Subchapter H. QUALITY IMPROVEMENT/SERVICE UTILIZATION
Sec.
5320.71. Quality improvement program.
5320.72. Indicators for duration of stay.
5320.73. Ancillary support services.
5320.74. Health services.§ 5320.71. Quality improvement program.
The provider shall have a written quality improvement (QI) plan and program that the program director reviews for the quality and appropriateness of services provided and monitors for compliance with standards of treatment and care. The plan shall:
(1) Specify who has responsibility for QI activities, to whom findings are reported, the frequency of reviews, what critical indicators are to be evaluated and acceptable levels for the critical indicators.
(2) Have indicators of quality care that include at least the following:
(i) The level of resident satisfaction and program input.
(ii) The level of family satisfaction and program input.
(iii) Appropriateness, completeness, timeliness and implementation of the treatment plans.
(iv) Case and trend review of crisis events and unusual situations.
(v) Direct-care staff performance.
(vi) Clinical case or peer reviews, quarterly or more often as indicated.
(vii) Medications management, including errors and adverse effects.
(viii) The appropriate documentation in the resident’s record.
(3) Include the names of the individuals who participated in the quality improvement activities and plans of correction.
§ 5320.72. Indicators for duration of stay.
Decisions which determine the duration of stay shall take into account:
(1) The resident’s needs, therapeutic requirements and recommendations of the interdisciplinary treatment team.
(2) The commitment status of the resident.
(3) Measurable indicators established by the provider that address expectations in the following areas in determining resident duration of stay.
(i) Resident and program outcomes.
(ii) Stability of the resident’s psychiatric condition.
(iii) Stability of the resident’s medication regime.
(iv) The length of time without the need for acute psychiatric interventions.
(v) The attainment of treatment goals.
(vi) Successful trial leaves.
(vii) The establishment of a support system.
(viii) A plan for continuity of care.
§ 5320.73. Ancillary support services.
The provider shall either directly or through arrangement, provide services needed by the residents. To provide services that are not available at the LTSR, the provider shall:
(1) Collaborate with the county administrator’s office case management services, and other programs to provide services as identified by the treatment plan and to ensure continuity of care.
(2) Ensure that transportation is available for residents who must be transported for services, recreation and other activities.
§ 5320.74. Health services.
The LTSR provider shall:
(1) Develop written arrangements for providing routine and emergency medical and dental care for residents.
(2) Notify the resident’s designated person and the county administrator or a designee who shall ensure whatever assistance is necessary in making arrangements for the resident’s transfer to an appropriate facility. A physician shall determine if the resident’s physical condition indicates the need for a transfer to a hospital, nursing home or rehabilitation center.
(3) Have first aid supplies available and adhere to current Centers for Disease Control and the Department of Health’s recommendations for universal precautions in the administration of first aid and CPR.
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