(v) Assurance of financial security. The facility provides extensive age specific nursing, medical, psychological and counseling support services to children with diverse and complex medical, emotional and social problems in a program recognized and approved by the department to provide these services. (3) For all personnel who provide services in the nursing home, for whom licensure, registration or certification is required, the facility shall obtain and retain verification of license number or certification with expiration date of same. (iv) In reviewing an application for withdrawal, the commissioner shall consider: (b) whether such withdrawal would impair the facility's ability to render quality care; (c) any expense which such withdrawal would generate; and. (d) conduct himself or herself in a professionally acceptable manner with all residents, employees and guests, including refraining from abusive, immoral or other unacceptable conduct, behavior or language and demonstrating respect for each resident's dignity in full recognition of his or her individuality; (iv) assign each employee duties consistent with his or her job description and with his or her level of competence, education, preparation and experience; and. (iv) maintenance of records of these activities, including the methods used and an evaluation on their effectiveness. The 75 hours includes 59 hours classroom and 16 hours of supervised practical training as follows: Home Care Curriculum - 40 hours (all classroom) (3) When, by reason of death, resignation, incapacity, illness or other reason, the nursing home does not have a licensed and currently registered nursing home administrator capable of carrying out such functions, the governing body shall immediately notify the commissioner, assign such duties to a named individual acceptable to the commissioner in accordance with that individual's training, experience and prior record of work performance at a nursing home, and provide for supervision of the nursing home by a licensed and currently registered nursing home administrator in accordance with the following: (i) A plan for the supervision of the unlicensed acting nursing home administrator shall be submitted to the Department which provides that: (a) The nursing home is making a bonafide effort to recruit a licensed and registered nursing home administrator; (b) There is no other licensed and registered person in the facility available, capable and willing to accept the position; (c) The supervising administrator will provide a minimum of four hours of on-site supervision weekly during normal business hours unless the Department determines that more hours are necessary based on: (2) the qualifications of the unlicensed acting administrator; and. Would you know your responsibility as a nurse and mandated reporter if you suspected a patient . (3) Nurse aide training program. If the nursing home does not employ a qualified professional person to furnish a specific service to be provided by the facility, the nursing home shall have that service furnished to residents by a qualified person or agency outside the facility in accordance with the following: (1) The operator shall enter into written agreement with the outside resource which shall comply with the provisions of this section and section 400.4 of this Title and shall: (i) specify that the operator retains professional and administrative responsibility for obtaining services that meet professional standards and principles that apply to professionals providing services in such a facility; (ii) require that such services are provided on a timely basis; (iii) set forth the responsibilities, function, objectives and terms of the agreement, including financial arrangements and charges of each such outside resource; and, (iv) be signed by an authorized representative of the facility and the person or the agency providing the service; and. In-service education may be obtained through web-based training programs. The policies and procedures shall include but not be limited to the following: (a) the prominent inclusion in admission application forms and policy statements of a legend summarizing the applicable Federal and State anti-discrimination laws; (b) the prominent display in the admissions office of the New York State Division of Human Rights nondiscrimination regulatory poster. 415.26 Organization and administration. (8) The operator shall ensure that the certified nurse aide regularly attends inservice education programs provided for all personnel and that the programs shall include the following: (i) A portion of each individual's annual inservice education as required by subparagraph (iv) of this paragraph shall be based upon the outcome of the individual's annual performance review as specified in paragraph (7) of this section, and address the areas of weakness in the individual's performance; (ii) Inservice education must also address the special needs of the residents in the facility, including the care of the cognitively impaired; (iii) Written records shall be maintained which indicate the content of and attendance at each inservice training program and the outcomes of the performance review; and. Occupational therapy assistants provide treatment according to a plan developed by or in collaboration with a licensed occupational therapist. (4) For all services and departments, the facility shall maintain: (d) Nurse aide certification and training. (c) for residents in general hospitals and residing in the community, the SCREEN, as specified in section 400.12 of this Title, performed prior to admission to the nursing home shall not be completed by personnel of a residential health care facility, except where a certified home health agency or other appropriate