reglab/statecodes huggingface dataset:
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-19 - Social services

Current through Supplement No. 393, July, 2024
The governing body shall ensure social services are provided
				  to ensure each resident attains and maintains their highest level of physical,
				  mental, and psychosocial functioning.
1. The facility shall have one or more
				designated staff members trained in the assessment of residents' psychosocial
				needs and in the provision of services to meet those needs. If a designee is
				not a qualified social worker as defined in North Dakota Century Code chapter
				43-41, the designee shall receive onsite consultation from a qualified social
				worker on a quarterly basis.
2. If
				the facility does not provide social services directly, the facility must have
				a contract with an agency or individual qualified to provide such services.
3. The facility shall have
				policies and procedures for the delivery of social services.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-20 - Activity services

Current through Supplement No. 393, July, 2024
The facility shall provide an ongoing program of activity
				  services to meet the needs and interests of each resident which promotes or
				  maintains each resident's physical, mental, and psychosocial well-being.
1. The facility shall employ a
				qualified activity coordinator who is responsible for the direction and
				supervision of the resident activity services. A qualified activity coordinator
				is:
a. An individual certified as a
				therapeutic recreation specialist by a recognized accrediting body;
b. An individual who is eligible for
				certification as a therapeutic recreation specialist by a recognized
				accrediting body for the first year the individual is eligible;
c. An individual who is activity director
				certified by a recognized accrediting body;
d. An individual who is activity consultant
				certified by a recognized accrediting body;
e. A qualified occupational therapist as
				defined in North Dakota Century Code chapter 43-40;
f. A certified occupational therapy
				assistant;
g. An individual who
				has the equivalent of two years of full-time experience in a social or
				recreational program within the last five years, one of which was in a resident
				activity program in a health care setting; or
h. An individual who has completed an
				activity training program approved by the department as meeting the
				requirements in section
				33-07-03.2-22; and
(1) Has one year of full-time experience in
				the past five years in an activity program in a health care setting; or
(2) Receives monthly onsite
				consultation for a minimum of one year after the completion of the program from
				an individual meeting the qualifications described in subdivision a, d, e, f,
				or g.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-21 - Approved activity training program

Current through Supplement No. 393, July, 2024
Only programs that the department determines to meet the
				  criteria in this section and approves in writing will be considered to be an
				  approved activity training program.
1. A department-approved activity training
				program must have a curriculum which contains, at a minimum, one hundred eighty
				hours, ninety of which are theory and ninety of which are practical training
				hours.
2. The primary instructor
				of a program shall have:
a. A bachelor's
				degree or be activity consultant certified;
b. Have current activity experience as a
				director or as a practicing consultant; and
c. Have experience in teaching adults.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-22 - Specialized rehabilitative services

Current through Supplement No. 393, July, 2024
Specialized rehabilitative services shall, at a minimum,
				  include physical therapy, speech and language pathology, occupational therapy,
				  and health services for mental illness and mental retardation and shall:
1. Be provided upon a written order
				of a licensed health care practitioner, who shall be responsible for the
				general medical direction of such services as part of the total care of the
				resident.
2. Be provided directly
				by facility staff or obtained through contract with outside resources.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-23 - Diagnostic services

Current through Supplement No. 393, July, 2024
The facility shall provide or have arrangements for
				  obtaining diagnostic services consistent with the needs of the resident.
1. If the facility provides any
				clinical laboratory testing services to residents, regardless of the frequency
				or the complexity of the testing, the governing body is required to obtain and
				maintain compliance with the applicable parts of the clinical laboratory
				improvement amendments of 1988, 42 CFR part 493.
2. If the facility provides radiology or
				other diagnostic services to residents, these services must be provided in
				accordance with the current standards of practice and state and federal
				regulations.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-24 - Housekeeping, maintenance, and laundry services

