reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1000 - ELIGIBILITY FOR SERVICES › Section 10 .1003 - REPEALED - INCOME ELIGIBILITY LEVELS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  143B-153;
Eff. July 1,
				  1983;
Amended Eff. April 1, 2001; July 1, 1992;
Repealed Eff. March 1, 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1000 - ELIGIBILITY FOR SERVICES › Section 10 .1004 - WITHOUT REGARD TO INCOME

Current through Register Vol. 39, No. 2, July 15, 2024
The Subsidized Child Care Assistance Program shall provide
				  assistance without regard to income for:
(1) child care services that are provided in
				conjunction with protective services as described in
				10A NCAC
				10 .0906(a);
(2) children receiving foster care services
				who are in the custody of the county department of social services and are
				residing in licensed foster care homes or in the care of adults other than
				their parents; and
(3) child care
				services that are provided to a child receiving Child Welfare Services as
				described in
				10A NCAC
				10 .0906(b).
Authority
				  G.S.
				  143B-153(2a);
Eff. July 1, 1983;
Amended Eff. April 1, 2001; February 1, 1996;
				  February 1, 1986;
Readopted Eff. March 1,
				  2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1000 - ELIGIBILITY FOR SERVICES › Section 10 .1005 - REPEALED - RESPONSIBILITY FOR ELIGIBILITY DETERMINATION

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
				  G.S.
				  143B-153;
Eff. July 1,
				  1983;
Amended Eff. April 1, 2001; February 1, 1996;
Repealed Eff. March 1, 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1000 - ELIGIBILITY FOR SERVICES › Section 10 .1006 - VERIFICATION OF INCOME

Current through Register Vol. 39, No. 2, July 15, 2024
(a) An individual
				who applies for child care services shall provide to the Local Purchasing
				Agency verification of the amount and sources of his or her countable income as
				set forth in
				10A NCAC
				10 .1002. The amount and source of income
				shall be verified by one of the following:
(1)
				a copy of a source document, such as wage stubs, pay statements, and award
				letters;
(2) identification of an
				existing agency record confirming the required information; or
(3) electronic verification through Online
				Verification Service (OVS) within NC FAST as defined in
				10A NCAC
				10 .0102.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1000 - ELIGIBILITY FOR SERVICES › Section 10 .1007 - REQUIREMENTS FOR DETERMINATION AND REDETERMINATION OF ELIGIBILITY

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The Local Purchasing Agency shall
				determine initial eligibility, in accordance with Sections.0900 and.1000 of
				this Chapter, and shall redetermine eligibility every 12 months
				thereafter.
(b) If the Local
				Purchasing Agency determines that a recipient is eligible, the recipient shall
				remain eligible for the 12 month eligibility period unless:
(1) the recipient ceases to be employed, in
				training leading to employment, or in an educational program, as described in
				10A NCAC
				10.0905, for more than 90 days;
(2) the recipient changes residency to
				outside the State;
(3) the
				recipient's income exceeds 85 percent of the State Median Income; or
(4) the Local Purchasing Agency or the
				Division issues the recipient a sanction for fraudulent misrepresentation in
				accordance with
				10A NCAC
				10.0308.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1100 - RECIPIENT FEES FOR CHILD CARE SERVICES › Section 10 .1101 - GENERAL RECIPIENT FEE POLICY

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				Recipient fees for child care services shall be 10 percent of the income unit's
				gross monthly income as set forth in
				10A NCAC
				10.1002; however, no fees shall be charged to
				a recipient if child care services are provided in the following circumstances:
(1) if child care services are provided in
				conjunction with protective services as described in
				10A NCAC
				10 .0906(a);
(2) if child care services are provided to a
				child receiving Child Welfare Services as described in
				10A NCAC
				10.0906(b); or
(3) if a child with no income is living with
				someone other than his or her biological or adoptive parent or is living with
				someone who does not have court-ordered financial responsibility.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1100 - RECIPIENT FEES FOR CHILD CARE SERVICES › Section 10 .1102 - AMOUNT AND COLLECTION OF RECIPIENT FEES

