reglab/statecodes huggingface dataset:
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-27 - Basic rehabilitation services

Current through Supplement No. 393, July, 2024
1.
				General acute hospitals shall provide basic rehabilitation services, including
				physical, occupational, and speech pathology and audiology to meet the needs of
				the patients served.
a. Basic rehabilitation
				services must be provided by qualified staff licensed or certified consistent
				with state law either directly or through contract or referral to an
				appropriate facility.
b. Basic
				rehabilitation services must be provided consistent with a written plan of
				treatment and based on the orders of the licensed health care practitioner who
				is authorized by the medical staff to order such services. The licensed health
				care practitioner's orders must be incorporated into the patient's medical
				record.
c. Sufficient qualified
				staff must be available to ensure the following services are provided:
(1) Evaluate the patient.
(2) Initiate the plan of treatment.
(3) Instruct and supervise
				supportive personnel when they are used to provide services.
(4) Provide education as needed to the
				patient and significant others.
d. Documentation of basic rehabilitation
				services provided must be placed in the patient's medical record, including the
				nature, duration, frequency, and complexity of the treatment and the results.
e. If basic rehabilitation
				services are offered on an outpatient basis, the quality of the service must be
				consistent with the inpatient basic rehabilitation services in accordance with
				the complexity of the services provided.
f. Specialized rehabilitation services must
				be provided in a distinct, clearly defined, special unit of a general acute
				hospital, or in a rehabilitation hospital. Hospitals holding themselves out to
				the public as providing specialized rehabilitation services are subject to
				licensure as a specialized rehabilitation hospital as described in section
				33-07-01-35.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-28 - Housekeeping and related services including laundry

Current through Supplement No. 393, July, 2024
1. The general acute hospital shall provide
				the housekeeping and related services necessary to maintain a sanitary and
				comfortable environment.
a. The hospital
				shall provide personnel to maintain the interior and exterior of the facility
				in a safe, clean, orderly, and attractive manner. The hospital shall establish,
				implement, and update consistent with current standards of practice procedures
				whereby:
(1) Housekeeping personnel use
				accepted practices and procedures to keep the facility free from offensive
				odors; accumulations of dirt, rubbish, and dust; and safety hazards.
(2) Floors are cleaned regularly. Polishes on
				floors provide a nonslip finish. Throw or scatter rugs are not used, except for
				nonslip entrance mats.
(3) Walls
				and ceilings are maintained free from cracks and are cleaned and painted as
				needed.
(4) Grounds are kept free
				from refuse and litter.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-30 - Recovery services

Current through Supplement No. 393, July, 2024
1. Postoperative
				recovery services must be provided by all general acute hospitals in which
				surgery is performed.
a. Recovery services
				must be provided in a room where patients who have undergone surgical
				procedures can be immediately observed, receive specialized care by selected
				and trained personnel, and when necessary, prompt emergency care can be
				initiated.
b. The services of the
				postoperative recovery room may be utilized for postpartum if the delivery room
				or place of delivery is in close proximity to the postoperative recovery room.
				Postpartum patients, after appropriate observation, must be returned to the
				obstetrical service area.
c. A
				physician shall be responsible for the conduct of the recovery services and for
				the establishment of admission and discharge policies and procedures.
d. A registered nurse who has
				education and experience in postoperative recovery services shall supervise all
				personnel performing nursing service functions.
(1) A licensed nurse shall be in attendance
				at all times when patients are in the recovery room.
(2) There must be sufficient nursing
				personnel to provide the specialized care required for the postsurgical
				patient.
e. Known
				contaminated cases must be returned to the isolation room or a private room.
f. A member of the medical staff
				shall provide initial orders for the care of each patient upon admission to the
				recovery services.
(1) A member of the
				medical staff shall be responsible for the patient's discharge from the
				recovery services.
(2) Patients
				under or recovering from anesthesia, and those who have received sedatives or
				analgesics, must remain under continuous, direct nursing supervision until
				vital signs have stabilized. Any nurse performing this duty must have been
				instructed in the management of postanesthetic patients, must have no other
				clinical duties while supervising such patients, and must have immediate
				recourse to the attending surgeon or anesthesiologist, or certified registered
				nurse anesthetist, present in the hospital.
(3) Side rails must be attached to movable
				carts and beds and raised above mattress level when occupied by anesthetized
				patients. Cribs must be provided for the anesthetized or postsurgical child.
g. Personnel with
				communicable diseases must be excluded from the recovery services.
h. Drugs, supplies, and equipment must be
				immediately and continually accessible in the unit during postoperative care,
				including emergencies. These include cardiac-respiratory resuscitation
				materials.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-31 - Central services

