Chapter 10A NCAC 13B

subchapter 13b – licensing of hospitals 10a ncac 13B .0100 reserved for future codification

Section .0200 – reserved for future codification 10A NCAC 13B .0200 Reserved for future codification

section .0300 – reserved for future codification 10A NCAC 13B .0300 Reserved for future codification

section .0400 – reserved for future codification 10A NCAC 13B .0400 Reserved for future codification

section .0500 – reserved for future codification 10A NCAC 13B .0500 Reserved for future codification

section .0600 – reserved for future codification 10A NCAC 13B .0600 Reserved for future codification

section .0700 – reserved for future codification 10A NCAC 13B .0700 Reserved for future codification

section .0800 – reserved for future codification 10A NCAC 13B .0800 Reserved for future codification

section .0900 – reserved for future codification 10A NCAC 13B .0900 Reserved for future codification

section .1000 – reserved for future codification 10A NCAC 13B .1000 Reserved for future codification

section .1100 – reserved for future codification 10A NCAC 13B .1100 Reserved for future codification

section .1200 – reserved for future codification 10A NCAC 13B .1200 Reserved for future codification

section .1300 – reserved for future codification 10A NCAC 13B .1300 Reserved for future codification

section .1400 – reserved for future codification 10A NCAC 13B .1400 Reserved for future codification

section .1500 – reserved for future codification 10A NCAC 13B .1500 Reserved for future codification

section .1600 – reserved for future codification 10A NCAC 13B .1600 Reserved for future codification

section .1700 – reserved for future codification 10A NCAC 13B .1700 Reserved for future codification

section .1800 – reserved for future codification 10A NCAC 13B .1800 Reserved for future codification

SECTION .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: adult care home BEDS IN A HOSPITAL 10A NCAC 13b .1901 SUPPLEMENTAL RULES When a hospital offers nursing facility or adult care home long-term care services, the services shall be included under one…

10A NCAC 13b .1902 DEFINITIONS The following definitions shall apply throughout this Section, unless text otherwise indicates to the contrary: (1) "Accident" means something occurring by chance or without intention that has caused physical or mental harm to a patient, resident, o…

10A NCAC 13B .1903 INSPECTIONS (a) Any hospital with beds licensed by the Department under Section .1900 of these Rules may be inspected by one or more authorized representatives of the Department at any time. Generally, inspections will be conducted between the hours of 8:00 a.m…

10A NCAC 13B .1904 PROCEDURE FOR APPEAL A hospital with nursing facility or adult care home beds may appeal any decision of the Department to deny, revoke or alter a license by making such an appeal in accordance with G.S. Chapter 150B. History Note: Authority G.S. 131E-79; 42 U.…

10A NCAC 13B .1905 ADMISSIONS (a) No patient shall be admitted except under the orders of a duly licensed physician. (b) The facility shall acquire prior to or at the time of admission orders from the attending physician for the immediate care of the patient or resident. (c) With…

10A NCAC 13B .1906 POLICIES AND PROCEDURES The governing board shall assure written policies and procedures which are available to and implemented by staff. These policies and procedures shall cover at least the following areas: (1) admissions; (2) dietary; (3) discharges with ph…

10A NCAC 13B .1907 GENERAL The governing board shall assure that policies and procedures are available and implemented for assessing each patient's or resident's health care needs and planning for meeting identified health care needs. There shall be a system for evaluating the ef…

10A NCAC 13B .1908 FREQUENCY: METHOD AND CONTENT OF ASSESSMENT: PLANNING Each patient's and resident's condition must be assessed on a regular, periodic basis, at least quarterly, with appropriate notation and updating of the health care plan. Health care planning for each patien…

10A NCAC 13B .1909 IMPLEMENTATION OF HEALTH PLAN All parts of the plan of care shall be assigned to specific disciplines or staff as indicated in the plan of care to assure that health care and rehabilitative services are performed daily and documented for those patients and resi…

10A NCAC 13B .1910 NURSING/HEALTH CARE ADMINISTRATION AND SUPERVISION (a) A licensed facility shall have a director of nursing service who shall be responsible for the overall organization and management of all nursing services and shall be currently licensed to practice as a reg…

10A NCAC 13B .1911 VACANT DIRECTOR OF NURSING POSITION (a) The administrator shall notify the Department within 72 hours when the director of nursing position becomes vacant and shall provide the name and license number of the individual who is acting director or the replacement …

10A NCAC 13B .1912 NURSE STAFFING REQUIREMENTS (a) A licensed facility shall provide licensed nursing personnel sufficient to accomplish the following: (1) patient needs assessment, (2) patient care planning, and (3) supervisory functions in accordance with the level of patient o…

