This
rule was filed as 7 NMAC 26.2
TITLE 7 HEALTH
CHAPTER 26 DEVELOPMENTAL DISABILITIES
PART 2 REQUIREMENTS
FOR INTERMEDIATE CARE FACILITIES FOR THE MENTALLY
RETARDED
7.26.2.1 ISSUING
AGENCY: Department of Health, Public Health Division,
Health Facility Licensing and Certification Bureau
[10/31/96;
Recompiled 10/31/01]
7.26.2.2 SCOPE: These regulations apply to any facility
providing services as outlined by these regulations and any facility which by
federal regulation must be licensed by the state of New Mexico to obtain or
maintain full or partial permanent or temporary federal funding as an
intermediate care facility for the mentally retarded (ICF/MR). All facilities
licensed after the effective date of these regulations shall be limited to a
capacity of no greater than four (4) clients, except as provided herein in
section 21.3.1 [now Subsection C of 7.26.2.21 NMAC].
[10/11/90,
11/30/99; Recompiled 10/31/01]
7.26.2.3 STATUTORY
AUTHORITY: The regulations set forth herein are
promulgated by the secretary of the New Mexico department of health, pursuant
to the general authority granted under Section 9-7-6 (E) of the Department of
Health Act, NMSA 1978, as amended; and the authority granted under Sections
24-1-2 (D), 24-1-3 (I) and 24-1-5 of the Public Health Act, NMSA 1978, as
amended.
[11/1/50,
1/1/54, 7/1/64, 3/25/69, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.4 DURATION: Permanent
[10/31/96;
Recompiled 10/31/01]
7.26.2.5 EFFECTIVE
DATE: October 31, 1996 unless a different date is
cited at the end of a Section or Paragraph.
[10/31/96;
Recompiled 10/31/01]
[Compiler’s
note: The words or paragraph, above, are no longer applicable. Later dates are now cited only at the end of
sections, in the history notes appearing in brackets.]
7.26.2.6 OBJECTIVE: The purpose of these regulations is to:
A. Establish professional minimum standards for ICF/MR
facilities in the state of New Mexico which were formerly licensed under
regulations governing long term care facilities.
B. Monitor ICF/MR facilities with these regulations through
surveys to identify any areas which could be dangerous or harmful to the
clients or staff.
C. Encourage the maintenance of ICF/MR facilities that provide
quality services which maintain or improve the health and quality of life to
the clients.
D. Expand the availability of ICF/MR programs to assure timely
placement for persons who need residential services.
E. Assure integrated active treatment programs, homelike
living arrangements, and consumer protections for ICF/MR clients.
F. Promote access and availability statewide.
G. Recognize specialized ICF/MR programs to serve individuals
with intense needs.
[7/1/64,
10/11/90, 11/30/99; Recompiled 10/31/01]
7.26.2.7 GENERAL
DEFINITIONS: For purposes of these regulations the
following shall apply:
A. “Active treatment”
means the consistent, aggressive, accountable, and continuous application of
competent interactions between caregivers and persons with developmental
disabilities whom they serve in structured and unstructured settings alike,
directed toward each individual's developmental progress through the life
cycle.
B. “Applicant”
means the individual who, or organization which, applies for a license. If the
applicant is an organization, then the individual signing the application on
behalf of the organization, must have authority from the organization. The
applicant must be the owner.
C. “Client” means
an individual living in and receiving services from an ICF/MR licensed pursuant
to these regulations.
D. “Community supports”
means community services such as recreational activities, social clubs,
religious services, employment services, and transportation, as well as other
supportive services that are available to the general population and not
designated to serve only persons with disabilities.
E. “Department”
means the New Mexico department of health.
F. “Dietitian”
means a person eligible or required to be licensed under the New Mexico
Nutrition and Dietetics Practice Act, Sections 61-7A-1 through 61-7A-15 NMSA
1978, effective July 1, 1989.
G. “Facility” means
a building or buildings in which clients live and ICF/MR services are provided
and is licensed or required to be licensed pursuant to these regulations.
H. “Governing body”
means the governing authority of a facility which has the ultimate
responsibility for all planning, direction, control and management of the
activities and functions of a facility licensed pursuant to these regulations.
I. “ICF/MR” means
an intermediate care facility that provides food, shelter, health or
rehabilitative and active treatment for the mentally retarded or persons with
related conditions.
J. “License” means
the document issued by the licensing authority pursuant to these regulations
granting the legal right to operate for a specified period of time, not to
exceed one (1) year.
K. “Licensee” means
the person(s) who, or organization which, has an ownership, leasehold or
similar interest in the ICF/MR facility and in whose name a license has been
issued and who is legally responsible for compliance with these regulations.
L. “Licensing
authority” means the New Mexico department of health.
M. “NMSA” means the
New Mexico Statutes Annotated 1978 compilation and all the revisions and
compilations thereof.
N. “Nurse” is an
individual who is currently licensed/registered in the state of New Mexico.
O. “Occupational
therapist” is an individual who is eligible for certification by the
American occupational therapy association or another comparable body.
P. “Physical
therapist” is an individual who is eligible for certification as a physical
therapist by the American physical therapy association or another comparable
body.
Q. “Plan of correction”
means the plan submitted by the licensee or representative of the licensee
addressing how and when deficiencies identified at time of a survey will be
corrected.
R. “Policy” means
a statement of principle that guides and determines present and future decisions
and actions.
S. “Premises” means all parts of
buildings, grounds, and equipment of a facility.
T. “Procedure”
means the action(s) that must be taken in order to implement a policy.
U. “Psychologist”
is an individual who has at least a master's degree in psychology from an
accredited school.
V. “Social worker”
means a person required to be licensed under the Social Work Practice Act
Sections 61-31-1 through 61-31-25 NMSA 1978.
W. “Speech language
pathologist or audiologist” is an individual who is eligible for a
certificate of clinical competence in speech-language pathology or audiology
granted by the American speech-language hearing association or another
comparable body or who meets the educational requirements for certification and
is in the process of accumulating the supervised experience required for
certification.
X. “U/L approved”
means approved for safety by the national underwriters laboratory.
Y. “Training and
habilitation services” means the training and services which are provided to
a client intended to aid the intellectual, sensorimotor, and emotional
development of that client.
Z. “Variance”
means an act on the part of the licensing authority to refrain from pressing or
enforcing compliance with a portion or portions of these regulations for an
unspecified period of time where the granting of a variance will not create a
danger to the health, safety, or welfare of clients or staff of a facility, and
is at the sole discretion of the licensing authority.
AA. “Waive/waiver”
means to refrain from pressing or enforcing compliance with a portion or
portions of these regulations for a limited period of time provided the health,
safety, or welfare of the clients and staff are not in danger. Waivers are
issued at the sole discretion of the licensing authority.
[11/1/50,
1/1/54, 7/1/64, 10/11/90, 10/31/96, 11-30-99; Recompiled 10/31/01]
7.26.2.8 STANDARD
OF COMPLIANCE: The degree of compliance required throughout
these regulations is designated by the use of the words “shall” or “must” or
“may”. “Shall” or “must” means
mandatory. “May” means permissive. The use of the words “adequate”, “proper”,
and other similar words means the degree of compliance that is generally
accepted throughout the professional field by those who provide ICF/MR services
to the public in facilities governed by these regulations.
[10/11/90;
Recompiled 10/31/01]
7.26.2.9 ICF/MR
FACILITY AND SCOPE OF SERVICES PROVIDED: The
ICF/MR provides active treatment in the least restrictive setting and includes
all needed services for mentally retarded individuals or persons with related
conditions whose mental or physical condition require services on a regular
basis that are above the level of a residential or room and board setting and
can only be provided in a facility which is equipped and staffed to provide the
appropriate services.
[11/1/50,
1/1/54, 3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.10 [RESERVED]
[10/11/90,
10/31/96; R 11/30/99; Recompiled 10/31/01]
7.26.2.11 INITIAL
LICENSURE PROCEDURES: The following procedures must be followed by
the applicant for initial licensure of an ICF/MR facility.
A. Initial phase:
These regulations should be thoroughly understood by the applicant and used as
a reference for design of a new building or renovation or addition to an
existing building for licensure as an ICF/MR facility pursuant to these
regulations. Prior to starting construction, renovations, or additions to an
existing building the applicant of the proposed facility shall:
(1) advise the licensing
authority of intention to open a ICF/MR facility pursuant to these regulations.
(2) submit a complete set of
construction documents (blueprints) for the total building
(3) blueprints will be
reviewed by the licensing authority for compliance with current licensing
regulations, building and fire codes.
(4) if blue prints or plans
are approved the licensing authority will advise the applicant that
construction may begin.
B. Construction phase:
During the construction of a new building or renovations or additions to an
existing building, the applicant must coordinate with the licensing authority
and submit any changes to the blueprints or plans for approval before making
such changes.
C. Licensing phase:
Prior to completion of construction, renovation or addition to an existing
building the applicant will submit to the licensing authority the following:
(1) Application form:
(a) will be provided by the licensing
authority.
(b) all information requested on the
application must be provided.
(c) will be printed or typed.
(d) will be dated and signed.
(e) will be notarized.
(2) Fees: All applications for licensure must
be accompanied by the required fee.
(a) Fees must be in the form of a certified
check, money order, personal or business check made payable to the state of New
Mexico.
(b) Fees are non-refundable.
(3) Zoning and building approval:
(a)
All initial applications must be accompanied with written zoning
approval from the appropriate authority (city, county, or municipality).
(b) All initial applications must be
accompanied with written building approval (certificate of occupancy) from the
appropriate authority (city, county, or municipality).
(4) Fire authority approval: All initial
applications must be accompanied with written approval of the fire authority
having jurisdiction.
(5) New Mexico environment department
approval: All initial applications must be accompanied by written approval of
the environmental improvement division for the following:
(a) private water supply, if applicable;
(b) private waste or sewage disposal, if
applicable;
(c) kitchen approval.
(d Exception: Facilities utilizing the
kitchen as a training site for clients to develop personal skills in meal
planning and preparation may be exempt from this requirement if the New Mexico
environment department waives the requirement and a letter of exemption is on
file in the facility.
(6)
Copy of appropriate drug permit issued by the state board of pharmacy.