Current through Supplement No. 393, July, 2024
1. General acute
				hospitals shall provide central services consistent with at least the
				following:
a. The central services must be
				provided with adequate direction, staffing, and facilities to provide service
				to all services in the hospital.
b. Policies and procedures must be developed,
				implemented, and updated as needed for all decontamination and sterilization
				services provided and at a minimum must include:
(1) Sterilization of equipment and supplies.
(2) Shelf life of stored sterile
				items.
(3) Reuse of disposable
				items.
(4) Reprocessing of
				disposable items to be reused.
(5)
				Proper handling of linen.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-32 - Anesthesia services

Current through Supplement No. 393, July, 2024
1. General acute
				hospitals providing surgical services shall provide anesthesia services to meet
				the needs of the patients served and shall ensure the following:
a. The anesthesia service must be under the
				direction of a qualified physician who is a member of the medical
				staff.
b. The anesthesia service
				must be organized under current written policies and procedures regarding staff
				qualifications, the administration of anesthetics, the maintenance of safety
				controls, and required electronic monitoring of patient vital signs and oxygen
				levels during the anesthetic procedures consistent with current standards of
				practice. The anesthesia service is responsible for all anesthetics
				administered in the hospital.
c.
				The patient must receive a preoperative visit from the anesthesiologist or the
				certified registered nurse anesthetist involved in the case.
d. The anesthesia service shall establish
				policies, procedures, rules, and regulations for the control, storage, and safe
				use of combustible anesthetics, oxygen, and other medicinal gases in accordance
				with national fire protection association standards; types of anesthesia to be
				administered and procedures for each; personnel permitted to administer
				anesthesia; infection control; safety regulations to be followed; and
				responsibility for regular inspection, maintenance, and repair of anesthesia
				equipment and supplies.
e.
				Anesthesia services may be initiated only when ordered by a member of the
				medical staff and must be administered only by individuals qualified and
				licensed in the management of such materials.
f. An intraoperative anesthetic record must
				be made a part of the patient's medical record. Drugs used, vital signs, and
				other relevant information must be recorded at regular intervals during
				anesthesia.
(1) There must be a preanesthesia
				evaluation by an individual qualified and licensed to administer anesthesia,
				performed within forty-eight hours prior to the surgery, with findings recorded
				in the patient's medical record.
(2) Except in emergency, anesthetic may not
				be administered until the patient has had a history and physical examination,
				and a record made of the findings.
g. Postanesthetic followup visits must be
				made within forty-eight hours after the procedure by the anesthesiologist,
				certified registered nurse anesthetist, or responsible physician who shall note
				and record any postoperative abnormalities or complications from
				anesthesia.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-33 - Respiratory care services

Current through Supplement No. 393, July, 2024
1. If the
				general acute hospital provides respiratory care services, the services must be
				under the supervision of a licensed health care practitioner, organized and
				integrated with other services of the hospital.
a. Respiratory care policies and procedures
				must be developed, implemented, and updated as needed for at least the
				following:
(1) Responsibility of the service
				to the medical staff.
(2) Clear
				protocol as to who can perform specific procedures.
(3) Written procedures for each type of
				therapeutic or diagnostic procedure.
(4) Written procedures for the cleaning,
				disinfection, or sterilization of all equipment that is not
				disposable.
(5) Written procedures
				for infection control.
(6) Written
				procedures for the control of all water used for respiratory therapy, if
				applicable.
(7) Protocol that
				establishes calibration and operation of equipment consistent with
				manufacturer's specifications and ensures that all equipment is maintained
				according to an established schedule.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-34 - Obstetrical services

