W. Va. Code R. § 64-54-12

Current through Register Vol. XLI, No. 36, September 6, 2024

Section 64-54-12 - Inpatient Facility Services

12.1. General Requirements.

12.1.a. If a hospice administers an inpatient facility for acute symptom management, respite care or residential care, the provisions of this section apply.

12.1.b. An inpatient facility shall have a full time administrator. The administrator shall designate an individual who shall act in his or her absence as needed.

12.1.c. An inpatient facility shall have a full or part time physician to meet the needs of the patient.

12.1.c.1. A physician, who can be the medical director for the hospice, or designee shall be available on call at all times.

12.1.d. An inpatient facility shall make reasonable efforts to safeguard personal property and promptly investigate complaints of any loss. At the time of admission, the inpatient facility shall prepare a record of all clothing, personal possessions and money brought by the patient to the inpatient facility. The inpatient facility shall update the record as additional personal property is brought to the inpatient facility.

12.1.e. If an inpatient facility keeps patient funds, the funds shall be kept in an account separate from the inpatient facility funds. Patient funds shall not be used by the inpatient facility.

12.1.f. An inpatient facility shall have a policy to admit only patients who:

12.1.f.1. Have been diagnosed as terminally ill; and

12.1.f.2. Have personally or through a legal representative, in writing, given informed consent to receive hospice care.

12.1.g. Inpatient facility admissions in excess of the licensed bed capacity are prohibited except when the Director approves an emergency admission.

12.1.h. If a patient is transferred from in-home hospice care to the inpatient facility then the following shall occur:

12.1.h.1. The home hospice staff shall contact the inpatient facility with a report including the services to be provided;

12.1.h.2. The home hospice care shall provide a copy of the interdisciplinary team care plan within twenty-four (24) hours to the inpatient facility;

12.1.h.3. The home hospice care shall provide significant information to the inpatient facility to ensure continuity of care.

12.2. Nursing requirements.

12.2.a. An inpatient facility shall provide nursing care and services by or under the direct supervision of a Registered Nurse at all times.

12.2.b. An inpatient facility shall have a Registered Nurse on site at all times.

12.2.c. Nursing care and services shall be provided in accordance with the plan of care developed by the interdisciplinary team and as ordered by the physician.

12.2.d. Nursing care, staffing and services shall meet the needs of the patients.

12.2.e. A Registered Nurse shall assign the nursing care of each patient to other nursing personnel in accordance with the patient's needs and the specialized qualifications and competence of the nursing staff available.

12.2.f. Nursing care and services shall be provided in accordance with recognized standards of practice.

12.3. Pharmaceutical Services

12.3.a. The pharmaceutical services shall be under the direction of a licensed pharmacist.

12.3.b. There shall be a medicine room or drug preparation area of sufficient size for the orderly storage of drugs, both liquid and solid dosage forms, and for the preparation of medications for patient administration within the unit. In the event that a drug cart is used for storage and administration of drugs, the room shall be of sufficient size for storage of the cart without crowding.

12.3.c. An inpatient facility shall develop policies to identify, monitor and track medication errors and adverse drug reactions. The results shall be reported to the quality assurance program.

12.4. Laboratory and Radiological Services.

12.4.a. An inpatient facility shall maintain or have available, whether directly or through a written agreement, adequate laboratory and radiological services available to meet the needs of the patients.

12.5. Food and Dietetic Services.

12.5.a. An inpatient facility shall comply with W. Va. Code § 64-17-1,

12.5.b. An inpatient facility shall designate a person, either directly or by contractual agreement, to serve as the food and dietetic services manager with responsibility for the daily management of the dietary services.

12.5.c. An inpatient facility that does not provide the services of a certified dietary manager shall, at a minimum, train all employees through the county health departments' food managers training course or a comparable course.

12.5.d. An inpatient facility shall designate a qualified dietitian, either directly or through a contractual agreement, who is responsible for the development and implementation of a nutrition care program to meet the needs of the patients. This dietician shall be available as needed to assist in nutritional assessment, menu planning, educating staff and evaluating safe food production.

12.5.e. Menus shall meet the needs of the patients. Special diets shall be prepared and served as ordered.

12.5.f. A current therapeutic diet manual approved by the dietitian and medical director shall be readily available to all medical, nursing and food service personnel.

12.5.g. Families shall be allowed to store home cooked food for a patient. This storage shall be readily available. Food brought from home shall not be co-mingled with the food prepared by the hospice for other patients.

12.6. Restraints

12.6.a. A patient has the right to be free from a restraint of any form imposed as a mean of coercion, discipline, convenience or retaliation by staff.

12.6.b. The use of a restraint shall be:

12.6.b.1. Selected only when less restrictive measures are found ineffective to protect the patient or other persons from harm;

12.6.b.2. Only used as ordered by the hospice physician or attending physician;

12.6.b.3. Implemented in the least restrictive manner possible not to interfere with the palliative care being provided;

12.6.b.4. In accordance with safe and appropriate restraining practices; and

12.6.b.5. Ended at the earliest possible time.

12.6.c. The hospice shall have policies and procedures for the use of restraints.

12.6.d. All staff shall receive training in proper and safe restraining techniques and training in de-escalation of behaviors at least annually.

12.6.e. The patient shall be monitored and evaluated to ensure the safety of the patient.

W. Va. Code R. § 64-54-12