governing body shall establish and the administrator shall implement written policies and procedures for medical services and therapeutic services based on documented applicable standards of practice.

15.2 Medical services, therapeutic services, diagnostic services, equipment, and assistive technology shall be provided in a timely manner as ordered by the authorized, licensed prescriber.

15.3 Each resident shall have a primary care practitioner designated to coordinate the resident's care.

15.4 A record of all prescribed medical services or therapeutic services shall be maintained as part of the resident record.

15.5 Changes in resident's physical condition shall be reported to the nurse. Following the nurse's assessment, the facility shall ensure the primary care practitioner is notified in a timely manner and others in accordance with facility policy.

15.6 The governing body shall develop and the administrator or designee shall implement a written policy for monitoring each resident's weight. The policy shall include:

(A) For the purposes of this rule, a significant weight change is a five percent (5%) change in one (1) month, seven and a half percent (7.5%) change in three (3) months, or ten percent (10%) change in six (6) months. A serious weight change is above those percentages in the same timeframes.

(B) Weight monitoring shall be documented and promptly assessed for significant/serious weight changes.

(C) The facility shall promptly notify the primary care or other appropriate practitioner when significant/serious weight changes occur and document this notification in the resident record.

15.7 Medical Services

(A) The facility shall arrange for a medical evaluation of each resident on an annual basis unless a greater or lesser frequency is specified by the primary care practitioner designated to coordinate resident's care. If it is determined an annual evaluation is not needed, a medical evaluation shall be conducted at least every two (2) years. The facility shall document the results of such evaluations and any required follow-up services.

(B) The facility shall assist each resident in obtaining an annual dental examination. If the dentist determines that an annual examination is unnecessary, a dental examination shall be conducted at least every two (2) years. The facility shall document the prescribed frequency, results of all dental examinations, and any required follow-up services. If the resident does not have teeth, an oral examination by a practitioner may be substituted for the dental examination and the frequency and documentation requirements in this rule shall apply to such oral examinations.

(C) Other medical and dental services and follow-up shall be obtained as ordered by the primary care or other practitioner and shall be documented in the resident record.

15.8 Therapeutic Services

(A) For the purpose of this Chapter 8, the term therapeutic services shall include, but not be limited to: physical therapy, occupational therapy, speech and Language therapy, and similar services.

(B) The facility shall ensure that all therapeutic services utilized by residents are provided by persons or facilities that are licensed, certified, or otherwise authorized by law to provide such therapies and meet the applicable standards of practice.

(1) Unlicensed staff may provide therapeutic services only if such staff has been trained by a person licensed, certified, or otherwise authorized by law to provide such therapies.

(a) The facility shall document the name and professional title of the person providing such training and the content of such training.

(b) The facility shall document the therapeutic service training received by unlicensed staff and have such documentation readily accessible.

(2) Unlicensed staff may provide therapeutic services only when a protocol with specific instructions for providing such therapies is documented.

(3) All therapeutic services provided by trained, unlicensed staff shall be supervised and monitored at least quarterly. Such supervision and monitoring shall be documented in the resident file and include:

(a) Reviewing to ensure services are being provided as prescribed; and

(b) Ensuring that the individual providing the service documented the service at the time the service was provided.

(4) All therapeutic services provided by trained, unlicensed staff shall be supervised and monitored annually by a person licensed, certified, or otherwise authorized by law to provide such services.

15.9 Equipment, Supplies, and Assistive Technology

(A) Residents who use wheelchairs, adaptive equipment, or other assistive technology services shall receive professional reviews at the prescribed or recommended frequency to ensure the continued applicability and fitness of such devices. Such reviews shall be documented in the resident record.

(B) Wheelchairs and other assistive technology devices shall be maintained according to the manufacturer's guidelines.

(C) The facility shall have portable emergency equipment as necessary to meet the specific needs of the residents. If such devices are present, the facility shall ensure that all personnel are trained in the proper use of such devices.

(D) Each resident shall have dentures, eyeglasses, hearing aids, and other aids as needed and prescribed by the appropriate professional. Resident refusal to use such aids shall be documented in the resident record.

(E) The facility shall have individual resident equipment and supplies necessary to meet each resident's continuing medical needs.

6 CCR 1011-1 Chapter 08 Part 15