Current through Supplement No. 393, July, 2024
1. All general
				acute hospitals providing obstetrical services shall provide for the admission,
				medical care, transfer, or discharge of obstetric and neonatal patients.
				Obstetrical services must include the following:
a. The obstetrical services must have an
				organized obstetric staff with a chief of obstetrical services who is either
				certified or qualified in obstetrics or a physician who regularly practices
				obstetrics as head of the obstetrical service. The level of qualification and
				expertise of the chief of the obstetrical services must be appropriate to the
				level of care rendered in the hospital. Responsibilities of the chief of the
				obstetrical service include:
(1) The general
				supervision of the care of obstetrical patients.
(2) The arrangement of conferences held at
				regular intervals to review surgical procedures and operations, complications,
				and mortality.
(3) The provision
				for exchange of information between medical, administrative, and nursing
				staffs.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-01.1 - Hospitals › Section 33-07-01.1-35 - Specialized rehabilitation services in hospitals

Current through Supplement No. 393, July, 2024
1. Specialized rehabilitation services in a
				general acute hospital must be provided in a distinct, clearly defined, special
				unit and are subject to the specialized rehabilitation services in hospitals
				requirements for specialized hospitals in this section. If in the course of the
				inspection of a general acute hospital, the department finds from a review of
				the rehabilitation services rendered and the adequacy of the consultation and
				referral resources that the hospital practice and staffing warrants the
				establishment of a specialized rehabilitation service, the department shall
				recommend the establishment of such service.
2. Primary care hospitals may not provide
				specialized rehabilitation services.
3. The specialized rehabilitation hospital
				shall provide preventive, diagnostic, therapeutic, and rehabilitative services
				to patients in accordance with the licensure requirements in this chapter
a. The rehabilitation hospital shall provide
				for services to inpatients and outpatients by a core group of professionals,
				who are licensed or certified consistent with state laws, which must include,
				dependent on the patient's needs, the following:
(1) Occupational therapist.
(2) Physical therapist.
(3) Physician.
(4) Psychologist.
(5) Rehabilitation nurse.
(6) Social worker.
(7) Speech and language pathologist.
(8) Therapeutic recreation
				specialist.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-02.1 - General Standards of Construction and Equipment for Hospitals › Section 33-07-02.1-01 - Site

Current through Supplement No. 393, July, 2024
The site of the hospital must be away from nuisances that
				  may be 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(3)(4), 28-32-02
Law Implemented: NDCC
					 23-16-05
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-02.1 - General Standards of Construction and Equipment for Hospitals › Section 33-07-02.1-02 - Plans and specifications

Current through Supplement No. 393, July, 2024
1.
				Hospitals shall contact the department prior to any substantial changes in or
				alterations to any portion of the structure to determine to what extent they
				are subject to review. A substantial change must include any 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 changes that may be governed by the standards of this
				article. 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. Hospitals
				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, as appropriate, licensed in North
				Dakota.
3. Start of construction
				prior to completion and approval by the department of the final plans and
				specifications is not permitted.
4. Routine maintenance does not require the
				submission of plans and specifications. For purposes of this subsection,
				"routine maintenance" includes repair or replacement of existing equipment,
				room finishes, and furnishings and similar activities.
5. All construction, remodeling, and
				installations must be in accordance with the final plans and specifications as
				approved by the department. Modifications or deviations from the approved plans
				and specifications must be submitted to and approved by the department.
6. The department may make
				inspections of construction, remodeling, or installations and arrange
				conferences with the hospital to assure conformance with the approved plans and
				specifications.
7. The
				construction specifications must require the contractor to perform tests to
				assure that all systems conform to the approved plans and specifications.
General Authority: NDCC 23-01-03(3)(4), 28-32-02
Law Implemented: NDCC
					 23-16-05
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-02.1 - General Standards of Construction and Equipment for Hospitals › Section 33-07-02.1-03 - Codes and standards