community-based assessor has been contacted by the resident or the resident's designated representative, for the purpose of completing the SCREEN, and has not completed the SCREEN within 48 hours; (ii) accept and retain only those nursing home residents for whom it can provide adequate care; (iii) admit each resident only after a pre-admission personal interview with the resident's physician, the resident, his or her next of kin and/or sponsor, as appropriate, except that a telephone interview may be substituted when a personal interview is not feasible, and a summary of all interviews shall be recorded on the resident's chart or other appropriate record; (iv) maintain a written record of all financial arrangements with the resident, his or her next of kin and/or sponsor, with copies executed by and furnished to each party; (v) make no arrangement for prepayment for basic services exceeding three months; (vi) assess no additional charges, expenses or other financial liabilities in excess of the daily, weekly or monthly basic rate except; (a) upon express written approval and authority of the resident, next of kin or sponsor; (b) upon express written orders of the resident's personal, alternate or staff physician stipulating specific services and supplies not included as basic services; (c) upon 30 days' prior written notice to the resident or designated representative, of additional charges, expenses or other financial liabilities due to the increased cost of maintenance and/or operation of the nursing home; and, upon request of the resident, designated representative or of the department, financial and statistical supportive evidence sufficient to reflect such change in economic status shall be provided; or. Home health aide training programs are allowed 60 days from the day an individual enters the program to complete the 75 hours. The curriculum shall otherwise include but not be limited to the following: (iv) psychological and cognitive changes; and. The nurse aide trainee will obtain certification and be listed in the Registry upon passing the written or oral examination. (3) The facility shall issue a certificate of completion to each individual who successfully completes the state-approved feeding assistant training program. Such records shall include, but not be limited to: (i) the full name of the feeding assistant, facility-issued trainee or employee ID number, name and address of the facility, dates on which each content area of the feeding assistant training program was delivered and successfully completed, the date on which the individual successfully completed the feeding assistant training program, and the name, title and signature of the training program instructor. (5) care of ostomies, including but not limited to colostomy and ileostomy. Half of all nursing home attendants have admitted abusing or neglecting elderly patients at some point in their careers, according to research from 2010.The elderly are some of the most vulnerable members of our society, and the law has certain safeguards in place in order to help prevent such abuses. Agencies are required to provide orientation for new staff (including aides) employed by the agency prior to provision of care. (a) Direction. (j) Misappropriation of resident property. (1) For purposes of this subdivision, misappropriation of resident property shall mean the theft, unauthorized use or removal, embezzlement or intentional destruction of the resident's personal property including but not limited to money, clothing, furniture, appliances, jewelry, works of art, and such other possessions and articles belonging to the resident regardless of monetary value. The administrator shall: (i) be readily accessible to residents and staff for consultations; (ii) involve the Resident Council in addressing the need to seek compromises between conflicting resident and staff interests and needs; (iii) encourage professional and respectful behavior on the part of the staff toward residents; and. (iii) Program approval will be granted for a term not to exceed 2 years and is subject to on-site review for the purpose of determining compliance with applicable State and federal requirements during the course of all facility surveys. In order to work as a certified nurse aide (CNA) in New York State, a person must successfully complete a nurse aide training program (NATP) delivered only by a program approved by NYSED or NYSDOH. (d) the financial condition of the facility in general. In 2021, if the applicant is single, countable assets must be no higher than $2,000. (1) physiology of bowel and bladder continence: (ii) physical, psychosocial and environmental causes of incontinence; (2) nursing care for the resident with urinary and/or bowel incontinence: (4) bowel and bladder training programs; and. (a) any payment of cash or transfer of other assets by a facility directly or indirectly to or for the benefit of its operator or owner; and. (5) The facility shall provide such secretarial, accounting, receptionist and other supportive personnel, and such office equipment and supplies, as are needed for satisfactory administration of the nursing home. (2) working with resident and family during admission/transfer/discharge; (4) sexual adjustments in relation to illness, physical handicaps and institutional living. By the end of March, all Aegis communities had hosted three rounds of vaccinations, with 95 percent of residents participating, mirroring a national trend of high resident uptake. Fiscal Year. An adult day health care program may be approved as a provider of specialized services for registrants with AIDS (acquired immune deficiency syndrome), and other human immunodeficiency virus (HIV) related illness. (c) explicit advice to potential residents