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				The amount of fees charged to a recipient shall be in accordance with the
				annual appropriations act.
(b) The
				child care provider shall collect recipient fees on a monthly basis.
Authority
				  G.S.
				  143B-153;
Eff. July 1,
				  1983;
Amended Eff. April 1, 2001; July 1, 1990;
Readopted Eff. March 1, 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1100 - RECIPIENT FEES FOR CHILD CARE SERVICES › Section 10 .1103 - ADJUSTMENTS IN FEES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If recipient
				medical expenses exceed 10 percent of a recipient's gross income as set forth
				in 10A
				NCAC 10.1002 in any eligibility period, the
				recipient's fee shall be reassessed based on the recipient's adjusted income.
				The recipient's income shall be adjusted by deducting the amount of medical
				expenses that exceed 10 percent of the recipient's gross income.
(b) If the plan of care is for less than a
				full day, the recipient fee shall be assessed in accordance with the annual
				appropriations act.
Authority
				  G.S.
				  143B-153;
Eff. July 1,
				  1983;
Amended Eff. April 1, 2001; December 1, 1992; July 1, 1992;
				  July 1, 1990;
Readopted Eff. March 1,
				  2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1200 - APPEALS › Section 10 .1201 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
In addition to the terms defined in
				  G.S.
				  110-86 and in
				  10A NCAC
				  10.0102, the following definitions shall
				  apply to the terms used in this Section:
(1) "Administrative Review Decision" means
				the decision made by the State Subsidy Services Appeals Panel that is made
				after review and analysis of documentation related to an appeal pursuant to
				this Section.
(2) "File or Filing"
				means personal delivery, delivery by certified mail, or delivery by overnight
				express mailed to the current Division Director or the Subsidy Appeals
				Coordinator, North Carolina Division of Child Development and Early Education,
				2201 Mail Service Center, Raleigh, NC 27699-2200.
(3) "Initial Review" means the review by the
				Local Purchasing Agency of the operator's appeal.
(4) "Local Appeal Hearing" means a hearing
				held by a hearing officer assigned by the Local Purchasing Agency after the
				Initial Review.
(5) "State Subsidy
				Services Appeals Panel" or "Panel" means the North Carolina Division of Child
				Development and Early Education internal review panel.
Authority
				  G.S.
				  108A-79;
				  143B-153;
Eff. March
				  1, 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1200 - APPEALS › Section 10 .1202 - NOTICE

Current through Register Vol. 39, No. 2, July 15, 2024
Notice shall be given by one of the methods for service of
				  process pursuant to
				  G.S.
				  1A-1, Rule 4(j) or Rule 4(j3). If given by
				  registered or certified mail, by signature confirmation as provided by the
				  United States Postal Service, or by designated delivery service authorized
				  pursuant to 26 U.S.C.
				  7502(f)(2) with delivery
				  receipt, notice shall be deemed to have been given on the delivery date
				  appearing on the return receipt, copy of the proof of delivery provided by the
				  United States Postal Service, or delivery receipt. If notice cannot be
				  accomplished pursuant to
				  G.S.
				  1A-1, Rule 4(j) or Rule 4(j3), notice shall
				  then be given in the manner provided in
				  G.S.
				  1A-1, Rule 4(j1).
Authority
				  G.S.
				  143B-153;
Eff. March 1,
				  2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1200 - APPEALS › Section 10 .1203 - FILING

Current through Register Vol. 39, No. 2, July 15, 2024
For purposes of this Chapter, the following apply:
(1) A document or paper shall be deemed filed
				as of the date it is delivered to the Division Director or the Subsidy Appeals
				Coordinator.
(2) Filings shall be
				denied under the following circumstances:
(a)
				the filing is not delivered as set forth in Item (1) of this Rule; or
(b) the filing fails to comply with the Rules
				of this Section.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1200 - APPEALS › Section 10 .1204 - APPEAL TO THE LOCAL PURCHASING AGENCY

