New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter A - Medical Facilities-minimum Standards › Article 3 - Residential Care Facilities › Part 415 - Nursing Homes-minimum Standards › Optional Services › Section 415.36 - Long-term inpatient rehabilitation program for head-injured residents

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Definition. A
						head injury program shall mean a planned combination of services provided in a
						nursing home unit approved by the commissioner pursuant to Part 710 of this
						Title as a provider of specialized services for head-injured residents on a
						designated resident care unit of at least 20 beds. The head-injury program
						shall be designed specifically to serve medically stable, traumatically
						brain-injured individuals with an expected length of stay from 3 to 12 months.
						The program shall provide goal-oriented, comprehensive, interdisciplinary and
						coordinated services directed at restoring the individual to the optimal level
						of physical, cognitive and behavioral functioning. The population served shall
						consist primarily of individuals with traumatically acquired, nondegenerative,
						structural brain damage resulting in residual deficits and disability. The
						program shall not admit or retain individuals who are determined to be a danger
						to self or others.
(b) General
						requirements. The nursing home shall ensure:
(1) the development and implementation of a
						planned and systematic program for monitoring and assessing the quality and
						appropriateness of resident care to assure care is provided in accordance with
						current standards of professional practice. The quality assurance process shall
						define methods for the identification and selection of clinical and
						administrative problems to be reviewed with written documentation of such
						reviews. The process shall include but not be limited to reviews of clinical
						records, resident and family complaints and suggestions, incident reports and
						the resident's response to discharge plans. There shall be documentation that
						recommendations are followed up, action is taken to resolve identified problems
						and results of such action are assessed periodically;
(2) sufficient space, equipment and
						facilities are available to support the clinical, educational and
						administrative functions of the program in accordance with standards set forth
						in Parts 711 and 713 of this Title;
(3) transfer agreements are in effect with
						other facilities, in accordance with section
						400.9 of this Title for the
						acceptance of referrals or the transfer of head-injured residents in need of
						services not available at the facility;
(4) the development and consistent
						application of written admission and continued stay criteria for this service
						which include but are not limited to the use of a generally recognized
						classification system for measuring each individual's physical, affective,
						behavioral and cognitive level of functioning and the family's capabilities and
						functioning, and are consistent with the following requirements:
(i) a resident admitted for long-term
						rehabilitation shall be a person who has suffered a traumatic brain injury with
						structural nondegenerative brain damage, is medically stable, is not in a
						persistent vegetative state, demonstrates potential for physical, behavioral
						and cognitive rehabilitation and may evidence moderate to severe behavior
						abnormalities. The resident must be capable of exhibiting at least localized
						responses by reacting specifically but inconsistently to stimuli;
(ii) a resident admitted for coma management
						shall be a person who has suffered a traumatic brain injury with structural
						nondegenerative brain damage and is in a coma. The resident may be completely
						unresponsive to any stimuli or may exhibit a generalized response by reacting
						inconsistently and nonpurposefully to stimuli in a nonspecific manner;
						and
(iii) a resident who has
						diffuse brain damage caused by anoxia, toxic poisoning, cerebral vascular
						accident, or encephalitis may be admitted to this program if considered
						appropriate for coma management and long-term rehabilitation;
(5) records are maintained for at
						least two years identifying persons who were determined by the facility to be
						ineligible for admission under the head injury program. The records should
						indicate the reason for ineligibility and any referral action taken;
(6) inservice and continuing education
						programs which address the medical, physical, cognitive, psychosocial and
						behavioral needs of head injured residents are conducted on a regular basis for
						all personnel caring for such residents;
(7) educational programs are conducted for
						personnel not providing direct care but who come in contact on a regular basis
						with head-injured residents. The programs should familiarize personnel with the
						specific needs of these residents; and
(8) education and counseling services are
						available and offered to the residents and families as needed.