reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Medical Records › Section 145.540 - Content of Medical Record

Current through Register 1525, July 5, 2024
(A)
General Requirement
. Medical records shall be retained
				for six years after the unit's last treatment of a patient. The medical record
				shall be sufficiently detailed to enable effective continuing care to the
				patient, and to enable communication among the medical professionals
				contributing to the patient's care.
(B)
Specific
				Provisions
. Each medical record shall include at least the
				following:
(1) Identification data including
				the patient's name, address, age and next of kin, and guardian, if
				any;
(2) The name, address, and
				telephone number of the patient's designated practitioner;
(3) History of present illness, past medical
				history, and family medical history;
(4) Records of initial and periodic physical
				examinations at intervals to be stated in written policies, approved by the
				medical director including all findings resulting from an assessment of all
				systems of the body;
(5) Reports of
				all diagnostic procedures, tests, evaluations and examinations;
(6) Records of treatment including order
				sheets, transfusion records, and record and date of each dialysis
				treatment;
(7) Records of
				complications of treatment, accidents or untoward incidents regarding
				patients;
(8) Progress notes, which
				shall be recorded in sufficient detail to delineate the course and results of
				treatment;
(9) Information
				pertaining to hospital admissions during the patient's course of treatment,
				including a discharge summary from the hospital whenever possible;
(10) A record of the patient's evaluations by
				an interdisciplinary team as set forth in
				105 CMR
				145.420. Records of annual evaluations shall
				list other methods of treatment considered and the indications for continued
				chronic maintenance dialysis, home dialysis, self-dialysis, transplantation or
				other methods of treatment;
(11)
				Discharge summary or clinical resume, which shall briefly recapitulate the
				significant findings and events of the patient's dialysis treatments and
				arrangements made for future care; and
(12) Date of admission and
				discharge.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Medical Records › Section 145.545 - Safeguards against Loss and Use of Medical Records by Unauthorized Persons

Current through Register 1525, July 5, 2024
The unit shall develop policies to safeguard its medical
				  records and the information therein against loss and use by unauthorized
				  persons.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Medical Records › Section 145.550 - Removal of Medical Record

Current through Register 1525, July 5, 2024
No medical records shall be removed from the unit except as
				  required by legal action. In the event removal is required by legal action, a
				  duplicate shall be made and kept at the unit until such time as the original is
				  returned from the court.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Medical Records › Section 145.555 - Release of Medical Record

Current through Register 1525, July 5, 2024
Prior to release of any information from a medical record to
				  any person not authorized by law to receive such information, the unit shall
				  have, and place in the record, the written consent of the patient, or the
				  patient's appropriate legal representative.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Medical Records › Section 145.560 - Medical Record Policies

Current through Register 1525, July 5, 2024
The unit shall have written policies, either in the unit's
				  by-laws or established by the administrator pursuant to such by-laws, with
				  respect to at least the following:
(A)
Use of Records by Authorized Personnel
. Use of records
				by authorized personnel;
(B)
Transmittal Outside the Unit of Information from Medical
				Record
. Transmittal outside the unit of information from a record,
				to an authorized person as defined in the by-laws as approved by the governing
				body;
(C)
Designation
				of Persons Authorized to Receive Medical Record
. Designation of
				persons authorized under
				105 CMR 145.560(A) and
				(B) to receive information from a record by
				either name of person or class of personnel or duty assignment, or any
				combination of such means; and
(D)
Release of Information from Medical Records Outside the
				Unit
. Release of information from a record outside the unit to any
				other person, including a list, supported by advice of counsel to the unit, of
				such classes of persons who, by law, are entitled to access to such information
				without the consent provided for under
				105 CMR
				145.555.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Other Requirements › Section 145.600 - Procurement, Use and Storage of Blood

Current through Register 1525, July 5, 2024
The unit shall obtain blood from a blood bank immediately
				  prior to its administration. All blood so obtained shall be identified, stored,
				  handled and administered in accordance with
				  105 CMR 135.000:
Use of Blood, Blood Components and Derivatives for the Purpose of
				  Transfusion
.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Other Requirements › Section 145.710 - Familiarity with Emergency Preparedness Plan