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				Appeals by recipients from services determinations pursuant to Section.1000 of
				this Chapter, changes in recipient fees pursuant to Section.1100 of this
				Chapter, terminations of payment pursuant to
				10A NCAC
				10.1007, or a sanctions issued by the Local
				Purchasing Agency in accordance with
				10A NCAC
				10.0308 shall be made in accordance with
				G.S.
				108A-79.
(b) Procedures for an operator to appeal to
				the Local Purchasing Agency are as follows:
(1) An operator wishing to contest an action
				shall contact the Local Purchasing Agency in writing to request an initial
				review. Requests shall be made within 30 calendar days after the date of the
				Local Purchasing Agency action.
(2)
				The Local Purchasing Agency shall make a determination on the initial review
				within 10 business days of the request for an initial review. Within 30
				calendar days of notice of the determination of the initial review by the Local
				Purchasing Agency, the operator may request a local appeal hearing by the Local
				Purchasing Agency.
(3) The local
				appeal hearing shall be held within five business days of receipt of the
				request for a hearing. The Local Purchasing Agency shall grant a delay of up to
				10 additional business days at the written request of the operator, but in no
				event shall the local appeal hearing be held more than 15 business days after
				the receipt of the request for a hearing.
(4) The Local Purchasing Agency shall serve a
				written statement of decision within 10 business days following the local
				hearing. The decision shall include the facts and conclusions that support the
				determination by the Local Purchasing Agency.
(5) The Local Purchasing Agency shall include
				with its written statement of decision instructions for appealing its decision
				in accordance with this Rule.
(6)
				If the operator is not satisfied with the final decision of the Local
				Purchasing Agency, he or she may appeal to the State Subsidy Services Appeals
				Panel by filing a notice of appeal within 30 calendar days of receipt of the
				written statement of decision in accordance with this Rule.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 10 - SUBSIDIZED CHILD CARE › Section .1200 - APPEALS › Section 10 .1205 - OPERATOR APPEAL TO DIVISION OF CHILD DEVELOPMENT AND EARLY EDUCATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The following persons may appeal a
				decision of a Local Purchasing Agency or the Division to the Panel within 15
				calendar days after having exhausted the appeals process at the appropriate
				Local Purchasing Agency or within 15 calendar days after the Division takes
				action as described in Subparagraphs (2) and (3) of this Paragraph:
(1) an operator to whom a Local Purchasing
				Agency has issued a sanction pursuant to
				10A NCAC
				10 .0308;
(2) an operator whom a Local Purchasing
				Agency or the Division has failed to approve for participation in or has
				terminated participation from the Subsidized Child Care Assistance Program
				pursuant to Section.0600 of this Chapter; or
(3) an operator contesting the determination
				of an overpayment pursuant to
				10A NCAC
				10.0309.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter A - EXECUTIVE COMMITTEE › Section .0100 - EXECUTIVE COMMITTEE › Section 13A .0101 - EXECUTIVE COMMITTEE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) There shall be
				  an executive committee of the North Carolina Medical Care Commission composed
				  of five members of the commission in addition to the chairman and vice-chairman
				  of the commission. Three members shall be appointed by a vote of the commission
				  at the December meeting of each odd year and two members shall be appointed by
				  the chairman of the commission at the December meeting of each even year. No
				  member of the executive committee, except the chairman and vice-chairman, shall
				  serve more than two two-year terms in succession. The chairman and
				  vice-chairman of the commission shall also be chairman and vice-chairman of the
				  executive committee.
(b) The
				  functions of the executive committee shall be to:
(1) transact business in behalf of the
				  commission, consistent with established policy, which in the opinion of the
				  chairman is of such urgency that action is required before the next regularly
				  scheduled commission meeting and the impact of the action would not justify the
				  convening of a special meeting of the commission;
(2) transact business in behalf of the
				  commission when a quorum is not obtained at any commission meeting for which
				  prior notice of at least ten days has been given;
(3) review periodically the activities of the
				  commission and the assignments and recommendations of the various committees
				  for the purpose of developing policy recommendations for commission
				  consideration.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter A - EXECUTIVE COMMITTEE › Section .0200 - RULEMAKING › Section 13A .0201 - PETITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Any person
				  wishing to submit a petition requesting the adoption, amendment, or repeal of a
				  rule or rules by the North Carolina Medical Care Commission shall submit the
				  petition addressed to: Office of the Director, Division of Health Service
				  Regulation, 2701 Mail Service Center, Raleigh, North Carolina,
				  27699-2701.
(b) The petition shall
				  contain the following information:
(1) the
				  text of the proposed rule or rules for adoption or amendment, the rule number
				  of the proposed rule or rules for repeal, and the statutory authority for the
				  agency to promulgate the rule or rules;
(2) a statement of the effect on existing
				  rules;
(3) a statement of the
				  effect of the proposed rule or rules on existing practices in the area
				  involved, if known; and
(4) the
				  name(s) and address(es) of petitioner(s).
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter A - EXECUTIVE COMMITTEE › Section .0200 - RULEMAKING › Section 13A .0202 - RULEMAKING PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The rulemaking
				  procedures for the Secretary of the Department of Health and Human Services
				  codified in
				  10A NCAC
				  01 are hereby adopted by reference pursuant
				  to G.S.
				  150B-14(c) to apply to the
				  actions of the Commission, with the following modifications:
(1) Correspondence related to the
				  Commission's rulemaking actions shall be submitted to:
APA/Rule-making Coordinator
Office of the Director
Division of Health Service Regulation
2701 Mail Service Center
Raleigh, North Carolina 27699-2701
(2) The Secretary's designee shall mean the
				  Director of the Division of Health Service Regulation (hereinafter referred to
				  as the Division).
(3) The
				  "Division" shall be substituted for the "Office of General Counsel" in
				  10A NCAC
				  01.
(4) "Hearing officer" shall mean the Chairman
				  of the Medical Care Commission or his designee.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter A - EXECUTIVE COMMITTEE › Section .0200 - RULEMAKING › Section 13A .0203 - DECLARATORY RULINGS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The Commission
				  shall have the power to make declaratory rulings. All requests for declaratory
				  rulings shall be written and submitted to: Chairman, Medical Care Commission,
				  2701 Mail Service Center, Raleigh, North Carolina, 27699-2701.
(b) All requests for a declaratory ruling
				  must include the following information:
(1)
				  name and address of the petitioner;
(2) statute or rule to which petition
				  relates;
(3) concise statement of
				  the manner in which petitioner is aggrieved by the rule or statute or its
				  potential application to him;
(4)
				  the consequences of a failure to issue a declaratory ruling.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1901 - SUPPLEMENTAL RULES

