La. Admin. Code tit. 48 § I-4765

Current through Register Vol. 50, No. 9, September 20, 2024

Section I-4765 - Quality of Life

A. Communication.

1. A provider shall have a written description of rules and procedures concerning:

a. telephone communication by clients;

b. visits from a client's family and friends.

B. Routines

1. A provider shall have a written set of daily routines for clients designed to provide for reasonable consistency and timeliness in daily activities, in the delivery of services to clients, and in the provision of adequate periods of recreation, privacy, and sleep.

C. Work

1. A provider shall assign as unpaid work for clients only housekeeping tasks similar to those performed in a normal home.

D. Recreation

1. A provider shall have a written plan for ensuring that a range of indoor and outdoor recreational and leisure opportunities are provided for clients. Such opportunities shall be based on both the individual interests and needs of the clients and the composition of the living group.

2. A provider shall utilize the recreational resources of the community whenever appropriate. The provider shall arrange the transportation and supervision required for maximum usage of community resources.

E. Religion and Culture

1. Every client shall be permitted to attend religious services in accordance with his/her faith.

2. Clients shall not be forced to attend religious services.

F. Clothing

1. If a client is admitted without adequate clothing, a provider shall ensure that the client is provided with clean, well-fitting clothing appropriate to the season and to the client's age, sex and individual needs.

a. Clothing shall be maintained in good repair.

b. All clothing provided to a client shall go with the client at discharge.

c. Clothing shall belong to the individual client and not be shared in common.

G. Food Services

1. A provider shall ensure that a client is, on a daily basis, provided with food of such quality and in such quantity as to meet the recommended daily dietary allowances adjusted for age, gender and activity of the Food Nutrition Board of the National Research Council.

2. A person designated by the chief administrator shall be responsible for the total food service of the provider. If this person is not a professionally qualified dietitian, regularly scheduled consultations with a professionally qualified dietitian shall be obtained.

3. A provider shall ensure that a client is provided at least three meals or their equivalent available daily at regular times with not more than 14 hours between the evening meal and breakfast of the following day. Between meal snacks of nourishing quality shall be offered. Meal times shall be comparable to those in a normal home.

a. The provider shall ensure that the food provided to a client is in accord with his/her religious beliefs.

b. A provider shall develop written menus at least one week in advance.

c. Written menus shall be maintained on file for 30 days. Menus shall provide for a sufficient variety of foods and shall vary from week to week.

d. No client shall be denied a meal for any reason except according to a doctor's order.

4. When meals are provided to staff, a provider shall ensure that staff members eat substantially the same food served to clients in care, unless age differences or special dietary requirements dictate differences in diet.

5. A provider shall purchase and provide to clients only food and drink of safe quality and the storage, preparation and serving techniques shall ensure that nutrients are retained and spoilage is prevented.

a. Milk and milk products shall be Grade A and pasteurized.

b. Dry or staple food items shall be stored at least twelve inches above the floor, in a ventilated room not subject to sewage or waste water backflow, or contamination by condensation, leakage, rodents, or vermin.

c. Perishable foods shall be stored at the proper temperatures to conserve nutritive values.

6. A provider shall show evidence of effective procedures for cleaning all equipment and work areas.

a. Handwashing facilities, including hot and cold water, soap, and paper towels, shall be provided adjacent to food service work areas.

H. Medical Care

1. A provider shall ensure the availability of a comprehensive program of emergency medical and dental care, as appropriate, for all clients. The provider shall have a written plan for providing such care. This plan shall include:

a. approaches that ensure that any medical treatment administered will be explained to the client in language suitable to his/her age and understanding;

b. an on-going relationship with a licensed physician and dentist to advise the provider concerning medical and dental care;

c. availability of a physician on a 24-hour a day, seven days a week basis;

d. the provider shall show evidence of access to the resources outlined in this plan.

2. A provider shall have access to psychiatric and psychological resources, on both an emergency and on-going basis, as appropriate to the needs of clients.

3. A provider must ensure that a client receives timely, competent medical care, in keeping with community standards of medical practice when he/she is ill or injured.

4. A provider shall ensure that no medication is given to any client except in accordance with the written order of a physician.

5. A provider shall ensure that medications are either self-administered or administered by qualified persons according to state law.

a. A medication shall not be administered to any client for whom the medication has not been ordered.

H. Reports on Critical Incidents

1. A provider shall have written procedures for the reporting and documentation of deaths of clients, injuries, fights or physical confrontations, suspected incidents of abuse or neglect, unusual incidents and other situations or circumstances affecting the health, safety or well-being of a client or clients.

a. Such procedures shall ensure timely verbal and written reports to the governing body of the provider.

2. When an incident involves abuse or neglect of a client, death of a client, or entails any serious threat to the client's health, safety or wellbeing, a provider shall:

a. ensure immediate verbal reporting to the governing body by the chief administrator or his/her designee and a preliminary written report within 24 hours of the incident;

b. ensure immediate notification of designated representatives of DHHR or other appropriate authorities, according to state law;

c. ensure immediate attempts to notify other involved agencies and parties, as appropriate;

d. ensure immediate notification of the appropriate law enforcement authority whenever warranted;

e. ensure follow-up written reports to all appropriate persons and agencies.

La. Admin. Code tit. 48, § I-4765

Promulgated by the Department of Health and Human Resources, Office of the Secretary, Division of Licensing and Certification, LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated in accordance with R. S. 46:2125.