(7) Initial survey: Upon receipt of a
properly completed application with all supporting documentation as outlined
above an initial survey of the proposed facility shall be scheduled by the
licensing authority.
(8) Issuance of license: Upon completion of
the initial survey and determination that the facility is in compliance with
these regulations the licensing authority shall issue a license.
[11/1/50,
1/1/54, 7/1/64, 3/25/69, 10/11/90, 10/31/96, 11/30/99; Recompiled 10/31/01]
7.26.2.12 LICENSES:
A. Annual license:
An annual license is issued for a one (1) year period to an ICF/MR facility
which has met all requirements of these regulations.
B. Temporary license:
The licensing authority may, at its sole discretion, issue a temporary license
prior to the initial survey or when the licensing authority finds partial
compliance with these regulations.
(1) A temporary license shall cover a period
of time, not to exceed one hundred twenty (120) days, during which the facility
must correct all specified deficiencies.
(2) In accordance with
Section 24-1-5 (D) NMSA 1978, no more than two (2) consecutive temporary
licenses shall be issued.
C. Amended license:
A licensee must apply to the licensing authority for an amended license when
there is a change of administrator/director, or when there is a change of name
for the facility
(1) Application must be on a
form provided by the licensing authority.
(2) Application must be
accompanied by the required fee for amended license.
(3) Application must be
submitted within ten (10) working days of the change.
[11/1/50,
1/1/54, 7/1/64, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.13 LICENSE
RENEWAL:
A. Licensee must submit a renewal application on forms provided
by the licensing authority, along with the required fee at least thirty (30)
days prior to expiration of the current license.
B. Upon receipt of renewal application and required fee prior
to expiration of current license the licensing authority will issue a new
license effective the day following the date of expiration of the current
license if the facility is in substantial compliance with these regulations.
C. If a licensee fails to submit a renewal application with
the required fee and the current license expires the facility shall cease
operations until it obtains a new license through the initial licensure
procedures. Section 24-1-5 (A) NMSA 1978 as amended, provides that no health
facility shall be operated without a license.
[11/1/50,
1/1/54, 7/1/64, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.14 POSTING
OF LICENSE: The facility's license must be posted in a
conspicuous place on the licensed premises in an area visible to the public.
[11/1/50,
7/1/64, 10/11/90; Recompiled 10/31/01]
7.26.2.15 NON-TRANSFERABLE
RESTRICTION ON LICENSE: 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 facility changes;
B. the facility changes location;
C. licensee of the facility changes;
D. The facility discontinues operation.
E. A facility wishing to continue operation as a licensed ICF/MR
facility under circumstances 15.1 through 15.4 [now Subsections A through D of
7.26.2.15 NMAC] above must submit an application for initial licensure in
accordance with Section 11 [now 7.26.2.11 NMAC] of these regulations at least
thirty (30) days prior to the anticipated change.
[11/1/50,
7/1/64, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.16 AUTOMATIC
EXPIRATION OF LICENSE: A license will
automatically 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;
B. on the day a facility is sold, leased, or otherwise
changes ownership and/or licensee;
C. on the day a facility changes location.
[11/1/50,
7/1/64, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.17 SUSPENSION
OF LICENSE WITHOUT PRIOR HEARING: In
accordance with 24-1-5 (H) NMSA 1978, if immediate action is required to
protect human health and safety, the licensing authority may suspend a license
pending a hearing, provided such hearing is held within five (5) working days
of the suspension, unless waived by the licensee.
[7/1/64,
10/11/90; Recompiled 10/31/01]
7.26.2.18 GROUNDS
FOR REVOCATION OR SUSPENSION OF LICENSE, DENIAL OF INITIAL OR RENEWAL
APPLICATION FOR LICENSE, OR IMPOSITION OF INTERMEDIATE SANCTIONS OR CIVIL
MONETARY PENALTIES: A license may be revoked or suspended, an
initial or renewal application may be denied, 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 material provision of these
regulations;
B. failure to allow survey by authorized representatives of
the licensing authority;
C. any person active in the operation of a facility licensed
pursuant to these regulations shall not be under the influence of alcohol or
narcotics or convicted of a felony;
D. misrepresentation or falsification of any information on
application forms or other documents provided to the licensing authority;
E. discovery of repeat violations of these regulations during
surveys;
F. failure to provide the required care and services as
outlined by these regulations for the clients receiving care at the facility.
[11/1/50,
7/1/64, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.19 HEARING
PROCEDURES:
A. Hearing procedures for adverse action taken by the
licensing authority against a facility license as outlined in Section 17 and 18
[now Sections 17 and 18 of 7.26.2 NMAC] above will be held in accordance with
Adjudicatory Hearings, New Mexico department of health, 7 NMAC 1.2 (2-1-96)
[now 7.1.2 NMAC].
B. A copy of the above regulations may be requested at any
time by contacting the licensing authority.
[11/1/50,
7/1/64, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.20 CURRENTLY
LICENSED FACILITIES: Any facility currently licensed on the date
these regulations are promulgated and which provides the services prescribed
under these regulations, but which fails to meet all building requirements may
continue to be licensed as an ICF/MR.
A. Variance may be granted for those building requirements
the facility cannot meet provided the variances granted will not create a
hazard to the health, safety and welfare of the clients and staff, and;
B. The building requirements for which variances are granted
cannot be corrected without an unreasonable expense to the facility, and
C. Variances granted will be recorded and made a permanent
part of the facility file.
D. Facilities currently licensed for more than four (4)
clients may not increase their capacity.
[11/1/50,
7/1/64, 10/11/90, 11/30/99; Recompiled 10/31/01]
7.26.2.21 NEW
FACILITY: A new facility may be opened in an existing
building or a newly constructed building.
A. If opened in an existing building a variance may be
granted for those building requirements the facility cannot meet under the same
criteria outlined in Sections 20.1, 20.2 and 20.3 [now Subsections A, B and C
of 7.26.2.20 NMAC] of these regulations, if not in conflict with existing
building and fire codes. This is at the sole discretion of the licensing
authority.
B. A new facility opened in a newly constructed building must
meet all requirements of these regulations.
C. A new facility may not be licensed for more than four (4)
clients. Exception: ICF/MR facilities
may be licensed for a maximum capacity of six (6) clients based upon a written
plan that must be submitted to the licensing authority prior to the facility's
licensure. Approval of the plan is in the discretion of the licensing
authority. The plan must demonstrate the following:
(1) The anticipated facility
service benefits to the client population.
(2) How the facility's
services will promote, independence, active treatment and community supports.
(3) How the facility's
services will address the needs and protections of the proposed clients.
[10/11/90,
11/30/99; Recompiled 10/31/01]
7.26.2.22 FACILITY
SURVEYS:
A. Application for licensure, whether initial or renewal
shall constitute permission for entry into and survey of a facility by
authorized licensing authority representatives at reasonable times during the
pendency of the application and, if licensed, during the licensure period.
B. Surveys may be announced or unannounced at the sole
discretion of the licensing authority.
C. Upon receipt of a notice of deficiency from the licensing
authority the licensee or his/her representative will be required to submit a
plan of correction to the licensing authority within ten (10) working days
stating how the facility intends to correct each violation noted and the
expected date of completion.
D. The licensing authority may at its sole discretion accept
the plan of correction as written or require modifications of the plan by the
licensee.
E. The licensing authority may impose intermediate
supervisory and management requirements, including the administrative costs
therefore, and civil monetary penalties pursuant to Section 24-1-5.2 NMSA 1978.
[11/1/50,
7/1/64, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.23 REPORTING
OF INCIDENTS: All facilities licensed pursuant to these
regulations must report to the licensing authority any serious incident or
unusual occurrence which has, or could threaten the health, safety, and welfare
of the clients or staff, such as but not limited to:
A. Fire, flood, or other natural disaster which creates
structural damages to the facility or poses health hazards;
B. Any serious outbreak of contagious diseases dangerous to
the public health;
C. Any serious human errors by staff members of the facility
which has resulted in the death, serious illness, or physical impairment of a
client.
D. In accordance with the 'Resident Abuse and Neglect Act”,
NMSA 1978, any incident of abuse, neglect or exploitation of a client, patient,
or resident of a health facility must be reported to the department of health
and adult protective services.
E. Any incidents of abuse, neglect, exploitation, death
or other reportable incidents must be reported in accordance with department of
health incident management policies.
[11/1/50,
3/25/69, 10/11/90, 10/31/96, 11/30/99; Recompiled 10/31/01]
7.26.2.24 QUALITY
ASSURANCE: All facilities licensed pursuant to these
regulations must have an on-going, comprehensive self-assessment of the
services provided by the facility. The assessment must include the total
operation of the facility.
A. To be considered comprehensive the assessment for quality
assurance must include, but is not limited to the following:
(1) condition of clients and
services rendered;
(2) completeness of client
records;
(3) organization of the
facility;
(4) administration;
(5) staff utilization and
training;
(6) policies and procedures.
B. Where problems (or potential problems) are identified the facility
must act as soon as possible to avoid any risks to clients by taking corrective
steps such as, but not limited to, the following:
(1) changes in policies and
procedures;
(2) staffing and assignment changes;
(3) additional educational
training for the staff;
(4) changes in equipment or
physical plant;
(5) deletion or addition of
services.
C. The governing body of the facility shall ensure that the
effectiveness of the quality assurance program is evaluated by professional and
administrative staff at least once a year. If the evaluation is not done all at
once, no more than a year must lapse between evaluation of the same parts.
D. Documentation of the quality assurance program must be
maintained by the facility.
[10/11/90;
Recompiled 10/31/01]
7.26.2.25 CLIENT
RECORDS: The facility must develop and maintain a
record keeping system that includes a separate record for each client which
documents the client's health care, active treatment, social information, and
protection of the client's rights. As a minimum the client's record must
contain:
A. Personal
information:
(1) Full name.
(2) Date of birth.
(3) Social security number.
(4) Height.
(5) Weight.
(6) Color of hair.
(7) Color of eyes.
(8) Identifying marks and
recent photograph.
(9) Full name of parents and
their dates of birth.
(10) Language(s) spoken and
understood and language used in the natural home.
(11) Information relevant to
religious preference.
(12) Legal documentation
relevant to commitment and/or guardianship status.
(13) Name, address, and
telephone number of next-of-kin, other person or agency to contact in case of
an emergency.