Current through Supplement No. 393, July, 2024
1. Hospitals must
				be designed, constructed, equipped, maintained, and operated in compliance
				with:
a. This chapter.
b. The Guidelines for Hospitals and
				Outpatient Facilities. 2014 edition, compiled by the facility guidelines
				institute.
c. The national fire
				protection association 101 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. Article - 62-03.1 relating to plumbing
				standards.
g.Article 24-02 relating
				to electrical wiring standards.
h.
				45-12 relating to boiler rules and regulations.
i. 33-15 governing air pollution control,
				relating to incinerators.
j. 33-10
				relating to radiological health.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-02.1 - General Standards of Construction and Equipment for Hospitals › Section 33-07-02.1-04 - Special considerations

Current through Supplement No. 393, July, 2024
1. Hospitals
				with a capacity of fifty beds or less may qualify for special consideration of
				these standards. Some functions allotted separate spaces or rooms in these
				standards may be combined, provided the resulting arrangement does not
				compromise safety and medical and nursing practices. In all other respects,
				these standards apply, including the space requirements.
2. If services are to be shared or purchased,
				modifications or deletions in space requirements may be allowed by the
				department. However, the services to be shared or purchased must be approved in
				writing by the department.
General Authority: NDCC 23-01-03(3)(4), 28-32-02
Law Implemented: NDCC
					 23-16-05
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-02.1 - General Standards of Construction and Equipment for Hospitals › Section 33-07-02.1-05 - Patient rooms

Current through Supplement No. 393, July, 2024
Each patient room must meet the following requirements:
1. A patient room may not be located
				on a floor unless a portion of the floor is at or above grade level. A patient
				room may not have its floor more than thirty inches [.76 meter] below the
				adjacent grade.
2. Patient rooms
				must have adequate space to conveniently house necessary furniture and
				equipment, to provide for efficient patient care, to provide for convenient
				movement of stretchers, and for the transfer of patients to and from beds.
3. The smallest dimension of a
				rectangular single patient 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-five square feet [11.61 square meters].
4. The smallest dimension of a rectangular
				multiple patient 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.
5. In other than rectangular-shaped rooms,
				the principles of space allocation specified by the minimum dimensions and
				floor area requirements in rectangular-shaped rooms must be adhered to.
6. Each patient 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
				patient room.
7. Multiple patient
				rooms must be designed to permit no more than two beds side by side parallel to
				the window wall.
8. A patient room
				may not be located more than one hundred twenty feet [36.58 meters] from the
				nurses station, the clean workroom, and the soiled workroom.
9. Patient toilet rooms must be functionally
				accessible and usable by the patients whom they serve.
General Authority: NDCC 23-01-03(3)(4), 28-32-02
Law Implemented: NDCC
					 23-16-05
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-02.1 - General Standards of Construction and Equipment for Hospitals › Section 33-07-02.1-06 - Details

Current through Supplement No. 393, July, 2024
1. At least one room must be provided for
				toilet training. It must be accessible from the corridor and may also serve the
				bathing area, and must provide three feet [.91 meter] clearance at the front
				and both sides of the water closet.
2. Ceilings must be acoustically treated in
				patient area corridors, nurses stations, labor rooms, dining areas, and
				dayrooms.
3. All lavatories and
				sinks required in patient care areas must have the water supply spout mounted
				so that its discharge point is a minimum distance of five inches [12.7
				centimeters] above the rim of the fixture.
4. Flush valves installed on plumbing
				fixtures must be of quiet operating type equipped with silencers.
General Authority: NDCC 23-01-03(3)(4), 28-32-02
Law Implemented: NDCC
					 23-16-05
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-02.1 - General Standards of Construction and Equipment for Hospitals › Section 33-07-02.1-07 - Conflict with federal requirements

