reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0600 - PATIENT/FAMILY CARE › Section 13K .0604 - PATIENT'S RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				  hospice agency shall provide each patient with a written notice of the
				  patient's rights and responsibilities in advance of furnishing care to the
				  patient or during the initial evaluation visit before the initiation of
				  services. The agency shall maintain documentation showing that each patient has
				  received a copy of his or her rights and responsibilities as defined in
				  G.S.
				  131E-144.3.
(b) A hospice agency shall provide patients
				  with a business hours telephone number for information, questions, or
				  complaints about services provided by the agency. The agency shall also provide
				  the Division of Health Service Regulation's complaints intake telephone
				  numbers: within N.C. (800) 624-3004; outside of N.C. (919) 855-4500. The
				  Division of Health Service Regulation shall investigate all allegations of
				  non-compliance with the rules of this Subchapter.
(c) A hospice agency shall initiate an
				  investigation within 72 hours of complaints made by a patient or his or her
				  family. Documentation of both the existence of the complaint and the resolution
				  of the complaint shall be maintained by the agency, for a minimum of one-year,
				  in accordance with hospice agency policy and procedures.
Authority
					 G.S.
					 131E-202;
Eff. February 1,
					 1996;
Readopted Eff. January 1,
					 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0600 - PATIENT/FAMILY CARE › Section 13K .0605 - HOME CARE

Current through Register Vol. 39, No. 2, July 15, 2024
If a hospice agency wishes to provide home care services as
					 defined in
					 G.S
					 131E-136 and meets the requirements of
					 10A NCAC
					 13J and the standards for the specific home
					 care services applied for, the hospice agency may apply for a home care
					 license. The licensure inspection shall be conducted either at the Department
					 offices or on-site.
Authority
					 G.S.
					 131E-202;
Eff. April 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0700 - PATIENT/FAMILY CARE PLAN › Section 13K .0701 - CARE PLAN

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The agency
				  shall develop and implement policies and procedures that ensure a written care
				  plan is developed and maintained for each patient and family. The plan shall be
				  established by the interdisciplinary team in accordance with the orders of the
				  attending physician and be based on the assessment of the patient's and
				  family's medical, psychosocial, and spiritual needs. The patient and family
				  care coordinator shall have the primary responsibility for assuring the
				  implementation of the patient's care plan. The care plan shall include the
				  following:
(1) the patient's diagnosis and
				  prognosis;
(2) the identification
				  of problems or needs and the establishment of goals that are appropriate for
				  the patient;
(3) the types and
				  frequency of services required to meet the goals; and
(4) the identification of personnel and
				  disciplines responsible for each service.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0800 - PHARMACEUTICAL AND MEDICAL TREATMENT ORDERS AND ADMINISTRATION › Section 13K .0801 - PHARMACEUTICAL AND MEDICAL TREATMENT ORDERS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall develop and implement written policies and procedures for the
				  administration of drugs and treatments including controlled
				  substances.
(b) The original order
				  for drugs and treatments shall be signed by the attending physician and
				  incorporated in the patient's medical record. Signed faxed orders are
				  acceptable. The receiver of faxed orders shall assure a hard copy is
				  incorporated in the patient record. Thermal paper faxes are not
				  acceptable.
(c) Verbal orders shall
				  be given to a licensed nurse, physician or other person authorized by state law
				  to implement orders, recorded and signed by the person receiving it and
				  countersigned by the prescribing physician, or person authorized by the North
				  Carolina Medical Board to sign for another physician. Care may commence with a
				  verbal order documented in the patient record.
(d) Changes in drugs and treatments shall be
				  signed by the physician and incorporated in the medical record within 30
				  days.
