216 R.I. Code R. 216-RICR-40-10-1.18

Current through November 7, 2024

Section 216-RICR-40-10-1.18 - Environmental and Maintenance Services

1.18.1Housekeeping

A. A full-time employee of the nursing facility shall be designated responsible for housekeeping services, supervision and training of housekeeping personnel.

B. Sufficient housekeeping and maintenance personnel shall be employed to maintain a comfortable, safe, clean, sanitary and orderly environment in the nursing facility.

1. Housekeeping personnel qualified in accordance with §1.14.6(A)(1) of this Part may assist in food distribution and food preparation. Careful hand washing shall be done prior to assisting in food distribution and/or food preparation.

2. Housekeeping personnel may provide assistance with eating and hydration of residents in accordance with §1.16.11(B) of this Part

C. Written housekeeping policies and procedures shall be established in accordance with §1.16.2(A) of this Part, for the operation of housekeeping services throughout the nursing facility. Copies shall be available for all housekeeping personnel.

D. All parts of the nursing facility and its premises shall be kept clean, neat and free of litter and rubbish and offensive odors.

E. Equipment and supplies shall be provided for cleaning of all surfaces. Such equipment shall be maintained in a safe, sanitary condition and shall be properly stored.

F. Hazardous cleaning solutions, compounds, and substances shall be labeled, stored in a safe place, and kept in an enclosed section separate from other cleaning materials.

G. Cleaning shall be performed in a manner which will minimize the development and spread of pathogenic organisms in the home environment.

H. Exhaust ducts from kitchens and other cooking areas shall be equipped with proper filters and cleaned at regular intervals. The ducts shall be cleaned as often as necessary and inspected by the nursing facility no less than twice a year.

I. Nursing facilities contracting with outside resources for housekeeping services shall require conformity with existing Regulations.

J. Each nursing facility shall be maintained free from insects and rodents through the operation of a pest control program.

1.18.2Laundry Services

A. Each nursing facility shall make provisions for the cleaning of all linens and other washable goods.

B. Nursing facilities providing laundry service shall have adequate space and equipment for the safe and effective operation of laundry service and, in unsewered areas, shall obtain approval of the sewage system by the licensing agency to ensure its adequacy.

C. Written policies and procedures for the operation of the laundry service including special procedures for the handling and processing of contaminated linens, shall be established in accordance with §1.16.2 of this Part.

D. There shall be distinct areas for the separate storage and handling of clean and soiled linens.

1. The soiled linen area and the washing area shall be negatively pressurized or otherwise protected to prevent introduction of airborne contaminants.

2. The clean linen area and the drying area shall be physically divorced from the soiled linen area and the washing area.

E. All soiled linen shall be placed in closed containers prior to transportation.

F. To safeguard clean linens from cross-contamination they shall be transported in containers used exclusively for clean linens which shall be kept covered at all times while in transit and stored in areas designated exclusively for this purpose.

G. A quantity of linen equivalent to three (3) times the number of beds including the set of linen which is actually in use shall be available and in good repair at all times.

H. Facilities contracting for services with an outside resource in accordance with §1.15.3(C) shall require conformity with this Part.

1.18.3Emergency Operations and Continuity of Operations Plan [EOP/COOP]

A. Each nursing facility shall develop and maintain a written emergency operations plan (EOP) that shall include plans and procedures to be followed in response to any situation, event or other emergency that impacts or threatens the normal operation of the nursing and/or the general health and safety of the residents, and shall include a Continuity of Operations Plan (COOP) detailing how essential functions shall be maintained and restored. The plan shall include provisions for evacuation of the nursing facility in the event of a natural disaster or any time or circumstance where the general health and safety of the residents cannot be maintained or provided for while remaining in place. The plan and procedures shall be developed with the assistance of qualified safety, emergency management, and/or other appropriate experts and shall be coordinated with the local emergency management agency.

B. The EOP plan shall include procedures to be followed pertaining to no less than the following:

1. Fire, explosion, severe weather, loss of power and/or water, flooding, failure of internal systems and/or equipment, and/or any other unforeseen circumstance that impacts or threatens the routine operation of services at the nursing facility;

2. Transfer of casualties;

3. Transfer, backup, and/or storage of records;

4. Location and use of alarm systems, signals and firefighting equipment;

5. Containment of fire;

6. Notification of appropriate persons inside and outside the operation of the home (i.e., local authorities);

7. Internal and external relocations of residents and potential evacuation scenarios, as coordinated with local and State emergency planning authorities;

8. The continuation of meals and hydration needs for residents;

9. Handling of all medications and biologicals;

10. Elopement and/or missing residents;

11. Back-up or contingency plans to address possible internal systems (e.g., food, power, water, sewage disposal) and/or equipment failures; and

12. Any other essentials as required by the local emergency management agency.

C. A copy of the EOP plan shall be available at every residential area.

D. Emergency steps of action shall be clearly outlined and posted in conspicuous locations throughout the nursing facility.

E. Simulated drills testing the effectiveness of the EOP plan shall be conducted at least annually and/or in conjunction with local emergency preparedness drills. Written reports and evaluation of all drills shall be developed and maintained by the nursing facility.

F. All personnel shall receive training in disaster preparedness and response as part of their employment orientation, consistent with current standards of practice (i.e., ICS 100, 200, 700).

G. The administrator of the nursing facility shall notify the licensing agency (Office of Facilities Regulation) immediately by telephone of any unscheduled implementation of any part of the nursing facility's emergency operations plan and shall provide a follow-up report in writing within five (5) business days using a reporting form designated by the licensing agency.

H. Each nursing facility shall agree to enter into a memorandum of agreement, upon written request, with the local municipality in which the nursing facility is geographically located to participate in a distribution and dispensing plan for medications and/or vaccines in the event of a public health emergency or disease outbreak.

1. The memorandum of agreement shall, at a minimum, include the following components:

a. A plan by the nursing facility to assess residents for medical appropriateness of medication or vaccine to be administered;

b. A plan outlining the process for receipt and management of medications and/or vaccines when transferred to the nursing facility by the municipality;

c. Review of the dispensing and distribution plan and memorandum of agreement by the nursing facility medical director; and

d. An agreement by the nursing facility to participate in trainings/exercises conducted by the municipality regarding distribution of medications and/or vaccines in the event of a public health emergency or disease outbreak.

I. Each nursing facility shall establish and maintain a health care facility specific electronic mail address (i.e., e-mail address) to be provided to the licensing agency for the purposes of contacting a high managerial agent for the nursing facility with both routine communications and emergency notices. The nursing facility shall be responsible for providing notice to the licensing agency at any time that the nursing facility's specific electronic mail address is changed or updated.

J. In the event of an onsite, local area, or statewide emergency or natural disaster, the nursing facility will respond to requests for information and/or status reports as requested by the Department and/or designated situation/incident commander.

216 R.I. Code R. 216-RICR-40-10-1.18

Amended effective 7/3/2022
Amended effective 8/25/2022
Amended effective 10/2/2023, exp. 1/30/2024(Emergency)
Amended effective 3/7/2024