Section R432-150-15 - Quality of Care(1)(a) The licensee shall ensure each resident is provided the necessary care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being, in accordance with the comprehensive assessment and care plan.(b) Necessary care and services under Subsection (1)(a) include the resident's ability to: (i) bathe, dress, and groom;(ii) transfer and ambulate;(v) use speech, language, or other functional communication systems.(c) Based on the resident's comprehensive assessment, the licensee shall ensure that: (i) each resident's abilities in activities of daily living do not diminish unless circumstances of the individual's clinical condition demonstrates that diminution was unavoidable;(ii) each resident is given the treatment and services to maintain or improve their abilities; and(iii) a resident who cannot carry out these functions receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene.(2) The licensee shall assist residents in scheduling appointments and arranging transportation for vision and hearing care as needed.(3) The licensee's comprehensive assessment of a resident shall include an assessment of pressure sores. The licensee shall additionally ensure: (a) a resident who enters the facility without pressure sores does not develop pressure sores unless the individual's clinical condition demonstrates that they were unavoidable; and(b) a resident having pressure sores receives the necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing.(4) The licensee's comprehensive assessment of the resident shall include an assessment of incontinence. The licensee shall additionally ensure that:(a) a resident who is incontinent of bowel or bladder receives the treatment and services to restore as much normal functioning as possible;(b) a resident who enters the facility without an indwelling catheter is not catheterized unless the resident's clinical condition demonstrates that catheterization is necessary;(c) a resident who is incontinent of bladder receives appropriate treatment and services to prevent urinary tract infections; and(d) a licensed nurse completes a written assessment to determine the resident's ability to participate in a bowel and bladder management program.(5) The licensee shall assess each resident to ensure that:(a) a resident who enters the facility without a limited range of motion does not experience reduction in range of motion unless the resident's clinical condition demonstrates that a reduction in range of motion is unavoidable; and(b) a resident with a limited range of motion receives treatment and services to increase range of motion or to prevent further decrease in range of motion.(6) The licensee shall ensure that the psychosocial function of the resident remains at or above the level at the time of admission, unless the individual's clinical condition demonstrates that a reduction in psychosocial function was unavoidable and psychosocial practices adhere to the following:(a) a resident who displays psychosocial adjustment difficulty receives treatment and services to achieve as much re-motivation and reorientation as possible; and(b) a resident whose assessment does not reveal a psychosocial adjustment difficulty does not display a pattern of decreased social interaction, increased withdrawn anger, or depressive behaviors, unless the resident's clinical condition demonstrates that such a pattern is unavoidable.(7) The licensee shall assess alternative feeding methods to ensure that:(a) a resident who has been able to eat enough alone or with assistance is not fed by naso-gastric tube unless the resident's clinical condition demonstrates that use of a naso-gastric tube is unavoidable; and(b) a resident who is fed by a naso-gastric or gastrostomy tube receives the treatment and services to prevent aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers and to restore, if possible, normal feeding function.(8) The licensee shall maintain the resident's environment and is free of accident hazards.(9) The licensee shall provide each resident with supervision and assistive devices to prevent accidents.(10) The licensee shall ensure that each resident's comprehensive assessment includes an assessment of nutritional status and nutritional practices ensure that each resident: (a) maintains acceptable nutritional status parameters, including body weight and protein levels, unless the resident's clinical condition demonstrates that this is not possible; and(b) receives a therapeutic diet when there is a nutritional problem.(11) The licensee shall provide each resident with sufficient fluid intake to maintain proper hydration and health.(12) The licensee shall ensure that residents receive proper treatment and care for the following special services: (b) parenteral and enteral fluids;(c) colostomy, ureterostomy, or ileostomy care;(13) The licensee shall ensure: (a) each resident's drug regimen is free from unnecessary drugs;(b) residents who have not used antipsychotic drugs are not given these drugs unless antipsychotic drug therapy is necessary to treat a specific condition as diagnosed and documented in the clinical record; and(c) residents who use antipsychotic drugs receive gradual dose reductions and behavioral interventions, unless clinically contraindicated in an effort to discontinue these drugs.(14) The licensee shall ensure the quality assurance committee monitors medication errors to ensure that: (a) the licensee does not have medication error rates of 5% or greater; and(b) residents are free of any significant medication errors.Utah Admin. Code R432-150-15
Amended by Utah State Bulletin Number 2024-01, effective 12/12/2023