Current through Supplement No. 393, July, 2024
The facility shall provide housekeeping and maintenance
				  services necessary to maintain a sanitary and comfortable environment and
				  laundry services, including personal laundry services, to meet the needs of the
				  residents.
1. The facility shall
				employ sufficient housekeeping and maintenance personnel to maintain the
				interior and exterior of the facility in a safe, clean, orderly, and attractive
				manner. The facility shall establish, implement, and update policies and
				procedures consistent with current standards of practice including procedures
				to ensure:
a. The facility is kept free from
				offensive odors, accumulations of dirt, rubbish, dust, and safety hazards;
b. Floors are regularly cleaned,
				polishes on floors provide a nonslip finish, and throw or scatter rugs have a
				nonslip backing;
c. Walls and
				ceilings are maintained, cleaned, and painted as needed;
d. The grounds are kept free from refuse and
				litter; and
e. Poisons and
				chemical compounds must be stored away from resident and food preparation and
				storage areas.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-25 - Adult day care services

Current through Supplement No. 393, July, 2024
1. Any
				facility seeking to develop an adult day care service shall contact the
				department and receive advance approval as a condition of licensure.
2. A facility may use existing space and
				equipment to deliver adult day care services provided services to the residents
				of the facility are not diminished and their needs are being acceptably
				addressed with the following exceptions:
a.
				The facility shall provide dining space for congregate dining of adult day care
				participants in addition to space required under section
				33-07-04.2-06.
b. The facility shall provide activity space
				in addition to space required under section
				33-07-04.2-06.
c. The facility shall provide an area
				allowing privacy for adult day care participants to allow for rest periods.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-26 - Secured units

Current through Supplement No. 393, July, 2024
Secured units, such as those designed for residents with
				  Alzheimer's disease or other dementias, must comply with the following:
1. Prior to admission or within seven days of
				admission, a multidisciplinary team shall evaluate the appropriateness of a
				resident's placement in a secured unit. The multidisciplinary team shall, at a
				minimum, consist of a registered nurse and a licensed social worker who will be
				providing service to the resident in the secured unit, the resident's licensed
				health care practitioner, and the resident or the individual who has legal
				status to act on behalf of the resident;
2. Licensed health care practitioner orders
				for placement in a secured unit must be documented in the resident's record and
				must be reviewed during the licensed health care practitioner's regular visits;
3. Placement in a secured unit may
				not be used as a punishment or for the convenience of the staff; and
4. A resident in a secured unit shall have
				access to the same services as other residents in the facility including
				provisions for routine and ongoing access to the outdoors as appropriate based
				on the resident's past history, personal preferences, and current condition.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-01 - Definitions

Current through Supplement No. 393, July, 2024
The definitions located in section
				  33-07-03.2-01 apply to this
				  chapter.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-02 - Conflict with federal requirements

Current through Supplement No. 393, July, 2024
The provisions located in section
				  33-07-03.2-02 apply to this
				  chapter.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-03 - Waiver provision

Current through Supplement No. 393, July, 2024
The waiver provision located in section
				  33-07-03.2-04 applies to this
				  chapter.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-04 - Access and surveillance by the department

Current through Supplement No. 393, July, 2024
The provisions located in section
				  33-07-03.2-05 apply to this
				  chapter.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-05 - Plans of correction

Current through Supplement No. 393, July, 2024
The provisions located in section
				  33-07-03.2-06 apply to this
				  chapter.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-06 - Site

Current through Supplement No. 393, July, 2024
For new construction, the site of the facility must be away
				  from nuisances detrimental to the proposed services, such as commercial or
				  industrial developments, or other types of facilities that produce noise or air
				  pollution. A site plan must be submitted to the department.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-07 - Emanating services

Current through Supplement No. 393, July, 2024
1. Sufficient
				information on the design of other types of facilities physically attached to
				the nursing facility must be submitted to the department so as to determine
				that safety from fire and the adequacy of the spaces and services of the
				facility are not compromised.
2.
				Occupants of other types of facilities may use service spaces such as dining
				and activities in the facility only when the size of such spaces exceed the
				standards of this chapter.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-01-03,
					 23-16-06
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-08 - Plans and specifications