Current through Supplement No. 393, July, 2024
If any part of this chapter is found to conflict with federal
				  requirements, the more stringent shall apply. Such a finding or determination
				  shall be made by the department and shall not affect the remainder of this
				  chapter.
General Authority:
NDCC 23-01-03. 28-32-02
Law Implemented:
NDCC
					 23-16-05
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-01 - Definitions

Current through Supplement No. 393, July, 2024
The following terms are defined for this chapter,
				  chapter
				  33-07-04.2, and North
				  Dakota Century Code chapter 23-16:
1.
				"Abuse" for the purposes of this chapter is defined in section
				33-07-06-01.
2. "Adult day care" means the provision of
				facility services to meet the needs of individuals who do not remain in the
				facility overnight.
3.
				"Authentication" means identification of the individual who made the resident
				record entry by that individual in writing, and verification that the contents
				are what the individual intended.
4. "Bed capacity" means bed space designed
				for resident care.
5. "Department"
				means the department of health and human services.
6. "Discharge" means movement from a facility
				to a noninstitutional setting when the discharging facility ceases to be
				legally responsible for the care of the resident.
7. "Emanating services" means services which
				are provided from a facility to nonresidents.
8. "Facility" means a nursing
				facility.
9. "Governing body" means
				the individual or group in whom legal responsibility is vested for conducting
				the affairs of a private or governmental facility. Governing body includes,
				where appropriate, a proprietor, the partners of any partnership including
				limited partnerships, the board of directors and the shareholders or members of
				any corporation including limited liability companies and nonprofit
				corporations, a city council or commission, a county commission or human
				service zone board, a governmental commission or administrative entity, and any
				other person or persons vested with management of the affairs of the facility
				irrespective of the name or names by which the person or group is
				designated.
10. "Licensed health
				care practitioner" means an individual who is licensed or certified to provide
				medical, medically related, or advanced registered nursing care to individuals
				in North Dakota.
11. "Licensee"
				means the legal entity responsible for the operation of a facility.
12. "Medical staff" means a formal
				organization of licensed health care practitioners with the delegated authority
				and responsibility to maintain proper standards of medical care.
13. "Misappropriation of resident property"
				means the willful misplacement, exploitation, or wrongful temporary or
				permanent use of a resident's belongings or money without the resident's
				consent. Willful for the purpose of this definition means to do so
				intentionally, knowingly, or recklessly.
a.
				"Intentionally" means to do deliberately or purposely.
b. "Knowingly" means to be aware or cognizant
				of what one is doing, whether or not it is one's purpose to do so.
c. "Recklessly" means to consciously engage
				in an act without regard or thought to the consequences.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-02 - Conflict with federal requirements

Current through Supplement No. 393, July, 2024
If any part of this chapter or chapter 33-07-04.2 is found
				  to conflict with federal requirements, the more stringent shall apply. Such a
				  finding or determination shall be made by the department and shall not affect
				  the remainder of this chapter or 33-07-04.2.
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 33-07-03.2-03 - Application for and issuance of license

Current through Supplement No. 393, July, 2024
An entity meeting the definition of nursing facility in this
				  chapter must obtain a license from the department to operate in North Dakota.
				  No person or entity shall establish or operate a facility without first having
				  obtained a license.
1. Any person or
				entity who owns or leases a facility and desires to maintain or operate it
				shall apply to the department for a license in the form prescribed and shall
				obtain an initial license before accepting residents for care or treatment.
a. The department shall not approve an
				application for an initial license unless:
(1) The application and all required
				attachments and statements submitted by the applicant meet the requirements of
				this chapter and chapter 33-07-04.2.
(2) The department has conducted an
				inspection or investigation of the facility to determine compliance with this
				chapter and 33-07-04.2.
(3) The
				department has completed an investigation into the fitness of the applicant and
				determined the applicant to be fit based on the following:
(a) Evidence provided by the applicant which
				identifies that financial resources and sources of revenue for the applicant's
				facility appear adequate to provide staff, services, and the physical
				environment sufficient to comply with North Dakota Century Code chapter 23-16,
				this chapter, and 33-07-04.2;
(b)
				The applicant has furnished the department with a signed and notarized
				statement describing and dating every proceeding, within five years of the date
				of the application, in which the applicant was involved that resulted in a
				limitation, suspension, revocation, or refusal to grant or renew a nursing
				facility license or resulted in a ban on medicare or medicaid admissions or a
				medicare or medicaid decertification action; and
(c) The applicant shall furnish a signed and
				notarized statement to the department describing every criminal proceeding
				within five years of the date of the application in which the licensee or any
				of its shareholders owning interest of five percent or more, officers,
				directors, partners, or other controlling or managing persons, has been
				convicted or nolo contendere plea accepted, of a criminal offense related to
				the operation, management, or ownership of a nursing facility.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-04 - Waiver provision