B. Medical
information:
(1) Reports of previous
histories, evaluations or observations.
(2) Age at onset of
disability.
(3) Name, address and
telephone number of physician or health facility providing medical care.
(4) Medication history,
including present medication dosage and schedule.
(5) Reports of all
treatments, etc.
C. Individual
habilitation plan: Each client must have an individual habilitation plan
which specifies goals and objectives.
D. Admission agreement:
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.26 REPORTS
AND RECORDS REQUIRED TO BE ON FILE IN THE FACILITY: Each facility licensed pursuant to these
regulations must keep the following reports and records on file and make them
available for review upon request of the licensing authority.
A. a copy of the latest fire inspection report by the fire authority
having jurisdiction;
B. a copy of the last survey conducted by the licensing
authority and variances granted;
C. record of fire and emergency evacuation drills conducted by
the facility;
D. Licensing regulations: A copy of these regulations: Requirements
for Intermediate Care Facilities for the Mentally Retarded, New Mexico
department of health, 7 NMAC 26.2 (10-31-96) [now 7.26.2 NMAC];
E. health certificates of staff;
F. a copy of the current license, registration or
certificate, of each staff member for which a license, registration, or
certification is required by the state of New Mexico;
G. valid drug permit as required by the state board of
pharmacy;
H. latest inspection by the state board of pharmacy;
I. New Mexico environment department approval of private
water system, if applicable;
J. New Mexico environment department approval of private
waste or sewage disposal, if applicable;
K. New Mexico environment department approval of the kitchen.
NOTE: An approval of kitchen is not required if preparing meals is part of the
training program of the clients of the facility and the facility has a letter
of exemption on file from the New Mexico environment department;
L. documentation of fire equipment and fire
systems inspections;
M. reports of client abuse and incidents involving clients.
[11/1/50,
10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.27 CLIENT
RIGHTS: Any facility licensed pursuant to these
regulations must support, protect, and enhance the rights of clients as listed
below:
A. Information:
Each client or legal guardian must be fully informed before or at time of
admission, of their rights and responsibilities and of all rules governing
clients conduct.
(1) If a facility amends its
policies on client rights and responsibilities and its rules governing conduct
the clients must be immediately informed.
(2) Each client and or legal
guardian must acknowledge, in writing, that they have been informed of these
rights.
(3) Each client and or legal guardian must be fully informed, in
writing, of all services available in the facility and of the charges for these
services. If charges change the client must be immediately informed.
B. Medical condition
and treatment: Each client must be fully informed by a physician of his/her
health and medical condition unless the physician decides that informing the
client is medically contraindicated.
(1) Each client must be given
the opportunity to participate in planning their total care and medical
treatment.
(2) Each client must be given
the opportunity to refuse treatment.
(3) Each client must give informed,
written consent before participating in experimental research.
C. Transfer and
discharge: Each client must be transferred or discharged only for:
(1) medical reasons;
(2) their welfare or that of
the other residents;
(3) non-payment for services
rendered;
(4) the client requests to be
discharged;
(5) the client no longer
requires an active treatment program.
D. Exercising rights:
Each client must be encouraged and assisted to exercise their rights as a
client of the facility and as a citizen and allowed to submit complaints or
recommendations concerning the policies and services of the facility.
E. Financial affairs:
Each client must be allowed to possess and use money in normal ways or be
learning to do so.
F. Freedom from abuse
and restraints: Each client must be free from mental and physical abuse and
free from chemical and physical restraints unless necessary as part of their
treatment plan.
G. Privacy: Each
client must be treated with consideration, respect, and full recognition of
their dignity and individuality.
(1) Each client must be given
privacy during treatment and care of personal needs.
(2) Each client's record, including information in an automatic
data bank (computer), must be treated confidentially.
(3) Each client must give
written consent before the facility may release information from their record
to someone not otherwise authorized by law to receive it.
(4) A married client must be
given privacy during visits by their spouse. If husband and wife are both
clients in the facility they must be permitted to share a room.
H. Work: No client
shall be required to perform services for the facility for which they are not
paid.
I. Freedom of
association and correspondence: Each client must be allowed to:
(1) communicate, associate, and
meet privately with individuals of their choice, unless this infringes on the
rights of another client;
(2) send and receive personal
mail unopened.
J. Activities:
Each client must be allowed to participate in social, religious, and community
group activities, unless the interdisciplinary team determines that these
activities are contraindicated for a client. Any such determination must be
documented in the client's records.
K. Personal
possessions: Each client must be allowed to retain and use their personal
possessions and clothing as space permits.
[1/1/54,
3/25/69, 10/11/90, 11/30/99; Recompiled 10/31/01]
7.26.2.28 PHILOSOPHY,
OBJECTIVES AND GOALS: Each facility licensed pursuant to these
regulations must have a written outline of the philosophy, objectives, and
goals it is striving to achieve that includes, at least:
A. the facility's role in the state comprehensive program for
the mentally retarded;
B. the facility's goals for its clients to include but not
limited to: an integrated active treatment program, homelike living
environments and consumer protections;
C. the facility's concept of its relationship to the parents
or legal guardians of its residents;
D. the facility's outline of the above must be available for distribution
to staff, consumer representatives, and the interested public;
E. the facility's promotion of informed decision making by
the consumer;
F. the facilities policies on utilization of community supports
and how clients will be involved in the community.
[10/11/90,
11/30/99; Recompiled 10/31/01]
7.26.2.29 POLICIES
AND PROCEDURES: Each facility licensed pursuant to these
regulations must have written policies and procedures covering the following
areas:
A. client's civil rights;
B. delegation of client's civil rights;
C. handling of client funds;
D. admission criteria and evaluations;
E. personnel policies;
F. prohibitions against mistreatment, neglect or abuse of
clients by employees or other persons;
G. staff training and evaluations;
H. control and discipline of clients, including behavior
management;
I. use of physical and chemical restraints;
J. quality assurance;
K. procurement, handling, storage, safeguarding and
accountability of medications;
L. maintenance of buildings, grounds and equipment;
M. transfer of client to hospital or other facility;
N. release of client medical records;
O. fire and disaster.
[10/11/90;
Recompiled 10/31/01]
7.26.2.30 STAFF
RECORDS: There must be maintained on file in the
facility or in a central office if there are multi-facilities run by the same
organization in the same city or town, a record for each staff member which
contains at least, but is not limited to, the following:
A. Personal information:
(1) name;
(2) address and telephone
number;
(3) position for which
employed;
(4) person to contact in case
of emergency.
B. a clearance letter from the department of health
caregivers criminal history screening program stating criminal records check
has been conducted with negative results;
C. documentation of training to include transportation and
wheelchair safety training.
D. health certificate as outlined in Section 68 [now 7.26.2.68
NMAC] of these regulations.
[10/11/90,
11/30/99; Recompiled 10/31/01]
7.26.2.31 FACILITY
RULES:
A. Each facility licensed pursuant to these regulations must
have facility rules which must include, but is not limited to, the following:
(1) the use of tobacco or
alcohol;
(2) visitors and visiting
hours;
(3) use of the telephone;
(4) hours and volume for
viewing and listening to television, radio, and phonographs;
(5) use and safekeeping of
personal property.
B. Facility rules shall be posted in a conspicuous place in
the facility.
[10/11/90;
Recompiled 10/31/01]
7.26.2.32 ADMISSION
AGREEMENT: Prior to admission to a facility, the
licensee or authorized representative and the client or client's parent/s or
guardian shall sign a written admission agreement. The facility shall keep the
original agreement in the client's record and a copy must be provided to the
client or client/s parent/s or guardian. A standard form may be developed and
used. The admission agreement must meet the criteria stated below:
A. The services that will be provided by the facility and the
charges for such services must be explained in full.
B. The method of payment for the services must be clearly
stated.
C. Terms for termination of the admission agreement either on
part of the facility or the client or parent/s or guardian must be clearly
outlined.
D. A new admission agreement must be made whenever any term of
the agreement is changed by either the facility or the client or the parent/s
or guardian of the client.
[11/1/50,
10/11/90; Recompiled 10/31/01]
7.26.2.33 AGREEMENTS
WITH OUTSIDE RESOURCES: If the ICF/MR does
not employ a qualified professional to furnish a required service, it must have
in effect a written agreement with a qualified professional outside the ICF/MR
to furnish the required service. The agreement must:
A. contain the responsibilities, functions, objectives, and
other items agreed to by the ICF/MR and the qualified professional;
B. be signed by the administrator or his representative and
by the qualified professional;
C. the facility must assure that outside providers meet all appropriate
state and federal requirements, and the quality of services meet the needs of
the individual.
[10/11/90;
Recompiled 10/31/01]
7.26.2.34 STAFF
CLIENT COMMUNICATIONS: The facility must provide
for effective staff and resident participation and communication in the
following manner:
A. The facility must establish appropriate standing
committees such as human rights, and other committees as appropriate to the
facility.
B. The committees must meet regularly and include direct-care
staff whenever appropriate.
C. Reports of staff meetings and standing and ad hoc committee
meetings must include recommendations and their implementation, and be filed in
the facility.
[10/11/90;
Recompiled 10/31/01]
7.26.2.35 COMMUNICATIONS
WITH THE CLIENTS, PARENTS/GUARDIANS: The
facility must have an active program of communication with the client's and
their families, that includes:
A. keeping client's families or legal guardians informed of
resident activities that may be of interest to them and of significant changes
in the client's condition;
B. answering communications from client's relatives promptly
and appropriately;
C. allowing close relatives and guardians to visit at any
reasonable hour, without prior notice, unless the client's needs limit visits;
D. allowing parents to visit any part of the facility that
provides services to clients;
E. encouraging frequent and informal visits home by the
clients;
F. having rules that make it easy to arrange visits home;
G. the facility must insure that individuals allowed to visit
the facility under Section 35.3 [now Subsection C of 7.26.2.35 NMAC] above do
not infringe on the privacy and rights of other clients.
[10/11/90;
Recompiled 10/31/01]
7.26.2.36 RESEARCH
STATEMENT: If the facility conducts research, it must
establish protocols based on standards of conduct currently endorsed by
professional and federal standards.
