Current through Register Vol. 46, No. 51, December 18, 2024
Section 415.1 - Basis and scope(a) Statement of purpose. (1) New York's residential health care facilities are responsible for the health and well-being of more than 100,000 residents ranging from infants with multiple impairments to young adults suffering from the sequelae of traumatic brain injury to the frail elderly with chronic disabilities. For the vast majority of residents, the residential health care facility is their last home. A license to operate a nursing home carries with it a special obligation to the residents who depend upon the facility to meet every basic human need.(2) Each resident comes to the nursing home with unique life experiences, values, attitudes and desires, and a singular combination of clinical and psychological needs. In order to assure the highest practicable quality of life, the individuality of the nursing home resident must be recognized, and the exercise of self-determination protected and promoted, by the operator and staff of the facility. The physical environment, care policies and staff behavior must at once acknowledge the dependence of the residents while fostering their highest possible level of independence.(3) In writing a code of minimum operating standards for nursing homes, it is also critical that the regulator recognize the infinite diversity of the nursing home population. A code intended to assure the highest possible quality of care and most meaningful quality of life for all residents must not only accept, but in fact invite variety in nursing home environments, policies and practices, and encourage creativity among nursing home managers and staff.(4) In order to meet obligations to nursing home residents, this set of requirements, to the extent possible, expresses expectations for facility operation in terms of performance and outcomes rather than by dictating structure and process. It is the intent of these requirements to grant a high degree of latitude and flexibility to administrators and staff while insisting upon conformance to fundamental principles of individual rights and to accepted professional standards. In those areas where a detailed process or procedure is mandated, it is based upon a firm belief that experience has proven the specific practice to be necessary in all cases to assure the high quality of care we expect nursing homes to provide.(5) In addition to the emphasis on individuality and self-determination, the code reflects certain precepts: that nursing homes should be viewed as homes as much as medical institutions, with the resident's psychosocial needs deserving a prominence at least equal to medical condition; that clinical interventions for the nursing home resident must be part of a comprehensive approach planned and provided by an interdisciplinary care team, with the participation of the resident, rather than through a physician-directed acute care orientation; and that quality assurance is a work ethic rather than an oversight method or a department.(b) General information. (1) Nursing homes, which shall include all facilities subject to article 28 of the Public Health Law and providing residential skilled nursing care and services and residential health-related care and services, shall provide such care and services in a manner and quality consistent with generally accepted standards of practice.(2) In accordance with article 28 of the Public Health Law, nursing homes, as defined in section 415.2 of this Part, and which include facilities referred to elsewhere in this Title as skilled nursing facilities, health-related facilities or residential health care facilities, shall comply with all the requirements of this Part.(3) Nursing homes shall comply with construction standards contained in Article 2 of Subchapter C of this Chapter (Medical Facility Construction).(4) Nursing homes shall comply with all pertinent Federal, State and local laws, regulations, codes, standards and principles including but not limited to those pertaining to nondiscrimination on the basis of race, color, national origin, handicap, protection of human subjects of research and fraud and abuse and the Public Health Law, Mental Hygiene Law, Social Services Law and Education Law of the State of New York.(5) The provisions of Parts 700 and 702, of Article 1 of Subchapter C of this Chapter shall not apply to nursing homes.N.Y. Comp. Codes R. & Regs. Tit. 10 § 415.1