North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter D - RULES FOR THE LICENSING OF NURSING HOMES › Section .3000 - SPECIALLY DESIGNATED UNITS › Section 13D .3004 - BRAIN INJURY LONG TERM CARE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The general
				  requirements in this Subchapter shall apply when applicable, but brain injury
				  long term care units shall meet the supplement requirements in Rules.3004 and
				  .3005 of this Section. The facility shall provide services through a medically
				  supervised interdisciplinary process as provided in Rule.2505 of this
				  Subchapter and that are directed toward maintaining the individual at the
				  optimal level of physical, cognitive and behavioral functioning. Following are
				  the minimum requirements for specific services that may be necessary to
				  maintain the individual at optimum level:
(1)
				  Overall supervisory responsibility for brain injury long term care services
				  shall be assigned to a registered nurse with one year experience in caring for
				  brain injured patients.
(2)
				  Physical therapy shall be provided by a physical therapist with a current valid
				  North Carolina license. Occupational therapy shall be provided by an
				  occupational therapist with a current valid North Carolina License. The
				  services of a physical therapist and occupational therapist shall be combined
				  to provide one full-time equivalent position for each 20 patients. The
				  assistance of a physical therapy aide and occupational therapy aide, with
				  appropriate supervision, shall be combined to provide one full-time equivalent
				  position for each 20 patients. A proportionate number of hours shall be
				  provided for a census less than 20 patients.
(3) Clinical nutrition services shall be
				  provided by a dietitian with two years clinical training and experience in
				  nutrition. The number of hours of clinical nutrition services on either a
				  full-time or part-time employment or contract basis shall be adequate to meet
				  the needs of the patients. Each patient's nutrition needs shall be reviewed at
				  least monthly. Clinical nutrition services shall include:
(A) Assessing the appropriateness of the
				  ordered diet for conformance with each patient's physiological and
				  pharmacological condition.
(B)
				  Evaluating each patient's laboratory data in relation to nutritional status and
				  hydration.
(C) Applying technical
				  knowledge of feeding tubes, pumps and equipment to each patient's specialized
				  needs.
(4) Clinical
				  social work shall be provided by a social worker meeting the requirements of
				  Rule.2802 of this Subchapter.
(5)
				  Recreation therapy, when required, shall be provided on either a full-time or
				  part-time employment or contract basis by a clinician eligible for
				  certification as a therapeutic recreation specialist by the State of North
				  Carolina Therapeutic Recreational Certification Board. The number of hours of
				  therapeutic recreation services shall be adequate to meet the needs of the
				  patients. In event that a qualified specialist is not locally available,
				  alternate treatment modalities shall be developed by the occupational therapist
				  and reviewed by the attending physician. The program designed shall be adequate
				  to meet the needs of this specialized population and shall be administered in
				  accordance with Section.3000 of this Subchapter.
(6) Speech therapy, when required, shall be
				  provided by a clinician with a current valid license in speech pathology issued
				  by the State Board of Speech and Language Pathologists and
				  Audiologists.
(7) Respiratory
				  therapy, when required, shall be provided by an individual meeting the same
				  qualifications for providing respiratory therapy under Rule.3003 of this
				  Section.