| (ii) The medical director or clinical director shall
be qualified by training or at least two years training and experience
to serve as medical director or clinical director. A person is qualified
under this subsection if the person has training and experience in
the treatment of rehabilitation patients in a rehabilitation setting.
(6) Admission criteria. A hospital providing comprehensive
medical rehabilitation services shall have written admission criteria
that are applied uniformly to all patients who are admitted to the
comprehensive medical rehabilitation unit.
(A) The hospital's admission criteria shall include
procedures to prevent the admission of a minor for a condition which
is not generally recognized as responsive to treatment in an inpatient
setting for comprehensive medical rehabilitation services.
(i) The following conditions are not generally recognized
as responsive to treatment in an inpatient setting for comprehensive
medical rehabilitation services unless the minor to be admitted is
qualified because of other disabilities, such as:
(I) cognitive disabilities due to intellectual disability;
(II) learning disabilities; or
(III) psychiatric disorders.
(ii) A minor may be qualified for admission based on
other disabilities which would be responsive to comprehensive medical
rehabilitation services.
(B) The hospital shall have a preadmission examination
procedure under which each patient's condition and medical history
are reviewed by a member of the medical staff to determine whether
the patient is likely to benefit significantly from an intensive inpatient
program or assessment.
(7) Care and services.
(A) A hospital providing comprehensive medical rehabilitation
services shall use a coordinated interdisciplinary team which is directed
by a physician and which works in collaboration to develop and implement
the patient's treatment plan.
(i) The interdisciplinary team for comprehensive medical
rehabilitation services shall have available to it, at the hospital
at which the services are provided or by contract, members of the
following professions as necessary to meet the treatment needs of
the patient:
(I) physical therapy;
(II) occupational therapy;
(III) speech-language pathology;
(IV) therapeutic recreation;
(V) social services and case management;
(VI) dietetics;
(VII) psychology;
(VIII) respiratory therapy;
(IX) rehabilitative nursing;
(X) certified orthotics;
(XI) certified prosthetics;
(XII) pharmaceutical care; and
(XIII) in the case of a minor patient, persons who
have specialized education and training in emotional, mental health,
or chemical dependency problems, as well as the treatment of minors.
(ii) The coordinated interdisciplinary team approach
used in the rehabilitation of each patient shall be documented by
periodic entries made in the patient's medical record to denote:
(I) the patient's status in relationship to goal attainment;
and
(II) that team conferences are held at least every
two weeks to determine the appropriateness of treatment.
(B) An initial assessment and preliminary treatment
plan shall be performed or established by the physician within 24
hours of admission.
(C) The physician in coordination with the interdisciplinary
team shall establish a written treatment plan for the patient within
seven working days of the date of admission.
(i) Comprehensive medical rehabilitation services shall
be provided in accordance with the written treatment plan.
(ii) The treatment provided under the written treatment
plan shall be provided by staff who are qualified to provide services
under state law. The hospital shall establish written qualifications
for services provided by each discipline for which there is no applicable
state statute for professional licensure or certification.
(iii) Services provided under the written treatment
plan shall be given in accordance with the orders of physicians, dentists,
podiatrists, or practitioners who are authorized by the governing
body, hospital administration, and medical staff to order the services,
and the orders shall be incorporated in the patient's record.
(iv) The written treatment plan shall delineate anticipated
goals and specify the type, amount, frequency, and anticipated duration
of service to be provided.
(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 before 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) Before 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;
Cont'd... |
