Section 17-1720-22 - Institutional care services(a) Institutional care services are provided in a licensed nursing facility to an enrollee who is referred by a physician and may require prior authorization.(b) Institutional care services shall be provided either directly by or under the general supervision of a licensed practical nurse or registered professional nurse.(c) Institutional care services shall minimally include, but are not limited to: (1) Activities of the enrollee's choice (including religious activities) that are designed to provide normal pursuits for physical and psychosocial well-being;(2) Administration of medication and treatment;(3) Basic nursing and treatment supplies include, but are not limited to: soap, skin lotion, alcohol, powder, applicators, tongue depressors, cotton ball, gauzes, adhesive tape, bandages, incontinent pads, V-pads, thermometers, blood pressure apparatus, plastic or rubber sheets, enema equipment, and douche equipment;(4) Development, management, and evaluation of the written care plan based on physician orders that necessitate the involvement of skilled technical or professional personnel to meet the enrollee's care needs, promote recovery, and ensure the enrollee's health and safety;(5) Durable medical equipment and supplies used but which are reusable include, but are not limited to: ice bag, hot water bottle, urinal, bedpan, commode, cane, crutch, walker, wheelchair, and side rail and traction equipment;(6) Health education services provided by skilled technical or professional personnel to teach the enrollee self care, such as gait training and self-administration of medications; (7) Laundry service for items of enrollee's washable personal clothing;(8) Nonrestorative or nonrehabilitative therapy, or both, provided by nursing staff;(9) Observation and assessment of the enrollee's unstable condition that requires the skills and knowledge of skilled technical or " professional personnel to identify and evaluate the enrollee's need for possible medical intervention, modification of treatment, or both, to stabilize the enrollee's condition;(10) Review of the drug regimen of each institutionalized enrollee at least once a month by a licensed pharmacist, as required for a nursing facility to participate in Medicaid;(11) Therapeutic diet and dietary supplements as ordered by the attending physician;(12) Social services provided by qualified personnel;(14) Provision of and payment for, through contractual agreements with appropriate skilled technical or professional personnel, other medical and remedial services ordered by the attending physician which are not regularly provided by the provider. Other services that may be needed, such as transportation to realize the provision of services ordered by the attending physician, shall also be arranged through contractual agreements. The contractual agreement shall stipulate the responsibilities, functions, objectives, service fee, and other terms agreed to by the NF and the person or entity that contracts to provide the service; and(15) Feeding assistance performed by a feeding assistant, nurse aide, or nurse. The feeding assistant must work under the supervision of a registered nurse or licensed practical nurse that is licensed to practice in Hawaii. Haw. Code R. § 17-1720-22
[Eff 09/30/13] (Auth: HRS § 346-14; Pub. L. No. 100-203; 42 C.F.R. §§434.10, 440.40, 440.150, 483.1, 483.20 ) (Imp: Pub. L. No. 100-203; 42 C.F.R. §§434.10, 440.40, 440.150, 483.1, 483.20 )[Eff 09/30/13; Am and Comp 11/10/2016] (Auth: HRS § 346-14; Pub. L. No. 100-203; 42 C.F.R. §§ 434.10, 440.40, 440.150, 483.1, 483.20) (Imp: Pub.L. No. 100-203; 42 C.F.R. §§ 434.10, 440.40, 440.150, 483.1, 483.20)