North Dakota Administrative Code

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…

Secured units, such as those designed for residents with Alzheimer's disease or other dementias, must comply with the following: 1. Prior to admission or within seven days of admission, a multidisciplinary team shall evaluate the appropriateness of a resident's placement in a sec…

The definitions located in section 33-07-03.2-01 apply to this chapter. History: Effective July 1, 1996. General Authority: NDCC 23-01-03, 28-32-02 Law Implemented: NDCC 23-16-01, 28-32-02

The provisions located in section 33-07-03.2-02 apply to this chapter. History: Effective July 1, 1996. General Authority: NDCC 23-01-03, 28-32-02 Law Implemented: NDCC 23-16-01, 28-32-02

The waiver provision located in section 33-07-03.2-04 applies to this chapter. History: Effective July 1, 1996. General Authority: NDCC 23-01-03, 28-32-02 Law Implemented: NDCC 23-16-01, 28-32-02

The provisions located in section 33-07-03.2-05 apply to this chapter. History: Effective July 1, 1996. General Authority: NDCC 23-01-03, 28-32-02 Law Implemented: NDCC 23-16-01, 28-32-02 1

The provisions located in section 33-07-03.2-06 apply to this chapter. History: Effective July 1, 1996. General Authority: NDCC 23-01-03, 28-32-02 Law Implemented: NDCC 23-16-01, 28-32-02

For new construction, the site of the facility must be away from nuisances 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. Histo…

1. Sufficient information on the design of other types of facilities physically attached to the nursing facility must be submitted to the department so as to determine that safety from fire and the adequacy of the spaces and services of the facility are not compromised. 2. Occupa…

1. A facility shall contact the department prior to any substantial changes in or alterations to any portion of the structure to determine to what extent it is subject to review. A substantial change includes alterations affecting the fire safety or structural integrity of the bu…

1. A nursing facility must be designed, constructed, equipped, maintained, and operated in compliance with: a. This chapter; b. The Guidelines for Residential Health, Care, and Support Facilities, 2014 edition, compiled by the facility guidelines institute; c. The national fire p…

1. A resident room must have adequate space to house necessary furniture and equipment, to provide for resident care, to provide for movement of beds, and for the transfer of residents to and from beds. 2. The smallest dimension of a rectangular single resident room may not be le…

The dining areas and activities areas may not be the same space. 1. The total area set aside for dining must be a minimum of twenty square feet [1.86 square meters] per bed. 2. The total area set aside for activities must be a minimum of fifteen square feet [1.40 square meters] p…

Exercise and treatment areas of at least three hundred square feet [27.87 square meters] must be provided for physical therapy, occupational therapy, or restorative nursing services. History: Effective July 1, 1996. General Authority: NDCC 23-01-03, 28-32-02 4 Law Implemented: ND…

Dietary areas and equipment must be designed to accommodate the requirements for sanitary storage, processing, and handling consistent with the food service sanitation manual issued by the department. History: Effective July 1, 1996. General Authority: NDCC 28-32-02 Law Implement…

1. Resident space may not be used for general facility storage. 2. Separate storage space with provisions for locking and security control must be provided for residents' personal effects. History: Effective July 1, 1996. General Authority: NDCC 23-01-03, 28-32-02 Law Implemented…

All details must meet the following requirements: 1. Soap in a soap dispenser must be provided at all lavatories and sinks used by personnel for handwashing. 2. In new construction, boiler rooms must not be located under any portion of the facility. 3. Ceilings must be acoustical…

1. An appropriate number of elevators, at least one which complies with the provisions of ANSI A17.1, must be provided in all multistory buildings. All new hospital-type elevators must comply with this standard. 2. All elevators, except freight elevators, must be equipped with a …

1. Asbestos insulation may not be used. Insulation of soft-type, spray-on, etc., may not be used where it is subject to air or mechanical erosion or where loose particles may create a maintenance problem. 2. Air-conditioning, heating, and ventilation systems. a. Air-conditioning …