Current through Supplement No. 393, July, 2024
1. A
				facility shall contact the department prior to any substantial changes in or
				alterations to any portion of the structure to determine to what extent it is
				subject to review. A substantial change includes alterations affecting the fire
				safety or structural integrity of the building, changes in service areas or
				services provided within a service area, changes in bed capacity, or any other
				change governed by the standards of this chapter. The department may request
				plans, specifications, or other information as may be required and shall make
				the final determination on those areas subject to review.
2. A facility shall submit plans and
				specifications to the department for all construction, remodeling, and
				installations subject to review. The plans and specifications must be prepared
				by an architect or engineer licensed in North Dakota, unless otherwise
				determined by the department.
3.
				Start of construction prior to approval by the department of the final plans
				and specifications is not permitted.
4. All construction, remodeling, and
				installations must be in accordance with the final plans and specifications
				approved by the department. Modifications or deviations from the approved plans
				and specifications must be submitted to and approved by the department.
5. The department may make
				inspections of construction, remodeling, or installations and arrange
				conferences with the facility to ensure conformance with approved plans and
				specifications.
6. The
				construction specifications must require the contractor to perform tests to
				ensure all systems conform to the approved plans and specifications.
7. Routine maintenance does not require the
				submission of plans and specifications. For the purpose of this subsection,
				"routine maintenance" means repair or replacement of existing equipment, room
				finishes and furnishings, and similar activities.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-09 - Codes and standards

Current through Supplement No. 393, July, 2024
1. A nursing facility must be designed,
				constructed, equipped, maintained, and operated in compliance with:
a. This chapter;
b. The Guidelines for Residential Health.
				Care and Support Facilities. 2014 edition, compiled by the facility guidelines
				institute;
c. The national fire
				protection association 101 life safety code Life Safety Code. 2012 edition;
d. North Dakota Century Code
				section 54-21.3-04.1, relating to accessibility for disabled persons;
e. The requirements for food and
				beverage establishments issued by the department;
f. North Dakota Administrative Code article
				62-03.1 relating to plumbing standards;
g. North Dakota Administrative Code 24-02
				relating to electrical wiring standards;
h. North Dakota Administrative Code 45-12
				relating to boiler rules and regulations;
i. North Dakota Administrative Code 33-15
				governing air pollution control, relating to incinerators; and
j. North Dakota Administrative Code 33-10
				relating to radiological health.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-10 - Nursing unit

Current through Supplement No. 393, July, 2024
1. A resident room
				must have adequate space to house necessary furniture and equipment, to provide
				for resident care, to provide for movement of beds, and for the transfer of
				residents to and from beds.
2. The
				smallest dimension of a rectangular single resident room may not be less than
				ten feet [3.05 meters] free of fixed obstructions and the floor area may not be
				less than one hundred twenty square feet [11.15 square meters].
3. The smallest dimension of a rectangular
				multiple resident room may not be less than eleven feet six inches [3.51
				meters] free of fixed obstructions, except in specially arranged rectangular
				rooms such as toe-to-toe arrangements where the minimum clear width may not be
				less than ten feet [3.05 meters] free of fixed obstructions.
4. In other than a rectangular-shaped room,
				the principles of space allocation specified by the minimum dimensions and
				floor area requirements in a rectangular-shaped room must be adhered to.
5. Each resident room must have an
				outside wall with natural light provided by a window. The area of the glazing
				material in the window may not be less than one-tenth of the floor area of the
				resident room.
6. In existing
				construction, a multiple resident room may not permit more than two beds side
				by side parallel to the window wall.
7. In new construction, a multiple resident
				room must be designed to permit no more than two beds.
8. A janitor's closet containing a floor
				receptor or service sink and storage space for housekeeping supplies and
				equipment shall be provided for each nursing unit.
9. A visiting room shall be provided where
				residents may visit privately.
10.
				Resident toilet rooms must be functionally accessible and usable by the
				residents which they serve. In new construction, a resident toilet room must
				provide space for two staff members to assist a resident as needed.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-11 - Dining and activity areas