of their right to nondiscriminatory treatment in admissions; (d) the training of admission personnel in the requirements of Federal and State anti-discrimination laws listed above; and. (b) the reassessment of the health status of all personnel as frequently as necessary, but no less than annually, to ensure that personnel are free from health impairments which pose a risk to residents or personnel which cannot be reasonably accommodated or which may interfere with the performance of duties; (c) that all personnel report immediately to their supervisor or the administrator any signs or symptoms of personal illness. Occupation therapy is provided by an occupational therapist that is a licensed rehabilitation care professional, which works to restore or improve physical abilities, promote behavioral changes, adapt surroundings, and teaches new skills; the goal is to have the individual achieve her or his best physical and/or mental functioning in daily life tasks. (b) Optional covered items and services. (b) any liability or contingent liability incurred within any period of 12 consecutive months by a facility or its operator by reason of a mortgage, lease, borrowing or other transaction relating to such facility that exceeds, in the aggregate, $25,000. Section 441.320 - Teaching program (approved), Section 441.321 - Teaching program (nonapproved), Part 442 - Reporting Principles And Concepts, Section 442.12 - Matching of revenue and expenses, Section 442.13 - Deductions from operating revenue, Section 442.15 - Long-term security investments, Section 442.18 - Accounting for property, plant and equipment, Section 442.23 - Debt financing for plant replacement and expansion purposes, Section 442.24 - Direct assignment of costs, Section 442.25 - Hospital research and education costs, Section 442.26 - In-service education--nursing, Section 442.27 - In-service education--nonnursing, Section 442.29 - Periodic interim payments, Section 443.2 - Functional and responsibility concepts, Section 443.4 - Listing of accounts--balance sheet, Section 443.5 - Listing of accounts--income statement, Section 443.6 - Small hospital reduced reporting requirements, Section 443.7 - Natural classification of revenue, Section 443.8 - Natural classification of expense, Section 444.2 - Unrestricted Fund assets, Section 444.4 - Unrestricted fund liabilities, Section 444.5 - Restricted fund liabilities, Section 444.8 - Operating revenue accounts--general, Section 444.9 - Operating revenue--daily hospital services, Section 444.10 - Operating revenue--ambulatory services, Section 444.11 - Operating revenue--ancillary services, Section 444.12 - Operating revenue--other operating revenue, Section 444.13 - Operating revenue--deductions from revenue, Section 444.14 - Patient revenue account descriptions, Section 444.15 - Other operating revenue account descriptions, Section 444.16 - Deductions from revenue account descriptions, Section 444.17 - Operating expenses--general, Section 444.18 - Daily hospital services expenses description, Section 444.19 - Ambulatory services expenses description, Section 444.20 - Ancillary services expenses description, Section 444.21 - Other operating expenses description, Section 444.22 - Non-operating revenue and expenses description, Section 444.23 - Natural classification of expense, Section 445.2 - Job titles by natural classification index, Section 445.3 - Supplies and services by natural expense classification index, Section 446.2 - Reclassification for reporting purposes, Section 446.3 - Reclassification for cost finding purposes, Section 446.4 - Alternative cost allocation bases--sequence of allocation, Section 446.5 - Recommended cost allocation bases--listing, Section 446.6 - Definitions and sources of statistics for Medicaid cost allocation, Section 446.7 - Description of other New York State supplemental data, Section 446.8 - Definitions and sources of statistics for Medicaid cost allocation, Section 446.9 - Expense detail reporting, Section 446.10 - Identification of supplemental data, Section 446.12 - Accommodation classification, Section 446.14 - Changes in certified bed capacity, Section 446.16 - Source of payment defined, Section 446.17 - Gross charges by source of payment, Section 446.18 - Patient days by source of payment, Section 446.19 - Discharges by source of payment, Section 446.20 - Ambulatory visits by source of payment, Section 446.21 - Direct admissions from emergency room, Section 446.22 - Inpatient care statistics by unit, Section 446.23 - Ambulatory care statistics, Section 446.25 - Home medical care program, Section 446.26 - Organized Drug Addiction Program, Section 446.27 - Organized alcoholic treatment program, Section 446.28 - Selected special service statistics, Section 446.30 - Cost allocation adjustments, Section 446.36 - Supplemental data for both upstate and downstate Blue Cross plans, Section 446.37 - Cost allocation adjustments, Section 446.38 - Funded depreciation calculation, Section 446.39 - Funded depreciation waiver, Section 446.41 - Hospital-based home health agencies, Section 446.44 - Program services for supplemental data, Part 447 - Standard Unit Of Measure References, Section 447.3 - Neurology--Diagnostic Services, Section 447.4 - Physical therapy services, Section 447.5 - Occupational Therapy Services, Section 448.1 - Specifications for cost reporting periods beginning in 1980, Title: Part 415 - Nursing Homes - Minimum Standards. (1) With regard to personnel management, the facility shall: (i) provide personnel in accordance with paragraph (2) of this subdivision, with a planned orientation to nursing home operation and resident care and such on-the-job training as is necessary for each properly to perform his or her individual job assignments: (ii) have on file and furnish each employee with a copy of written policies governing conditions of employment, including the job description for his or her position; (iii) assure that each part-time, full-time or private duty employee, consultant, volunteer, or other person serving in any other capacity in the nursing home shall: (a) receive an orientation which shall include but not be limited to the following: (1) a review and explanation of relevant personnel policies and procedures, including his or her job description; (2) an orientation to the facility's organization, its long-term care philosophy, the roles of all personnel in the organization; (3) an orientation to the physical plant, infection control, quality assessment and assurance and the environmental aspects of the facility; (4) the facility safety program, including fire safety, accident prevention, resident emergency procedures, and facility operation during disruption of services; (6) resident abuse and neglect reporting requirements as set forth in section 2803-d of the Public Health Law. In terms of income, patients pay a share of cost based on an income after deduction for health insurance premiums and other expenses. If it chooses to provide these items and services, they shall be included as covered Medicare or Medicaid services and reimbursed under those program benefits. Listed below are general categories and examples of items and services that the facility may charge to residents' funds if they are requested by a resident and payment is not made by Medicare or Medicaid: (3) Personal comfort items, including smoking materials, notions and novelties, and confections. 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. When COVID vaccines became available at year's end, Aegis enrolled in a federal program that brought on-site vaccinations to virtually all the country's nursing homes and assisted living facilities. (3) Upon receipt of such notice of criminal conviction involving misappropriation of property by a nurse aide and after the department has provided to the individual an opportunity to be heard to dispute the allegations and conviction resulting from misappropriation of resident property, the department shall, pursuant to Public Health Law Section 2803-d, as amended by Chapter 717 of the Laws of 1989, report such finding to the New York State RHCF Nurse Aide Registry established in accordance with Public Health Law, Section 2803-j, as amended by such chapter. Such laws include, but need not be limited to, the applicable provisions of this Part; Public Health Law, section 2801-a(9); the New York State Civil Rights Law, sections 40 and 40-c; article 15 (Human Rights Law) of the State Executive Law, sections 291, 292 and 296 and title 42 of the Unites States Code, sections 1981, 2000a, 2000a-2, 2000d, 3602, 3604 and 3607. Skilled nursing facilities (SNFs) and nursing facilities (NFs) are required to be in compliance with the requirements in 42 CFR Part 483, Subpart B, to receive payment under the Medicare or Medicaid programs. Additional health care personnel may supplement the instructor to provide specialized training provided that such supplemental trainers have at least one year of experience in their field of expertise. The governing body shall: (1) appoint an administrator who is eligible for such appointment and who functions in accordance with subdivision (a) of this section; (2) determine and establish written policies consistent with the stated purposes of the facility, the program of services provided, its physical structure and equipment, the number and qualifications of staff members, and their job classifications and descriptions; (3) be responsible for the operation of the facility; (4) be responsible for providing or arranging services for residents as required in this Subchapter; (5) employ or otherwise arrange for the services of such personnel as are required in this Subchapter; (6) assure that a method is implemented to promptly deal with complaints and recommendations made by residents or designated representatives which: (i) enables complaints and recommendations to be made orally or put in writing; (ii) brings complaints and recommendations promptly to the attention of the administration for review and resolution; (iii) responds to all residents or designated representatives as to action taken or the reason why no action was taken, as soon as possible and except under extraordinary circumstances such as health or administrative emergencies, within 21 days after the complaint or recommendation was made; and. The medical staff shall develop and implement policies regarding positive findings, including procedures for facilitating and documenting treatment for latent TB infection where indicated. Nursing homes shall have in effect a written transfer agreement with one or more general hospitals as required to meet the medical care needs of residents. (i) The residential health care facility nurse aide training program shall be reviewed and approved by the Department prior to implementation as to the requirements contained in this section. (1) No nursing home shall operate unless it is under the supervision of an administrator who holds a currently valid nursing home administrator's license and registration, or temporary license, issued pursuant to Article 28-D of the Public Health Law. (i) train all employees in emergency procedures when they begin to work for the facility; (ii) periodically, but at least annually review the written plan with existing staff; and. (iii) The governing body shall designate in writing a staff member to serve as alternate administrator for all hours that the administrator of record is absent from duty to ensure that all shifts, 24 hours-a-day, 7 days-a-week are covered