Current through Supplement No. 393, July, 2024
Any provisions of this chapter or chapter 33-07-04.2 may be
				  waived by the department for a specified period in specific instances, provided
				  such a waiver does not adversely affect the health and safety of the residents
				  and would result in unreasonable hardship upon the facility. A waiver may be
				  granted for a specific period of time not to exceed one year and shall expire
				  on December thirty-first of the year issued.
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 33-07-03.2-05 - Access and surveillance by the department

Current through Supplement No. 393, July, 2024
The department may evaluate a facility's compliance with
				  this chapter or chapter 33-07-04.2 at any time through:
1. An announced or unannounced onsite review;
				or
2. A request for submission of
				written documentation verifying compliance.
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 33-07-03.2-06 - Plan of correction

Current through Supplement No. 393, July, 2024
1. A
				facility shall submit to the department a plan of correction addressing areas
				of noncompliance with the licensure requirements of this chapter and chapter
				33-07-04.2.
2. A plan of
				correction must include:
a. How the
				corrective action will be accomplished;
b. How the facility will identify other
				residents or portions of the facility having the potential to be affected by
				the same deficient practice;
c.
				What measures will be put into place or systemic changes made to ensure that
				the deficient practice will not recur; and
d. How the facility will monitor its
				corrective actions to ensure that the deficient practice is being corrected and
				will not recur.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-07 - Governing body

Current through Supplement No. 393, July, 2024
The governing body is legally responsible for the quality of
				  resident care services; for resident safety and security; for the conduct,
				  operation, and obligations of the facility; and for ensuring compliance with
				  all federal, state, and local laws.
1. The governing body shall establish, cause
				to implement, maintain, and as necessary, revise its practices, policies,
				procedures, and bylaws for the ongoing evaluation of the services operated or
				delivered by the facility and for the identification, assessment, and
				resolution of problems that may develop in the conduct of the facility. These
				policies, procedures, and bylaws must be in writing, dated, and made available
				to all members of the governing body and facility staff.
2. The governing body shall appoint a
				qualified administrator who is responsible for the management of the facility.
a. The administrator shall hold a valid North
				Dakota nursing home administrator's license.
b. In the absence of the administrator, an
				employee must be designated in writing to act on behalf of the administrator.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-08 - Physical environment

Current through Supplement No. 393, July, 2024
The facility must be constructed, arranged, and maintained
				  to ensure the safety and well-being of the residents.
1. The physical plant must comply with the
				construction standards of chapter 33-07-04.2; and
2. The facility must provide an environment
				that is maintained, clean, comfortable, and appropriately responds to the
				physical, functional, and psychosocial needs of the residents. The facility
				must provide adequate space, lighting levels, ventilation, and safety measures
				consistent with the services being offered and the needs of the residents being
				served.
General Authority: NDCC 23-01-03
Law Implemented: NDCC 23-01-03,
					 23-16-01
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-09 - Emergency plan

Current through Supplement No. 393, July, 2024
The facility shall have a written procedure to be followed
				  in case of emergencies. The emergency plan must specify persons to be notified,
				  locations of alarm signals and fire extinguishers, evacuation routes,
				  procedures for evacuating residents, and assignment of specific tasks, and
				  responsibilities to the personnel of each shift.
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 33-07-03.2-10 - Quality improvement program