[10/11/90;
Recompiled 10/31/01]
7.26.2.37 BUILDING(S),
GROUNDS, AND SAFETY REQUIREMENTS:
A. Those programs which are located in a building which is
licensed as a long term care facility or hospital must meet all the building
requirements for that type facility as outlined in the following regulations:
(1) Requirements for General
and Special Hospitals, New Mexico department of health, 7 NMAC 7.2 (10-31-96)
[now 7.7.2 NMAC].
(2) Requirements for Long
Term Care Facilities, New Mexico department of health, 7 NMAC 9.2 (10-31-96)
[now 7.9.2 NMAC].
(3) Copies of these
regulations may be requested from the licensing authority.
B. Capacity of
building(s): All building requirements contained in these regulations are
based on a maximum capacity of fifteen (15) clients. All facilities requesting
licensure for more than fifteen (15) clients will have additional requirements
according to the applicable building and fire codes. Due to the complexities of
the building and fire codes these additional requirements will be outlined by the
appropriate building and fire authorities, and by the licensing authority
through plan review and on site surveys during the licensing process. Maximum
capacity for any facility licensed after the effective date of revisions to
these regulations is four (4) clients.
Exception: ICF/MR facilities may be licensed for a maximum capacity of
six (6) clients based upon a written plan that must be approved by the
licensing authority prior to the facility's licensure. The plan must
demonstrate the following:
(1) the anticipated facility service benefits to the client
population;
(2) how the facility's
services will promote, independence, active treatment and community supports;
(3) how the facility's
services will address the needs and protections of the proposed clients.
C. Number of stories:
All building requirements contained in these regulations are based on buildings
of one (1) story,which do not house clients above or below ground level.
Buildings which are multi-storied or house clients below ground level shall
have additional requirements which vary due to the complexities of the building
and fire codes. These additional requirements will be outlined by the
appropriate building and fire authorities and by the licensing authority
through plan review and on-site surveys during the licensing process.
D. Additional
requirements: A facility applying for licensure pursuant to these
regulations may have additional requirements not contained herein. The
complexity of building and fire codes and requirements of city, county, or
municipal governments may require these additional requirements. Any additional
requirement will be outlined by the appropriate building and fire authorities,
and by the licensing authority through plan review, consultation and on-site
surveys during the licensing process.
E. Access to the
handicapped: All facilities licensed pursuant to these regulations must be
accessible to and usable by handicapped employees, visitors and clients.
F. Prohibition on
mobile homes: Trailers and mobile homes must not be used as any part of a
facility in which services and care are given to clients.
G. Extent of a facility:
All buildings on the premises providing client care and services shall be
considered part of the facility and must meet all requirements of these
regulations.
H. Individual living unit may not be located within 150 feet
of each other.
[11/1/50,
1/1/54, 3/25/69, 10/11/90, 10/31/96, 11/30/99; Recompiled 10/31/01]
7.26.2.38 MAINTENANCE
OF BUILDING(S), GROUNDS, AND EQUIPMENT:
Facilities licensed pursuant to these regulations must keep the
building(s), grounds, and equipment in good repair and presentable at all times
such as, but not limited to the following:
A. All electrical, signaling, mechanical, water supply,
heating, fire protection, and sewage disposal systems must be maintained in a
safe and functioning condition to include regular inspections of these systems.
B. All client care equipment must be maintained in a safe and
operable condition at all times.
C. All furniture and furnishings must be kept clean and in
good repair. Furnishings or decorations of an explosive or highly flammable
character must not be used.
D. The grounds of the facility must be maintained in a safe,
sanitary and presentable condition at all times.
[11/1/50,
1/1/54, 3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.39 HOUSEKEEPING:
A. The facility must be kept free from offensive odors,
accumulations of dirt, rubbish, dust and safety hazards.
B. Client rooms must be cleaned and tidied daily.
C. Floors and walls must be constructed of a finish that can
be easily cleaned. Floor polish shall provide a slip-resistant finish.
D. Bathrooms and lavatories must be cleaned as often as
necessary to maintain a clean and sanitary condition.
E. Deodorizers must not be used to mask odors caused by the
unsanitary conditions or poor housekeeping practices.
F. Storage areas must be kept free from accumulation of
refuse, discarded furniture, old newspapers, and the like.
G. Combustibles such as cleaning rags and compounds must be
kept in closed metal containers in areas providing adequate ventilation and
away from client rooms.
H. Poisonous or flammable substances must not be stored in
residential areas, food preparation areas, or food storage areas.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.40 HEATING,
VENTILATION AND AIR CONDITIONING:
A. Heating, air-conditioning, piping, boilers, and
ventilation equipment must be furnished, installed and maintained to meet all
requirements of current state and local mechanical, electrical, and
construction codes. All facilities must have documentation that fuel-fire
heating systems have been checked, tested and maintained annually by qualified
personnel.
B. The heating method used by the facility must provide a
minimum temperature of seventy (70) degrees F. in all rooms used by the
clients.
C. An ample supply of outside air for proper combustion must
be provided in all spaces where fueled fired boilers or heaters are located.
D. All gas fired heating equipment must be provided with a 100
percent automatic cutoff control valve in event of pilot failure.
E. Each building where gas is used must have an outside gas
shutoff valve. The facility must have a tool readily available which will
operate the shut-off valve. All personnel employed by the facility must be
instructed as to location of the shut-off valve and tool and must know how to
shut off the gas supply in case of fire or gas leakage.
F. No open-face gas or electric heater nor unprotected single
shell gas or electric heating device shall be used for heating the facility.
Portable heating units shall not be used for heating the facility.
G. All boiler, furnace or heater rooms shall be protected from
other parts of the building by construction having a fire resistance rating of
not less than one-hour. Doors to these rooms shall be 1-3/4” solid core.
H. A facility must be adequately ventilated at all times to
provide fresh air and the control of unpleasant odors by either mechanical or
natural means.
I. All gas burning heating and cooking equipment must be
connected to an approved venting system to take the products of combustion
directly to the outside air.
J. All openings to the outer air used for ventilation must be
screened with screening material of not less than sixteen (16) meshes per
lineal inch.
K. Screen doors must be equipped with self-closing devices.
L. A facility must be provided with a system for maintaining
residents comfort during periods of hot weather.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.41 WATER
HEATERS:
A. All fuel fired water heaters shall be separated from other
parts of the facility by partitions having a fire resistive rating of one hour.
Doors to enclosure must be 1-3/4” solid core.
B. All water heaters must be equipped with a pressure relief
valve (pop-off valve).
C. Water heaters must not be located in sleeping rooms or
rooms opening into sleeping rooms.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.42 WATER:
A. A facility must be provided with an adequate supply of
water which is of a safe and sanitary quality suitable for domestic use.
B. If the water supply is not obtained from an approved
public system, the private water system must be inspected, tested, and approved
by the New Mexico environment department prior to licensure. It is the
facility's responsibility to insure that subsequent periodic testing or
inspection of such private water systems be made at intervals prescribed by the
New Mexico environment department.
C. Hot and cold running water under pressure must be distributed
to all food preparation areas, lavatories, washrooms, and laundries. The hot
water temperature in all rooms accessible to clients must be maintained at a
maximum of 110 degrees F.
[11/1/50,
3/25/69, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.43 SEWAGE
AND WASTE DISPOSAL:
A. All sewage and liquid wastes must be disposed of into a
municipal sewage system where such facilities are available.
B. Where a municipal sewage system is not available, the
system used must be inspected and approved by the environmental health
authority.
C. Where municipal or community garbage collection and
disposal service are not available the method of collection and disposal of
garbage used by the facility must be inspected and approved by the New Mexico environment
department.
D. All garbage and refuse receptacles must be durable, have
tight fitting lids, must be insect and rodent proof, washable, leak proof, and
constructed of material which will not absorb liquids. Receptacles must be kept
clean.
[11/1/50,
3/25/69, 10/11/90, 10/31/96; Recompiled 10/31/01]
7.26.2.44 LIGHTING
AND LIGHTING FIXTURES:
A. All areas of the facility including storerooms, stairways,
hallways, and entrances must be lighted sufficiently to make all parts of the
area clearly visible.
B. Exits, exit-access ways, and other areas used at night by
clients and staff must be illuminated.
C. Lighting fixtures must be selected and located with the
comfort and convenience of the clients in minds [sic].
D. Lamps and lighting fixtures must be shaded to prevent glare
to the eyes of clients and staff, and shielded from accidental breakage or
shattering.
E. A facility must be provided with emergency lighting which
will activate automatically upon disruption of electrical services.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.45 ELEMENTS
OF FACILITY ELECTRICAL SYSTEM:
A. Electrical installations and electrical equipment must
comply with all current state and local codes.
B. All fuse and breaker boxes must be labeled to indicate the
area of the facility to which each fuse or circuit breaker provides services.
C. The main electrical service line must have a readily
available disconnect switch. All staff personnel of the facility must know the
location of the electrical disconnect switch in each building to which such
staff are regularly assigned.
D. The use of jumpers or devices to bypass circuit breakers or
fuses is prohibited.
E. Electrical cords and appliances must be U/L approved.
(1) Electrical cords shall be replaced as
soon as they show wear.
(2) Under no circumstances shall extension
cords be used as a general wiring method.
(3) Extension cords must be plugged into an
electrical outlet within the room where used and may not be connected in one
room and extended to some other room.
(4) Extension cords must not be used in
series.
F. The use of multiple sockets in electrical outlets is
strictly prohibited.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.46 WINDOWS:
A. Each resident sleeping room and activity room must have
window area of at least 1/10 the floor area with a minimum of at least ten (10)
square feet.
B. Each sleeping room must provide at least one window for
egress or rescue with a minimum net clear opening of five point seven (5.7)
square feet. The minimum net clear opening for height dimension shall be
twenty-four (24) inches. The minimum net clear opening width dimension shall be
twenty (20) inches.
C. Egress and rescue windows shall have a finished sill height
of not more than forty-four (44) inches above the floor. Exception:
If a sleeping room has a door directly to the outside, egress/rescue window is
not required.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.47 EXITS:
A. Each building must have at least two (2) approved exits.
B. Each exit will be clearly marked with signs having letters
at least six inches (6”) high whose principal strokes are at least three
fourths (3/4”) of an inch wide. Exit signs shall be visible at all times.
