The World of Computer Software

home *** CD-ROM | disk | FTP | other *** search

/ The World of Computer Software / World_Of_Computer_Software-02-387-Vol-3of3.iso / o / open4.zip / TITLE22 < prev next >

Wrap

Text File | 1991-12-10 | 19KB | 496 lines

Subject: Title 22 ROLE OF THE STATE AND FEDERAL REGULATIONS One of your very important functions will be to assist your facility in maintaining compliance to State and Federal Regulations. Facilities must comply with these regulations in order to be licensed to operate. Title 22 is the California State Code which contains regulations for licensing and Certification of health facilities. A copy of these regulations is located: ______________________________________________________________________ The Department of Health, Education and Welfare also issues "Standards of Participation" which must be followed if the facility wishes to participate in the federally funded Medicare program. These standards are referred to as Federal Regulations. A copy of the Federal Regulations is located: ADM-D.O.N -OFFICE ______________________________________________________________________ Failure of any facility to comply with these established regulations can result in any or all of the following: * Loss of license to operate the facility, resulting in sale or closure of the facility and transfer of all patients. * Withdrawnal of state and federal funds which support many of the patients and pay the expenses of operation of the facility. * Issuance of violation citations to the facility resulting in fines/penalties. * Legal actions filed against the facility and/or individuals employed by the facility. The State of California through Title 22 has defined violations and civil penalties: * 72701 Definitions {1} Substantial probability means that the likeihood of an event is real, real and not imaginary, insignificant or remote. {2} Serious physical harm means that type of dangerous bodily injury, illness or condition in which: [A] A part of the body would be permanently removed, rendered functionally useless or substantially reduced in capacity, either temporarily or permanently, and/or [B] A part of an internal function of the body would be inhibited in its normal performance to such a degree as to temporarily or permanently cause a reduction in physical or mental capacity or shorten life. *72703 Page 2 Class "A" Violations -- Examples [A] Each of the following are examples of a class "A" violation whenever the situation in which it occurs presents an imminent danger to the patients of the facility or a substantial probability that death or serious physical harm would result therefrom: [1] A violation of Section 72311<a><3>relating to the notification of the attending physician of any significant change in a patient's condition. [2] A violation of Section 72311<a><1>relating to the unauthorized administration of medications or treatments or both. [3] A violation of Section 72313<a><2>relating to the administration of medications, treatments or both, as prescribed [4] A violation of Section 72313<a><4>relating to the preparation of medications. [5] A violation of Section 72313<a><5> relating to the administration of medications by unauthorized personnel. [6] A violation of Section 72315 relating to the physical abuse of patients that results in a patient's death or serious physical harm. [7] A violation of Section 72631<a> relating to an adequate emergency call system from patient to staff. [8] A violation of Section 72321<a><1> relating to adequate isolation procedures. [9] A violation of Section 72639<a> relating to maintaining the facility in a state and sanitary condition. [10] A violation of Section 72349<d><7> relating to the capability to serve safe and untainted food. [11] A violation of Section 72377 relating to the availability and contents of the emergency drug supply. [12] A violation of Section 72357 relating to the labeling and storage of drugs. [13] A violation of Section 72505 relating to fire safety measures or procedures. [14] A violation of Section 72551<e> or 72553<c> relating to the immediate availability of adequately trained staff personnel to respond to emergency situations. [15] A violation of Section 72649relating to the provision for safe handling and storage of medical gas cylinders. [16] A violation of Section 72651<d> relating to the temperature of hot water delivered to plumbing fixtures used by patients. 72705 Page 3 Class "B" Violations -- Examples [A] The following are examples of a class "B" violation whenever the situation in which it occurs has a direct or immediate relationship to the health, safety or security of a patients: [1] A violation of Section 72311<a><1> relating to patient care plans. [2] A violation of Section 72311<a><3> relating to the notification of the attending physician of a change in patients condition. [3] A violation of Section 72311<a><1> relating to the unauthorized administration of medications or treatments or both. Class "B" Violations -- Examples [4] A violation of Section 72313 <a><2> relating to the administration of medications,treatments or both as prescribed. [5] A violation of Section 72313<a><4> relating to the preparation of medications. [6] A violation of Section 72313<a><5> relating to the administration of medication by unauthorized personnel. [7] A violation of Section 72315<a> relating to the admission of patients without an attending physician. [8] A violation of Section 72315 relating to the abuse of patients. [9] A violation of Section 72315<d> relating to the personal hygiene of patients. [10] A violation of Section 72315<f> relating to the prevention of decubiti, contractures or deformities. [11] A violation of Section 72315 relating to measures to prevent and reduce incontinence. [12] A violation of Section 72317 relating to standing orders for drugs. [13] A violation of Section 72319<c><d><e><f><g> and <h> relating to the use of restraints. [14] A violation of Section 72329 relating to the nursing staff. [15] A violation of Section 72335<a> relating to the dietetic needs of the patients. [16] A violation of Section 72335<a><7> relating to food preparation and service. [17] A violation of Section 72339 relating to therapeutic diets. [18] A violation of Section 72343 and <c> relating to storage of food. [19} A violation of Section 72345 relating to kitchen sanitation. [20] A