New Mexico Administrative Code

A. "Administrative law judge (ALJ)" means the HSD fair hearings bureau's (FHB) appointed judge to oversee the claimant's administrative hearing process and render a recommendation to the medical assistance division (MAD) director. B. "Adverse action": means:(1) the belief of a cl…

The objective of this rule is to provide instruction for the service portion of the New Mexico medical assistance programs.

HSD has established a hearing process for a MAP eligible recipient or a MCO member who is adversely affected by the preadmission screening and annual resident review (PASRR) or the transfer or discharge from a NF as required by Section 1919(e)(7) of the Social Security Act. A. Cl…

New Mexico Health Care Authority.

A. The authority will conduct incident investigations of community-based service providers subject to these requirements. These investigations may be either announced or unannounced. B. All community-based service providers programs shall facilitate immediate physical or in-perso…

A. The authority may sanction a community-based service provider in accordance with applicable law if the community-based service provider fails to report incidents of abuse, neglect, exploitation, suspicious injury, or any death; fails to provide or maintain evidence of an exist…

The division will inform the provider, the guardian, or alleged victim, the case manager or consultant, the developmental disabilities supports division regional office, and the reporter of the conclusion reached by the investigator(s) when the report is final. The responsible pr…

A. An aggrieved person or provider agency may request an informal reconsideration of findings (IRF) of a decision made by the division regarding a substantiation of abuse, neglect, or exploitation in accordance with the provisions set forth in this section. B. A request for an IR…

A. In the case of substantiated cases of abuse, neglect, or exploitation, the written report may be shared publicly upon request and subject to all other applicable federal and state laws and regulations. Unsubstantiated incident investigation reports shall not be shared publicly…

If any provision or application of 8.370.10NMAC is held invalid, the remainder, or its application to other situations or persons, shall not be affected.

This rule is applicable to persons, organizations or legal entities receiving developmental disability waiver funds and developmental disability medically fragile waiver funds acting as community-based service providers as defined in this rule.

Subsection E of Section 9-8-6, NMSA 1978, Subsection D of Section 24-1-2, Subsections I, L, O, T and U of Sections 24-1-3 and 24-1-5 NMSA 1978 of the Public Health Act as amended. Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (authority) as a single, unifi…

Permanent.

July 1, 2024, unless a later date is cited at the end of a section.

This rule establishes standards for community-based service providers to institute and maintain an incident management system and employee and volunteer training programs for the reporting of abuse, neglect, exploitation, suspicious injuries, environmentally hazardous conditions …

A. "Abuse" including verbal abuse, means: (1) knowingly, intentionally, and without justifiable cause inflicting physical pain, injury or mental anguish; (2) the intentional deprivation by a caretaker or other person of services necessary to maintain the mental and physical healt…

A. Duty to report: (1) All community-based providers shall immediately report alleged crimes to law enforcement or call for emergency medical services as appropriate to ensure the safety of consumers. (2) All community-based service providers, their employees and volunteers shall…

A. General: All community-based service providers shall establish and maintain an incident management system, which emphasizes the principles of prevention and staff involvement. The community-based service provider shall ensure that the incident management system policies and pr…

New Mexico Health Care Authority.

If any part or application of the long-term care facility dementia training regulation is held invalid, the remainder or its application to other situations or persons shall not be affected.

These regulations apply to any long-term care facility and long-term care facility contractor in the state of New Mexico or licensed by the New Mexico health care authority, division of health improvement.

The regulations set forth herein are promulgated by the secretary of the health care authority by authority of Subsection E of Section 9-8-6 NMSA 1978, Section 24-17B-1 through Section 24-17B-4 NMSA 1978. The division of health improvement of the health care authority (authority)…

Permanent.

July 1, 2024, unless a later date is cited at the end of a section.

The regulations establish policy, standards, and criteria relating to: the educational and certification requirements, issuing of certifications, and continuing education of persons who provide direct care service to long-term care facility residents in order to maintain or impro…

A. "Act" shall mean the Long-Term Care Facility Dementia Training Act Section 24-17B-1, et seq NMSA 1978. B. "Certificate" shall mean the training certificate issued by the provider of training pursuant to 8.370.11 NMAC and the Long-Term Care Facility Dementia Training Act Sectio…

A. Every direct care service staff member shall complete the requirements for and obtain certification as provided in 8.370.11.9 NMAC. B. Every direct care service staff member is required to complete the training and written examination set forth in 8.370.11.9 NMAC pursuant to t…

New Mexico requires a state training education process to become a certified direct care staff member. The education program shall provide knowledge on the skills and abilities necessary to perform as a competent direct care service staff member; this is established through train…

New Mexico Health Care Authority.