Current through Register 1525, July 5, 2024
Every staff member shall be familiar with the plan and be
				  able to execute his or her responsibility under the plan. A copy of the plan
				  shall be available to members of the staff, and to any other person on request.
				  Staff shall ensure that patients have a copy of the plan and are trained in
				  emergency preparedness. Emergency preparedness training shall be
				  documented.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Other Requirements › Section 145.720 - Provision of Emergency Preparedness Plan

Current through Register 1525, July 5, 2024
The emergency preparedness plan shall specify persons to be
				  notified, location of alarms and fire extinguishers, evacuation routes,
				  procedures for evacuation of persons with disabilities, and assignment of
				  specific responsibilities by name or title of employee. The plan shall include
				  provisions for direction and control, communication, alerts and warnings, and
				  evacuation and/or closure of the unit.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Other Requirements › Section 145.730 - Fire Drills

Current through Register 1525, July 5, 2024
Fire drills shall be conducted for all staff at least twice a
				  year at varied times, including two drills per work shift per year. The unit
				  shall maintain records that identify the dates and attendance at such
				  drills.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Other Requirements › Section 145.740 - Emergency Supplies and Equipment

Current through Register 1525, July 5, 2024
The unit shall maintain on the premises and immediately
				  available at all times emergency drugs, including, at a minimum, drugs to treat
				  allergic and hypoglycemic reactions, and medical supplies and equipment
				  including, but not limited to, oxygen, airways, suction, artificial
				  resuscitator, and an automated external defibrillator or, if appropriately
				  trained staff are available, a defibrillator.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.800 - Access to Home Dialysis

Current through Register 1525, July 5, 2024
Every unit shall have a home dialysis program or provide its
				  patients access to such a program through affiliation under
				  105 CMR
				  145.340.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.805 - Written Plan for Training of Home Dialysis Patients

Current through Register 1525, July 5, 2024
There shall be a written plan for the training of patients
				  and partners in home dialysis.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.815 - Inspection of Equipment at Home

Current through Register 1525, July 5, 2024
There shall be policies and procedures for supervision of
				  installation and inspection of equipment in the home. These policies and
				  procedures shall be approved by the medical director and director of
				  nursing.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.820 - Procedures for Supervision of Home Dialysis

Current through Register 1525, July 5, 2024
There shall be procedures approved by the medical director
				  and director of nursing for supervision of initial dialysis at
				  home.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.825 - Provision of Supplies to Home

Current through Register 1525, July 5, 2024
There shall be a continuing program for arranging for the
				  provision of supplies to patients at home.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.830 - Provision of Renal and Ancillary Services

Current through Register 1525, July 5, 2024
Each patient on home dialysis shall have available any renal
				  and ancillary services necessary for his/her care on the same basis as patients
				  being dialyzed in the unit.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.835 - Medical Records on Home Dialysis Patients

Current through Register 1525, July 5, 2024
Clinical records shall be maintained for patients in a home
				  dialysis program and maintained by the unit in the same manner as set forth in
				  105 CMR
				  145.500 through
				  145.560.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.845 - Affiliation Agreements for Home Dialysis Patients

Current through Register 1525, July 5, 2024
Each patient on home dialysis shall, under the affiliation
				  agreement of the unit, have access to the services of affiliate hospitals on
				  the same basis as patients being dialyzed in the unit.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.850 - Description of Home Dialysis Program

Current through Register 1525, July 5, 2024
The unit shall have and maintain a written description of the
				  nature and the scope of the program which shall be available upon request to
				  any patient or other person. The responsibilities of each participating
				  institution or agency shall be set forth in this description.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.900 - Licensing and Related Administrative Procedures

Current through Register 1525, July 5, 2024
Licensing and related administrative procedures for
				  out-of-hospital dialysis units shall be the same as those set forth in
				  105 CMR
				  140.101 through
				  140.150.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 145.000 - Licensing Of Out-of-hospital Dialysis Units In Massachusetts › Home Dialysis › Section 145.910 - Severability

Current through Register 1525, July 5, 2024
The provisions of 105 CMR 145.000 are severable. If any
				  provision herein is declared unconstitutional or invalid by a court of
				  competent jurisdiction, the validity of the remaining portions shall not be so
				  affected.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › PREAMBLE

