Section He-P 804.14 - Duties and Responsibilities of the Licensee(a) The licensee shall comply with all relevant federal, state, and local laws, rules, codes, and ordinances as applicable.(b) The licensee shall have written policies and procedures to include: (1) The rights and responsibilities of admitted residents in accordance with the patients' bill of rights under RSA 151:20, II;(2) The policies described in He-P 804.14(r), He-P 804.16(c) (11) , and He-P 804.19(e) ; and(3) A policy that ensures the safety of all persons present on the licensed premises where firearms are permitted.(c) The licensee shall provide the following core services: (1) Health and safety services to minimize the likelihood of accident or injury, with protective care and oversight provided 24 hours a day regarding: a. The residents' functioning, safety, and whereabouts; andb. The residents' health status, including the provision of intervention as necessary or required;(2) Emergency response and crisis intervention;(3) Assistance with taking and ordering medications as needed;(4) The provision of 3 nutritious meals and snacks in accordance with He-P 804.21 unless the resident chooses other options according to their admission agreement;(5) Housekeeping, laundry, and maintenance services in accordance with the admission agreement;(6) The availability of activities, for which the facility shall make reasonable accommodation for residents with disabilities, to include, but not be limited to, television, radio, internet, games, newspapers, visitors, and music, designed to sustain and promote physical, intellectual, social, and spiritual well-being of all residents in accordance with the admission agreement;(7) Assistance in arranging medical and dental appointments, which shall include assistance in arranging transportation to and from such appointments and reminding the residents of the appointments; and(8) Supervision of residents when required to offset cognitive deficits that may pose a risk to self or others if the resident is not supervised.(d) The licensee shall have a system to regularly identify the ALR-RC's daily census, including times when a resident is absent from the ALR-RC.(e) The licensee shall assist with arranging transportation to community activities, as available, designed to meet the individual interests of residents to sustain and promote physical, intellectual, social, and spiritual well-being of all residents.(f) The licensee shall: (1) Make available basic supplies necessary for residents to maintain grooming and personal hygiene, such as soap, shampoo, toothpaste, toothbrush, and toilet paper. Such basic supplies shall be included in the basic rate except that there may be an additional charge for specific brands or items required to meet individual residents' needs or requests;(2) Identify in the admission agreement the cost, if any, of basic supplies or other services for which there will be a charge;(3) Ensure that all personnel have received the training necessary to be qualified personnel to include demonstrated competency in the training given with documentation maintained in the employee file;(4) Require any paid provider of direct care, other than an employee, providing health care related services to provide a brief written, signed, and dated note describing the reason for the service(s), and the next planned visit, if known; and(5) Have a clearly identified policy for CPR that includes the following: a. If CPR is not performed, the policy shall include a statement that 911 shall be called in an emergency;b. If CPR is performed, there shall be either at least one person on duty per shift who is certified to perform CPR or an AED available for use; andc. This policy shall be signed by each resident and their guardian, agent, or personal representative, if any, and be located in the resident's file with their admission agreement.(g) The licensee shall educate personnel about the needs and services required by the residents under their care and document such education to include demonstrated competancies.(h) Physical or chemical restraints shall only be used in the case of an emergency, pursuant to RSA 151:21, IX.(i) As soon as is practicable and in no case longer than 24 hours after the use of a physical or chemical restraint, the resident's licensed practitioner, guardian, agent, or personal representative, if any, and the department shall be notified of the use of such restraints.(j) The use of mechanical restraints, limited to locked or secured ALR-RCs, or units within an ALR-RC, or anklets, bracelets, or similar devices that cause a door to automatically lock when approached, thereby preventing a resident from freely exiting the ALR-RC or unit within as permitted by the state fire code, shall be allowed.(k) Notwithstanding (j) above, the following methods of mechanical restraints shall be prohibited: (2) Gates, if they prohibit a resident's free movement throughout the living areas of the ALR-RC;(3) Half doors, if they prohibit a resident's free movement throughout the living areas of the ALR-RC;(4) Geri chairs, when used in a manner that prevents or restricts a resident from getting out of the chair at will;(5) Wrist or ankle restraints;(6) Vests or pelvic restraints; and(7) Other similar devices that prevent a resident's free movement.