|
|
To amend sections 3721.011 and 3721.04 of the Revised | 1 |
Code regarding the provision of hospice care in | 2 |
residential care facilities. | 3 |
Section 1. That sections 3721.011 and 3721.04 of the Revised | 4 |
Code be amended to read as follows: | 5 |
Sec. 3721.011. (A) In addition to providing accommodations, | 6 |
supervision, and personal care services to its residents, a | 7 |
residential care facility may provide skilled nursing care to its | 8 |
residents as follows: | 9 |
(1) Supervision of special diets; | 10 |
(2) Application of dressings, in accordance with rules | 11 |
adopted under section 3721.04 of the Revised Code; | 12 |
(3) | 13 |
section, administration of medication | 14 |
15 |
(4) | 16 |
skilled nursing care provided on a part-time, intermittent basis | 17 |
18 | |
of one hundred twenty days in a twelve-month period; | 19 |
(5) Subject to division (D) of this section, skilled nursing | 20 |
care provided for more than one hundred twenty days in a | 21 |
twelve-month period to a hospice patient, as defined in section | 22 |
3712.01 of the Revised Code. | 23 |
A residential care facility may not admit or retain an | 24 |
individual requiring skilled nursing care that is not authorized | 25 |
by this section. A residential care facility may not provide | 26 |
skilled nursing care beyond the limits established by this | 27 |
section. | 28 |
(B)(1) A residential care facility may admit or retain an | 29 |
individual requiring medication, including biologicals, only if | 30 |
the individual's personal physician has determined in writing that | 31 |
the individual is capable of self-administering the medication or | 32 |
the facility provides for the medication to be administered to the | 33 |
individual by a home health agency certified under Title XVIII of | 34 |
the
"Social Security Act," | 35 |
U.S.C.A. | 36 |
under Chapter 3712. of the Revised Code; or a member of the staff | 37 |
of the residential care facility who is qualified to perform | 38 |
medication administration. Medication may be administered in a | 39 |
residential care facility only by the following persons authorized | 40 |
by law to administer medication: | 41 |
(a) A registered nurse licensed under Chapter 4723. of the | 42 |
Revised Code; | 43 |
(b) A licensed practical nurse licensed under Chapter 4723. | 44 |
of the Revised Code who holds proof of successful completion of a | 45 |
course in medication administration approved by the board of | 46 |
nursing and who administers the medication only at the direction | 47 |
of a registered nurse or a physician authorized under Chapter | 48 |
4731. of the Revised Code to practice medicine and surgery or | 49 |
osteopathic medicine and surgery; | 50 |
(c) A physician authorized under Chapter 4731. of the Revised | 51 |
Code to practice medicine and surgery or osteopathic medicine and | 52 |
surgery. | 53 |
(2) In assisting a resident with self-administration of | 54 |
medication, any member of the staff of a residential care facility | 55 |
may do the following: | 56 |
(a) Remind a resident when to take medication and watch to | 57 |
ensure that the resident follows the directions on the container; | 58 |
(b) Assist a resident by taking the medication from the | 59 |
locked area where it is stored, in accordance with rules adopted | 60 |
pursuant to section 3721.04 of the Revised Code, and handing it to | 61 |
the resident. If the resident is physically unable to open the | 62 |
container, a staff member may open the container for the resident. | 63 |
(c) Assist a physically impaired but mentally alert resident, | 64 |
such as a resident with arthritis, cerebral palsy, or Parkinson's | 65 |
disease, in removing oral or topical medication from containers | 66 |
and in consuming or applying the medication, upon request by or | 67 |
with the consent of the resident. If a resident is physically | 68 |
unable to place a dose of medicine to the resident's mouth without | 69 |
spilling it, a staff member may place the dose in a container and | 70 |
place the container to the mouth of the resident. | 71 |
(C) A residential care facility may admit or retain | 72 |
individuals who require skilled nursing care beyond the | 73 |
supervision of special diets, application of dressings, or | 74 |
administration of medication, only if the care will be provided on | 75 |
a part-time, intermittent basis for not more than a total of one | 76 |
hundred twenty days in any twelve-month period. In accordance with | 77 |
Chapter 119. of the Revised Code, the public health council shall | 78 |
adopt rules specifying what constitutes the need for skilled | 79 |
nursing care on a part-time, intermittent basis. The council shall | 80 |
adopt rules that are consistent with rules pertaining to home | 81 |
health care adopted by the director of job and family services for | 82 |
the medical assistance program established under Chapter 5111. of | 83 |
the Revised Code. Skilled nursing care provided pursuant to this | 84 |
division may be provided by a home health agency certified under | 85 |
Title XVIII
of the
"Social Security Act," | 86 |
87 | |
Chapter 3712. of the Revised Code, or a member of the staff of a | 88 |
residential care facility who is qualified to perform skilled | 89 |
nursing care. | 90 |