Current through Supplement No. 393, July, 2024
The dining areas and activities areas may not be the same
				  space.
1. The total area set aside
				for dining must be a minimum of twenty square feet [1.86 square meters] per
				bed.
2. The total area set aside
				for activities must be a minimum of fifteen square feet [1.40 square meters]
				per bed. Adequate storage space must be provided for recreational equipment and
				supplies in addition to the space required.
3. A dayroom must be provided in each nursing
				unit in addition to the required activity space.
4. A functionally accessible toilet room must
				be provided convenient to activity and dining areas.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-12 - Rehabilitation therapy

Current through Supplement No. 393, July, 2024
Exercise and treatment areas of at least three hundred
				  square feet [27.87 square meters] must be provided for physical therapy,
				  occupational therapy, or restorative nursing services.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-13 - Dietary services

Current through Supplement No. 393, July, 2024
Dietary areas and equipment must be designed to accommodate
				  the requirements for sanitary storage, processing, and handling consistent with
				  the food service sanitation manual issued by the department.
General Authority: NDCC 28-32-02
Law Implemented: NDCC
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-14 - General storage

Current through Supplement No. 393, July, 2024
1. Resident space
				may not be used for general facility storage.
2. Separate storage space with provisions for
				locking and security control must be provided for residents' personal effects.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-15 - Details

Current through Supplement No. 393, July, 2024
All details must meet the following requirements:
1. Soap in a soap dispenser must be provided
				at all lavatories and sinks used by personnel for handwashing.
2. In new construction, boiler rooms must not
				be located under any portion of the facility.
3. Ceilings must be acoustically treated in
				corridors in resident areas, nurses stations, and dining and activity areas.
4. Noise reduction criteria shown
				in the following table apply to partition, floor, and ceiling assembly
				construction in resident areas:
Location
Airborne SoundTransmissionClass
						  (STC)*Partitions
Floors
ImpactInsulationClass
						  (IIC)**Floors
Resident room to resident
						  room
45
45
51
Public space to resident room
						  ***
50
50
51+
Service areas to resident room
						  ++
55
55
55+
Footnotes:
* Sound transmission class (STC) must be determined by tests
				  in accordance with methods set forth in ASTM Standard E 90 and ASTM Standard E
				  413.
** Impact insulation class (IIC) must be determined in
				  accordance with criteria set forth in HUD FT/TS 24.
*** Public space includes lobbies, dining rooms, recreation
				  rooms, treatment rooms, and similar spaces.
+ Impact noise limitation applicable
				  only when corridor, public space, or service area is over resident's room.
++ Service areas include kitchens,
				  elevators, elevator machine rooms, laundries, garages, maintenance rooms,
				  boiler and mechanical equipment rooms, and similar spaces of high noise or
				  vibration or both. Mechanical equipment located on the same floor or above or
				  below the residents' rooms, offices, nurses' stations, and similar occupied
				  spaces must be effectively isolated from such spaces with respect to noise and
				  vibration.
NOTE: The requirements set forth in this table assume
				  installation methods which will not appreciably reduce the efficiency of the
				  assembly as tested. Location of electrical receptacles, grilles, duct work, and
				  other mechanical items, and blocking and sealing of partitions at floors and
				  ceilings must not compromise the sound isolation required.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-16 - Elevators

Current through Supplement No. 393, July, 2024
1. An appropriate number of elevators, at
				least one which complies with the provisions of ANSI A17.1, must be provided in
				all multistory buildings. All new hospital-type elevators must comply with this
				standard.
2. All elevators, except
				freight elevators, must be equipped with a two-way special service switch to
				permit the car to bypass all landing button calls and be dispatched directly to
				any floor.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 28-32-02
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-17 - Mechanical requirements