Current through Register 1525, July 5, 2024
The Department of Public Health is charged with the
				responsibility of ensuring that the Commonwealth's long term care facilities
				provide good quality care, quality of life and safety for facility residents.
				In keeping with this responsibility, the Department has developed rest home
				regulations intended mainly to address the unmet needs of residents with mental
				health problems through the establishment of a new facility type referred to as
				Community Support Facility (CSF). The CSF is required to provide special
				services, staffing, and medication administration safeguards.
After the effective date of 105 CMR 150.000 only CSFs will be
				permitted to admit new residents from private or public psychiatric
				institutions. Community Support Residents (CSRs) below the age of 50 and
				residing in Level IV facilities or in Level IV units in multi-level facilities
				prior to the effective date of 105 CMR 150.000 shall not be discharged or
				transferred due to their age from such facilities or units without their
				consent (if they are competent to give such consent) or the consent of their
				guardian (if they are not competent). Such residents are also eligible for all
				services provided in a CSF as set out in these regulations. The Department will
				consider and approve waiver requests for admission of residents with mental
				health problems to non-CSF facilities when special circumstances arise. Special
				circumstances which may require a waiver request might include: a married
				couple which desires not to be separated and a resident who would be
				geographically separated from his/her family, or community supports
				(
eg
., church, medical care).
Rest home residents shall have the following rights as set
				forth in 105 CMR 150.000:
(1) The right
			 to refuse a social services plan and a support services plan.
(2) The right to give signed consent for
			 admission and services in a Community Support Facility (if he or she is
			 competent to give such consent) or the written consent of his/her guardian (if
			 he or she is not competent).
(3)
			 The right to resident protections against arbitrary transfers or discharges
			 related to the change in a facility's designation as a CSF or non-CSF;
			 and
(4) The right to refuse
			 antipsychotic medications.
The Department will monitor the implementation and effect of
				105 CMR 150.000 on residents and on Level IV facilities, Level IV units and
				Community Support Facilities, and by July 1, 1988 will provide a report to the
				Public Health Council with appropriate recommendations. An opportunity will be
				offered for interested parties to comment on the implementation of 105 CMR
				150.000 through a public meeting, which will be held prior to the Department's
				report to the Public Health Council.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.002 - Administration

Current through Register 1525, July 5, 2024
(A) Every licensee shall designate a
			 qualified administrator and shall establish by-laws or policies describing the
			 organization of the facility, establish authority and responsibility, and
			 identify programs and goals.
(B)
Administration
.
(1)
			 Facilities providing Level I care, Level II care in more than one unit, or
			 Level III or IV care in more than two units shall employ a full-time
			 administrator.
(2) Facilities
			 providing Level II care with only a single unit, and facilities providing Level
			 III or IV care with less than two units shall employ an administrator for the
			 number of hours as needed in accordance with the size and services provided by
			 the facility.
(3) No more than one
			 full-time administrator is required even in facilities providing multiple units
			 or multiple levels of care.
(4) A
			 full-time administrator shall be on the premises during the working
			 day.
(5) In facilities providing
			 Level I, II or III care, the administrator shall be a nursing home
			 administrator licensed by the Board of Registration of Nursing Home
			 Administrators.
(6) The
			 administrator shall be a suitable and responsible person.
(7) A responsible person shall be designated
			 to act in the absence of the administrator.
(8) The names and telephone numbers of the
			 administrator and his or her alternate shall be posted and available to the
			 individual in charge at all times.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.003 - Admissions, Transfers and Discharges