(e) Each patient's drug
				  regimen shall be monitored to assure optimal symptom control in accordance with
				  physician's orders. Individuals qualified to perform such reviews are
				  registered nurses, pharmacists, licensed physicians, nurse practitioners, and
				  physician's assistants approved to practice in North Carolina.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. April 1, 1996; November 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0800 - PHARMACEUTICAL AND MEDICAL TREATMENT ORDERS AND ADMINISTRATION › Section 13K .0802 - ADMINISTRATION OF PHARMACEUTICALS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) In
				  a private home, the administration of prescribed medications is the primary
				  responsibility of the patient, family member or caregiver. Where special skills
				  or knowledge are required, medication shall be administered by a licensed
				  registered nurse, licensed practical nurse with training specified by the North
				  Carolina Board of Nursing, or physician.
(b) In a licensed hospice residence,
				  medications shall be administered by a licensed nurse. Exceptions to this
				  requirement are as follows:
(1) persons who
				  hold statutory authority to administer medications;
(2) hospice patients, their families or
				  caregivers who provide personal care to individuals whose health care needs are
				  incidental to the personal care required;
(3) administration of oral nutritional
				  supplements;
(4) applications of
				  non-systemic, topical skin preparations which have local effects only provided
				  that ongoing, periodic assessment of any skin lesion present is carried out by
				  a person licensed to make such assessments; and
(5) administration of commonly used cleansing
				  enema solutions or suppositories with local effects only.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0800 - PHARMACEUTICAL AND MEDICAL TREATMENT ORDERS AND ADMINISTRATION › Section 13K .0803 - RESERVED FOR FUTURE CODIFICATION

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0900 - MEDICAL RECORDS › Section 13K .0901 - CONTENT OF MEDICAL RECORD

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall develop and implement policies and procedures to ensure that a medical
				  record is maintained for each patient and is made available for licensure
				  inspection. If the patient or responsible party wishes to deny the Department
				  access to the medical record, that person shall sign a statement denying
				  access. This statement shall be kept at the front of the record. If the patient
				  is not able to approve or disapprove the release of such information for
				  inspection, the patient's legal guardian shall make the decision and so
				  indicate in writing.
(b) The record
				  shall contain past and current medical and social data and include the
				  following information:
(1) identification
				  data (name, address, telephone, date of birth, sex, marital status);
(2) name of next of kin or legal
				  guardian;
(3) names of other family
				  members;
(4) religious preference
				  and church affiliation and spiritual caregiver if appropriate;
(5) diagnosis, as determined by attending
				  physician;
(6) authorization from
				  attending physician for hospice care;
(7) source of referral;
(8) initial assessments, including physical,
				  social, spiritual, environmental, and bereavement;
(9) consent for care form;
(10) physician's orders for drugs, treatments
				  and other special care, diet, activity and other specific therapy
				  services;
(11) care plan;
(12) clinical notes containing a record of
				  all professional services provided directly or by contract with entries signed
				  by the individual providing the services;
(13) nurse aide and hospice caregiver notes
				  describing activities performed and pertinent observations;
(14) a copy of the signed patient's rights
				  form or documentation of its delivery;
(15) patient family volunteer notes, as
				  applicable, indicating type of contact, activities performed and time
				  spent;
(16) discharge summary to
				  include services provided, or reason for discharge if services are terminated
				  prior to the death of the patient; and
(17) bereavement counseling notes.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0900 - MEDICAL RECORDS › Section 13K .0902 - RECORD CONTENT, HANDLING AND RETENTION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  hospice agency shall develop and implement written policies governing the
				  content, handling and retention of patient records.
(b) The agency shall maintain a patient
				  record for each patient. Each page of the patient record shall have the
				  patient's name. All entries in the record shall reflect the actual date of
				  entry. Reference to any activity which occurred on a date prior to the date of
				  entry shall be identified as a late or out of sequence entry. A system for
				  maintaining originals and copies shall be described in the agency policies and
				  procedures.
(c) The agency shall
				  assure that originals of patient records are kept confidential and secure on
				  the licensed premises unless in accordance with Rule.0209 of this Subchapter,
				  or subpoenaed by a court of legal jurisdiction, or to conduct an evaluation as
				  required in Rule.1001 of this Subchapter.
