Section 11-89-14 - Resident health and safety standards(a) The caregiver shall, in coordination with the case manager, arrange for resident access to medical services at all times, including emergency services. The facility shall have a written policy which specifies the procedures to be followed in medical emergencies.
(b) Basic first aid supplies and equipment shall be available at the facility.(c) In the event of an emergency concerning a resident such as hospitalization, serious illness, serious bodily harm or injury, or imminent death or death, the caregiver shall inform the case manager, who in turn, shall promptly notify the resident's next of kin, guardian or significant others. The wishes of the resident and the parent or guardian regarding religious matters shall be considered, and the resident's wishes shall be followed as closely as possible. (1) Staff observing an emergency shall complete a written incident report within twenty-four hours of the emergency and shall submit it to the case manager within seventy-two hours.(2) In cases of known or suspected neglect or abuse, the staff person aware of the situation shall notify the adult protective services (APS) which is mandated to have the authority to investigate such incidents, and/or for elderly persons at least sixty-five years of age, follow procedures as outlined in chapter 349C, HRS.(d) The caregiver shall develop an emergency evacuation plan to ensure rapid evacuation of the facility in the event of fire or other life-threatening situations. The plan shall be posted and shall include a provision for evacuation drills as follows: (1) Evacuation drills shall be held at least monthly and at varied times during the twenty-four hour period. Instruction in the evacuation procedures shall be given to each new resident upon admission to the facility.(2) A written record of each drill shall be kept on file.(3) Each resident of the facility shall be certified annually by a physician that the resident is capable of self-preservation. A maximum of two residents not so certified may reside in the facility provided that a staff ratio of one-to-one is maintained, at all times, for each of these residents and there are no stairways which must be negotiated by such noncertified residents. As an alternative, the facility shall install an automatic sprinkler system, as defined in the national fire protection association's 101 life safety code.(e) Medications: (1) All medicines shall be properly and clearly labeled. The storage shall be in a staff-controlled workcabinet/workcounter apart from either residents' bathrooms or bedrooms.(2) Drugs shall be stored under proper conditions of sanitation, temperature, light, moisture, ventilation, segregation, and security. Medications that require storage in a refrigerator shall be properly labeled and kept in a separate locked container.(3) Compartments shall be provided, for each resident's medications and separated as to: (A) External use only; and(4) All poisons shall be plainly labeled and stored separately in a locked' cabinet.(5) All medications and supplements, such as vitamins, minerals, and formulas shall be made available by written physician order and shall be based upon current evaluation of the resident's condition.(6) All physician orders shall be reevaluated and signed by the physician every three months or at the next physician's visit, whichever comes first.(7) All verbal orders for medication shall be recorded on the physician's order sheet by the certified caregiver receiving the verbal orders. Written confirmation from the attending physician shall be obtained within seventy-two hours.(8) Only an appropriately trained caregiver shall be allowed to make available prescribed medications to residents.(9) Medications shall not be offered to any resident other than the one for whom they were ordered.(10) Medication errors and drug reactions shall be reported immediately to the physician responsible for the medical care of the resident and the case manager. An incident report shall be prepared within twenty-four hours from the time of the incident and shall be properly documented in the resident's record.(11) Discontinued or outdated medications shall be disposed of by flushing down the toilet.(12) All medications and supplements, such as vitamins, minerals, and formulas, shall have written physician's orders and shall be labeled according to pharmaceutical practices for prescribed items. When taken by the resident, the date, time, name of drug, and dosage shall be recorded on the resident's medication record and initialed by the certified caregiver.(13) Only oral, suppository and topical medications shall be made available to the resident for administration or application. Any injections or intravenous medication shall be administered by a licensed nurse.[Eff FEB 03 1992] (Auth: HRS §§ 321-9, 321-11, 321-15.9) (Imp: HRS § 321-15.9)