Current through Register Vol. 39, No. 2, July 15, 2024
When a hospital offers nursing facility or adult care home
					 long-term care services, the services shall be included under one hospital
					 license as provided in Rule.0201(c). The general requirements included in this
					 Subchapter shall apply when applicable but in addition the nursing facility
					 care and adult care home care unit must meet the supplemental requirements of
					 this Section.
Authority
					 G.S.
					 131E-79;
					 42 U.S.C.
					 1396 r (a);
Eff. February 1,
					 1986;
Temporary Amendment Eff. October 1, 1990 For a Period of 142
					 Days to Expire on February 28, 1991;
Amended Eff. March 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1903 - INSPECTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Any hospital
				  with beds licensed by the Department under Section.1900 of these Rules may be
				  inspected by one or more authorized representatives of the Department at any
				  time. Generally, inspections will be conducted between the hours of 8:00 a.m.
				  and 6:00 p.m., Monday through Friday. However, complaint investigations shall
				  be conducted at the most appropriate time for investigating allegations of the
				  complaint.
(b) At the time of
				  inspection, any authorized representative of the Department shall make his
				  presence known to the administrator or other person in charge who shall
				  cooperate with such representative and facilitate the inspection.
Authority
					 G.S.
					 131E-79;
					 42 U.S.C.
					 1396 r (a);
Eff. February 1,
					 1986;
Amended Eff. March 1, 1990;
Temporary Amendment
					 Eff. October 1, 1990 For a Period of 142 Days to Expire on February 28,
					 1991;
Amended Eff. March 1, 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1904 - PROCEDURE FOR APPEAL

