North Dakota Administrative Code

1. General acute hospitals shall provide pharmaceutical services consistent with chapter 61-07-01. The hospital, upon receipt, shall submit to the department a copy of the annual board of pharmacy hospital inspection report under subsection 2 of section 61-07-01-13 and plans of c…

1. General acute hospitals shall have a well-organized, adequately supervised, clinical laboratory service available with the necessary space, facilities, and equipment and qualified, licensed staffing to perform these services commensurate with the hospital's needs for its patie…

1. The general acute hospital shall provide and maintain radiology services sufficient to perform and interpret the radiological examinations necessary for the diagnosis and treatment of patients, to the extent that the complexity of services are commensurate with the size, scope…

1. If the acute hospital provides nuclear medicine services, the services must be provided to meet the needs of the patients and in a safe and effective manner. a. The hospital shall have available written verification of compliance with article 33-10. b. The hospital shall have …

1. Each general acute hospital shall provide emergency services to its inpatients. If the hospital does not provide emergency services to the public, it shall be prepared to provide immediate lifesaving measures to individuals who may appear for emergency care and arrange for the…

1. Social services must be provided in all general acute hospitals by a qualified social worker or a social services designee to meet the needs of the patients. Hospitals utilizing social services designees must have quarterly consultation by a qualified social worker. a. Records…

1. General acute hospitals shall provide basic rehabilitation services, including physical, occupational, and speech pathology and audiology to meet the needs of the patients served. a. Basic rehabilitation services must be provided by qualified staff licensed or certified consis…

1. The general acute hospital shall provide the housekeeping and related services necessary to maintain a sanitary and comfortable environment. a. The hospital shall provide personnel to maintain the interior and exterior of the facility in a safe, clean, orderly, and attractive …

1. The general acute hospital that provides surgical services shall have effective policies and procedures regarding surgical privileges, maintenance of the operating rooms, and evaluation of the surgical patient. a. Surgical services must be provided in a manner sufficient to me…

1. Postoperative recovery services must be provided by all general acute hospitals in which surgery is performed. 39 a. Recovery services must be provided in a room where patients who have undergone surgical procedures can be immediately observed, receive specialized care by sele…

1. General acute hospitals shall provide central services consistent with at least the following: a. The central services must be provided with adequate direction, staffing, and facilities to provide service to all services in the hospital. b. Policies and procedures must be deve…

1. General acute hospitals providing surgical services shall provide anesthesia services to meet the needs of the patients served and shall ensure the following: a. The anesthesia service must be under the direction of a qualified physician who is a member of the medical staff. b…

1. If the general acute hospital provides respiratory care services, the services must be under the supervision of a licensed health care practitioner, organized and integrated with other services of the hospital. a. Respiratory care policies and procedures must be developed, imp…

1. All general acute hospitals providing obstetrical services shall provide for the admission, medical care, transfer, or discharge of obstetric and neonatal patients. Obstetrical services must include the following: a. The obstetrical services must have an organized obstetric st…

1. General acute hospitals providing outpatient birth services in hospitals are subject to the outpatient birth services requirements for specialized hospitals in this section. 2. Primary care hospitals may not provide outpatient birth services. 3. Any facility that provides outp…

1. Specialized rehabilitation services in a general acute hospital must be provided in a distinct, clearly defined, special unit and are subject to the specialized rehabilitation services in hospitals requirements for specialized hospitals in this section. If in the course of the…

1. General acute hospitals providing psychiatric services are subject to the psychiatric services in hospitals requirements for specialized hospitals in this section. If, in the course of the inspection of a general acute hospital, the department finds from a review of the psychi…

The site of the hospital must be away from nuisances that may be detrimental to the proposed services, such as commercial or industrial developments, or other types of facilities that produce noise or air pollution. A site plan must be submitted to the department. History: Effect…

1. Hospitals shall contact the department prior to any substantial changes in or alterations to any portion of the structure to determine to what extent they are subject to review. A substantial change must include any alterations affecting the fire safety or structural integrity…

1. Hospitals must be designed, constructed, equipped, maintained, and operated in compliance with: a. This chapter. b. The Guidelines for Hospitals and Outpatient Facilities, 2014 edition, compiled by the facility guidelines institute. c. The national fire protection association …

1. Hospitals with a capacity of fifty beds or less may qualify for special consideration of these standards. Some functions allotted separate spaces or rooms in these standards may be combined, provided the resulting arrangement does not compromise safety and medical and nursing …

Each patient room must meet the following requirements: 2 1. A patient room may not be located on a floor unless a portion of the floor is at or above grade level. A patient room may not have its floor more than thirty inches [.76 meter] below the adjacent grade. 2. Patient rooms…

1. At least one room must be provided for toilet training. It must be accessible from the corridor and may also serve the bathing area, and must provide three feet [.91 meter] clearance at the front and both sides of the water closet. 2. Ceilings must be acoustically treated in p…

If any part of this chapter is found to conflict with federal requirements, the more stringent shall apply. Such a finding or determination shall be made by the department and shall not affect the remainder of this chapter. History: Effective July 1, 2015. General Authority: NDCC…

The following terms are defined for this chapter, chapter 33-07-04.2, and North Dakota Century Code chapter 23-16: 1. "Abuse" for the purposes of this chapter is defined in section 33-07-06-01. 2. "Adult day care" means the provision of facility services to meet the needs of indi…