(d) If a record is removed to conduct an
				  evaluation, the record shall be returned to the agency premises within five
				  working days. The agency shall maintain a sign out log that includes to whom
				  the record was released, patient's name and date removed.
(e) A copy of the patient record for each
				  patient must be readily available to the hospice staff providing services or
				  managing the delivery of such services.
(f) Patient records shall be retained for a
				  period of not less than three years from the date of discharge of the patient,
				  unless the patient is a minor in which case the record must be retained until
				  five years after the patient's eighteenth birthday. If a minor patient dies, as
				  opposed to being discharged for other reasons, the minor's records must be
				  retained at least five years after the minor's death. When an agency ceases
				  operation, the Department shall be notified in writing where the records will
				  be stored for the required retention period.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1000 - EVALUATION › Section 13K .1001 - EVALUATION REQUIRED

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall develop and implement policies and a written plan for the implementation
				  of a comprehensive assessment at least annually of its overall program and
				  performance. The quality and appropriateness of care provided shall be assessed
				  with the findings used to verify policy implementation, to identify problems
				  and to establish problem resolution and policy revision as necessary.
(b) The hospice shall determine what
				  individuals will carry out the evaluation. Representatives of the governing
				  body, hospice staff, the interdisciplinary care team, and other appropriate
				  professionals may be used.
(c) The
				  evaluation shall include, as a minimum, a review of all policies and procedures
				  and a medical record review.
(d)
				  Documentation of the evaluation shall include the names and qualifications of
				  the persons carrying out the evaluation, the criteria and methods used to
				  accomplish it, and the action taken by the agency as a result of the
				  findings.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. February 1, 1996; November 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1101 - ADMINISTRATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Hospice
				  residences must conform to the rules outlined in
				  10A NCAC
				  13K.0100 through
				  13K.0100 .1000.
(b) The hospice shall maintain administrative
				  control of and responsibility for the provision of all services.
(c) The governing body shall have written
				  policies and procedures governing the admission and delivery of all residential
				  and inpatient hospice care services, including the management of medical and
				  other emergencies.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1102 - HOSPICE RESIDENCE STAFFING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) There
				  shall be trained hospice caregivers on duty 24 hours a day. A registered nurse
				  shall be continuously available, for consultation and direct participation in
				  nursing care. The registered nurse shall be on site when required to perform
				  duties specified in the Nurse Practice Act. Supervision shall be provided by
				  the Patient and Family Care Coordinator who may delegate this responsibility to
				  the registered nurse on call.
(b)
				  There shall be at least two staff on duty at all times.
(c) All staff, including patient family
				  volunteers, counselors and clergy, shall complete training specific to dealing
				  with the terminally ill and their families.
(d) Nurse aides employed to provide direct
				  care shall be supervised by licensed nurses.
(e) Interdisciplinary team services shall be
				  provided in accordance with the hospice plan of care.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Amended Eff. February 1, 1996; February 1, 1995;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1103 - PHARMACEUTICAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall establish and implement written policies and procedures to govern the
				  procurement, storage, administration and disposal of all drugs and biologicals
				  in accordance with federal and state laws.
(b) Pharmaceutical services shall be provided
				  directly or through written agreement under the supervision of a licensed
				  pharmacist and in accordance with Rule .0505 of this Subchapter. The
				  pharmacist's duties shall include, but are not limited to the following:
(1) advising the hospice and the hospice
				  interdisciplinary team on all matters pertaining to the procurement, storage,
				  administration, disposal and record-keeping of drugs and biologicals;
				  interactions of drugs; and counseling staff on appropriate and new
				  drugs;
(2) inspecting all drug
				  storage areas at least monthly;
(3)
				  conducting patients' drug regimen reviews frequently enough to monitor symptom
				  control, no less often than monthly, with appropriate recommendations to the
				  physician and hospice staff.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1104 - DIETARY SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall develop and maintain written policies and procedures for dietary
				  services.