Current through Register Vol. 39, No. 2, July 15, 2024
A hospital with nursing facility or adult care home beds
					 may appeal any decision of the Department to deny, revoke or alter a license by
					 making such an appeal in accordance with G.S. Chapter 150B.
Authority
					 G.S.
					 131E-79;
					 42 U.S.C.
					 1396 r (a);
Eff. February 1,
					 1986;
Amended Eff. March 1, 1990;
Temporary Amendment
					 Eff. October 1, 1990 For a Period of 142 Days to Expire on February 28,
					 1991;
Amended Eff. March 1, 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1905 - ADMISSIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) No patient
				  shall be admitted except under the orders of a duly licensed
				  physician.
(b) The facility shall
				  acquire prior to or at the time of admission orders from the attending
				  physician for the immediate care of the patient or resident.
(c) Within 48 hours of admission, the
				  facility shall acquire medical information which shall include current medical
				  findings, diagnosis, rehabilitation potential, a summary of the hospital stay
				  if the patient is being transferred from a hospital, and orders for the ongoing
				  care of the patient.
(d) If a
				  patient is admitted from somewhere other than a hospital, a physical
				  examination shall be performed either within 5 days prior to admission or
				  within 48 hours following admission.
(e) Hospitals offering nursing facility or
				  domiciliary home care as a new service must prepare a plan of admission which,
				  at a minimum, assures availability of staff time and plans for individual
				  patient assessments, initiation of health care or nursing care plans, and
				  implementation of physician and nursing treatment plans. This plan must be
				  available for inspection during the initial licensure survey prior to issuance
				  of a license.
(f) Only persons who
				  are 18 years of age or older shall be admitted to adult care home beds in a
				  facility.
Authority
					 G.S.
					 131E-79;
					 42 U.S.C.
					 1396 r (a);
Eff. February 1,
					 1986;
Amended Eff. March 1, 1990;
Temporary Amendment
					 Eff. October 1, 1990 For a Period of 142 Days to Expire on February 28,
					 1991;
Amended Eff. March 1, 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1906 - POLICIES AND PROCEDURES

Current through Register Vol. 39, No. 2, July 15, 2024
The governing board shall assure written policies and
					 procedures which are available to and implemented by staff. These policies and
					 procedures shall cover at least the following areas:
(1) admissions;
(2) dietary;
(3) discharges with physician orders and
				  patients or residents leaving against physician advice;
(4) gratuities and solicitation which at a
				  minimum shall provide that no owner, operator, agent or employee of a facility
				  nor any member of his family shall accept a gratuity directly or indirectly
				  from an patient or resident in the facility or solicit for any type of
				  contribution;
(5)
				  housekeeping;
(6) infection control
				  which must include, but shall not be limited to, requirements for sterile,
				  aseptic and isolation techniques; and communicable disease screening including,
				  at a minimum, annual tuberculosis screening for all staff and inpatients of the
				  facility;
(7) maintenance of
				  patient medical or health care records including charging or record
				  keeping;
(8) orientation of all
				  facility personnel;
(9) patient or
				  resident care plans, treatment and other health care or nursing care, including
				  but not limited to all policies and procedures required by rules contained in
				  this Subchapter;
(10) patients' or
				  residents' rights;
(11) physical
				  evaluation for residents and patients at least annually;
(12) physician services and utilization of
				  the individual's private physician;
(13) procurement of supplies and equipment to
				  meet individual patient care needs;
(14) protection of patients from abuse and
				  neglect;
(15) range of services
				  provided;
(16) recording and
				  reporting to the department of accidents or incidents occurring to patients in
				  any part of the facility and maintenance of such reports or records;
(17) rehabilitation services;
(18) release of medical record
				  information;
(19) screening and
				  reporting communicable disease to the local health department; and
(20) transfers.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Amended Eff. March 1, 1990;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1907 - GENERAL