Current through Supplement No. 393, July, 2024
1.
Asbestos insulation may not be used.
Insulation of soft-type,
				spray-on, etc., may not be used where it is subject to air or mechanical
				erosion or where loose particles may create a maintenance problem.
2.
Air-conditioning, heating, and
				ventilation systems.
a.
				Air-conditioning is optional.
b. A
				temperature range of seventy-one to eighty-one degrees Fahrenheit [39.4 to 45.0
				degrees Celsius] must be maintained for all occupied areas.
c. All air supply and air exhaust systems
				must be mechanically operated. Gravity exhaust may be used in nonresident areas
				and in areas not normally occupied by staff.
d. A ceiling exhaust fan may be used to
				ventilate a single isolated toilet room when a central exhaust system is not
				readily available.
e. Boiler rooms
				must be provided with sufficient air to maintain equipment combustion rates and
				to limit room temperatures.
f.
				Unit ventilators may be used to ventilate individual rooms in existing
				facilities, and in additions to existing facilities not to exceed six beds.
				Such ventilators may only be used when a central ventilation system is
				inaccessible.
g. Filters for a
				central ventilation system must be located upstream of air-conditioning
				equipment. If a prefilter is employed, the prefilter must be upstream of the
				equipment and the final filter may be located downstream.
h. A manometer must be installed across each
				filter serving a central ventilation system.
i. An exhaust hood in a dietary area must
				have an exhaust rate of not less than fifty cubic feet [1.41 cubic meters] per
				minute per square foot of face area. Face area is defined as the open area from
				the exposed perimeter of the hood to the average perimeter of the cooking
				surfaces.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-04.2 - General Standards of Construction and Equipment for Nursing Facilities › Section 33-07-04.2-18 - Electrical requirements

Current through Supplement No. 393, July, 2024
1. All
				materials must be listed as complying with applicable standards of
				underwriters' laboratories incorporated, or other similarly established
				standards.
2. Circuit breakers or
				fusible switches that provide disconnecting means and overcurrent protection
				for conductors connected to switchboard and distribution panels must be
				enclosed or guarded to provide a dead-front type of assembly. The main
				switchboard must be located in a separate enclosure accessible only to
				authorized persons. The switchboard must be convenient for use, readily
				accessible for maintenance, clear of traffic lanes, and in a dry ventilated
				space devoid of corrosive fumes or gases. Overload protective devices must be
				suitable for operating properly in the ambient temperature conditions.
3. Lighting and appliance panels
				must be provided for the circuits on each floor. This requirement does not
				apply to emergency system circuits.
4. Two duplex receptacles are required
				between adjacent beds.
5. A nurse
				calling station must be installed at each resident bed, toilet, bath, and
				shower. The nurse calling station at the toilet, bath, or shower must be an
				emergency call.
a. All calls must register
				both visibly and audibly at the nurses' station and must actuate a visible
				signal in the corridor at the resident's door, in the clean workroom, and
				soiled workroom.
b. If installed,
				a nurse calling system providing two-way voice communication must be equipped
				with an indicating light at each calling station that lights and remains
				lighted as long as the voice circuit is operative.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-01 - Purpose

Current through Supplement No. 393, July, 2024
This chapter is intended to conform North Dakota law to the
				  requirements of 42 U.S.C.
				  1396 r(h) by the creation of an enforcement
				  process to be applied upon a finding, on the basis of a standard, extended, or
				  partial extended survey of a nursing facility, or otherwise, that a nursing
				  facility no longer meets the requirements of
				  42 U.S.C.
				  1396 r(c) (requirements relating to
				  residents' rights), or 42
				  U.S.C. 1396 r(d) (requirements relating to
				  administration and other matters), or of rules, regulations, or policies
				  adopted to implement those requirements including rules and regulations
				  relating to North Dakota Century Code section 23-16-01.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 23-16-11
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-02 - Authority and objective

Current through Supplement No. 393, July, 2024
The state department of health and consolidated laboratories
				  is authorized by North Dakota Century Code section 23-01-11 to adopt such rules
				  as necessary to enable the state to be in compliance with any federal laws in
				  order to qualify for any federal funds related to medical facilities or
				  agencies licensed by the department.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 23-16-11
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-03 - Definitions