by administrative supervision. Published: May 2021. (1) The facility shall: (i) specify its refund policies in writing to each resident, next of kin and/or sponsor prior to admission; and. It is important to realize that people living in nursing homes may not be able to evacuate because of mobility or other disabilities. (a) Services included in Medicare or Medicaid payment. The nursing home shall require the following of all personnel as a condition of employment or affiliation: (1) for all personnel prior to employment or affiliation, except for personnel with no clinical or patient contact responsibilities who are located in a building or site with no patient care services, an initial individual tuberculosis (TB) risk assessment, symptom evaluation, and TB test (either tuberculin skin test or Food and Drug Administration (FDA) approved blood assay for the detection of latent tuberculosis infection), and annual assessments thereafter. A facility may choose to provide residents with supplies, equipment and transportation essential to the activities program required by 415.5(g) of this Title. A state-by-state analysis of training requirements for home health aides in regards to the federally-required minimum of 75 hours. (8) No facility shall enter into a real property mortgage or lease transaction without 30 days' prior notice in writing to the commissioner. As a minimum, the performance record shall include the following: (a) a listing of the measurable performance criteria for each duty and skill expected to be learned in the program; (b) an entry showing satisfactory or unsatisfactory performance; (d) the name of the instructor supervising the performance. 04/09/1997. (2) The nursing home shall develop and implement written policies concerning missing residents. The facility shall not impose a charge against the personal funds of a resident for any item or service for which payment is made under Medicaid or Medicare (except for applicable deductible and coinsurance amounts). (9) Social events and entertainment offered off the premises and outside the scope of the activities program, provided under subdivision (g) of section 415.5. (r) Care of cognitively impaired residents: (1) techniques for addressing the unique needs and behaviors of individuals with dementia; (2) communicating with cognitively impaired residents; (3) understanding the behaviors of cognitively impaired residents; (4) appropriate responses to the behaviors of cognitively impaired residents; and. This person shall have the day to day responsibility for implementing the facility's training program in accordance with the facility's policies and procedures and State and federal requirements. The goal of scheduled short term care is to provide relief for the caregiver(s) while providing nursing home care for the individual. CMS COVID-19 Reporting Requirements for Nursing Homes - June 2021 [PDF - 300 KB] CMS Press Release: CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 [PDF - 400 KB] CDC and CMS Issue Joint Reminder on NHSN Reporting. (o) Mental health and social service needs: (1) self care according to the resident's capabilities; (2) modifying behavior in response to the behavior of others; (3) developmental tasks associated with the aging process; and. (ii) Negative net worth shall be calculated without regard to any surplus created by reevaluation of assets. The stark reality in 21st-century America is that child abuse is reported to authorities every ten seconds.During the time they are being trafficked, 30-88% of survivors of human trafficking see a healthcare provider. They must work under the supervision of a licensed occupational therapist or a licensed physician to assist in providing occupational therapy services. During the course of a covered Medicare or Medicaid stay, the facilities shall not charge a resident for the following items and services: (1) nursing services and specialized rehabilitative services; (5) routine personal hygiene items and services. The resident may be completely unresponsive to any stimuli or may exhibit a generalized response by reacting inconsistently and non-purposefully to stimuli in a nonspecific manner. (3) any investigations or other problems brought to the attention of the Commissioner. Such reimbursement shall be on a pro rata basis based on the length of subsequent employment as an RHCF nurse aide in the RHCF. Terminal illness is defined as a medical life expectancy of six months or less if the illness runs its normal course. (ii) prepare food for consumption off-site as part of a nutrition program or make available service of meals, nutrition education, and nutrition counseling for nonresidents on-site; (13) notify the department immediately of anticipated or actual termination of any service vital to the continued safe operation of the facility or to the health and safety of its residents and personnel, including but not limited to the anticipated or actual termination of telephone, electric, gas, fuel, water, heat, air conditioning, rodent or pest control, contract food, or contract laundry services, and the services of key full- or part-time personnel such as the administrator, director of nurses, consultant physician, consultant dietitian or others; and apply remedial measures promptly and notify the department immediately regarding the nature of results of such measures; (14) transfer residents to another appropriate facility only after consultation, as appropriate, with the resident, his or her physician, and designated representative except in an emergency situation, in which case the operator shall notify the physician and designated representative immediately and record the reason for the transfer; and. 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