A residential care facility that provides skilled nursing | 91 |
care pursuant to this division shall do both of the following: | 92 |
(1) Evaluate each resident receiving the skilled nursing care | 93 |
at least once every seven days to determine whether the resident | 94 |
should be transferred to a nursing home; | 95 |
(2) Meet the skilled nursing care needs of each resident | 96 |
receiving the care. | 97 |
(D) A residential care facility may admit or retain a hospice | 98 |
patient who requires skilled nursing care for more than one | 99 |
hundred twenty days in any twelve-month period only if the | 100 |
facility has entered into a written agreement with a hospice care | 101 |
program licensed under Chapter 3712. of the Revised Code. The | 102 |
agreement between the residential care facility and hospice | 103 |
program shall include all of the following provisions: | 104 |
(1) That the hospice patient will be provided skilled nursing | 105 |
care in the facility only if a determination has been made that | 106 |
the patient's needs can be met at the facility; | 107 |
(2) That the hospice patient will be retained in the facility | 108 |
only if periodic redeterminations are made that the patient's | 109 |
needs are being met at the facility; | 110 |
(3) That the redeterminations will be made according to a | 111 |
schedule specified in the agreement; | 112 |
(4) That the hospice patient has been given an opportunity to | 113 |
choose the hospice care program that best meets the patient's | 114 |
needs. | 115 |
(E) Notwithstanding any other provision of this chapter, a | 116 |
residential care facility in which residents receive skilled | 117 |
nursing care pursuant to this section is not a nursing home. | 118 |
Sec. 3721.04. (A) The public health council shall adopt and | 119 |
publish rules governing the operation of homes, which shall have | 120 |
uniform application throughout the state, and shall prescribe | 121 |
standards for homes with respect to, but not limited to, the | 122 |
following matters: | 123 |
(1) The minimum space requirements for occupants and | 124 |
equipping of the buildings in which homes are housed so as to | 125 |
ensure healthful, safe, sanitary, and comfortable conditions for | 126 |
all residents, so long as they are not inconsistent with Chapters | 127 |
3781. and 3791. of the Revised Code or with any rules adopted by | 128 |
the board of building standards and by the state fire marshal; | 129 |
(2) The number and qualifications of personnel, including | 130 |
management and nursing staff, for each class of home, and the | 131 |
qualifications of nurse aides, as defined in section 3721.21 of | 132 |
the Revised Code, used by long-term care facilities, as defined in | 133 |
that section; | 134 |
(3) The medical, rehabilitative, and recreational services to | 135 |
be provided by each class of home; | 136 |
(4) Dietetic services, including but not limited to | 137 |
sanitation, nutritional adequacy, and palatability of food; | 138 |
(5) The personal and social services to be provided by each | 139 |
class of home; | 140 |
(6) The business and accounting practices to be followed and | 141 |
the type of patient and business records to be kept by such homes; | 142 |
(7) The operation of adult day-care programs provided by and | 143 |
on the same site as homes licensed under this chapter; | 144 |
(8) The standards and procedures to be followed by | 145 |
residential care facilities in admitting and retaining a resident | 146 |
who requires the application of dressings, including requirements | 147 |
for charting and evaluating on a weekly basis; | 148 |
(9) The requirements for conducting weekly evaluations of | 149 |
residents receiving skilled nursing care in residential care | 150 |
facilities. | 151 |
(B) The public health council may adopt whatever additional | 152 |
rules are necessary to carry out or enforce the provisions of | 153 |
sections 3721.01 to 3721.09 and 3721.99 of the Revised Code. | 154 |
(C) The following apply to the public health council when | 155 |
adopting rules under division (A)(2) of this section regarding the | 156 |
number and qualifications of personnel in homes: | 157 |
(1) When adopting rules applicable to residential care | 158 |
facilities, the public health council shall take into | 159 |
consideration the effect that the | 160 |
the number of personnel needed: | 161 |
(a) Provision of personal care
services | 162 |
(b) Provision of part-time, intermittent skilled nursing care | 163 |
pursuant to division (C) of section 3721.011 of the Revised Code | 164 |
165 |
(c) Provision of skilled nursing care to hospice patients | 166 |
pursuant to division (D) of section 3721.011 of the Revised Code. | 167 |
(2) The rules prescribing qualifications of nurse aides used | 168 |
by long-term care facilities, as those terms are defined in | 169 |
section 3721.21 of the Revised Code, shall be no less stringent | 170 |
than the requirements, guidelines, and procedures established by | 171 |
the United States secretary of health and human services under | 172 |
sections 1819 and 1919 of the "Social Security Act," 49 Stat. 620 | 173 |
(1935), 42 U.S.C.A. 301, as amended. | 174 |
Section 2. That existing sections 3721.011 and 3721.04 of the | 175 |
Revised Code are hereby repealed. | 176 |