216 R.I. Code R. 216-RICR-40-10-17.8

Current through August 19, 2024

Section 216-RICR-40-10-17.8 - Additional Requirements - Home Nursing Care Providers

A. In addition to meeting the General Requirements as set forth in §§ 17.1 through 17.7.1 of this Part, home nursing care providers shall meet the additional requirements of § 17.8.1 of this Part.

17.8.1Governing Body & Management Professional Advisory Committee

A. An advisory group of professional personnel ("Professional Advisory Committee") shall be established by the governing body or other legal authority which shall include at least:

1. One (1) physician and a registered nurse; and

2. A representative of each therapeutic service offered by the home nursing care provider or home care provider, which may also include appropriate representation from other professional disciplines.

3. The administrator of the home nursing care provider or home care provider shall be ex-officio member of the committee.

4. At least one (1) member shall neither be an owner nor an employee of the home nursing care provider or home care provider.

5. The Professional Advisory Committee shall meet at least twice per year to advise the agency on professional issues and to establish and annually review the home nursing care provider's or home care provider's policies pertaining to:

a. The scope of services offered;

b. Admission and discharge policies;

c. Plans of care;

d. Clinical records;

e. Personnel qualifications;

f. Program evaluation; and

g. Such other matters as may be deemed appropriate by the governing body or other legal authority.

6. The physician member of the Professional Advisory Committee shall attend at least one (1) meeting per year and show evidence of participation (e.g., review of agenda/minutes) in any other Professional Advisory Committee meetings.

B. Scope of Services

1. Each home nursing care provider shall provide direct nursing services in the home, or by contractual agreement with another Department-licensed agency, delivered by a Registered (RN) or Licensed Practical (LPN) Nurse.

2. Each home nursing care provider may provide homemaker and Nursing Assistant services, either directly or by contractual agreement with another Department-licensed agency; and may provide other therapeutic service(s), to be provided either directly or by contractual agreement.

3. Additional health services or related services may be provided by a home nursing care provider as may be deemed appropriate to meet community needs in a manner consistent with acceptable standards of practice.

C. Medical Services

1. Patients admitted for medical services shall be under the care of an attending clinician responsible for the development of the plan of care.

a. A care plan prescribed by the attending clinician, if appropriate, shall contain no less than the following:

(1) Pertinent diagnosis, including mental status, level of consciousness, ability to communicate including language, speech and hearing;

(2) Types of services and equipment required, frequency of visits, prognosis, rehabilitative potential, functional limitations, activities permitted, nutritional requirements, medications and treatments, safety measures (if any), instructions for continuing care, referral or discharge; dates/times of any follow-up appointment(s), when known;

(3) Medical diagnosis and nursing assessment, therapeutic goals, prognosis and all conditions relevant to the plan of care, including any known allergies and reactions; and

(4) Surgical procedures, surgical complications, infections, prior diagnoses, presence of pressure ulcers, incontinence, disabilities;

2. The attending clinician's orders for any services which shall specify the procedures and modalities to be used including the amount, frequency and duration of therapy and/or care, including therapeutic services, such as physical therapy, occupational therapy, speech therapy, clinical social work, nutritional assessment, audiology, intravenous (IV) therapy, percutaneous endoscopic gastrostomy (PEG) feeding, wound/dressing, surgical drains, central line, oxygen, diet, all medications prescribed.

3. The plan of care shall not be modified without consent of the attending clinician and shall furthermore be reviewed by the attending clinician and home nursing care provider or home care provider staff as often as the severity of the patient's condition requires but no less than once every sixty (60) days beginning with the start of care date.

4. Direct Nursing Services Direct nursing services shall be provided by Registered and/or Practical Nurses duly licensed in Rhode Island and in accordance with the written plan of care, acceptable standards of nursing practice and Subchapter 05 Part 3 of this Chapter, Licensing of Nurses and Standards for the Approval of Basic Nursing Education Programs.

5. Copies of the plan of care and the number of service hours scheduled shall be provided to the patient upon admission and as revised.

17.8.2Supervision of Therapeutic Services

A. Therapeutic services may include, but are not limited to, speech pathology/audiology, physical therapy, occupational therapy and respiratory care. Supervision of therapeutic services shall be in accordance with applicable Rules and Regulations for licensing of said therapists.

216 R.I. Code R. 216-RICR-40-10-17.8

Amended effective 3/24/2022
Amended effective 5/6/2024