If any part of this chapter or chapter 33-07-04.2 is found to conflict with federal requirements, the more stringent shall apply. Such a finding or determination shall be made by the department and shall not affect the remainder of this chapter or chapter 33-07-04.2. History: Eff…

An entity meeting the definition of nursing facility in this chapter must obtain a license from the department to operate in North Dakota. No person or entity shall establish or operate a facility without first having obtained a license. 1. Any person or entity who owns or leases…

Any provisions of this chapter or chapter 33-07-04.2 may be waived by the department for a specified period in specific instances, provided such a waiver does not adversely affect the health and safety of the residents and would result in unreasonable hardship upon the facility. …

The department may evaluate a facility's compliance with this chapter or chapter 33-07-04.2 at any time through: 1. An announced or unannounced onsite review; or 2. A request for submission of written documentation verifying compliance. History: Effective July 1, 1996. General Au…

1. A facility shall submit to the department a plan of correction addressing areas of noncompliance with the licensure requirements of this chapter and chapter 33-07-04.2. 2. A plan of correction must include: a. How the corrective action will be accomplished; b. How the facility…

The governing body is legally responsible for the quality of resident care services; for resident safety and security; for the conduct, operation, and obligations of the facility; and for ensuring compliance with all federal, state, and local laws. 1. The governing body shall est…

The facility must be constructed, arranged, and maintained to ensure the safety and well-being of the residents. 1. The physical plant must comply with the construction standards of chapter 33-07-04.2; and 2. The facility must provide an environment that is maintained, clean, com…

The facility shall have a written procedure to be followed in case of emergencies. The emergency plan must specify persons to be notified, locations of alarm signals and fire extinguishers, evacuation routes, procedures for evacuating residents, and assignment of specific tasks, …

1. The facility shall develop and implement a quality improvement program, approved by the governing body, for assessing and improving the quality of services and care provided to residents. The written program must describe objectives, organization, scope, and mechanisms for ove…

The facility shall develop and implement a facilitywide program, approved by the governing body, for surveillance, prevention, and control of infections. This program must be consistent with the centers for disease control and prevention standards specific to disease control. The…

The facility shall design, implement, and document educational programs to orient new employees and keep all staff current on new and expanding programs, techniques, equipment, and concepts of quality care. The following topics must be covered with all staff annually: 1. Safety a…

1. The facility shall have a licensed physician who is specified as the medical director or a medical staff organized under bylaws and rules approved by and responsible to the governing body. The medical director or medical staff shall be responsible for the quality of all medica…

1. Nursing services must be under the direction of a nurse executive (director of nursing) who is employed by the facility and is a registered nurse licensed to practice in North Dakota. 2. The nurse executive must have written administrative authority, responsibility, and accoun…

1. The facility shall complete and maintain an up-to-date comprehensive resident assessment for each resident by using the resident assessment instrument, the utilization guidelines, the minimum data set of core elements and common definitions, and the resident assessment protoco…

The facility shall provide for the dietary needs of the residents and provide dietary services in conformance with the food service sanitation manual issued by the department. Dietary services must include: 1. A qualified director of dietary services must be designated to be resp…

Any individual employed by a facility, or under contract, to feed or assist with the feeding of nursing facility residents must either have successfully completed a department-approved paid feeding assistant training course or be a certified nurse aide. 1. Instructors of a depart…

The governing body of the facility shall establish and implement policies and procedures to ensure the facility has a resident record service with administrative responsibility for resident records. 1. A resident record must be maintained and kept confidential for each resident a…

The facility shall provide pharmaceutical services to meet resident needs. 1. The facility shall obtain the services of a licensed pharmacist who shall develop policies and procedures for the provision of pharmaceutical services within the facility consistent with chapter 61-03-0…

The governing body shall ensure social services are provided to ensure each resident attains and maintains their highest level of physical, mental, and psychosocial functioning. 1. The facility shall have one or more designated staff members trained in the assessment of residents…

The facility shall provide an ongoing program of activity services to meet the needs and interests of each resident which promotes or maintains each resident's physical, mental, and psychosocial well-being. 1. The facility shall employ a qualified activity coordinator who is resp…

Only programs that the department determines meet the criteria in this section and approves in writing are considered to be an approved activity training program. 1. A department-approved activity training program must have a curriculum which contains, at a minimum, ninety hours …

Specialized rehabilitative services shall, at a minimum, include physical therapy, speech and language pathology, occupational therapy, and health services for mental illness and mental retardation and shall: 1. Be provided upon a written order of a licensed health care practitio…

The facility shall provide or have arrangements for obtaining diagnostic services consistent with the needs of the resident. 1. If the facility provides any clinical laboratory testing services to residents, regardless of the frequency or the complexity of the testing, the govern…

The facility shall provide housekeeping and maintenance services necessary to maintain a sanitary and comfortable environment and laundry services, including personal laundry services, to meet the needs of the residents. 1. The facility shall employ sufficient housekeeping and ma…

1. Any facility seeking to develop an adult day care service shall contact the department and receive advance approval as a condition of licensure. 2. A facility may use existing space and equipment to deliver adult day care services provided services to the residents of the faci…