C. Exits must be clear of obstructions at all times.
D. Exits, exit paths, or means of egress shall not pass
through hazardous areas, storerooms, closets, bedrooms, or spaces subject to
locking.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.48 CORRIDORS
A. Corridors in a facility must have a minimum width of
thirty-six (36) inches. Corridors in newly constructed facilities shall have a
minimum width of forty-four (44) inches.
B. Corridors shall have a clear ceiling height of not less
than seven (7) feet measured to the lowest projection from the ceiling.
C. Corridors shall be maintained clear and free of
obstructions at all times.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.49 MINIMUM
ROOM DIMENSIONS:
A. All habitable rooms in a facility shall have a ceiling
height of not less than seven feet six inches (7'6”). Kitchens, halls,
bathrooms and toilet compartments will have a ceiling height of not less than
seven (7) feet.
B. All habitable rooms other than a kitchen shall be not less
than seven (7) feet in any dimension.
C. Any room with sloped ceiling is subject to review and
approval or disapproval by the licensing authority, based upon Uniform Building
Code computation of minimum area.
[10/11/90;
Recompiled 10/31/01]
7.26.2.50 DOORS:
A. All client sleeping room doors must be at least 1-3/4”
bonded solid core with a minimum width of 30”.
B. All exit doors must have a minimum width of 36”.
C. All doors to toilet and bathing facilities must have a
minimum width of 24”.
D. Locks on doors to toilets, if used, shall
be of such type that the lock can be released from the outside.
E. Exit doors leading to the outside of the facility with a
capacity of ten (10) or more clients must open outward. Exit doors may be
provided with a night latch, dead bolt, or security chain, provided such
devices are openable from the inside without the use of a key, tool, or any
special knowledge and are mounted at a height not to exceed forty-eight (48)
inches above the finished floor.
F. If locks are not readily openable by all occupants within
the building, then the locks must:
(1) unlock upon activation of the fire detection
or sprinkler system;
(2) unlock upon loss of power in the
facility. The facility must have written approval from the fire authorities
having jurisdiction prior to installing such locking devices.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.51 CLIENT
ROOMS:
A. Each client room must be an outside room.
B. There must be no through traffic in client rooms.
C. Client rooms must communicate directly with other areas of
the facility.
D. Client rooms must be private or semi-private.
E. Private rooms must have at least one hundred (100) square
feet of floor area. Closet and locker area shall not be counted as part of the
available floor space.
F. Semi-private rooms must have at least eighty (80) square
feet of floor area for each bed. Closet and locker area shall not be counted as
part of the available floor space.
G. Client rooms will have beds spaced at least three (3) feet
apart.
[11/1/50,
1/1/54, 3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.52 TOILET
AND BATHING FACILITIES:
A. Toilets and sinks for residents in a facility must be
provided in a ratio of at least one (1) toilet and one (1) sink for every eight
(8) clients.
B. If a facility has a capacity greater than five (5) and
provides service to both male and female clients, separate facilities must be
provided for each sex in the same ratio as stated in 52.1 [now Subsection A of
7.26.2.52 NMAC] above.
C. Both showers and/or tubs must be provided for the clients
use in the same ratio as stated in 52.1 and 52.2 [now Subsections A and B of
7.26.2.52 NMAC] above. At least one tub and one shower must be provided to
allow for residents bathing preference.
D. The combination type tub and shower is permitted.
E. Toilets, tubs, and showers must be provided with grab
bars.
F. If a facility has live-in staff, a separate toilet, hand
washing, and bathing facilities for staff must be provided.
G. Tubs and showers must have a slip resistant surface.
H. Toilet, hand washing, and bathing facilities must be
readily available to the clients. No passage through a client room by another
client to reach a toilet, bath, or hand washing facility is permitted.
I. All facilities must have at least one (1) toilet and
bathing facility which meets requirements for handicapped.
J. Toilet paper and soap must be provided in each toilet
room.
K. The use of a common towel is prohibited.
[11/1/50,
1/1/54, 3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.53 FIRE
SAFETY COMPLIANCE: All current applicable requirements of state
and local codes for fire prevention and safety must be met by the facility.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.54 FIRE
CLEARANCE AND INSPECTIONS:
A. Written documentation from the state fire marshall’s
office or fire prevention authority having jurisdiction evidencing a facility's
compliance with applicable fire prevention codes shall be submitted to the
licensing authority prior to issuance of a initial license.
B. Each facility shall request, from the local fire
prevention authorities, an annual fire inspection. If the policy of the local
fire department does not provide for annual inspection of the facility, the
facility will document the date the request was made and to whom. If the local
fire prevention authorities do make annual inspections, a copy of the latest
inspection must be kept on file in the facility.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.55 FIRE
ALARMS, SMOKE DETECTORS AND OTHER FIRE EQUIPMENT:
A. The facility shall be equipped with an approved, manually
operated alarm system or other continuously sounding alarm approved in writing
by the fire authority having jurisdiction.
B. Approved smoke detectors powered by house electrical
service shall be installed to provide, when activated, an alarm which is
audible in all sleeping areas. Smoke detectors must be installed in corridors
at no more than thirty (30) foot spacing. Areas of assembly, such as the dining
and living room, must be provided with smoke detectors. All smoke detectors
must be connected to the electrical system of the facility and have battery
back-up.
C. Heat detectors shall be installed in all enclosed kitchens
and also powered by the facility electrical service.
D. Fire extinguishers, as approved by the state fire marshall
or fire prevention authority having jurisdiction, must be located in the
facility. Facilities must, as a minimum, have two (2) 2A10BC fire
extinguishers, one (1) located in the kitchen or food preparation area, and one
(1) centrally located in the facility. All fire extinguishers shall be
inspected yearly and recharged as needed. All fire extinguishers must be tagged
noting the date of inspection.
E. Fire extinguishers, alarm systems, automatic detection
equipment, and other fire fighting equipment must be properly maintained and
inspected as recommended by the manufacturer, state fire marshall, or fire
authority having jurisdiction. Documentation of these inspections must be
maintained on file in the facility.
[3/25/69,
10/11-90; Recompiled 10/31/01]
7.26.2.56 STAFF
AND CLIENT FIRE AND SAFETY TRAINING:
A. All staff personnel of the facility must know the location
of and be instructed in proper use of fire fighting equipment and other
procedures to be observed in case of fire or other emergencies. The facility
should request the local fire prevention authority to give periodic
instructions in the use of fire prevention and techniques of evacuation.
B. Facility staff must be instructed as part of their duties
to constantly strive to detect and eliminate potential safety hazards, such as
loose handrails, frayed electrical cords, blocked exits or exit ways, and any
other condition which could cause burns, falls, or other personal injury to the
clients or staff.
C. Each new client must, upon being accepted into the
facility, be given an orientation tour of the facility to include, but not be
limited to, the location of the exits, fire extinguishers, and telephones, and
shall be instructed in action to be taken in case of fire or other emergency.
D. Fire drills and evacuation drills: The facility must
conduct at least one (1) fire drill each month.
(1) Fire drills must be held
at different times of the day.
(2) The fire alarm system or
detector system in the facility shall be used in the conduct of fire drills.
(3) In the conduct of fire
drills, emphasis must be placed upon orderly evacuation under proper discipline
rather than upon speed.
(4) A record of fire drills
held must be maintained on file in the facility. Such record must show date and
time of the drill, number of personnel participating in the drill, any problem
noted during the drill and the evacuation time in total minutes.
(5) The local fire department
should be requested to supervise and participate in fire drills.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.57 PROVISIONS
FOR EMERGENCY CALLS:
A. An easily accessible telephone for summoning help in case of
emergency must be available in each facility. A pay telephone will not fulfill
this requirement.
B. A list of emergency numbers, including, but not limited
to, fire department, police department, ambulance services, and poison control
center, shall be posted by each telephone in the facility.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.58 SMOKING:
A. Smoking by clients and staff must only be done in
supervised areas designated by the facility and approved by the state fire
marshall or local fire prevention authorities. Smoking must not be allowed in a
kitchen or food preparation area.
B. All designated smoking areas must be provided with
suitable ashtrays.
[10/11/90;
Recompiled 10/31/01]
7.26.2.59 ACCESS
REQUIREMENTS FOR THE HANDICAPPED IN NEW FACILITIES: Accessibility to the handicapped must be
provided in all facilities in accordance with ANSI standards and shall include
the following:
A. main entry into the facility must be
ground level or ramped to allow wheelchair access;
B. building must allow access to main living
area and dining area;
C. access to at least one bedroom is
provided which requires a door clearance of thirty-four (34) inches;
D. access to at least one toilet and bathing
facility is required which requires a minimum door clearance of thirty-four
(34) inches, thirty-six (36) inches is recommended. Toilet and bathing area
must also provide a sixty inch (60”) diameter clear space (turning radius for a
wheelchair);
E. if ramps are provided to the building, slope
must be at least twelve inches (12”) horizontal run for each one inch (1”) of
vertical rise;
F. ramps leading to doorway must have a five
(5) foot by five (5) foot level area at the doorway;
G. ramps exceeding a six (6) inch rise shall
be provided with handrails;
H. Requirements contained herein are minimum
and additional handicap requirements may apply depending on size and complexity
of the facility.
[10/11/90;
Recompiled 10/31/01]
7.26.2.60 GOVERNING
BODY:
A. Each facility licensed pursuant to these regulations must
have a governing body that:
(1) exercises general
direction over the affairs of the facility.
(2) establishes policies
concerning the operation of the facility and the welfare of the individuals it
serves.
(3) establishes
qualifications for the administrator in the following areas:
(a) education;
(b) experience;
(c) personal factors;
(d) skills;
(4) appoints the
administrator.
B. The governing body may consist of one individual or a
group.
[10/11/90;
Recompiled 10/31/01]
7.26.2.61 ADMINISTRATOR: Each facility licensed pursuant to these
regulations must have an administrator appointed by the governing body who acts
for the governing body in the overall management of the facility.
[10/11/90;
Recompiled 10/31/01]
7.26.2.62 QUALIFIED
MENTAL RETARDATION PROFESSIONAL: Each
facility licensed pursuant to these regulations must have a qualified mental
retardation professional. A qualified
mental retardation professional is a person who has specialized training or one
(1) year of experience in treating or working with the mentally retarded and is
one of the following:
A. a
psychologist with a masters degree from an accredited program;
B. a
licensed doctor of medicine or osteopathy;
C. an
educator with a degree in education from an accredited program;
D. a
social worker with a bachelors degree in:
(1) social work from an
accredited program; or
(2) a field other than social
work and at least three (3) years of social work experience under the supervision of a qualified
social worker.