Current through Register 1525, July 5, 2024
(A)
			 The admission, transfer and discharge of residents shall be in accordance with
			 written policies and procedures developed by each facility and acceptable to
			 the Department. Any restrictions, priorities or special admission criteria
			 shall be applied equally to all potential admissions. All facilities shall
			 comply with state and federal anti-discrimination laws and
			 regulations.
(B) Facilities shall
			 admit and care for only those individuals in need of long-term care services
			 for whom they can provide care and services appropriate to the individual's
			 physical, emotional, behavioral, and social needs. Prior to admission, an
			 individual's needs shall be evaluated and alternative care plans considered.
			 This evaluation shall be a joint responsibility of the referring agency or
			 institution, the primary care provider and the receiving facility.
(1) Residents shall be admitted only on the
			 written order of the primary care provider, who designates the placement as
			 medically and socially appropriate.
(2) No facility shall admit a resident
			 without written consent of the individual or his or her guardian except in
			 emergencies.
(a) No SNCFC shall admit a
			 resident without written consent of the individual (if he or she is competent
			 to enter into such an agreement) or his or her parent or guardian (if he or she
			 is not) except in emergencies.
(b)
			 A SNCFC may provide respite services only after prior approval by the
			 Department and contingent upon submission of policies and procedures related to
			 respite care. The Department shall be duly notified in regard to any changes in
			 an approved respite service policy or in regard to the termination of a SNCFC
			 respite service.
(3) In
			 order to promote appropriate placements, facilities shall exchange information
			 on resources and services with other agencies and institutions providing health
			 care in their area.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.004 - Resident Care Policies

Current through Register 1525, July 5, 2024
(A) All facilities
			 providing Level I, II or III care shall have current, written policies
			 governing the services provided in the facility. All facilities shall develop
			 policies for the following services:
(1)
Emergency Needs of Residents
.
(a) Admission, transfer and discharge
			 procedures;
(b) Primary care
			 provider services;
(c)
			 Pharmaceutical services and medications;
(d) Dietary services;
(e) Rehabilitation services;
(f) Social services;
(g) Resident activities and
			 recreation;
(h) Emergency and
			 disaster plans;
(i) Personal
			 comfort, safety, and accommodations;
(j) Clinical Records.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.005 - Physician Services

Current through Register 1525, July 5, 2024
(A) Facilities
			 providing Level I, II or III care shall establish a medical director who shall
			 be responsible for the implementation of resident care policies and the
			 coordination of medical care in the facility.
(1) Supervisory and advisory functions shall
			 include: advice on the development of medical and resident care policies
			 concerning resident admissions and discharge, medical records, responsibilities
			 of primary care providers, supportive and preventive services, emergency
			 medical care, and the review of the facility's overall program of resident
			 care.
(2) Staff physicians or the
			 medical director shall spend at least four hours per month in the facility
			 devoted to supervisory and advisory functions.
(3) A SNCFC shall appoint a pediatrician with
			 experience in developmental disabilities who shall participate in the
			 development of resident care policies, familiarize himself or herself with the
			 condition, needs and care of each resident, and participate in periodic staff
			 conferences.
(4) In a SNCFC,
			 services of a neurologist, orthopod, psychiatrist, psychologist or any other
			 consultant services shall be provided as needed to those individuals requiring
			 such services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.006 - Other Professional Services and Diagnostic Services

Current through Register 1525, July 5, 2024
(A) Each resident or resident's guardian
			 shall have the right to designate other licensed practitioners of his or her
			 choice.
(B)
Dental
.
(1) All
			 residents shall be assisted to obtain proper dental care including
			 prophylactic, therapeutic and emergency dental services. Such services shall be
			 rendered with the knowledge of the primary care provider and consent of the
			 resident or the resident's guardian.
(2) All dental services shall be documented
			 and recorded in the clinical record.
(3) A SNCFC shall appoint a consultant
			 dentist with experience or training in developmental disabilities who shall
			 participate in the development of patient care policies related to dental
			 health, familiarize him or herself with the dental condition, needs and care of
			 each resident, and as necessary, participate in periodic staff conferences. A
			 SNCFC shall retain the services of a dental hygienist to work under the general
			 supervision of the consultant dentist. The dental hygienist shall conduct
			 periodic inspections of residents every six months and develop dental disease
			 prevention programs within the facility. A SNCFC shall ensure each resident has
			 a complete dental examination annually.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.007 - Nursing Services

