10A NCAC 13D .2305       QUALITY OF CARE

(a)  The facility shall provide necessary care and services in accordance with medical orders, the patient's comprehensive assessment and on‑going plan of care.

(b)  Acute changes in the patient's physical, mental or psychosocial status shall be evaluated and reported to the physician or other persons legally authorized to perform medical acts.

(c)  The facility shall not utilize any chemical or physical restraints for the purpose of discipline or convenience, and that are not required to treat the patient's medical condition.  An evaluation shall be done to ensure that the least restrictive means of restraint have been initiated on patients requiring restraints.

(d)  The facility shall ensure that all patients who are unable to perform activities of daily living receive the necessary assistance to maintain good grooming, and oral and personal hygiene.  The facility shall ensure appropriate measures are taken to restore the patient's ability to bathe, dress, groom, transfer and ambulate, toilet and eat.

(e)  The facility shall ensure measures are taken to prevent the formation of pressure sores and to promote healing of existing pressure sores.  The facility shall ensure that patients with limited mobility receive appropriate care to promote comfort and maintain skin integrity.

(f)  The facility shall ensure that in‑dwelling catheters are not used unless the patient's clinical condition necessitates their use.  The facility shall ensure incontinent patients receive appropriate treatment to prevent infections and to regain continence to the degree possible.

(g)  The facility shall ensure that patients with limited range of motion, or who are at risk for loss of range of motion, receive treatment services to prevent development of contractures or deformities, and to obtain and maintain their optimal level of functioning.

(h)  The facility shall ensure that patients who are unable to feed themselves receive the appropriate assistance, retraining and assistive devices when needed.

(i)  The facility shall ensure that enteral feeding tubes are used only when the patient's condition indicates the use of an enteral feeding tube is unavoidable.

(j)  The facility shall ensure that patients fed by enteral feeding tubes receive the proper treatment to avoid aspiration pneumonia, metabolic and gastrointestinal problems, and to restore the patient to the highest practicable level of normal feeding function.  The facility shall ensure appropriate care and services are provided to address needs related to hydration and nutrition.

(k)  The facility shall ensure that patients requiring special respiratory care receive appropriate services.

(l)  The facility shall ensure that patients are assisted to utilize personal visual lenses, hearing aids and dentures.

 

History Note:        Authority G.S. 131E‑104;

Eff. January 1, 1996.