(b) Dietary services
				  shall be provided directly or through written agreement with a food service
				  company. Any written agreement shall meet the provisions of Rule.0505 of this
				  Subchapter.
(c) The hospice shall
				  offer the residents' favorite foods in their diets.
(d) The food service shall be planned and
				  staffed to serve at least three meals throughout the day, timed to meet the
				  needs of the residents. No more than 14 hours shall elapse between an evening
				  meal which shall consist of three or more menu items, including a protein, and
				  breakfast that includes a protein.
(e) The hospice shall appoint a staff member
				  trained or experienced in nutrition care services to:
(1) plan menus to meet the nutritional needs
				  of the residents; and
(2) supervise
				  meal preparation and service.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1105 - HOSPICE VISITATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall:
(1) provide areas that ensure privacy
				  for visitation and at the time of death;
(2) arrange for family members to remain with
				  the patient overnight.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1106 - INFECTION CONTROL

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall develop and implement an infection control program which shall aim to
				  protect the residents, family and personnel from hospice or community
				  associated infections.
(b) There
				  shall be written policies and procedures governing the infection control
				  program, developed by the hospice administrator and medical director and
				  approved by the governing body.
(c)
				  Universal precautions, as specified by the Centers for Disease Control (CDC),
				  shall be defined in writing and strictly followed.
(d) All employees shall wear clean garments
				  or protective clothing at all times and shall practice good personal hygiene
				  and cleanliness.
(e) A procedure
				  shall be developed whereby the implementation of the infection control program
				  is monitored on a monthly basis.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1107 - HOUSEKEEPING AND LINENS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Requirements
				  for linens and personal care articles shall include:
(1) The use of common towels, washcloths,
				  cups or any other personal care articles is prohibited.
(2) Each resident shall have a supply of
				  towels, washcloths and soap.
(3)
				  There shall be a supply of clean bed linens, towels, and washcloths.
(4) There shall be a separate closed area for
				  storage of clean linen.
(5) Clean
				  bed linens shall be changed as often as necessary, but no less than twice each
				  week.
(6) Mattress pads and pillows
				  shall be of washable material.
(7)
				  There shall be separate storage for soiled linen and clothing. Such storage may
				  consist of individual plastic bags or covered hampers or a soiled linen room.
				  All personnel shall wash their hands thoroughly after handling soiled
				  linen.
(8) Laundry equipment shall
				  be maintained in the facility or arrangements made with a commercial laundry to
				  handle soiled linen.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1108 - REPORT OF DEATH

Current through Register Vol. 39, No. 2, July 15, 2024
The hospice shall have a written plan to be followed in
					 case of patient death. The plan must provide for:
(1) collection of data needed for the death
				  certificate, as required by
				  G.S.
				  130A-117;
(2) recording time of death;
(3) pronouncement of death;
(4) notification of attending physician
				  responsible for signing death certificate;
(5) notification of next of kin or legal
				  guardian;
(6) authorization and
				  release of body to funeral home; and
(7) notification to the Department of any
				  death resulting from an injury, accident, or other possible unnatural
				  causes.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1109 - RESIDENT CARE AREAS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A facility
				  shall meet the following requirements for resident bedrooms:
(1) private bedroom with not less than 100
				  square feet of floor area or semi-private bedroom with not less than 80 square
				  feet of floor area per bed shall be provided;
(2) infants and small children shall not
				  share a bedroom with an adult resident unless requested by the resident and
				  families;
(3) each bedroom shall be
				  furnished with a bed, a mattress protected by waterproof material, a mattress
				  pad, a pillow, and one chair per resident;
(4) each bedroom shall be provided with one
				  closet or wardrobe per bed. Each closet or wardrobe shall have clothing storage
				  space of not less than 48 cubic feet per bed with one-half of this space for
				  hanging clothes;
(5) each bedroom
				  shall:
(A) be located at or above grade
				  level;
(B) have provisions to
				  ensure visual privacy for treatment or visiting; and
(C) be equipped with a towel rack for each
				  resident;
(6) each
				  bedroom shall provide lighting for treatment and non-treatment needs, 50
				  foot-candles for treatment needs, and 35 foot-candles for non-treatment needs;
				  and
(7) no resident bedroom shall
				  be accessed through a bathroom, kitchen, or another bedroom.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1110 - FURNISHINGS

Current through Register Vol. 39, No. 2, July 15, 2024
Furnishings of the residence shall be home-like and
					 non-institutional and include lounge furniture in addition to furnishings in
					 resident rooms. Accessories such as wallpaper, bedspreads, carpets and lamps
					 shall be selected to create such an atmosphere. Provision shall be made for
					 each resident to bring items from home to place about the room to the extent
					 available space allows.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1111 - HOSPICE RESIDENCE ZONING AND FIRE SAFETY REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
Hospices maintained as residential facilities shall provide
					 documentation of approval from local zoning commissions, fire departments and
					 building departments.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1112 - DESIGN AND CONSTRUCTION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A new facility
				  or remodeling of an existing facility shall meet the requirements of the North
				  Carolina State Building Codes, which are incorporated by reference, including
				  all subsequent amendments and editions, in effect at the time of licensure,
				  construction, additions, alterations, or repairs. Copies of these codes may be
				  purchased from the International Code Council online at
https://shop.iccsafe.org/
at a
				  cost of eight hundred fifty-eight dollars ($858.00) or accessed electronically
				  free of charge at
https://codes.iccsafe.org/codes/north-carolina
.
				  Existing licensed facilities shall meet the requirements of the North Carolina
				  State Building Codes in effect at the time of licensure, construction, or
				  remodeling.
(b) Each facility shall
				  be planned, constructed, and equipped to support the services to be offered in
				  the facility.
(c) Any existing
				  building converted to a hospice facility shall meet all requirements of a new
				  facility.
(d) The sanitation, water
				  supply, sewage disposal, and dietary facilities shall meet the requirements of
				  15A NCAC
				  18A.1300, which is incorporated by reference
				  including subsequent amendments.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22, 2018;
Amended Eff.
					 October 1, 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1113 - PLANS AND SPECIFICATIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				  When construction or remodeling of a facility is planned, one copy of
				  construction documents and specifications shall be submitted by the owner or
				  the owner's appointed representative to the Department for review and approval.
				  Schematic design drawings and design development drawings may be submitted for
				  approval prior to the required submission of construction documents.
(b) Approval of construction documents and
				  specifications shall be obtained from the Department prior to licensure.
				  Approval of construction documents and specifications shall expire one year
				  after the date of approval unless a building permit for the construction has
				  been obtained prior to the expiration date of the approval of construction
				  documents and specifications.
(c)
				  If an approval expires, renewed approval shall be issued by the Department,
				  provided revised construction documents and specifications meeting the
				  standards established in Sections.1100 and.1200 of this Subchapter are
				  submitted by the owner or owner's appointed representative and reviewed by the
				  Department.
(d) Any changes made
				  during construction shall require the approval of the Department to
				  ensurecompliance with the standards established in Sections.1100 and.1200 of
				  this Subchapter.
(e) Completed
				  construction or remodeling shall conform to the standards established in
				  Sections.1100 and.1200 of this Subchapter. Construction documents and building
				  construction, including the operation of all building systems, shall be
				  approved in writing by the Department prior to licensure or patient and
				  resident occupancy.
(f) The owner
				  or owner's appointed representative shall notify the Department in writing
				  either by U.S. Mail or e-mail when the construction or remodeling is
				  complete.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Amended Eff. February 1, 1996;
Readopted Eff.
