3917.1Skilled nursing services shall be provided by a registered nurse, or by a licensed practical nurse under the supervision of a registered nurse, and in accordance with the patient's plan of care.
3917.2Duties of the nurse shall include, at a minimum, the following:
(a) Initial assessment and evaluation;(b) Coordination of care and referrals;(c) Ensuring that patient needs are met in accordance with the plan of care;(d) Implementing preventive and rehabilitative nursing procedures;(e) For registered nurses, supervision of nursing services delivered by licensed practical nurses, including on-site supervision at least once every sixty-two (62) calendar days;(f) Supervision of services delivered by home health and personal care aides and household support staff, as appropriate;(g) Recording progress notes at least once every thirty (30) calendar days and summary notes at least once every sixty-two (62) calendar days;(h) Reporting changes in the patient's condition to the patient's physician;(i) Patient instruction, and evaluation of patient instruction; and3917.3Except as described further in this subsection, wound care and tube feeding shall be provided only by a registered nurse or by a licensed practical nurse. Simple wound care and gastrostomy tube feeding may be provided by a home health aide or personal care aide, provided that the aide receives adequate training prior to performing the service and provided that the service is monitored continuously, with on-site supervision by a licensed nurse at least every two (2) weeks.
D.C. Mun. Regs. tit. 22, r. 22-B3917
Final Rulemaking published at 51 DCR 2876 (March 19, 2004)