Section 33-03-10.1-14 - Nursing services1. Skilled nursing services must be provided under the direction of a nurse executive (director of nursing) who is a registered nurse licensed to practice in North Dakota, with at least one year's full-time experience in providing direct patient care in a home health setting and three years' experience as a registered nurse. The nurse executive must have written administrative authority, responsibility, and accountability for the integration and coordination of nursing services consistent with the overall agency organization and plan for patient care. The nurse executive shall: a. Be a full-time, salaried employee of the agency; b. Supervise all patient care activities to assure compliance with current standards of accepted nursing and medical practice; c. Develop, maintain, periodically review, and cause to implement philosophy, objectives, standards of practice, policies and procedures, and job descriptions for each level of nursing service personnel; d. Ensure there are sufficient qualified nursing personnel to meet the nursing care needs of the patients in accordance with the plan of care; e. Ensure there is a registered nurse available by telephone during operating hours and when home health services are being provided to receive referrals, orders, patient phone calls, and any other concerns that may arise; and f. Identify an alternate registered nurse in writing to function as the nurse executive when the nurse executive is not available. 2. A registered nurse shall: a. Make the initial evaluation visit, initiate the plan of care, regularly reevaluate the patients' nursing needs, and make necessary revisions to the plan of care. (1) If the patient receives skilled nursing services and home health aide services, the registered nurse must make supervisory visits no less frequently than every two weeks. (2) If the patient is not receiving skilled nursing services, but is receiving home health aide, homemaker, or companion services, the registered nurse must make contact at least every sixty-two days to determine the appropriateness of the plan of care and the acceptability of the care provided. b. Initiate preventive and rehabilitative nursing procedures, prepare clinical notes, coordinate therapeutic and supportive services, inform the physician and other personnel of changes in the patient's condition and needs, and counsel the patient and family regarding patient care needs. c. Assign home health aides to specific patients dependent upon the needs of the patient and the skill of the home health aide. d. Participate in inservice programs, supervise and teach other nursing personnel. 3. Licensed practical nurses shall furnish patient care services in accordance with agency policies, prepare clinical and progress notes, and assist the physician and registered nurse in performing specialized procedures and patient teaching. 4. If home health aide services are provided, either directly or by contract, the services must be provided by individuals who meet the training and competency or competency requirements specified in section 33-03-10.1-18 and meet registry requirements as specified by state statute. Individuals providing home health aide services shall: a. Be supervised by a registered nurse; and b. Provide patient care and services that home health aides are permitted to provide by state statute and rules which are consistent with the physician's orders, assigned by the registered nurse for a specific patient, contained in the patient's plan of care and written instructions from the registered nurse or other appropriate professionals, and agency policies and procedures. N.D. Admin Code 33-03-10.1-14
Effective January 1, 1998.General Authority: NDCC 23-01-04, 23-17.3-08
Law Implemented: NDCC 23-17.3-05, 23-17.3-08