Current through Supplement No. 393, July, 2024
1. The
				facility shall develop and implement a quality improvement program, approved by
				the governing body, for assessing and improving the quality of services and
				care provided to residents. The written program must describe objectives,
				organization, scope, and mechanisms for overseeing and reporting the
				effectiveness of monitoring, evaluation, and improvement activities.
2. The quality improvement program must
				include a written plan for all services including indicators of care that are
				important to the health and safety of the residents.
3. The indicators of the written quality
				improvement plan must relate to quality of services and care provided to
				residents and must be objective, measurable, and based on current standards of
				practice.
4. Written documentation
				of quality improvement activities, including infection control, must be
				prepared and reported to the governing body.
General Authority: NDCC 23-01-03, 28-32-02
Law Implemented: NDCC
					 23-16-06
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-11 - Infection control program

Current through Supplement No. 393, July, 2024
The facility shall develop and implement a facilitywide
				  program, approved by the governing body, for surveillance, prevention, and
				  control of infections. This program must be consistent with the centers for
				  disease control and prevention standards specific to disease control. The
				  responsibilities of the program include:
1. Establishment of an infection control plan
				that includes the use of techniques and precautions in accordance with the
				standards of practice for each department or service.
2. Establishment of policies and procedures
				for reporting, logging, surveillance, monitoring, and documentation of
				infections, and the development and implementation of systems to collect and
				analyze data and activities to prevent and control infections.
3. Development and implementation of policies
				and procedures including:
a. The criteria to
				determine admission eligibility of an individual with a contagious or
				infectious disease; and
b. The
				immediate isolation of all residents in whom the condition jeopardizes the
				safety of the resident or other residents.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-12 - Education programs

Current through Supplement No. 393, July, 2024
The facility shall design, implement, and document
				  educational programs to orient new employees and keep all staff current on new
				  and expanding programs, techniques, equipment, and concepts of quality care.
				  The following topics must be covered with all staff annually:
1. Safety and emergency procedures, including
				procedures for fire and other disasters.
2. Prevention and control of infections,
				including universal precautions.
3. Resident rights.
4. Advanced directives.
5. Care of the emotionally disturbed and
				confused resident.
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 33-07-03.2-13 - Medical services

Current through Supplement No. 393, July, 2024
1. The facility
				shall have a licensed physician who is specified as the medical director or a
				medical staff organized under bylaws and rules approved by and responsible to
				the governing body. The medical director or medical staff shall be responsible
				for the quality of all medical care provided to residents and for the ethical
				and professional practices of its members.
2. The duties and responsibilities of the
				medical director or medical staff must be delineated in a formal agreement with
				the governing body.
3. The medical
				director or medical staff shall be involved in the development of written
				medical staff policies which are approved by the governing body, which
				delineate the responsibilities of licensed health care practitioners.
4. The medical director or a
				member of the medical staff shall participate in the quality improvement and
				infection control program meetings.
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 33-07-03.2-14 - Nursing services

Current through Supplement No. 393, July, 2024
1. Nursing services
				must be under the direction of a nurse executive (director of nursing) who is
				employed by the facility and is a registered nurse licensed to practice in
				North Dakota.
2. The nurse
				executive must have written administrative authority, responsibility, and
				accountability for the integration of nursing services consistent with the
				overall facility plan and philosophy of resident care. The nurse executive
				shall retain administrative responsibility to:
a. Ensure development, maintenance,
				implementation, and revision of nursing service objectives, standards of
				practice, policy and procedure manuals, and written job descriptions for each
				level of nursing personnel, including unlicensed staff.
b. Ensure a resident assessment is completed
				and a comprehensive care plan is established in coordination with the resident
				or legal representative within the required timeframes.
c. Ensure care plans are implemented so as to
				assist each resident to attain and maintain their highest level of functioning.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-15 - Resident assessment and care plan