Current through Register Vol. 39, No. 2, July 15, 2024
The governing board shall assure that policies and
					 procedures are available and implemented for assessing each patient's or
					 resident's health care needs and planning for meeting identified health care
					 needs. There shall be a system for evaluating the effectiveness of the
					 assessment, planning and implementation (delivery of care processes) for each
					 patient or resident.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1908 - FREQUENCY: METHOD AND CONTENT OF ASSESSMENT: PLANNING

Current through Register Vol. 39, No. 2, July 15, 2024
Each patient's and resident's condition must be assessed on
					 a regular, periodic basis, at least quarterly, with appropriate notation and
					 updating of the health care plan. Health care planning for each patient and
					 resident shall be an on-going process and must include, but shall not be
					 limited to, the following:
(1) data
				  which is systematically and continuously collected about his or her health
				  status; the data shall be recorded so as to be accessible and communicated to
				  all staff involved in the patient's or resident's care;
(2) current problems or needs identified and
				  prioritized from a completed assessment relevant to the patient's or resident's
				  response to aging, illness and general health status; and
(3) a current plan of care developed in
				  conjunction with the patient or resident or legal guardian that includes
				  measurable time related goals and approaches, or measures to be employed by
				  various disciplines in order to achieve the identified goals.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Amended Eff. March 1, 1990;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1909 - IMPLEMENTATION OF HEALTH PLAN

Current through Register Vol. 39, No. 2, July 15, 2024
All parts of the plan of care shall be assigned to specific
					 disciplines or staff as indicated in the plan of care to assure that health
					 care and rehabilitative services are performed daily and documented for those
					 patients and residents who require such services.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1911 - VACANT DIRECTOR OF NURSING POSITION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  administrator shall notify the Department within 72 hours when the director of
				  nursing position becomes vacant and shall provide the name and license number
				  of the individual who is acting director or the replacement for the director of
				  nursing.
(b) A facility shall not
				  operate without either a director of nursing or acting director or
				  nursing.
(c) The administrator
				  shall employ a director of nursing within 30 days after a position becomes
				  vacant. A vacancy which exceeds 30 days shall be reviewed by the Department for
				  action relative to licensure status of the facility.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Amended Eff. March 1, 1990;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1912 - NURSE STAFFING REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				  licensed facility shall provide licensed nursing personnel sufficient to
				  accomplish the following:
(1) patient needs
				  assessment,
(2) patient care
				  planning, and
(3) supervisory
				  functions in accordance with the level of patient or resident care advertised
				  or offered by the facility.
The facility also shall provide other nursing personnel
					 sufficient to assure that at least activities of daily living, personal
					 grooming, restorative nursing actions and other health care needs as identified
					 in each patient's or resident's plan of care are met.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1913 - 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 B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1914 - 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 B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1915 - ADULT CARE HOME PERSONNEL REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  administrator shall designate a person to be in charge of the adult care home
				  residents at all times. The nurse in charge of nursing services may also serve
				  as supervisor-in-charge of the adult care home beds.
(b) If adult care home beds are located in a
				  separate building or a separate level of the same building, there shall be a
				  person on duty in the adult care home areas at all times.
(c) A licensed facility shall provide staff
				  to assure that activities of daily living, personal grooming, and assistance
				  with eating are provided to each resident. Medication administration as
				  indicated by each resident's condition or physician's orders shall be carried
				  out as identified in each resident's plan of care.
(d) Adult care home facilities licensed as a
				  part of a combination facility shall comply with the staffing requirements in
				  10A NCAC
				  13F.0605 herein incorporated by reference
				  including subsequent amendments and editions.
Authority
					 G.S.
					 131E-79;
					 42 U.S.C.
					 1396 r (a);
Eff. February 1,
					 1986;
Temporary Amendment Eff. October 1, 1990 For a Period of 142
					 Days to Expire on February 28, 1991;
Amended Eff. March 1,
					 1991;
Readopted Eff. April 1,
					 2020.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1916 - REHABILITATIVE NURSING AND DECUBITUS CARE