(l) For reportable incidents, the licensee shall:(1) Complete an investigation to determine if abuse or neglect could have been a contributing factor to the incident;(2) Fax to 271-4968 or, if a fax machine is not available, convey by electronic or regular mail, the following information to the department within 48 hours of a reportable incident:b. A description of the incident, including identification of injuries, if applicable;c. The name of the licensee(s) or personnel involved in, witnessing, or responding to the reportable incident;d. The name of resident(s) involved in or witnessing the reportable incident;e. The date and time of the reportable incident;f. The action taken in direct response to the reportable incident, including any follow-up;g. If medical intervention was required, by whom and the date and time;h. When the resident's guardian, agent, or personal representative, if any, was notified;i. The signature of the person reporting the reportable incident;j. The date and time the resident's licensed practitioner was notified, if applicable; andk. The date the facility performed the investigation required by (1) above;(3) As soon as practicable, notify the guardian, agent, or personal representative, if any;(4) As soon as practicable, notify the local police department, the department, and the guardian, agent, or personal representative, if any, when a resident has an elopement or unexplained absence and the licensee has searched the building and the grounds of the ALR-RC without finding the resident; and(5) Notify the department with a written report within 5 days describing the actions taken by personnel, the final outcome or continuation of the reportable incident, and actions taken to prevent a reoccurrence if it was not submitted in the initial report.(m) The licensee shall comply with the patients' bill of rights as set forth in RSA 151:19-30.(n) The licensee shall not exceed the maximum number of residents or beds licensed by the department, unless authorized by the department, such as during an emergency.(o) The licensee shall give a resident and the resident's guardian, agent, or personal representative, as applicable, written notice of the following: (1) For an increase in the cost or fees for any ALR-RC services, 30 days advance notice shall be required except for residents receiving Medicaid whose financial liability is determined by the state's standard of need, or residents funded by the department's Choices for Independence program in accordance with He-E 801 and which limitation shall only pertain to costs and fees under the direction of these programs; or(2) For an involuntary change in room or bed location, the facility shall make reasonable accommodation of individual needs and preferences and give 14 days advanced notice, unless the change is required to protect the health, safety, and well-being of the resident or other residents, in such case the notice shall be as soon as practicable.(p) In addition to the posting requirements specified in RSA 151:29, the licensee shall post the following documents in a conspicuous area accessible to residents, employees, and visitors: (1) The current license certificate issued in accordance with RSA 151:2;(2) All inspection reports for the last 12 months in accordance with He-P 804.09(d) and He-P 804.11(d) ;(3) A copy of the patients' bill of rights specified by RSA 151:21;(4) A copy of the licensee's complaint procedure, including a statement that complaints may be submitted, in writing, to The Department of Health and Human Services, Office of Legal and Regulatory Services, Health Facilities Administration, 129 Pleasant Street, Concord, NH 03301 or by calling 1-800-852-3345, and information on how to contact the office of the long-term care ombudsman; and(5) The licensee's evacuation floor plan identifying the location of, and access to, all fire exits.(q) The licensee shall determine whether smoking will be allowed at the ALR-RC.(r) If smoking is to be allowed, the licensee shall develop and implement smoking policies and designate smoking areas in accordance with RSA 155:66, RSA 155:68, and RSA 155:69 and He-P 804.26(f) .(s) If the licensee holds or manages a resident's funds or possessions, it shall first receive written authorization in accordance with RSA 151:24 and RSA 151:21, VII, and such funds shall not be used for the benefit of the licensee, other residents, or other household members.(t) The licensee shall not falsify any documentation required by law or provide false or misleading information to the department.(u) The licensee shall not advertise or otherwise represent themselves as having a license to provide services that they are not licensed to provide.(v) The licensee shall comply with all conditions of warnings and administrative remedies issued by the department and all court orders.(w) The licensee shall develop quality assurance plans and policies that evaluate: (1) The quality of care and services provided to residents;(2) Compliance with RSA 151 and He-P 804;(3) The effectiveness of training provided to personnel; and(4) The effectiveness of corrective actions taken in response to statements of findings, notices to correct, and problems identified in (1) -(3) above.N.H. Admin. Code § He-P 804.14
Amended by Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12047, Effective 11/19/2016, Expires 5/18/2017.Amended by Volume XXXVII Number 45, Filed November 09, 2017, Proposed by #12414, Effective 11/3/2017, Expires 11/3/2027.