North Dakota Administrative Code › Title 33 - State Department of Health › Article 33-03 - State Department of Health › Chapter 33-03-24.1 - Basic Care Facilities › Section 33-03-24.1-23 - End-of-life care service

Current through Supplement No. 393, July, 2024
A facility that retains residents who require end-of-life
				  care continues to be responsible for the care and services of all residents,
				  must comply with the requirements of this section, and apply on basic care
				  application form and indicate a change in services provided.
1. A facility may retain residents who
				require more than intermittent nursing care if the resident requires
				end-of-life care and chooses to remain in the facility .
2. A facility providing end-of-life care must
				employ or contract with a registered nurse to supervise resident care to meet
				the needs of the residents at all times, either directly or indirectly. The
				facility must employ a licensed nurse to identify and respond to resident
				needs, care plan accordingly, provide oversight related to care, and review and
				document the resident's individual needs and care provided.
3. The facility, the resident in need of
				end-of-life care, or the resident's designee may contract with a person or
				hospice agency to meet the needs of the resident.
4. Individuals in need of end-of-life care
				who require skilled nursing care or are not capable of self-preservation may
				not be admitted.
5. The facility,
				in consultation with the resident or resident's designee, shall develop and
				implement an interdisciplinary care plan that identifies how the resident's
				needs are met and includes delineation of the roles of facility staff and
				others in the provision of care and services for the resident in need of
				end-of-life care and a list of medications the resident receives related to
				end-of-life care and who is authorized to administer the medications.
6. Facility evacuation or E scores
				must be completed when there is a significant change in the resident's
				capability for self evacuation when a resident is receiving end-of-life care. A
				significant change for the resident is defined as any change in the resident's
				status or capabilities which results in a change in the E score for that
				resident. Facility staffing must be adjusted consistent with the E scores to
				maintain a slow evacuation capability. The fire evacuation needs of the
				resident receiving end-of-life care may be met by facility staff that wraps
				around hospice staff, family members, the resident's designee, or volunteers.
7. If a facility provides
				end-of-life care to residents, the facility shall ensure training and
				competency evaluation is completed for all nursing and personal care staff
				members specific to the care and services necessary to meet the needs of the
				terminally ill resident. The training and competency evaluation must be
				completed prior to caring for a resident in need of end-of-life care. The
				facility staff must be trained by a nurse. Training of the other individuals
				may be completed by any of the following:
a.
				Facility personnel;
b. Other
				experts;
c. Nurse or nurse
				consultant; or
d. Hospice agency
				nurse.
If the facility utilizes family, volunteers, or the
				  resident's designee to provide end-of life care, the facility shall ensure
				  appropriate training for these individuals specific to the care and services
				  provided by this person. The facility shall assure the competency of the
				  individual for this task and address changes if the needs of the resident are
				  not being met.