E. a
physical or occupational therapist who meets all criteria of the state or
federal government as a physical or occupational therapist.
F. a
speech pathologist or audiologist who meets all criteria of the state or
federal government as a speech pathologist or audiologist.
G. a
registered nurse licensed in the state of New Mexico.
H. a
therapeutic recreation specialist who:
(1) is a graduate of an
accredited program; or
(2) meets all criteria of the
state or federal government as a therapeutic recreation specialist;
I. a
rehabilitation counselor who is certified by the committee on rehabilitation
counselor certification.
J. a
human services professional who has at least a bachelor's degree in a human
services field (including but not limited to sociology, special education,
rehabilitation counseling, or psychology).
[10/11/90;
Recompiled 10/31/01]
7.26.2.63 INTERDISCIPLINARY
TEAM: Each facility licensed pursuant to these
regulations must have an interdisciplinary team assigned to each client.
A. Each interdisciplinary team shall be composed of staff
members including direct care staff and individuals including the client's family
or guardian who are involved or interested in meeting the client's active
treatment needs.
B. Interdisciplinary teams must:
(1) evaluate each client's
needs;
(2) plan an individualized
habilitation program to meet each client's identified needs;
(3) quarterly review each
client's responses to their program and revise the program accordingly.
[10/11/90;
Recompiled 10/31/01]
7.26.2.64 SUPPORT
STAFF: Each facility licensed pursuant to these
regulations must have either adequate staff not involved in direct care to
clients or contractual services to perform the following functions:
A. administration;
B. fiscal;
C. clerical;
D. housekeeping and maintenance.
[10/11/90;
Recompiled 10/31/01]
7.26.2.65 DIRECT
CARE STAFF: Direct care staff must make care and
development of the clients, their primary responsibility, this includes
training of each client in the activities of daily living and in the
development of self-help and social skills.
A. The facility management must insure that the direct care
staff are not diverted from their primary responsibilities by housekeeping or
clerical duties or other activities not related to client care.
B. Members of the direct care staff from all shifts must
participate in appropriate activities relating to the care and development of
the client including at least, referral, planning, initiation, coordination,
implementation, follow-through, monitoring and evaluation.
[10/11/90;
Recompiled 10/31/01]
7.26.2.66 STAFF
EVALUATION AND DEVELOPMENT: A facility licensed
pursuant to these regulations must have a written plan for the orientation,
on-going staff development, supervision, and evaluation of all staff members.
A. The facility must have a staff training program
appropriate to the size and nature of the facility that includes:
(1) orientation for each new
employee to acquaint them with the philosophy, organization, program, practices
and goals of the facility;
(2) orientation for each new employee on the facility's emergency
and safety procedures;
(3) orientation for each new
employee on the policies and procedures of the facility.
B. The facility must have continuing in-service training for
all employees to update and improve their skills.
C. The facility must have supervisory and management training
for each employee who is in, or a candidate for, a supervisory position.
D. Each facility must have someone designated to be
responsible for staff development and training.
E. Any employee or agent of a facility or agency who is
responsible for assisting a client in boarding or alighting from a motor
vehicle must complete a state-approved training program in passenger transportation
assistance before assisting any client.
F. Any employee or agent of a facility or agency who drives a
motor vehicle provided by the facility or agency for use in the transportation
of clients must complete:
(1) a state approved training
program in passenger assistance, and
(2) a state approved training
program in the operation of a motor vehicle to transport clients of a regulated facility or
agency.
G. Each facility and agency shall establish and enforce
written policies (including training) and procedures for employees who provide
assistance to clients with boarding or alighting from motor vehicles.
H. Each facility and agency shall establish and enforce
written policies (including training) and procedures for employees who operate
motor vehicles to transport clients.
[10/11/90,
11/30/99; Recompiled 10/31/01]
7.26.2.67 ORGANIZATION
CHART: The facility must have an organization chart
that shows the following:
A. the major operating programs of the facility;
B. the staff divisions of the facility;
C. the administrative personnel in charge of the programs and
divisions;
D. the lines of authority, responsibility and communication
for administrative personnel.
[10/11/90;
recompiled 10/31/01]
7.26.2.68 HEALTH
REQUIREMENTS FOR STAFF:
A. Prior to employment all staff must obtain a health
certificate stating that they are free from tuberculosis.
B. Health certificate means a completed New Mexico department
of health, public health division form 015, “health certificate” signed by a
physician licensed in New Mexico or a public health nurse in one of the public
health division health offices who is acting for the state tuberculosis control
officer.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.69 STAFF/CLIENT
RATIOS: For each facility regardless of organization
or design must have, as a minimum, overall staff/client ratios (allowing for a
five (5) day work week plus holiday, vacation and sick time) as shown below:
A. Those facilities serving children under the age of six (6)
years, severely and profoundly retarded, severely physically handicapped, or
client's who are aggressive, assaultive, or security risks, or who manifest
severely hyperactive or psychotic-like behavior, the overall ratio is one (1)
staff member to three point two (3.2) clients.
B. Those facilities serving moderately retarded clients
requiring habit training, the overall ratio is one (1) staff member to four (4)
clients.
C. Those facilities serving clients in vocational
training programs and adults who work in sheltered employment situation, the
overall ratio is one (1) staff member to six point four (6.4) clients.
[10/11/90;
Recompiled 10/31/01]
7.26.2.70 CRIMINAL
RECORDS CHECK AS CONDITION OF EMPLOYMENT:
A. All staff of a facility providing services must apply for
a nationwide criminal records check and employment history in compliance with
New Mexico regulations governing criminal records check.
B. Copies of the above cited regulations will be provided by
the department of health, caregivers criminal history screening program.
C. Fingerprint cards, instructions, and employment history
forms will be provided by the department of health, caregivers criminal history
screening program.
[10/11/90,
11/30/99; Recompiled 10/31/01]
7.26.2.71 ACTIVE
TREATMENT SERVICES: Each client must receive a continuous active
treatment program, which includes aggressive, consistent implementation of a
program of specialized and generic training, treatment, health services, and
related services as described in these regulations, that is directed toward:
A. the acquisition of the behaviors necessary for the client
to function with as much self determination and independence as possible;
B. the prevention of deceleration of regression or loss of
current optimal functional status;
C. clients who are admitted by the facility must be in need of
receiving active treatment services;
D. active treatment does not include services to maintain
generally independent clients who are able to function with little supervision
or in the absence of a continuous active treatment plan.
[10/11/90;
Recompiled 10/31/01]
7.26.2.72 CLIENT
ACTIVITIES: Every facility licensed pursuant to these
regulations must develop an activity schedule for each client that:
A. The amount of daily active treatment a person receives
should be based on the individual needs of that person and planned and provided
for by the facility in both formal and informal settings directed at achieving
needed and possible independence. To the extent possible, the active treatment
schedule should allow for the flexible participation of the individual in a
broad range of options, rather than a fixed routine.
B. Allows free time for individual or group activities using
appropriate materials.
C. Includes planned outdoor periods all year round.
D. Each client's activity schedule must be available to direct
care staff and be carried out daily.
E. The facility must insure that a multiple-handicapped or
non-ambulatory client:
(1) spends a major portion of
the waking day out of bed;
(2) spends a portion of the
waking day out of his bedroom area;
(3) has planned daily
activity and exercise periods;
(4) moves around by various methods and devices whenever possible.
[1/1/54,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.73 PERSONAL
POSSESSIONS: The facility must allow the clients to have
personal possessions such as toys, books, pictures, games, radios, arts and
crafts materials, religious articles, toiletries, jewelry, and letters.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.74 CONTROL
AND DISCIPLINE OF CLIENTS: The facility must
have written policies and procedures for the control and discipline of clients
that are available in each living unit and to parents and guardians.
A. If appropriate, clients must participate in formulating
these policies and procedures.
B. The facility must not allow:
(1) corporal punishment of a
client;
(2) a client to discipline
another client unless it is done as part of an organized self-government
program conducted in accordance with written policy;
(3) a client to be placed
alone in a locked room.
[10/11/90;
Recompiled 10/31/01]
7.26.2.75 PHYSICAL
RESTRAINT OF CLIENTS: Except as provided for behavior modification
programs, the facility may allow the use of physical restraint on a client only
if absolutely necessary to protect the client from injuring himself or others.
A. The facility may not use physical restraint:
(1) as punishment;
(2) for the convenience of
the staff;
(3) as a substitute for activities
or treatment.
B. The facility must have written policies that specify:
(1) how and when physical
restraints may be used;
(2) the staff members who
must authorize its use;
(3) the method for monitoring
and controlling its use.
C. An order for physical restraint may not be in effect longer
than twelve (12) hours.
D. Appropriately trained staff must check a client placed in a
physical restraint at least every thirty (30) minutes and keep a record of
these checks.
E. A client who is in a physical restraint must be given an
opportunity for motion and exercise for a period of not less than ten (10)
minutes during each two (2) hours of restraint.
[10/11/90;
Recompiled 10/31/01]
7.26.2.76 MECHANICAL
DEVICES USED FOR PHYSICAL RESTRAINT:
Mechanical devices used for physical restraint must be designed and used
in a way that causes the client no physical injury and the least possible
physical discomfort.
A. A totally enclosed crib or a barred enclosure is a
physical restraint.
B. Mechanical supports used to achieve proper body position
and balance are not physical restraints. However, mechanical supports must be
designed and applied:
(1) under the supervision of
a qualified professional;
(2) in accordance with
principles of good body alignment, concern for circulation, and allowance for change of position.
[10/11/90;
Recompiled 10/31/01]
7.26.2.77 CHEMICAL
RESTRAINT OF CLIENTS: The facility shall not use chemical
restraints in the following manner:
A. excessively;
B. as punishment;
C. for the convenience of the staff;
D. as a substitute for activities or treatment;
E. in quantities that interfere with a client habilitation program.
[10/11/90;
Recompiled 10/31/01]
7.26.2.78 BEHAVIOR
MODIFICATION PROGRAMS:
A. “Aversive stimuli”:
things or events that a client finds unpleasant or painful that are used
to immediately discourage undesired behavior may be used by the facility as a
means of behavior modification.