					 October 1, 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1114 - PLUMBING

Current through Register Vol. 39, No. 2, July 15, 2024
For hospice residential facilities with five or more
					 residents, a 50-gallon quick recovery water heater is required. For hospice
					 residential facilities with fewer than five residents, a 40-gallon quick
					 recovery water heater is required.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Readopted Eff. October 1,
					 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1115 - WASTE DISPOSAL

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Sewage shall be
				  discharged into a public sewer system, or in the absence of a public sewer
				  system, sewage shall be disposed of in a manner approved by the North Carolina
				  Department of Health and Human Services, Division of Public Health,
				  Environmental Health Section.
(b)
				  Garbage and rubbish shall be stored in impervious containers in a manner as to
				  prevent insect breeding and public health nuisances. Impervious containers with
				  tight-fitting lids shall be provided and kept clean and in good repair. Garbage
				  shall be removed from the outside storage at least once a week to a disposal
				  site approved by the local health department having jurisdiction.
(c) The facility or unit shall take measures
				  to keep insects, rodents, and other vermin out of the residential care
				  facility. All openings to the outer air shall be protected against the entrance
				  of flying insects by screens, closed doors, closed windows, or other
				  means.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Readopted Eff. October 1,
					 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1100 - HOSPICE RESIDENTIAL CARE › Section 13K .1116 - APPLICATION OF PHYSICAL PLANT REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
The physical plant requirements for each hospice
					 residential facility or unit shall be applied as follows:
(1) New construction shall comply with all
				  the requirements of this Section.
(2) Except where otherwise specified,
				  existing buildings shall meet the licensure and code requirements in effect at
				  the time of licensure, construction, alteration, or modification.
(3) Rules contained in this Section are
				  minimum requirements and are not intended to prohibit buildings, systems, or
				  operational conditions that exceed minimum requirements.
(4) The Division may grant an equivalency to
				  allow alternate methods, procedures, design criteria, or functional variation
				  from the requirements of this Rule and the rules contained in this Section. The
				  equivalency may be granted by the Division when a governing body submits a
				  written equivalency request to the Division that states the following:
(a) the rule citation and the rule
				  requirement that will not be met because strict conformance with current
				  requirements would be:
(i)
				  impractical;
(ii) unable to be met
				  due to extraordinary circumstances;
(iii) unable to be met due to new programs;
				  or
(iv) unable to be met due to
				  unusual conditions;
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1201 - REQUIREMENTS FOR HOSPICE INPATIENT UNITS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Hospice
				  inpatient facilities or units shall conform to the rules outlined in Sections
				  .0100 through.1100 of this Subchapter and the rules of this Section.
(b) Hospice inpatient units located in a
				  licensed hospital shall meet the requirements of
				  10A NCAC
				  13B, which is incorporated by reference with
				  subsequent amendments except for rules:
				  10A NCAC
				  13B.1912,
				  13B.1912 .1919,
				  13B.1912 .1922,
				  and.1923.
(c) Hospice inpatient
				  units located in a licensed nursing facility shall meet the requirements of
				  10A NCAC
				  13D, which is incorporated by reference with
				  subsequent amendments.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Readopted Eff. October 1,
					 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1202 - ADDITIONAL STAFFING REQUIREMENTS FOR HOSPICE INPATIENT UNITS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) All nursing services shall be provided
				  under the supervision of a registered nurse.
(b) A facility providing respite care must
				  provide 24-hour nursing services that meet the nursing needs of all patients
				  and are furnished in accordance with each patient's plan of care. Each patient
				  must receive all nursing services as prescribed by the physician and must be
				  kept comfortable, clean, well-groomed and protected from accident, injury and
				  infection. The presence of a Registered Nurse (RN) to provide direct care on
				  all shifts is not required for patients receiving general inpatient care for
				  respite unless specific nursing needs are in an individual patient's plan of
				  care. If a patient in an inpatient facility is receiving general inpatient care
				  for symptom management, then the 24-hour patient care RN staff must be
				  available.
