| (v) Within 10 working days after the date of admission,
the written treatment plan shall be provided. It shall be in the person's
primary language, if practicable. What is or would have been practicable
shall be determined by the facts and circumstances of each case. The
written treatment plan shall be provided to:
(I) the patient;
(II) a person designated by the patient; and
(III) upon request, a family member, guardian, or individual
who has demonstrated on a routine basis responsibility and participation
in the patient's care or treatment, but only with the patient's consent
unless such consent is not required by law.
(vi) The written treatment plan shall be reviewed by
the interdisciplinary team at least every two weeks.
(vii) The written treatment plan shall be revised by
the interdisciplinary team if a comprehensive reassessment of the
patient's status or the results of a patient case review conference
indicates the need for revision.
(viii) The revision shall be incorporated into the
patient's record within seven working days after the revision.
(ix) The revised treatment plan shall be reduced to
writing in the person's primary language, if practicable, and provided
to:
(I) the patient;
(II) a person designated by the patient; and
(III) upon request, a family member, guardian, or individual
who has demonstrated on a routine basis responsibility and participation
in the patient's care or treatment, but only with the patient's consent
unless such consent is not required by law.
(8) Discharge and continuing care plan. The patient's
interdisciplinary team shall prepare a written continuing care plan
that addresses the patient's needs for care after discharge.
(A) The continuing care plan for the patient shall
include recommendations for treatment and care and information about
the availability of resources for treatment or care.
(B) If the patient's interdisciplinary team deems it
impracticable to provide a written continuing care plan prior to discharge,
the patient's interdisciplinary team shall provide the written continuing
care plan to the patient within two working days after the date of
discharge.
(C) Prior to discharge or within two working days after
the date of discharge, the written continuing care plan shall be provided
in the person's primary language, if practicable, to:
(i) the patient;
(ii) a person designated by the patient; and
(iii) upon request, to a family member, guardian, or
individual who has demonstrated on a routine basis responsibility
and participation in the patient's care or treatment, but only with
the patient's consent unless such consent is not required by law.
(d) Dietary services. The hospital shall have organized
dietary services that are directed and staffed by adequate qualified
personnel. However, a hospital that has a contract with an outside
food management company or an arrangement with another hospital may
meet this requirement if the company or other hospital has a dietitian
who serves the hospital on a full-time, part-time, or consultant basis,
and if the company or other hospital maintains at least the minimum
requirements specified in this section, and provides for the frequent
and systematic liaison with the hospital medical staff for recommendations
of dietetic policies affecting patient treatment. The hospital shall
ensure that there are sufficient personnel to respond to the dietary
needs of the patient population being served.
(1) Organization.
(A) The hospital shall have a full-time employee who
is qualified by experience or training to serve as director of the
food and dietetic service, and be responsible for the daily management
of the dietary services.
(B) There shall be a qualified dietitian who works
full-time, part-time, or on a consultant basis. If by consultation,
such services shall occur at least once per month for not less than
eight hours. The dietitian shall:
(i) be currently licensed under the laws of this state
to use the titles of licensed dietitian or provisional licensed dietitian,
or be a registered dietitian;
(ii) maintain standards for professional practice;
(iii) supervise the nutritional aspects of patient
care;
(iv) make an assessment of the nutritional status and
adequacy of nutritional regimen, as appropriate;
(v) provide diet counseling and teaching, as appropriate;
(vi) document nutritional status and pertinent information
in patient medical records, as appropriate;
(vii) approve menus; and
(viii) approve menu substitutions.
(C) There shall be administrative and technical personnel
competent in their respective duties. The administrative and technical
personnel shall:
(i) participate in established departmental or hospital
training pertinent to assigned duties;
(ii) conform to food handling techniques in accordance
with paragraph (2)(E)(viii) of this subsection;
(iii) adhere to clearly defined work schedules and
assignment sheets; and
(iv) comply with position descriptions which are job
specific.
(2) Director. The director shall:
(A) comply with a position description which is job
specific;
(B) clearly delineate responsibility and authority;
(C) participate in conferences with administration
and department heads;
(D) establish, implement, and enforce policies and
procedures for the overall operational components of the department
to include, but not be limited to:
(i) quality assessment and performance improvement
program;
(ii) frequency of meals served;
(iii) nonroutine occurrences; and
(iv) identification of patient trays; and
(E) maintain authority and responsibility for the following,
but not be limited to:
(i) orientation and training;
(ii) performance evaluations;
(iii) work assignments;
(iv) supervision of work and food handling techniques;
(v) procurement of food, paper, chemical, and other
supplies, to include implementation of first-in first-out rotation
system for all food items;
(vi) ensuring there is a four-day food supply on hand
at all times;
(vii) menu planning; and
(viii) ensuring compliance with Chapter 228 of this
title (relating to Retail Food).
(3) Diets. Menus shall meet the needs of the patients.
(A) Therapeutic diets shall be prescribed by the physician(s)
responsible for the care of the patients. The dietary department of
the hospital shall:
(i) establish procedures for the processing of therapeutic
diets to include, but not be limited to:
(I) accurate patient identification;
(II) transcription from nursing to dietary services;
(III) diet planning by a dietitian;
(IV) regular review and updating of diet when necessary;
and
(V) written and verbal instruction to patient and family.
It shall be in the patient's primary language, if practicable, prior
to discharge. What is or would have been practicable shall be determined
by the facts and circumstances of each case;
(ii) ensure that therapeutic diets are planned in writing
by a qualified dietitian;
(iii) ensure that menu substitutions are approved by
a qualified dietitian;
(iv) document pertinent information about the patient's
response to a therapeutic diet in the medical record; and
(v) evaluate therapeutic diets for nutritional adequacy.
(B) Nutritional needs shall be met in accordance with
recognized dietary practices and in accordance with orders of the
physician(s) or appropriately credentialed practitioner(s) responsible
for the care of the patients. The following requirements shall be
met.
(i) Menus shall provide a sufficient variety of foods
served in adequate amounts at each meal according to the guidance
provided in the Recommended Dietary Allowances (RDA), as published
by the Food and Nutrition Board, Commission on Life Sciences, National
Research Council, Tenth edition, 1989, which may be obtained by writing
the National Academies Press, 500 Fifth Street, NW Lockbox 285, Washington,
D.C. 20055, telephone (888) 624-8373.
Cont'd... |