B. “Time out”: a
procedure designed to improve a client's behavior by removing positive
reinforcement when his behavior is undesirable may be used by the facility as a
means of behavior modification.
C. Behavior modification programs involving the use of
aversive stimuli or time out must be:
(1) reviewed and approved by
the facility's human rights committee and the qualified mental retardation
professional;
(2) conducted only with the
consent of the affected client's parents or legal guardian;
(3) described in written
plans that are kept on file in the facility;
(4) a physical restraint used
as a time-out device shall be applied only during behavior modification
exercises and only in the presence of the trainer.
(5) time-out devices and
aversive stimuli may not be used for longer than one (1) hour for time-out
purposes involving removal from a situation, and then only during the behavior
modification program and only under the supervision of the trainer.
[10/11/90;
Recompiled 10/31/01]
7.26.2.79 GROUPING
AND ORGANIZATION OF LIVING UNITS:
A. A facility licensed pursuant to these regulations may not
house clients of grossly different ages, developmental levels, and social needs
in close physical or social proximity unless the housing is planned to promote
the growth and development of all those housed together.
B. The facility may not segregate clients on the basis of
their physical handicaps. It must integrate residents who are mobile,
non-ambulatory, deaf, blind, epileptic, and so forth with others of comparable
social and intellectual development.
C. Individual living units may not be located within 150 feet
of each other.
[10/11/90,
11/30/99; Recompiled 10/31/01]
7.26.2.80 RECREATION
SERVICES: The facility must coordinate recreational
services with other services and programs provided to each client in order to:
A. make the fullest possible use of the facility's resources;
B. maximize benefits to the clients;
C. design and construct or modify recreation areas and
facilities so that all residents, regardless of their disabilities have access
to them;
D. provide recreation equipment and supplies in a quantity and
variety that is sufficient to carry out the stated objectives of the activities
programs.
[10/11/90;
Recompiled 10/31/01]
7.26.2.81 RESIDENT
CLOTHING: The facility must insure that each client:
A. has enough neat, clean, suitable and seasonable clothing;
B. has his own clothing marked with his name when necessary;
C. is dressed daily in their own clothing unless this is
contraindicated in written medical orders;
D. is trained and encouraged as appropriate to:
(1) select their daily
clothing;
(2) dress themselves;
(3) change their clothes to
suit their activities;
(4) has storage space for
their clothing that is accessible to them even if they are in a wheelchair.
[1/1/54,
3/25/96, 10/11/90; Recompiled 10/31/01]
7.26.2.82 CLIENT
ROOMS: The facility must provide each client with:
A. a separate bed of proper size and height for the
convenience of the client;
B. bedding appropriate to the weather and climate;
C. a clean comfortable mattress;
D. appropriate furniture, such as a chest of drawers, a table
or desk, and an individual closet with clothes racks and shelves accessible to
the client.
[11/1/50,
1/1/54, 3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.83 STORAGE
SPACE IN LIVING UNITS: Each facility
licensed pursuant to these regulations must provide:
A. space for equipment for daily out-of-bed activity for all
clients who are not yet mobile, except those who have a short-term illness or
those few clients for whom out-of-bed activity is a threat to life;
B. suitable storage space, accessible to the client for
personal possessions, such as toys and prosthetic equipment;
C. adequate clean linen and dirty linen storage areas.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.84 HEALTH,
HYGIENE, GROOMING AND TOILET TRAINING:
A. Each client must be trained to be as independent as
possible in health, hygiene and grooming practices, including bathing, brushing
teeth, shampooing, combing and brushing hair, shaving and caring for toenails
and fingernails.
B. Each client who does not eliminate appropriately and
independently must be in a regular, systematic toilet training program and a record
must be kept of their progress in the program.
C. A client who is incontinent must be bathed or cleaned
immediately upon voiding or soiling, unless specifically contraindicated by the
training program and all soiled items must be changed.
D. The facility must establish procedures
for:
(1) weighing each client
monthly, unless the special needs of the client require more frequent weighing;
(2) measuring the height of
each client every 3 months until the client reaches the age of maximum growth;
(3) maintaining weight and
height records for each client;
(4) insuring that each client
maintains a normal weight.
E. At least every three (3) days a physician must review
orders prescribing bed rest or prohibiting a client from being outdoors.
F. The facility must furnish, maintain in good repair, and
encourage the use of dentures, eyeglasses, hearing aids, braces, and other aids
prescribed for a client by an appropriate specialist.
[1/1/54,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.85 DENTAL
SERVICES:
A. Diagnostic
services:
(1) The facility must provide
each client with comprehensive diagnostic dental services that include a
complete extraoral and intraoral examination using all diagnostic aids
necessary to properly evaluate the client's oral condition, not later than one
(1) month after a client's admission to the facility unless they received the
examination within six (6) months before admission.
(2) The facility must review
the results of the examination and enter them in the client's record.
B. Treatment: The
facility must provide each client with comprehensive dental treatment that
includes:
(1) provision for emergency dental treatment on a 24-hour-a-day
basis by a qualified dentist;
(2) a system that assures
that each client is re-examined as needed but at least once a year.
C. Education and
training: The facility must provide education and training in the
maintenance of oral health that includes:
(1) a dental hygiene program
that informs clients and all staff on nutrition and diet control measures, and
clients and living unit staff on proper oral hygiene methods;
(2) instruction of parents or
guardians in the maintenance of proper oral hygiene in appropriate instances,
for example when the client leaves the facility.
[3/25/69,
10/11/90; Recompiled 10/31/01]
7.26.2.86 PREVENTIVE
HEALTH SERVICES: The facility must have preventive health
services for clients that include:
A. means for the prompt detection and referral of health
problems through adequate medical surveillance, periodic inspection and regular
medical examinations;
B. annual physical examinations that include:
(1) examination of vision and
hearing;
(2) routine screening
laboratory examinations as determined necessary by the physician and special studies
when needed.
C. immunizations using as a guide the recommendations of the
public health service advisory committee on immunization practices and of the
committee on the control of infectious diseases of the American academy of
pediatrics;
D. Tuberculosis control in accordance with New Mexico state
law;
E. Reporting of communicable diseases and infections in
accordance with New Mexico state law.
[10/11/90;
Recompiled 10/31/01]
7.26.2.87 MEDICAL
SERVICES: The facility must:
A. provide medical services through direct contact between
physicians and clients and through contact between physicians and individuals
working with the clients;
B. provide health services including treatment, medications,
diet, and any other health service prescribed or planned for the client
twenty-four (24) hours a day;
C. have available electroencephalographic services as needed;
D. have enough space, facilities and equipment to fulfill the
medical needs of the clients;
E. provide evidence that hospital and laboratory services are
used in accordance with professional standards.
F. Goals and evaluations: Physicians must participate, when
appropriate, in:
(1) the continuing
interdisciplinary evaluation of individual clients for the purposes of
beginning, monitoring, and following-up on individualized habilitation
programs;
(2) the development for each
client of a detailed written statement of:
(a) case management goals for physical and mental health,
education and functional and social competence;
(b) a management plan detailing the various habilitation or
rehabilitation services to achieve those goals with clear designation of
responsibility for implementation.
(3) The facility must review
and update the statement of treatment goals and management plans as needed but
at least annually to insure:
(a) continuing appropriateness of the goals;
(b) consistency of management methods with
the goals;
(c) the achievement of progress toward the goals.
[11/1/50,
10/11/90; Recompiled 10/31/01]
7.26.2.88 PSYCHOLOGICAL
SERVICES: The facility must:
A. provide psychological services through personal contact
between psychologists and clients and through contact between psychologists and
individuals involved with the clients;
B. have available enough qualified staff and support
personnel to furnish the following psychological services based on need:
(1) administration and
supervision of psychological services;
(2) staff training.
C. A qualified psychologist must:
(1) participate, when
appropriate, in the continuing interdisciplinary evaluation of each individual
client for the purpose of beginning, monitoring and following-up on the clients
individualized habilitation program.
(2) report and disseminate
evaluation results in a manner that:
(a) promptly provides information useful to staff working directly
with the clients;
(b) maintains accepted standards of confidentiality.
(3) participate, when appropriate, in the development of written
detailed, specific and individualized habilitation program that:
(a) provide for periodic review, follow-up and updating;
(b) are designated to maximize each client's
development and acquisition of perceptual skills, sensorimotor skills,
self-help skills, communication skills, social skills,self-direction, emotional
stability, and effective use of time, including leisure time.
[10/11/90;
Recompiled 10/31/01]
7.26.2.89 PHYSICAL
AND OCCUPATIONAL THERAPY SERVICES: The
facility must provide physical and occupational therapy services through direct
contact between therapist and individuals involved with the clients.
A. Physical and occupational therapy staff must provide
treatment training programs that are designed to:
(1) preserve and improve
abilities for independent function, such as range of motion, strength,
tolerance, coordination and activities of daily living;
(2) prevent, insofar as
possible, irreducible or progressive disabilities through means such as the use
of orthotic and prosthetic appliances, assistive and adaptive devices,
positioning, behavior adaptations and sensory stimulation.
B. The therapist must:
(1) work closely with the
client's primary physician and with other medical specialists;
(2) record regularly and
evaluate periodically the treatment training progress;
(3) use the treatment
training progress as the basis for continuation or change in the client's
program.
C. The facility must have evaluation results, treatment
objectives, plans and procedures, and continuing observations of treatment
progress, which must be:
(1) recorded accurately,
summarized, and communicated to all relevant parties;
(2) used in evaluating
progress;
(3) included in the client's
record kept in the living unit.
[10/11/90;
Recompiled 10/31/01]
7.26.2.90 NURSING
SERVICES: The facility must provide clients with
nursing services, in accordance with their needs, that include, as appropriate,
the following:
A. Registered nurse participation:
(1) The pre-admission
evaluation study and plan.
(2) The evaluation study,
program design, and placement of the client at the time of admission.
(3) The periodic re-evaluation
of the type, extend [sic] and quality of services and programming.
B. Training in habits of personal hygiene, family life and
sex education that includes, but is not limited to, family planning and
venereal disease counseling.
C. Control of communicable diseases and infections through:
(1) Identification and
assessment.
(2) Reporting to medical
authorities.
(3) Implementation of
appropriate protective and preventive measures.