Current through Supplement No. 393, July, 2024
1. "Class I violation" refers to a requirement found out of
				  compliance that immediately jeopardizes the health or safety of one or more
				  residents.
2. "Class II violation" refers to requirement found out of
				  compliance that has the potential for causing a direct and substantial threat
				  to the health, safety, welfare, rights of one or more residents, or
				  unauthorized removal of a posted notice of sanction.
3. "Class III violation" refers to a requirement found to be
				  or to have been out of compliance on consecutive surveys or visits, or failure
				  to inform a caller inquiring about the availability of beds in the facility of
				  the violations that are the subject of an order imposing sanctions.
4. "Department" means the state department of health and
				  consolidated laboratories.
5. "Director" means the director of the division of health
				  facilities of the state department of health and consolidated laboratories, or
				  the director's designee.
6. "Facility" or "nursing facility" means an institution or a
				  distinct part of an institution which:
a. Is primarily engaged in providing to residents:
(1) Skilled nursing care and related services for residents
				  who require medical or nursing care;
(2) Rehabilitation services for the rehabilitation of
				  injured, disabled, or sick persons; or
(3) On a regular basis, health-related care and services to
				  individuals who because of their mental or physical condition require care and
				  services (above the level of basic care) that can be made available to them
				  only through institutional facilities;
b. Is required to have in effect a transfer agreement
				  (meeting the requirements of 42 U.S.C. 1395 x(1) with one or
				  more hospitals having agreements in effect under
				  42 U.S.C.
				  1395 cc; and
c. Is required to meet the requirements for a nursing
				  facility described in 42
				  U.S.C. 1396 r(b), (c), and (d) and North
				  Dakota Century Code section 23-16-01.
7. "Initial deficiency" means the first occurrence of a
				  violation recorded by the survey agency, including violations found during a
				  standard survey, during an extended survey, in response to a complaint
				  investigation visit, or otherwise.
8. "Repeat deficiency" means a violation which is
				  substantially similar to a violation cited within the thirty-six preceding
				  months.
9. "Secretary" means the secretary of the United States
				  department of health and human services.
10. "Survey agency" means the department of health and
				  consolidated laboratories.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 23-16-11
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-04 - Provision of sanctions

Current through Supplement No. 393, July, 2024
The department may impose any sanction described in section
				  33-07-05-06 if it is found that a
				  nursing facility no longer meets a requirement of
				  42 U.S.C.
				  1396 r(b), (c), or (d), or North Dakota
				  Century Code section 23-16-01, and it is further found that the facility's
				  deficiencies are:
1. A class I
				violation which immediately jeopardizes the health or safety of its residents,
				in which case the director shall immediately recommend the appointment of a
				receiver, as provided for in North Dakota Century Code chapter 23-16.1, and as
				specified in subsection 8 of section
				33-07-05-06, or recommend
				termination of the facility's participation in the medical assistance program,
				and may provide, in addition, for one or more of the other sanctions described
				in section
				33-07-05-06; or
2. A class II or class III violation which
				does not immediately jeopardize the health or safety of its residents, in which
				case the department may:
a. Recommend
				termination of the facility's participation under the state plan;
b. Provide for one or more of the remedies
				described in section
				33-07-05-06; or
c. Do both.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-05 - Imposition of sanctions