(c) Considerations for
				  determining sufficiency of nursing personnel include:
(1) number of patients;
(2) specific patient care
				  requirements;
(3) family care
				  needs; and
(4) availability of
				  support from other interdisciplinary team members.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1203 - ADDITIONAL SERVICES REQUIRED FOR HOSPICE INPATIENT CARE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice shall assure, directly or
				  through written agreement, the provision of duly licensed radiology,
				  laboratory, pathology and other medically related services in accordance with
				  physicians' orders. Written agreement shall be in keeping with Rule.0505 of
				  this Subchapter. If those services are provided directly, written policies and
				  procedures shall govern their implementation.
(b) Radiology, laboratory and pathology
				  services shall be under the direction of a physician qualified by education,
				  training and experience to assume that function.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1204 - ADDITIONAL PATIENT CARE AREA REQUIREMENTS FOR HOSPICE INPATIENT UNITS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A facility shall meet the following
				  requirements for patient bedrooms:
(1) private
				  bedrooms shall be provided with not less than 100 square feet of floor
				  area;
(2) semi-private bedrooms
				  with not less than 80 square feet of floor area per bed; and
(3) floor space for closets, toilet rooms,
				  vestibules, or wardrobes shall not be included in the floor areas required by
				  this Paragraph.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1205 - FURNISHINGS FOR HOSPICE INPATIENT CARE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A facility
				  shall provide handgrips at all toilet and bath facilities used by patients.
				  Handrails shall be provided on both sides of all corridors where corridors are
				  defined by walls and used by patients.
(b) For each nursing unit on each floor, the
				  following shall be provided:
(1) a
				  nourishment station separated from the nurses' station with:
(A) work space;
(B) cabinets;
(C) refrigerated storage;
(D) a sink trimmed with valves that can be
				  operated without hands. If the sink is equipped with blade handles, the blade
				  handles shall not be less than four inches in length. If the sink faucet
				  depends on the building electrical service for operation, the faucet shall be
				  connected to the essential electrical system. If the faucet has battery
				  operated sensors, the facility shall have a maintenance policy to keep extra
				  rechargeable or non-rechargeable batteries on premises for the faucets;
				  and
(E) a small stove, microwave,
				  or hot plate; and
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1206 - HOSPICE INPATIENT FIRE AND SAFETY REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  hospice shall establish written policies and procedures governing disaster
				  preparedness and fire protection.
(b) The hospice shall have detailed written
				  plans and procedures to meet potential emergencies and disasters, including
				  fire and severe weather.
(c) The
				  plans and procedures shall be made available upon request to local or regional
				  emergency management offices.
(d)
				  The facility shall provide training for all employees in emergency procedures
				  upon employment and annually.
(e)
				  The facility shall conduct unannounced drills using the emergency
				  procedures.
(f) The facility shall
				  ensure that:
(1) the patients' environment
				  remains as free of accident hazards as possible; and
(2) each patient receives adequate
				  supervision and assistance to prevent accidents.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1207 - HOSPICE INPATIENT REQUIREMENTS FOR HEATING/AIR CONDITIONING

Current through Register Vol. 39, No. 2, July 15, 2024
A facility shall provide heating and cooling systems
					 complying with the following:
(1) The
				  American National Standards Institute and American Society of Heating,
				  Refrigerating, and Air Conditioning Engineers Standard 170: Ventilation of
				  Health Care Facilities, which is incorporated by reference, including all
				  subsequent amendments and editions, and may be purchased for a cost of
				  ninety-four dollars ($94.00) online at
https://www.techstreet.com/ashrae/index.html
.
				  This incorporation does not apply to Section 9.1, Table 9-1 Design Temperature
				  for Skilled Nursing Facility. The environmental temperature control systems
				  shall be capable of maintaining temperatures in the facility at 71 degrees F.