Current through Register Vol. 39, No. 2, July 15, 2024
Each patient or resident shall be given care to prevent
					 contractures, deformities, and decubiti, including but not limited to:
(1) changing positions of bedfast and
				  chairfast patients or residents every two hours and administering simple
				  preventive care. Documentation of such care and outcome must be included in
				  routine summaries or progress notes;
(2) maintaining proper alignment and joint
				  movement to prevent contractures and deformities, which must be documented in
				  routine summaries or progress notes;
(3) implementing an individualized bowel and
				  bladder training program except for patients or residents whose records are
				  documented that such training is not effective. A monthly summary for patients
				  and quarterly summaries for domiciliary residents shall be written relative to
				  each patient's or resident's performance in the bowel and bladder training
				  program; and
(4) such other
				  services as necessary to meet the needs of the patient.
Authority
					 G.S.
					 131E-79;
					 42 U.S.C.
					 1396 r (a);
Eff. February 1,
					 1986;
Amended Eff. March 1, 1990;
Temporary Amendment
					 Eff. October 1, 1990 For a Period of 142 Days to Expire on February 28,
					 1991;
Amended Eff. March 1, 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1917 - MEDICATION ADMINISTRATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A
				  licensed facility shall have policies and procedures governing the
				  administration of medications which shall be enforced and implemented by
				  administration and staff. Policies and procedures shall include, but shall not
				  be limited to:
(1) automatic stop orders for
				  treatment and drugs;
(2)
				  accountability of controlled substances as defined by the North Carolina
				  Controlled Substances Act, G.S. 90, Article 5;
(3) dispensing and administering behavior
				  modifying drugs, such as hypnotics, sedatives, tranquilizers, antidepressants
				  and other psychotherapeutic agents; insulin; intravenous fluids and
				  medications; cardiovascular regulating drugs; and antibiotics.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1918 - TRAINING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A licensed
				  facility shall provide patient or resident care employees a planned orientation
				  and continuing education program emphasizing patient or resident assessment and
				  planning, activities of daily living, personal grooming, rehabilitative nursing
				  or restorative care, other patient or resident care policies and procedures,
				  patients' rights, and staff performance expectations. Attendance and subject
				  matter covered shall be documented for each session, retained in accordance
				  with policy established by the facility, and available for licensure
				  inspections.
(b) The administrator
				  shall assure that employees are oriented within the first week of employment to
				  the facility's philosophy and goals.
(c) Employees shall have specific on-the-job
				  training as necessary to perform their individual job assignment.
(d) A nurse aide trainee may be employed to
				  perform the duties of a nurse aide for a period of time not to exceed four
				  months. During this period of time the nurse aide trainee shall be permitted to
				  perform only those tasks that competence has been demonstrated and documented
				  on the record. Nurse aide I shall meet the training and competency evaluation
				  standards in
				  10A NCAC
				  13O.0301, incorporated herein by reference
				  including subsequent amendments and editions. A record of nurse aide
				  qualifications shall be maintained for each nurse aide used by a facility and
				  shall be retained in the general personnel files of the facility in accordance
				  with policy established by the facility.
(e) The initial orientation to the facility
				  shall be exclusive of the Nurse Aide I training program. Competency evaluation
				  shall be conducted in each of the following areas:
(1) Observation and documentation,
(2) Basic nursing skills,
(3) Personal care skills,
(4) Mental health and social service
				  needs,
(5) Basic restorative
				  services, and
(6) Residents'
				  Rights.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1919 - DENTAL CARE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A dental
				  examination shall be performed at the time of admission with the following
				  information being placed in the patient's or resident's medical or health care
				  record:
(1) type of diet which the patient or
				  resident can best manage (such as normal, soft or pureed);
(2) the presence of infection of gums, teeth,
				  or jaws;
(3) brief descriptions of
				  any removable dental appliances and a statement of their condition;
				  and
(4) indications for dental
				  treatment at the time of admission.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1920 - AVAILABILITY OF PHARMACEUTICAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A licensed
				  facility shall provide pharmaceutical services under the supervision of a
				  pharmacist currently licensed to practice pharmacy in North Carolina.
(b) A facility shall be responsible for
				  obtaining drugs, therapeutic nutrients and related products prescribed or
				  ordered by a physician for patients or residents in the facility.
(c) Services shall include documented on-site
				  pharmaceutical reviews accomplished at least every 31 calendar days for all
				  patients and residents.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1921 - DINING FACILITIES