(4) Development of a written
nursing services plan for each client as part of the total habilitation
program.
(5) Modification of the
nursing plan in terms of the client's daily needs, at least annually for adults
and more frequently for children in accordance with developmental changes.
D. Management of the medication aide program in accordance
with the board of nursing.
[3/25/69,
10/11/90, 11/30/99; Recompiled 10/31/01]
7.26.2.91 SOCIAL
SERVICES: The facility must provide, as part of an
inter-disciplinary set of services, social services to each client directed
toward:
A. maximizing the social functioning of each client;
B. enhancing the coping capacity of each client's family;
C. asserting and safeguarding the human and civil rights of
the retarded and their families;
D. fostering the human dignity and personal worth of each
client;
E. the development of the discharge plan;
F. the referral to appropriate community resources.
[10/11/90;
Recompiled 10/31/01]
7.26.2.92 LAUNDRY
SERVICES: The facility must manage its laundry
services to [sic] that it meets daily clothing and linen needs without delays.
A. Each client must have available a clean change of clothing
whenever necessary.
B. There must be separate handling and storage of clean and
soiled linens.
C. Linens must be laundered and disinfected prior to re-use by
another client.
D. New linens must be laundered before use.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.93 SPEECH
PATHOLOGY AND AUDIOLOGY SERVICES: The
facility must provide speech pathology and audiology services through direct
contact between speech pathologists and audiologist and clients, and working
with other personnel, including but not limited to, teachers and direct care
staff. Speech pathology and audiology services must include:
A. screening and evaluation of clients with respect to speech
and hearing functions;
B. comprehensive audiological assessment of clients, as indicated
by screening results that include tests of puretone air and bone conduction,
speech audiometry and other procedures as necessary, and the assessment of the
use of visual cues;
C. assessment of the use of amplification;
D. provision for procurement, maintenance and replacement of
hearing aids, as specified by a qualified audiologist;
E. comprehensive speech and language evaluation of clients,
as indicated by screening results including appraisal of articulation, voice,
rhythm, and language;
F. participation in the continuing interdisciplinary
evaluation of individual clients for purposes of beginning, monitoring, and
following-up on individualized habilitation programs;
G. treatment services as an extension of the evaluation
process that include:
(1) direct counseling with
clients;
(2) consultation with
appropriate staff for speech improvement and speech education activities;
(3) work with appropriate
staff to develop specialized programs for developing each client's
communication skills, in comprehension, including speech, reading, auditory
training, hearing aid utilization and skills in expression, including
improvement in articulation, voice, rhythm, and language.
H. participation in in-service training programs for direct
care and other staff.
[10/11/90;
Recompiled 10/31/01]
7.26.2.94 PHARMACY
SERVICES: Any facility licensed pursuant to these
regulations that supervises the administration or self-administration of medications
for clients must have a current custodial care facility license issued by the
New Mexico board of pharmacy.
A. The facility must make formal arrangements for qualified
pharmacy services, including provision for emergency service.
B. Have a current pharmacy manual that:
(1) includes policies and
procedures and defines the functions and responsibilities relating to pharmacy
services;
(2) is revised annually to
keep abreast of current developments in services and management techniques;
(3) have a formulary system
approved by a responsible physician and pharmacist and other appropriate staff.
Copies of the facility's formulary system and of the American Hospital
Formulary Service must be located and available in the facility.
C. Pharmacist:
(1) Pharmacy services must be
provided under the direction of a qualified pharmacist.
(2) The pharmacist must:
(a)
when a client is admitted
obtain, if possible, a history of prescription and non-prescription drugs used
and enter this information in the client's record;
(b) receive the original, or a direct copy, of the physician's drug
treatment order;
(c) maintain for each client an individual record of all
prescription and non-prescription medication dispensed, including quantities
and frequency of refills;
(d) participate, as appropriate, in the continuing
interdisciplinary evaluation of individual clients for the purpose of
beginning, monitoring and following up on individualized habilitation programs;
(e) establish quality specifications for drug purchases and insure
that they are met.
(3) A pharmacist must
regularly review the medication record of each client for potential adverse
reactions, allergies, interactions, contraindications, rationality and laboratory
test modifications and advise the physician of any recommended changes with
reasons and with an alternate drug regimen.
(4) The responsible
pharmacist, physician, nurse and other professional staff must write policies
and procedures that govern the safe administration and handling of all drugs.
The following policies and procedures must be included:
(a) self-administration of drugs, whether prescribed or not.
(b)
the pharmacist or an
individual under his supervision must compound, package, label and dispense
drugs including samples and investigational drugs. Proper controls and records
must be kept of these processes.
(c) each drug must be identified up to the point of
administration.
(d) whenever possible, the pharmacist must dispense drugs that
require dosage measurements in a form ready to be administered to the client.
D. Drugs and medications:
(1) A medication must be used
only by the client for whom it is issued. Only appropriately trained staff may
administer drugs.
(2) Any drug that is
discontinued or outdated and any container with a worn, illegible or missing
label must be returned to the pharmacy for proper disposition.
(3) The facility must have:
(a) an automatic stop order on all drugs;
(b) a drug recall procedure that can be readily used;
(c) a procedure for reporting adverse drug reactions to the Food
and Drug Administration;
(d) an emergency kit available to each living unit and appropriate
to the needs of its clients.
(4) Medication errors and
drug reactions must be recorded and reported immediately to the practitioner
who ordered the drug.
E. Drug storage:
(1) The facility must store
drugs under proper conditions of sanitation, temperature, light, moisture,
ventilation, segregation and security.
(2) The facility must store
drugs used externally and drugs taken internally on separate shelves or in
separate cabinets.
(3) The facility must keep
medication that is stored in a refrigerator containing other items in a
separate compartment with proper security.
(4) If there is a drug
storeroom separate from the pharmacy, an inventory of receipts and issues of
all drugs from that storeroom must be kept.
(5) The facility must meet
the drug security requirements of federal and state laws that apply to
storerooms, pharmacies and living units.
[11/1/50,
1/1/54, 3/25/69, 10/11/90, 11/30/99; Recompiled 10/31/01]
7.26.2.95 FOOD
AND NUTRITION SERVICES:
A. Dietician: The facility must employ a qualified
dietitian either full-time, part-time, or on a consultant basis. If a qualified
dietitian is not employed full-time, the facility must designate a person to
serve as the director of food service.
B. Food services: The facility's food services must include:
(1) menu planning;
(2) initiating food orders or
requisitions;
(3) establishing
specifications for food purchases and insuring that the specifications are met;
(4) storing and handling
food;
(5) preparing and serving
food;
(6) maintaining sanitary standards in compliance with the New
Mexico environment department food service regulations;
(7) orienting, training and
supervising food service personnel.
C. Diet requirements:
(1) The facility must provide each client
with a nourishing well-balanced diet.
(2) Modified diets must be:
(a) prescribed by the client's interdisciplinary team with a
record of the prescription kept on file;
(b) planned, prepared and served by individuals who have received
adequate instruction;
(c) periodically reviewed and adjusted as needed.
(3) The facility must furnish
a nourishing, well-balanced diet in accordance with the recommended dietary
allowances of the food and nutrition board of the national research council,
national academy of sciences, adjusted for age, sex, activity and disability,
unless otherwise required by medical needs.
(4) A client may not be
denied a nutritionally adequate diet as a form of punishment.
D. Meal service:
(1) The facility must serve
at least three (3) meals daily at regular times comparable to normal mealtimes
in the community with:
(a) not more than fourteen (14) hours between a substantial
evening meal and breakfast of the following day;
(b) not less than ten (10) hours between breakfast and the evening
meal of the same day.
(2) Food must be served:
(a) in appropriate quantity;
(b) at appropriate temperature;
(c) in a form consistent with the developmental level of the
resident;
(d) with appropriate utensils;
(e) food served and uneaten must be discarded.
E. Menus:
(1) Must be written in
advance.
(2) Provide a variety of
foods at each meal.
(3) Be different for the same
days of each week and adjusted for seasonal changes.
(4) Menus must be kept on file for at least
thirty (30) days as served.
F. Food storage:
(1) Dry or staple food items
at least twelve (12) inches above the floor, in a ventilated room not subject
to sewage or waste water back flow or contamination by condensation, leakage,
rodents or vermin.
(2) Perishable foods must be
kept at proper temperatures to conserve nutritive values.
G. Work areas:
(1) The facility must have effective
procedures for cleaning all equipment and work areas.
(2) The facility must be
provided with hand washing facilities to include hot and cold water, soap and
paper towels adjacent to the work areas.
H. Dining areas and service:
(1) The facility must serve
meals for all residents, including the mobile non-ambulatory, in dining rooms
unless otherwise required for health reasons or by decision of the team
responsible for the client's program.
(2) The facility must provide table service for all clients who
can and will eat at a table, including clients in wheelchairs.
(3) The facility will equip
areas with table, chairs, eating utensils and dishes designed to meet the
developmental needs of each client.
(4) The facility must
supervise and staff dining rooms adequately to direct self-help dining
procedures and to assure that each client receives enough food.
[11/1/50,
3/25/69, 10/11/90; Recompiled 10/31/01]
7.26.2.96 RELATED
REGULATIONS AND CODES: ICF/MR facilities
subject to these regulations are also subject to other regulations, codes and
standards as the same may from time to time be amended as follows:
A. Health Facility Licensure Fees and Procedures, New Mexico
department of health, 7 NMAC 1.7 (10-31-96) [now 7.1.7 NMAC].
B. Health Facility Sanctions and Civil Monetary Penalties, 7
NMAC 1.8 (10-31-96) [now 7.1.8 NMAC].
C. Adjudicatory Hearings, New Mexico department of health, 7
NMAC 1.2 (2-1-96) [now 7.1.2 NMAC].
D. Caregivers Criminal History Screening Requirements, New
Mexico department of health, 7 NMAC 1.9 (9-1-98) [now 7.1.9 NMAC].
[10/11/90,
10/31/96, 11/30/99; Recompiled 10/31/01]
HISTORY
OF 7.26.6 NMAC:
Pre-NMAC
History: The material in this part was
derived from that previously filed with the State Records Center:
HED
90-5 (PHD), Regulations Governing ICF/MR Facilities, 10-11-90.
History
of Repealed Material: [RESERVED]