				  minimum in the heating season and a maximum of 81 degrees F. during non-heating
				  season, even upon loss of utility power; and
(2) The National Fire Protection Association
				  90A: Standard for the Installation of Air-Conditioning and Ventilating Systems,
				  which is incorporated by reference, including all subsequent amendments and
				  editions, and may be purchased at a cost of fifty dollars and fifty cents
				  ($50.50) from the National Fire Protection Association online at
http://www.nfpa.org/catalog/
or accessed electronically free of charge at
				  http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=90A.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Readopted Eff. October 1,
					 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1208 - HOSPICE INPATIENT REQUIREMENTS FOR EMERGENCY ELECTRICAL SERVICE

Current through Register Vol. 39, No. 2, July 15, 2024
A facility shall provide an emergency electrical service
					 for use in the event of failure of the normal electrical service. This
					 emergency electrical service shall consist of the following:
(1) In any existing facility:
(a) type 1 or 2 emergency lights as required
				  by the North Carolina State Building Codes: Electrical Code;
(b) additional emergency lights for all
				  nurses' stations required by Rule.1205(b)(2) of this Section, medication
				  preparation areas required by Rule.1204(d)(1) of this Section, storage areas,
				  and for the telephone switchboard, if applicable;
(c) one or more portable battery-powered
				  lamps at each nurses' station; and
(d) a source of emergency power for
				  life-sustaining equipment, if the facility admits or cares for occupants
				  needing such equipment, to ensure continuous operation with on-site fuel
				  storage for a minimum of 72 hours.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1209 - HOSPICE INPATIENT REQUIREMENTS FOR GENERAL ELECTRICAL

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				  All main water supply shut off valves in the sprinkler system shall be
				  electronically supervised so that if any valve is closed an alarm will sound at
				  a continuously manned central station.
(b) No two adjacent emergency life safety
				  branch lighting fixtures shall be on the same circuit.
(c) Receptacles in bathrooms shall have
				  ground fault protection.
(d) Each
				  patient bed location shall be provided with a minimum of eight single or four
				  duplex receptacles.
(e) Each
				  patient bed location shall be supplied by at least two branch circuits, one
				  from the equipment branch and one from the normal system.
(f) The fire alarm system shall be installed
				  to transmit an alarm automatically to the fire department that is legally
				  committed to serve the area where the facility is located, by the direct and
				  reliable method approved by local ordinances.
(g) In patient areas, fire alarms shall be
				  gongs or chimes rather than horns or bells.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22, 2018;
Amended Eff.
					 October 1, 2021.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1210 - OTHER HOSPICE INPATIENT REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				  nurses' calling system shall be provided:
(1)
				  in each patient bedroom for each patient bed. The call system activator shall
				  be such that it can be activated with a single action and remain on until
				  deactivated by staff at the point of origin. The call system activator shall be
				  within reach of a patient lying on the bed. In rooms containing two or more
				  call system activators, indicating lights shall be provided at each calling
				  station;
(2) nurses' calling
				  systems that provide two-way voice communication shall be equipped with an
				  indicating light at each calling station that lights and remains lighted as
				  long as the voice circuit is operating;
(3) a nurses' call emergency activator shall
				  be provided at each patients' use toilet fixture, bath, and shower. The call
				  system activator shall be accessible to a patient lying on the floor;
				  and
(4) calls shall register with
				  the floor staff and shall activate a visible signal in the corridor at the
				  patient's door. In multi-corridor units, additional visible signals shall be
				  installed at corridor intersections.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .1200 - HOSPICE INPATIENT CARE › Section 13K .1211 - ADDITIONAL PLUMBING REQUIREMENTS/HOSPICE INPATIENT UNITS

Current through Register Vol. 39, No. 2, July 15, 2024
Hospice inpatient facilities or units shall provide a flow
					 of hot water within safety ranges specified as follows:
(1) Patient Areas - 6 1/2 gallons per hour
				  per bed and at a temperature of 100 to 116 degrees F;
(2) Dietary Services - 4 gallons per hour per
				  bed and at a minimum temperature of 140 degrees F; and
(3) Laundry Area - 4 1/2 gallons per hour per
				  bed and at a minimum temperature of 140 degrees F.
Authority
					 G.S.
					 131E-202;
Eff. June 1,
					 1991;
Readopted Eff. October 1,
					 2021.