Current through Register Vol. 39, No. 2, July 15, 2024
Patients, including wheelchair patients, shall be
					 encouraged to eat at the tables in the dining area and shall be assisted when
					 necessary by non-dietary staff. An overbed table shall be provided for patients
					 who eat in bed. A sturdy tray stand shall be provided for those patients who
					 eat out of bed but are unable to go to the dining area. An overbed table which
					 can be lowered to chair height may substitute for the tray
					 stand.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1922 - ACTIVITIES AND RECREATION

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  administrator shall designate an activities and recreation director to be in
				  charge of activities and recreation for all patients and residents. The
				  activities and recreation director shall have training and experience in
				  directing recreational and group activities. The designated activities and
				  recreation director shall be under the supervision of the administrator and
				  shall be qualified to meet the needs of the patients and residents. A qualified
				  individual shall be anyone eligible for a N.C. license as an occupational
				  therapist or assistant therapist under
				  G.S.
				  90-270; anyone eligible for N.C.
				  certification as a recreation therapist or assistant therapist under
				  G.S.
				  90C-9; anyone with a baccalaureate degree and
				  one year experience; anyone who has completed an approved 36-hour or longer
				  course in activities program management; or anyone not otherwise qualified but
				  receiving at least four hours consultation per month from one who is
				  qualified.
(b) The facility shall
				  maintain and make available a listing of local resources for activities and
				  recreation to be utilized in meeting the needs and interests of all patients
				  and residents.
(c) Restoration to
				  self care and resumption of normal activity shall be one of the main goals of
				  the recreation or activity program. The scope of the activity program shall
				  include:
(1) social activities involving
				  individual and group participation which are designed to promote group
				  relationships;
(2) recreational
				  activities, both indoor and outdoor;
(3) opportunity to participate in activities
				  outside the facility;
(4) religious
				  programs, including the right of each patient and resident to attend the church
				  or religious program of his choice;
(5) creative and expressive
				  activities;
(6) educational
				  activities; and
(7)
				  exercise.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1923 - SOCIAL SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  administrator shall designate an employee to be responsible for the provision
				  of social services. This person shall be known as the social services director.
				  Subsequent to the effective date of the rules contained in this Subchapter any
				  newly designated person must be a graduate of a four year college or university
				  with one year's experience in the health care or long-term care field or have
				  an equivalent combination of education and experience. An equivalent
				  combination of education and experience means the number of years of education
				  leading to a baccalaureate or associate degree plus the number of years of
				  long-term nursing facility experience equal to five years; or eligible for
				  certification as a social worker pursuant to
				  G.S.
				  90B-7. The social services director shall
				  have authority to carry out provisions contained in Rule.1923(b) of this
				  Section.
(b) Each patient's or
				  resident's plan of care shall contain a written plan for meeting his individual
				  social needs and involving his active participation, the plan shall provide
				  for:
(1) needed assistance in meeting the
				  patient's or resident's physical, social and emotional needs through
				  consultation with the patient or resident or his legal guardian, and relative,
				  physician or others;
(2) assisting
				  the patient or resident in adjusting to his environment, for referral to other
				  supporting resources, for protective services, for financial services and for
				  assistance at the time of discharge or transfer into a new
				  environment;
(3) the utilization of
				  caseworkers employed by the county department of social services in the case of
				  recipients of public assistance and for the utilization of appropriate persons
				  with experience and training in the general area of social work in the case of
				  those not on public assistance.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1924 - RESTRAINTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Patients and
				  residents shall be restrained only by physician orders.
(b) The nurse in charge shall be responsible
				  for making the decision relative to necessity for, type and duration of
				  restraint in emergency situations requiring restraints while contacting the
				  physician. The nurse also shall be responsible for documenting same in the
				  patient's or resident's record.
(c)
				  The type of restraint used and the time of application and removal shall be
				  recorded by a licensed nurse in the patient's or resident's record.
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1986;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.