Current through Supplement No. 393, July, 2024
1. The
				department may implement sanctions based on a determination that a nursing
				facility no longer meets the requirements of
				42 U.S.C.
				1396 r(b), (c), or (d), or of rules or
				regulations adopted to implement those requirements, including licensure
				requirements. The determination of appropriate sanctions must be at the
				discretion of the department. The appointment of a receiver must be as provided
				in North Dakota Century Code chapter 23-16.1. The department shall provide for
				the imposition of incrementally more severe sanctions for the violations that
				are repeated, uncorrected, pervasive, or present a threat to the health,
				safety, or welfare of the residents. When a determination is made that a civil
				money penalty will be imposed, the amount of the penalty will be based on
				recommendations made to the department by a committee composed of a
				representative from medical services, a representative from aging services, and
				a representative from health facilities.
2. The following factors must be considered
				in determining the sanctions to be imposed:
a. Seriousness of the violation;
b. Extent of the violation;
c. History of prior violations;
d. Prior imposition of sanctions;
e. Prior provision of provider information
				and training;
f. Willingness of
				facility management to adhere to program rules;
g. Agreement to make restitution to
				residents, the medical assistance program, or other third-party payors; and
h. Actions taken or recommended by
				licensing boards.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-06 - Scope of sanctions

Current through Supplement No. 393, July, 2024
The following sanctions may be imposed upon a finding that a
				  nursing facility no longer meets the requirements of
				  42 U.S.C.
				  1396 r(b), (c), or (d) or the requirements of
				  North Dakota Century Code section 23-16-01:
1. Preparation, by the facility, of a
				directed plan of correction which is subject to approval of the department.
2. Mandatory attendance at
				provider information sessions.
3.
				Recommendation to the state medicaid agency to implement one hundred percent
				review of the facility's claims prior to payment.
4. Recommendation for denial of payment with
				respect to any individual admitted to the nursing facility after receipt of the
				order. Denial of payment may not provide a basis for discharge or transfer of
				the individual.
5. A ban on the
				admission of residents, except those who were temporarily absent from the
				facility on hospital or therapeutic leave on the date of receipt of the order
				or thereafter.
6. Recommendation
				of denial of payment for any service furnished after receipt of the order.
				Denial of payment may not provide a basis for discharge, transfer, or denial of
				service to a resident of the facility.
7. A civil money penalty, not exceeding one
				hundred fifty dollars per licensed facility bed, assessed, with interest at the
				legal rate, up to a maximum of ten thousand dollars, for each day the violation
				existed or continues to exist.
8.
				The appointment of a receiver to oversee the operation of the facility and to
				assure the health and safety of the facility's residents, where there is a need
				for temporary management while:
a. There is
				an orderly closure of the facility; or
b. Improvements are made in order to bring
				the facility into compliance with the requirements of the
				42 U.S.C.
				1396 r(b), (c), and (d) and North Dakota
				Century Code section 23-16-01
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-07 - Determination of amount of civil money penalties

Current through Supplement No. 393, July, 2024
A facility which has been subjected to the imposition of a
				  sanction under subsection 7 of section
				  33-07-05-06 is liable to the state
				  for each day the violation existed or continues to exist. A violation must be
				  presumed to continue to exist from the time it is found until the department
				  finds it to have been corrected. The amount of the civil money penalty must be
				  determined as follows:
1. For each
				class I violation, not more than fifty dollars per licensed facility bed;
2. For each class II violation,
				not more than twenty-five dollars per licensed facility bed;
3. For each class III violation, not more
				than ten dollars per licensed facility bed; and
4. For each repeat violation, not more than
				three times the amount otherwise provided for under subsection 1, 2, or 3.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 23-16-11
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-08 - Recommendation of prohibition on submission of claims through other providers

Current through Supplement No. 393, July, 2024
The department shall recommend that any facility which is
				  subject to a suspension or termination from participation or to any limitation
				  or denial of payment shall be prohibited from submitting claims for payment,
				  either directly or through any clinic, group, corporation, or other
				  association, to the division of medical services or any fiscal agent or any
				  services or supplies provided under the medical services program except for any
				  services or supplies provided prior to the effective date of imposition of the
				  remedy. The submission of any claim in violation of this section may subject
				  the provider submitting the claim to sanctions under this chapter.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 23-16-11
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-09 - Order and notice of order