Current through Register 1525, July 5, 2024
(A) All facilities
			 shall provide appropriate, adequate and sufficient nursing services to meet the
			 needs of residents and to ensure preventive measures, treatments, medications,
			 diets, restorative nursing care, activities and related services are carried
			 out, recorded and reviewed.
(1) Facilities
			 providing Level I, II or III care shall provide a 24-hour nursing service with
			 an adequate number of trained and experienced nursing personnel on duty 24
			 hours per day, seven days a week, including vacation and other relief
			 periods.
(2) Nursing services in
			 facilities providing Level I, II or III care shall be in accordance with
			 written policies and procedures.
(3) Community Support Facilities and Resident
			 Care Facilities with Community Support Residents shall provide organized,
			 routine nursing services in order to monitor resident medications, potential
			 medication side effects, and general resident physical and psychosocial
			 well-being. Nursing services shall be provided at a minimum of at least 15
			 hours per 30 residents per month and more if needed, and shall be scheduled so
			 as to assure at least one visit per week. Such services shall be equally
			 distributed across the month.
(4)
			 Facilities providing only Level IV care are not required to provide organized,
			 routine nursing services. However, nursing services shall be provided as needed
			 to residents in the case of minor illness of a temporary nature.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.008 - Pharmaceutical Services and Medications

Current through Register 1525, July 5, 2024
(A)
			 All facilities shall maintain current written policies and procedures regarding
			 the procurement, storage, dispensing, administration and recording of drugs and
			 medications.
(1) Policies and procedures
			 shall be developed with the advice of a committee of professional personnel
			 including a primary care provider, a pharmacist and a nurse.
(2) Provision shall be made for the prompt
			 and convenient acquisition of prescribed drugs from licensed community,
			 institutional or hospital pharmacies. Facilities shall make no exclusive
			 arrangements for the supply or purchase of drugs. Residents or their guardian
			 may arrange for the purchase of prescribed medications from pharmacies of their
			 own choice provided medications are dispensed and labeled as specified in 105
			 CMR 150.008.
(3) No drug or
			 medication removed from the market by the Food and Drug Administration shall be
			 stocked or administered in any facility.
(4) Facilities shall comply with all federal
			 and state laws and regulations relating to the procurement, storage,
			 dispensing, administration, recording and disposal of drugs.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.009 - Dietary Service

Current through Register 1525, July 5, 2024
(A) All facilities
			 shall provide adequate dietary services to meet the daily dietary needs of
			 residents in accordance with written dietary policies and procedures.
(1) Dietary services shall be directed by a
			 food service supervisor and shall be organized with established lines of
			 accountability and clearly defined job assignments.
(2) Dietary services shall be provided
			 directly by the facility, or facilities may contract with an outside food
			 company provided the facility and the food company comply with
			 105 CMR 150.000; provided
			 the facility or the company has a qualified dietitian who serves, as required
			 in
			 105 CMR 150.000; and
			 provided the facility and the dietitian provide for continuing liaison with
			 physicians and the nursing staff.
(3) In a SNCFC, the dietary services shall
			 provide all residents with a nutritionally adequate diet designed to help them
			 reach their proper physical developmental level and their full feeding
			 potential. The care plan shall indicate procedures instituted to restore an
			 appropriate nutritional level.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.010 - Rehabilitation Services: Physical Therapy, Occupational Therapy, Speech, Hearing and Language Therapy (and Therapeutic Recreation in a SNCFC)

Current through Register 1525, July 5, 2024
(A) Facilities providing Levels I, II or III
			 care shall establish written policies and procedures governing the delivery of
			 rehabilitation services.
(1) Facilities
			 providing Level I care, shall have an organized, continuous, rehabilitation
			 services program.
(2) Facilities
			 providing Level II care shall provide meaningful availability of rehabilitation
			 services beyond restorative and maintenance nursing care.
(3) Facilities providing Level III or IV care
			 should make arrangements for rehabilitation services when needed by
			 residents.
(4) A SNCFC shall have
			 an organized continuous, restorative nursing care program including
			 recreation/rehabilitation therapy.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.012 - Activities and Recreation

Current through Register 1525, July 5, 2024
(A) All facilities
			 shall provide an ongoing program of activities and recreation suited to meet
			 the interests of and support the physical, mental and psychosocial well-being
			 of each resident, including residents with disabilities. The program shall also
			 be suited to meet the needs of residents for whom English is not their primary
			 spoken language.
(1) The activities program
			 shall provide a broad assortment of both facility-sponsored group and
			 individual activities, as well as independent activities, that accommodate
			 residents of various needs and backgrounds.
(2) The activities program shall utilize all
			 possible community, social, recreational, public and voluntary resources to
			 encourage independence and interaction in the community.
(3) In a SNCFC, therapeutic
			 recreation/rehabilitation programming shall be incorporated within the
			 rehabilitation services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.013 - Clinical and Related Records