violation of Section 72347<c> or 72653<e> relating to the cleaning and sanitizing of utensils and dishes. [21] A violation of Section 72349<d> relating to food supplies [22] A violation of Section 72351 relating to dietetic personnel. [23] A violation of Section 72351<g> relating to the hygiene of dietetic. personnel. [24] A violation of Section 72355 relating to obtaining drugs on a 24-hour basis. [25] A violation of Section 72357 relating to the labeling and storage of drugs. Page 4 [26] A violation of Section 72361 relating to drugs orders. [27] A violation of Section 72377 relating to emergency drugs supply. [28] A violation of Section 72319 relating to the unauthorized use of restraint or seclusion. [29] A violation of Section 72459 relating to the restraint and seclusion of patients. [30] A violation of Section 72329<a> relating to the adequacy of staff. [31] A violation of Section 72505 relating to fire safety. [32] A violation of Section 72507<a>,or <d> relating to patients smoking. [33] A violation of Section 72535<a> or relating to employee's health examinations. Class "B" Violations -- Examples [34] A violation of Section 72547 relating to patients records [35] A violation of Section 72501 relating to the reporting of unusual occurrences. [36] A violation of Section 72551<a> relating to the written disaster program. [37] A violation of Section 72551<c> relating to instructing staff in the disaster plan. [38] A violation of Section 72551<e> relating to the rehearsal of the disaster program. [39] A violation of Section 72553 relating to the fire program. [40] A violation of Section 72553<c> relating to fire drills. [41] A violation of Section 72553<d> relating to evacuation plan. [42] A violation of Section 72557 relating to patient care equipment. [43] A violation of Section 72607<a>, or <c> relating to the housing of patients. [44] A violation of Section 72615 relating to patient privacy. [45] A violation of Section 72619 relating to autoclaving. [46] A violation of Section 72619<1><A> relating to equipping of autoclave. [47] A violation of Section 72621 relating to housekeeping. [48] A violation of Section 72623<a> or , 72625 or 72627 relating to laundry and linen service. [49] A violation of Section 72637 relating to general maintenance. Page 5 [50] A violation of Section 72641<a>,<<d> or <e> relating emergency power. [51] A violation of section 72643 or 72645<a>,,<d> or <e> relating to the storage and disposal of solid waste. [52] A violation of Section 72647 relating to infectious waste. [5g to grab bars. [58] A violation of Section 72653 relating to lighting. [59] A violation of Section 72657 relating to mechanical systems. -NOTES- _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ Page 6 Facilities are usually survey or inspected by members of the Health Department annually --- some more frequently. These inspections are called routine inspections. A law was passed recently which allows facilities with a good record to be evaluated every two years. Facilitiy may also be surveyed or inspected when complaints are made about the facility and /or its operation. You will need to understand your responsibility when participating in the survey process. Title 22 states: 72725 Interference with Official Duties <a> Any duly authorized officer, employee or agent of the Department may enter and inspect any facility, including, but not limited to, interviewing patients and reviewing records at any time. Inspections conducted pursuant to complaints filed with the Department shall be conducted in such a manner as to ensure maximum effectiveness. No advance notice shall be given of any inspection unless previously and specifically authorized by the Director or required by federal law. No licensee oe employee of any skilled nursing facility shall: <1> Willfully prevent, interfere with or attempt to impede in any way the work of any duly authorized representative of the Department in the lawful enforcement of his inspection duties. <2> Willfully prevent or attempt to prevent any such representative from examining any relevant books or records in the conduct of his inspection duties. <3> Willfully prevent or interfere with any such representative in the preserving of evidence of any violation of these regulations. Page 7 The best ways for you to participate in the survey process is to know your regulations and to do all you can to maintain your area of responsibility in continuing compliance with these regulations. Make sure you report promptly special problems/situations that jeopardize compliance to your immediate Nursing Supervisor, Director of Nursing and/ or Administrator. Review the last survey report issued to your facility. The survey report is posted [ ] Take corrective action to eliminate deficiencies identified so that "repeat" deficiencies will not occur. The facility is due for the next routine survey in [ ] Don't panic when surveyors arrive in the facility. Make sure your staff knows there is a survey in progress and monitor their performance carefully. Make rounds and verify that your area of responsibility is ready for inspection. Sometimes the presence of surveyors causes disruption of normal routines, so close supervision is needed to keep patient care routines as normal as possible. Greet surveyors with courtesy and respect. Answer questions concisely and accurately. If you are unsure of something, ask for assistance from your immediate Nursing Supervisor. A surveyor's primary responsibility is to gather, validate and interpret data in reference to established standards spelled out in the regulations Developing good working relationships with your surveyors benefits everyone. Surveyors frequently offer constructive suggestions to help solve problems identified. If problems are identified, avoid becoming defensive or argumentative -- the surveyors do not generally write the regulations, they simply enforce them. Most will work cooperatively with facilities toward the common goal of improved patient care. The best way to have a "good survey" is to provide care in compliance with the regulations and accepted standards of nursing practice every day. When you do this you protect your patients, your staff and your facility. Page 8 Title 22 ________________________________I have received and reviewed information on the Role of State and Federal Regulations Title 22.