Current through Supplement No. 393, July, 2024
1.
				The facility shall complete and maintain an up-to-date comprehensive resident
				assessment for each resident by using the resident assessment instrument, the
				utilization guidelines, the minimum data set of core elements and common
				definitions, and the resident assessment protocol summary with triggers as
				specified by the department and approved by health care financing
				administration and published in the state operations manual.
2. In coordination with the resident or
				resident's legal representative and staff providing resident care services, a
				comprehensive written resident care plan for each resident must be developed
				and maintained consistent with each resident's individual needs and licensed
				health care practitioner's plan of medical care. An initial care plan must be
				implemented upon admission and revised within seven days after the completion
				of the resident assessment instrument.
3. A care plan must be individualized to meet
				the needs of the resident and must include problem and strength identification,
				measurable resident-centered goals, plans of action, and which professional
				service is responsible for each element of care. Goals must be measurable,
				behavior oriented, time-limited, and achievable.
4. Resident assessment and quarterly
				assessment information on each resident must be submitted electronically to a
				location specified by the department in a timeframe specified by 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 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-16 - Dietary services

Current through Supplement No. 393, July, 2024
The facility shall provide for the dietary needs of the
				  residents and provide dietary services in conformance with the food service
				  sanitation manual issued by the department. Dietary services must include:
1. A qualified director of dietary
				services must be designated to be responsible for the dietary service of the
				facility.
a. A director of dietary services
				is:
(1) A dietitian licensed to practice in
				North Dakota and registered by the American dietetic association;
(2) A graduate of a dietetic technician or
				dietetic assistant training program approved by the American dietetic
				association;
(3) A certified
				dietary manager, certified by the certifying board for dietary managers;
(4) A graduate of a state-approved
				course that provides ninety or more hours of instruction in dietary service
				supervision in a health care institution with consultation from a licensed and
				registered dietitian; or
(5) An
				individual trained and experienced in food service supervision and management
				in a military service equivalent to the program described in paragraph 2 or 4.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-16.1 - Paid feeding assistants

Current through Supplement No. 393, July, 2024
Any individual employed by a facility, or under contract, to
				  feed or assist with the feeding of nursing facility residents must either have
				  successfully completed a department-approved paid feeding assistant training
				  course or be a certified nurse aide.
1. Instructors of a department-approved paid
				feeding assistant course must meet the following requirements:
a. The primary instructor of the program must
				be a licensed health care professional with experience in the feeding of
				nursing facility residents.
b.
				Certified nurse aides and paid feeding assistants may not be used as
				instructors in a department-approved paid feeding assistant course.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-17 - Resident record services

Current through Supplement No. 393, July, 2024
The governing body of the facility shall establish and
				  implement policies and procedures to ensure the facility has a resident record
				  service with administrative responsibility for resident records.
1. A resident record must be maintained and
				kept confidential for each resident admitted to the facility. The resident
				record shall be complete, accurately and legibly documented, and readily
				accessible.
a. The resident or the resident's
				legal representative have the right to view and authorize release of their
				medical information.
b. The
				facility shall develop policies which address access to resident
				records.
c. Resident records may be
				removed from the facility only upon subpoena, court order, or pursuant to
				facility policies when a copy of the original record is maintained at the
				facility.
North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-07 - Licensing Medical Hospitals › Chapter 33-07-03.2 - Nursing Facilities › Section 33-07-03.2-18 - Pharmaceutical services

Current through Supplement No. 393, July, 2024
The facility shall provide pharmaceutical services to meet
				  resident needs.
1. The facility shall
				obtain the services of a licensed pharmacist who shall develop policies and
				procedures for the provision of pharmaceutical services within the facility
				consistent with chapter 61-03-02, state laws, and federal laws. These policies
				and procedures must be approved by medical staff or medical director and
				governing body and must include provisions for:
a. The procurement, storage, dispensing,
				labeling, administration, and disposal of drugs and biologicals.
b. Allowing the resident to be totally
				responsible for the resident's own medication based on request of the resident,
				assessment of the functional capability of the resident by facility nursing
				staff, documentation of the assessment and resultant recommendations, and
				specific approval and order of the licensed health care practitioner. The
				facility must provide a secure storage area for medications self-administered
				by the resident.