Current through Register 1525, July 5, 2024
(A) Each facility
			 shall develop, through an interdisciplinary team, and adopt written policies
			 and procedures to ensure complete and accurate clinical records are maintained
			 for each resident and readily available as needed, including to the resident
			 and his or her guardian and other providers as permitted by law or authorized
			 by the resident or his or her guardian prior to submitting an application for a
			 license. Each facility shall implement, review and revise, through an
			 interdisciplinary team as needed, but not less than once a year, its written
			 policies and procedures. A facility shall ensure all staff, including temporary
			 staff and volunteers, are trained and determined to be competent as needed for
			 their duties on such policies and procedures.
(B) All records shall be complete, accurate,
			 current, available on the premises of the facility. In addition to the clinical
			 record for each resident, the following records shall be maintained:
(1) Daily census;
(2) Resident care policies;
(3) Incident, fire, epidemic, emergency and
			 other report forms;
(4) Schedules
			 of names, telephone numbers, dates and alternates for all emergency or "on
			 call" personnel;
(5) A Resident
			 Roster approved by the Department;
(6) Orders for all medications, treatments,
			 diets, rehabilitation services and medical procedures ordered for residents.
			 Orders shall be dated, recorded and signed (telephone orders countersigned) by
			 the resident's primary care provider. If electronic signatures are permitted,
			 the facility must ensure their system is designed to ensure integrity,
			 authenticity and non-repudiation;
(7) A record of narcotic and
			 sedatives;
(8) A bound Day and
			 Night Report Book with a stiff cover and numbered pages, or electronic record
			 of reports with an audit trail;
(9)
			 Identification and summary sheets on all residents;
(10) In a SNCFC, an Individual Service Plan
			 (ISP) shall be developed for each resident.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.014 - Utilization Review

Current through Register 1525, July 5, 2024
(A) Facilities
			 providing Level I or II care shall review the services, quality of care and
			 utilization of their facilities.
(B) The utilization review process or
			 activity shall include a review of all or a sample of residents to determine
			 appropriateness of admissions, duration of stays by level of care, professional
			 services and other relevant aspects of care and services provided by the
			 facility.
(C) Utilization review
			 shall be conducted by one or a combination of the following:
(1) By a utilization review committee, which
			 is multidisciplinary and consists of at least two physicians or
			 physician-physician assistant teams or physician-nurse practitioner teams, a
			 registered nurse and, where feasible, other health professionals.
(2) By a committee or group outside the
			 facility that may be established by the following on the approval of the
			 Department:
(a) By a medical
			 society.
(b) By some or all of the
			 hospitals and long-term care facilities in the locality.
(c) By other health care facilities in the
			 locality in conjunction with at least one hospital.
(3) When the above alternatives are not
			 feasible, by a committee sponsored and organized in such a manner as to be
			 approved by the Department.
(4) No
			 member of the utilization review committee shall have a proprietary interest in
			 the facility.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.015 - Resident Comfort, Safety, Accommodations and Equipment

Current through Register 1525, July 5, 2024
(A) All facilities shall provide for the
			 comfort, safety and mental and physical well-being of residents.
(B)
Personal Care
.
(1) Every resident shall have a reasonable
			 amount of privacy.
(2) Residents
			 shall be treated with dignity and kindness at all times.
(3) Residents' personal effects shall be
			 treated with respect and care.
(4)
			 Residents shall be encouraged and assisted to dress and move about from
			 sleeping quarters to sitting rooms, dining areas and out-of-doors when their
			 conditions permit.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.016 - Environmental Health and Housekeeping