A. The licensee must submit a renewal application on forms provided by the licensing authority, along with the required fee prior to the expiration of the current license. B. Upon receipt of the renewal application and the required fee prior to expiration of current license, the …

The license, or a copy thereof, shall be conspicuously posted in a location accessible to public view within the hospital.

A license shall not be transferred by assignment or otherwise to other persons or locations. The license shall be void and must be returned to the licensing authority when any one of the following situations occur: A. ownership of the hospital changes; B. the facility changes loc…

A license will expire at midnight on the day indicated on the license as the expiration date, unless sooner renewed, suspended, or revoked, or: A. on the day a facility discontinues operation; or B. on the day a facility is sold, leased, or otherwise changes ownership or licensee…

In accordance with Subsection H of Section 24-1-5 NMSA 1978, if the licensing authority determines immediate action is required to protect human health and safety, the licensing authority may suspend a license. A hearing must be held in accordance with the regulations governing a…

A license may be denied, revoked or suspended, or intermediate sanctions or civil monetary penalties may be imposed after notice and opportunity for a hearing for any of the following reasons: A. failure to comply with any provisions of these requirements; B. failure to allow sur…

A. An applicant or licensee subject to an adverse action may request an administrative appeal. B. Hearing procedures for an administrative appeal of an adverse action taken by the licensing authority against the hospital as outlined in Section 14 and 15 above will be held in acco…

A. Applications. All applications for the grant of a waiver or variance shall be made in writing to the licensing authority, specifying the following: (1) the rule from which the waiver or variance is requested; (2) the time period for which the waiver or variance is requested; (…

A. General requirements: The hospital shall have an effective governing body, which is legally responsible for the management and provision of all hospital services, maintenance of the hospital services and the quality thereof. B. Responsibilities. by-laws: The governing body sha…

Every hospital shall have written policies approved by the governing board and shall include provisions for implementation, and for access by the patient, on: A. Patient rights and responsibilities: a list of these patient rights and responsibilities shall be available in languag…

These requirements apply to public and private hospitals as defined in Section 8.370.12.7 of these requirements. Facilities that are specifically exempt under Subsection D of Section 24-1-2, NMSA 1978, from being treated as hospitals for purposes of regulation under Section 24-1-…

A. Appointment: The hospital shall be directed by a chief executive officer/administrator. The chief executive officer/administrator shall be appointed by the governing body, shall be responsible for the management of the hospital and shall provide liaison among the governing bod…

The hospital shall have an employee health program under the direction of a physician, an authorized licensed independent practitioner or professional registered nurse, which shall include. A. Post hiring health screen: A post hiring health screening shall be required for all emp…

A. Program. The hospital shall have an infection control program designed to reduce the number of infections, including nosocomial infections, within the hospital. B. Program approval: (1) Purpose: The governing body or medical staff shall approve an infection control program to …

A. Responsibility of the governing body: The governing body shall ensure that the hospital has a written quality improvement program for monitoring, evaluating and improving the quality of patient care and the ancillary services in the hospital on an on-going basis. The program s…

A. Plan: Every hospital shall have in operation a written utilization management plan designed to ensure that quality patient care is provided in the most appropriate manner. The plan should address potential over and under utilization as well as the efficient use of resources fo…

A. Plan: Each hospital shall have in operation a written plan for disaster and emergency management developed with the involvement of the hospital's executive, medical, and nursing staff and designed to ensure that each hospital is prepared to provide effective and efficient resp…

A. General requirements: (1) Organization and Accountability: The hospital shall have a medical staff organized under by-laws approved by the governing body. The medical staff shall be responsible to the governing body of the hospital for the quality of all medical care provided …

A. Requirement: The hospital shall provide a 24-hour nursing service, supervised by a professional registered nurse, and have a licensed practical nurse or professional registered nurse on duty at all times. B. Administration: (1) The nursing services shall be directed by a profe…

The hospital shall provide a 24-hour dietary service or contract for a 24-hour dietary services which meets the requirements of this section, and which shall provide meals and other nutritional care to its patients. The dietary service shall be integrated with other services of t…

A. Organization: (1) Pharmacy: The hospital pharmacy including pharmaceuticals contained in disaster and emergency caches held by the hospital, shall be supervised by a designated pharmacist-in-charge who is employed part-time or full-time. If employed part-time, the pharmacist s…