Current through Supplement No. 393, July, 2024
1. Upon
				a determination that the circumstances make the imposition of a sanction
				appropriate, the department shall issue a written order identifying the
				violations and the sanction imposed. If the violations are of a nature to
				require the imposition of an incrementally more severe sanction, the order must
				identify the reasons therefor. A copy of the order must be sent by registered
				or certified mail, return receipt requested, to the facility's owner, the
				facility's administrator, or head of the facility's governing board; or hand
				delivered to the facility's owner, the facility's administrator, or the head of
				the facility's governing board. The order must specify the terms or conditions
				under which the sanction will be terminated. The order must also advise the
				facility of the right to seek reconsideration.
2. When a facility has been subjected to a
				sanction, the department may notify, as appropriate, applicable professional
				licensing agencies, boards of registration or licensure, and federal, state, or
				county agencies of the circumstances and the sanctions imposed.
3. When a facility has been subjected to a
				sanction, the department shall notify the long-term care ombudsman and the
				county social service board of each county within seventy-five miles [120.7
				kilometers] of the location of the facility. Each county social service board
				so notified shall post, in a prominent place within its office, the name and
				location of the facility and the sanction. The posting must remain in place for
				the entire period of any sanction other than closure or termination from the
				program and for the first ninety days of a closure or termination.
4. When a facility has been subjected to a
				sanction, the facility shall place notices of the sanction, supplied by the
				department, at all facility entrances and exits. In the event a sanction was
				imposed under subsection 5, 8, or 9 of section
				33-07-05-06, the facility shall
				inform every person inquiring by telephone about the availability of beds in
				the facility of the violations and the sanctions imposed. Unauthorized removal
				of a posted notice, or failure to so inform a telephone caller, is a class II
				violation. The director may also require the facility to purchase space in the
				print media to achieve the public dissemination of information concerning any
				sanction.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 23-16-11
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-10 - Request for reconsideration

Current through Supplement No. 393, July, 2024
1.
				Within ten days after receipt of the order, the facility may request
				reconsideration by the department. Within fifteen days after receipt of a
				request for reconsideration, the department shall grant or deny the request for
				reconsideration and may suspend the imposition of any sanction except one
				imposed under subsection 8 or 9 of section
				33-07-05-06, pending a decision on
				reconsideration.
2. A request for
				reconsideration must, in any event, be denied unless it identifies, with
				specificity, each disputed violation and states the factual basis for its
				contention that the violation was erroneously determined. The correction of the
				factors which led to the determination of a violation may not be asserted as a
				basis for a request for reconsideration.
3. If the department denies the request for
				reconsideration the department shall notify the facility in writing of that
				decision. If the denial was for any reason other than a failure of the request
				to conform to the requirements of subsection 2, the notice must advise the
				facility of the right to appeal.
4. If the department determines to undertake
				reconsideration, the decision on reconsideration must be rendered within forty
				days after the issuance of the order. The notice of the decision on
				reconsideration must advise the facility of the right to appeal.
5. If the facility fails to file a timely
				request for reconsideration which conforms to the requirements of subsection 2,
				the order is final in all respects, and no further administrative or judicial
				review is applicable.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC 23-16-01,
					 23-16-11
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-05 - Nursing Facility Sanctions › Section 33-07-05-11 - Appeals

Current through Supplement No. 393, July, 2024
1. A facility dissatisfied with a decision on
				a timely request for reconsideration, which conforms to the requirements of
				subsection 2 of section
				33-07-05-10, may appeal. An appeal
				may be perfected by mailing or delivering the information, described in
				subdivisions a through d, to the department, state capitol, Bismarck, North
				Dakota, so that the mailed or delivered material arrives at the office of the
				division of health facilities on or before 5:00 p.m. on the thirty-first day
				after the date of the determination of the department made with respect to a
				request for reconsideration. An appeal under this section is perfected only if
				accompanied by written documents including all of the following information:
a. A copy of the notice received from the
				department advising of the department's decision on the request for
				reconsideration;
b. A statement of
				each disputed violation and the reason or basis in fact for the dispute;
c. The authority in statute or
				rule upon which the appealing party relies for each disputed item; and
d. The name, address, and
				telephone number of the person upon whom all notices will be served regarding
				the appeal.