Current through Register 1525, July 5, 2024
(A)
Waste Disposal and Garbage Disposal
.
(1) Suitable sanitary procedures and
			 equipment shall be provided for the collection, storage and disposal of all
			 wastes and garbage.
(2) All
			 accumulated soiled dressings, that do not meet the definition of infectious or
			 physically dangerous medical or biological waste as set forth in
			 105 CMR 180.000:
State Sanitary Code, Chapter VIII
, and other wastes, and all
			 garbage not disposed of by mechanical means shall be stored, both indoors and
			 out-of-doors, in sanitary, rodent-proof, leak-proof, fire-proof, non-absorbent,
			 watertight containers with tight-fitting covers.
(3) Wastes and garbage shall be stored and
			 disposed of at proper intervals in a manner to prevent fire hazard,
			 contamination, transmission of disease, a nuisance, a breeding place for flies
			 and insects, or feeding place for rodents.
(4) Garbage and wastes shall be stored in
			 areas separate from those used for the preparation, storage and service of
			 food.
(5) Equipment for proper
			 cleaning and disinfection of these containers each time they are emptied during
			 all seasons shall be provided.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.017 - Construction and Equipment

Current through Register 1525, July 5, 2024
(A)
New
			 Construction, Alterations and Conversions
.
(1) The establishment and construction of new
			 long-term care facilities, conversions of other types of facilities to
			 long-term care facilities, or any alterations or additions to existing
			 facilities now licensed by the Department shall conform to the Department's
			 most current standards of construction and shall be constructed, converted or
			 altered for the specific purpose of providing a specific (level or levels) of
			 long-term care.
(2) New
			 construction, conversions, alterations, additions or other structural changes
			 or acquisition of special equipment in a proposed or existing facility shall
			 not be made until a letter of intent and proper application forms have been
			 filed with the Department and approval of the final plans and specifications
			 for construction or acquisition have been issued by the Department of Public
			 Health and the Office of Public Safety and Inspections.
(3) No facility presently licensed as a rest
			 home shall be licensed as a facility that provides Level I, II or III care
			 unless it conforms to the Department's most recent standards for new
			 construction, alterations and conversions.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.018 - Hospital Based Long-term Care Facilities (HB/LTCF) - Provisions Regarding the Sharing of Services

Current through Register 1525, July 5, 2024
(A)
Ancillary Services
. Ancillary services, such as
			 dietary and laundry, furnished by an HB/LTCF may be provided to the HB/LTCF by
			 the hospital under specific written arrangements for such services.
(B)
Equipment
. An
			 HB/LTCF may under written arrangement, obtain equipment from the hospital for
			 use in the HB/LTCF.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.019 - Education Services (SNCFC)

Current through Register 1525, July 5, 2024
(A) An
			 educational program shall be provided which shall be approved by the
			 Massachusetts Department of Education.
(B) Opportunity for participation in the
			 approved educational program shall be available to all school-age children
			 within the facility upon admission.
(C) The educational program shall be an
			 integral part of the total resident care provided. Scheduling of daily
			 activities shall be done in such manner as to encourage and facilitate
			 participation of residents in the educational program.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.021 - Support Services Plan for Level IV Community Support Facilities

Current through Register 1525, July 5, 2024
(A) In Level IV facilities with Community
			 Support Residents, the Support Services Coordinator must develop a Support
			 Services Plan. The plan shall be written as soon as possible but no later than
			 two weeks after admission for new resident admissions and as soon as possible
			 for Community Support Residents already residing in a facility. The Support
			 Plan must describe the service needs of the resident, including those service
			 needs specified in his or her Mental Health Treatment Plan. The Support Plan
			 must be developed by the Community Support Resident and the Support Services
			 Coordinator, in consultation with the resident's social worker, physician,
			 psychiatrist, and other staff.
(1) Each plan
			 must include, but is not limited to, the following:
(a) A narrative statement describing the
			 resident's service needs. These needs must include those specified in the
			 mental health treatment plan. It should also include service needs consistent
			 with the mental health treatment plan but are not mental health needs, such as
			 other health needs, educational or vocational needs, and recreational or
			 socialization needs.
(b) Within
			 each area of specified need, goals and objectives, as well as time frames for
			 the beginning of services and the achievement of objectives should be
			 developed.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.022 - Standards for Dementia Special Care Units