1. All materials must be listed as complying with applicable standards of underwriters' laboratories incorporated, or other similarly established standards. 2. Circuit breakers or fusible switches that provide disconnecting means and overcurrent protection for conductors connecte…

This chapter is intended to conform North Dakota law to the requirements of 42 U.S.C. 1396r(h) by the creation of an enforcement process to be applied upon a finding, on the basis of a standard, extended, or partial extended survey of a nursing facility, or otherwise, that a nurs…

The state department of health is authorized by North Dakota Century Code section 23-01-11 to adopt such rules as necessary to enable the state to be in compliance with any federal laws in order to qualify for any federal funds related to medical facilities or agencies licensed b…

1. "Class I violation" refers to a requirement found out of compliance that immediately jeopardizes the health or safety of one or more residents. 2. "Class II violation" refers to requirement found out of compliance that has the potential for causing a direct and substantial thr…

The department may impose any sanction described in section 33-07-05-06 if it is found that a nursing facility no longer meets a requirement of 42 U.S.C. 1396r(b), (c), or (d), or North Dakota Century Code section 23-16-01, and it is further found that the facility's deficiencies…

1. The department may implement sanctions based on a determination that a nursing facility no longer meets the requirements of 42 U.S.C. 1396r(b), (c), or (d), or of rules or regulations adopted to implement those requirements, including licensure requirements. The determination …

The following sanctions may be imposed upon a finding that a nursing facility no longer meets the requirements of 42 U.S.C. 1396r(b), (c), or (d) or the requirements of North Dakota Century Code section 23-16-01: 1. Preparation, by the facility, of a directed plan of correction w…

A facility which has been subjected to the imposition of a sanction under subsection 7 of section 33-07-05-06 is liable to the state for each day the violation existed or continues to exist. A violation must be presumed to continue to exist from the time it is found until the dep…

providers. The department shall recommend that any facility which is subject to a suspension or termination from participation or to any limitation or denial of payment shall be prohibited from submitting claims for payment, either directly or through any clinic, group, corporati…

1. Upon a determination that the circumstances make the imposition of a sanction appropriate, the department shall issue a written order identifying the violations and the sanction imposed. If the violations are of a nature to require the imposition of an incrementally more sever…

1. Within ten days after receipt of the order, the facility may request reconsideration by the department. Within fifteen days after receipt of a request for reconsideration, the department 5 shall grant or deny the request for reconsideration and may suspend the imposition of an…

1. A facility dissatisfied with a decision on a timely request for reconsideration, which conforms to the requirements of subsection 2 of section 33-07-05-10, may appeal. An appeal may be perfected by mailing or delivering the information, described in subdivisions a through d, t…

An appeal may not suspend or delay the imposition of a remedy under this chapter. All civil penalties received pursuant to this chapter must be paid into a special fund of the department for the cost of implementation of this chapter, to be applied to the protection of the health…

"Replacement equipment" means equipment which will be used instead of existing equipment which is documented to be obsolete, or not serviceable. Such equipment may be expected to possess expanded capabilities due to technical improvements but will not provide expansion into new h…

1. Each applicant shall submit a notification of intent on forms prescribed by the health council. Each notification of intent must be accompanied by a filing fee of seventy-five dollars payable to the North Dakota state department of health. 2. The department, with concurrence o…

1. Full review. A full review must be conducted of each proposal found subject under North Dakota Century Code section 23-17.2-03, unless the proposal is found eligible for a special review under provisions of subsection 2 of this section. a. Completed applications must be submit…

The health council will base its consideration of each application subject to full review on the department's review of the proposal and on the record of administrative proceedings held on the application. Complex applications may, at the discretion of the department, be divided …

Each certificate of need is valid for a period of one year from the date of determination. One extension of one hundred eighty days may be granted by the department upon request of the applicant. Failure by the applicant to obligate funds for implementation of the proposal within…