La. Admin. Code tit. 48 § I-7523

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-7523 - Procedural Standards

A. The following processes are required for RHCs in Louisiana:

1. Access to Care. Rural health clinics shall:

a. be in compliance with R.S. 40:2007 if the RHC is located within another health care provider;

b. be located away from metropolitan areas;

c. provide services to all citizens of the community across all life cycles;

d. provide service delivery to accommodate the majority of residents of the community; and

e. provide professional coverage as required by §7517 and §7519 C

2. Patient Assessment. Documentation of an assessment shall include:

a. comprehensive scope of information with updates as indicated by changes in the patient's status;

b. physical examination and medical history, that identifies the patient's condition and care needs, and an estimate of his/her continuing care needs;

c. indicators that identify the need for further assessment/treatment such as the signs/symptoms of substance abuse, which requires a substance abuse assessment be included as part of the mental status evaluation; and

d. pertinent and comprehensive information relative to the reason for the encounter.

3. Care Planning. The plan of care shall be based upon the needs documented in the assessment and may be generic if original assessment and physical examination indicates the patient is generally healthy. The plan of care shall be modified to reflect any changes in the patient's condition.

4. Continuity of Care. The clinic staff shall:

a. provide orderly and efficient transition between levels of care without duplication or disruption of services;

b. provide post-hospitalization care based on the hospital's discharge assessment, possibly a Uniform Needs Assessment Instrument (UNAI), but includes at least a description of the patient's functional status, nursing and/or other care requirements, and the availability of family/care givers;

c. update comprehensive care plan as indicated and provide clinic services as indicated in the plan of care;

d. coordinate care and treatment interventions by all relevant disciplines;

e. evaluate progress and adjust actual care as needed to achieve progress.

5. Infection Control. A facility shall maintain and implement written and dated effective infection control policies and procedures that protect the patients and staff from infections and communicable diseases.

6. Information Management. A facility shall maintain a record keeping system to communicate and measure clinic performance to assure that patient needs are documented and met. This system shall include accurate documentation of a patient visit for quality assessment and performance improvement purposes. The facility shall ensure the integrity, effectiveness, confidentiality, and security of the facility's data system.

7. Clinical Protocols. Written clinical protocols shall be established between mid-level practitioner(s) and the physician and the treatment(s) of choice shall be easy to identify.

8. The facility must have a grievance process and must indicate who the patient can contact to express a grievance. Records of all grievances, steps taken to investigate, and results of interventions must be available to surveyors upon request.

La. Admin. Code tit. 48, § I-7523

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 25:1846 (October 1999), amended LR 28:510 (March 2002), Amended by the Department of Health, Health Standards Section, LR 501280 (9/1/2024).

AUTHORITY NOTE: Promulgated in accordance with R.S. 46:153 and R.S. 40:2197.