10A NCAC 13B .1913 reserved for future codification

10a NCAC 13B .1914 reserved for future codification

10A NCAC 13B .1915 adult care HOME PERSONNEL REQUIREMENTS (a) The administrator shall designate a person to be in charge of the adult care home residents at all times. The nurse in charge of nursing services may also serve as supervisor-in-charge of the adult care home beds. (b) …

10A NCAC 13B .1916 REHABILITATIVE NURSING AND DECUBITUS CARE Each patient or resident shall be given care to prevent contractures, deformities, and decubiti, including but not limited to: (1) changing positions of bedfast and chairfast patients or residents every two hours and ad…

10A NCAC 13B .1917 MEDICATION ADMINISTRATION (a) A licensed facility shall have policies and procedures governing the administration of medications which shall be enforced and implemented by administration and staff. Policies and procedures shall include, but shall not be limited…

10A NCAC 13B .1918 TRAINING (a) A licensed facility shall provide patient or resident care employees a planned orientation and continuing education program emphasizing patient or resident assessment and planning, activities of daily living, personal grooming, rehabilitative nursi…

10A NCAC 13B .1919 DENTAL CARE (a) A dental examination shall be performed at the time of admission with the following information being placed in the patient's or resident's medical or health care record: (1) type of diet which the patient or resident can best manage (such as no…

10A NCAC 13B .1920 AVAILABILITY OF PHARMACEUTICAL SERVICES (a) A licensed facility shall provide pharmaceutical services under the supervision of a pharmacist currently licensed to practice pharmacy in North Carolina. (b) A facility shall be responsible for obtaining drugs, thera…

10A NCAC 13B .1921 DINING FACILITIES Patients, including wheelchair patients, shall be encouraged to eat at the tables in the dining area and shall be assisted when necessary by non-dietary staff. An overbed table shall be provided for patients who eat in bed. A sturdy tray stand…

10A NCAC 13B .1922 ACTIVITIES AND RECREATION (a) The administrator shall designate an activities and recreation director to be in charge of activities and recreation for all patients and residents. The activities and recreation director shall have training and experience in direc…

10A NCAC 13B .1923 SOCIAL SERVICES (a) The administrator shall designate an employee to be responsible for the provision of social services. This person shall be known as the social services director. Subsequent to the effective date of the rules contained in this Subchapter any …

10A NCAC 13B .1924 RESTRAINTS (a) Patients and residents shall be restrained only by physician orders. (b) The nurse in charge shall be responsible for making the decision relative to necessity for, type and duration of restraint in emergency situations requiring restraints while…

10A NCAC 13B .1925 REQUIRED SPACES (a) A combination or nursing facility shall meet the following requirements for bedrooms, dining, recreation, and common use areas: (1) single bedrooms shall be provided with not less than 100 square feet of floor area; (2) bedrooms with more th…

10A NCAC 13B .1926 NURSING HOME PATIENT OR RESIDENT RIGHTS (a) Written policies and procedures shall be developed and enforced to implement requirements in G.S. 131E-115 et seq. (Nursing Home Patients' Bill of Rights) concerning the rights of patients and residents. The administr…

10A NCAC 13B .1927 BRAIN INJURY LONG-TERM CARE PHYSICIAN SERVICES (a) For nursing facility patients located in designated brain injury long-term care units, there shall be an attending physician who is responsible for the patient's specialized care program. The intensity of the p…

10A NCAC 13B .1928 BRAIN INJURY LONG-TERM CARE PROGRAM REQUIREMENTS History Note: Authority G.S. 131E-79; Eff. December 1, 1991; Amended Eff. February 1, 1993; Expired Eff. August 1, 2017 pursuant to G.S. 150B-21.3A.

10A NCAC 13B .1929 SPECIAL NURSING REQUIREMENTS FOR BRAIN INJURY LONG-TERM CARE Direct care nursing personnel staffing ratio (NH/PD) established in Rule .1912 of this Section shall not be applied to nursing services for patients who require brain injury long-term care, due to the…

10A NCAC 13B .1930 VENTILATOR DEPENDENCE The general requirements in this Subchapter shall apply when applicable. In addition, facilities having patients requiring the use of ventilators for more than eight hours a day must meet the following requirements: (1) Respiratory therapy…

10A NCAC 13B .1931 PHYSICIAN SERVICES FOR VENTILATOR DEPENDENT PATIENTS Hospitals with nursing facility beds with ventilator dependent care patients shall contract with a physician who is licensed to practice in North Carolina with Board Certification and who has specialized trai…

10A NCAC 13B .1932 EMERGENCY ELECTRICAL SERVICE (a) A minimum of one dedicated emergency branch circuit per bed is required for ventilator dependent patients in addition to the normal system receptacle at each bed location required by the National Electrical Code. This emergency …