Current through Register 1525, July 5, 2024
105 CMR 150.022 through 105.029 set forth the minimum dementia
				staff training requirements for all nursing homes, and set forth the minimum
				standards with which a Dementia Special Care Unit (DSCU) must comply, and apply
				only to Level I, II and III facilities licensed under
				105 CMR
				150.000.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.023 - DSCU Definitions

Current through Register 1525, July 5, 2024
The following definitions shall apply to
				105 CMR
				150.022 through
				150.029:
Dementia Special Care Unit (DSCU)
means a facility licensed pursuant to
				105 CMR 150.000, or a unit
				thereof, that uses any word, term, phrase, or image, or suggests in any way,
				that it is capable of providing specialized care for residents with dementia,
				which must comply with 150.022 through 150.029. The purpose of a DSCU is to
				care for residents with dementia in the long term.
Dementia Special Care Unit Standards
means those requirements in
				105 CMR
				150.022 through
				150.029.
Direct Care
means any service, whether
				clinical or not, provided directly to a resident.
Evaluation
means a determination by
				the facility that the individual is competent to provide direct care to
				residents based on the individual's demonstration of competency in the
				applicable skills and techniques.
Reasonable Time
means during the
				individual resident's normal waking hours, and absent severe weather
				conditions.
Relevant Staff Members
means direct
				care workers, therapeutic activity directors and supervisors of direct care
				workers.
Resident Areas
means residents' rooms,
				common rooms, dining rooms, activities rooms, and any other indoor space meant
				for resident use.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.024 - Staff Qualifications and Training

Current through Register 1525, July 5, 2024
(A)
			 The training requirements listed in 105 CMR 150.024 shall supplement training
			 requirements set forth in
			 105 CMR 150.000 and must be
			 completed in addition to those training requirements.
(B) Each facility must maintain written
			 documentation that all relevant staff members have met the required training
			 standards set forth in
			 105 CMR
			 150.025.
(1) Prior to being released from the
			 orientation process (providing care without the supervision of a preceptor),
			 all relevant staff members shall receive a minimum of eight hours of initial
			 training. After initial training is completed and documented, a staff member
			 does not have to receive initial training if he or she changes jobs or begins
			 working in another long-term care facility unless the individual has a lapse in
			 employment in long term care for 24 consecutive months or more.
(2) All relevant staff members providing care
			 in a facility, whether or not care is provided to residents in a DSCU, shall
			 receive a minimum of four hours of ongoing training each calendar
			 year.
(3) A relevant staff member
			 does not need to receive ongoing training in the same calendar year he or she
			 receives eight hours of initial training as required by
			 105 CMR
			 150.025.
(4) Each facility shall appropriately train
			 its volunteers for the tasks they will be performing.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.025 - Content of Training

Current through Register 1525, July 5, 2024
(A) All training
			 required for relevant staff members pursuant to
			 105 CMR
			 150.024 shall be in accordance with
			 Department guidelines.
(B) The
			 training must include a basic introduction to the foundations of dementia and
			 dementia care, as well as any other topics listed in Department
			 guidelines.
(C) The training must
			 be at least partially interactive, as defined in guidelines of the
			 Department.
(D) Training must
			 include an evaluation, as deemed appropriate by the facility staff development
			 coordinator or his or her designee.
(1) No
			 training shall be considered complete until the staff member or contractor has
			 taken and passed the evaluation.
(2) Written documentation the staff member or
			 contractor has passed the evaluation must be available for the Department's
			 review during inspection.
(3)
			 Training shall be appropriate for the population served by facility, and
			 training must include cultural competency as appropriate.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 150.000 - Standards for Long-Term Care Facilities › Section 150.026 - Therapeutic Activity Directors in Dementia Special Care Units

Current through Register 1525, July 5, 2024
(A) A facility operating one or more DSCUs
			 shall have a therapeutic activity director for the DSCU(s) who is a qualified
			 therapeutic recreation specialist or an activities professional who:
(1) Is certified as a therapeutic recreation
			 specialist or as an activities professional by an accrediting body recognized
			 by the Department;
(2) Has two
			 years of experience in a social or recreational program within the last five
			 years, one of which was full-time in a resident activities program in a health
			 care setting; or
(3) Is a qualified
			 occupational therapist or occupational therapy assistant.