HAR §17-1737-29. Content of NF services

(a) Long- term institutional services shall be provided by free-standing or distinct part NFs that shall meet the eligibility requirements specified in chapters 17-1736 and 17-1739. (b) NFs shall provide: (1) Skilled nursing care and related services for residents who require medical or nursing care; (2) Rehabilitation services for the rehabilitation of injured, disabled, or sick persons; or (3) On a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases. (c) NF services shall be provided either directly by or under the general supervision of licensed practical nurses or registered professional nurses. (d) NF services shall include, but shall not be limited to: (1) Room and board; (2) Administration of medication and treatment; (3) Development, management, and evaluation of the written resident care plan based on physician orders that necessitate the involvement of skilled technical or professional personnel to meet the resident's care needs, promote recovery, and ensure the resident's health and safety; (4) Observation and assessment of the resident's unstable condition that requires the skills and knowledge of skilled technical or professional personnel to identify and evaluate the resident's need for possible medical intervention, modification of treatment, or both, to stabilize the resident's condition; (5) Health education services provided by skilled technical or professional personnel to teach the recipient self care, such as gait training and self administration of medications; (6) Provision of therapeutic diet and dietary supplement as ordered by the attending physician; UNOFFICIAL 1737-27 (7) Laundry service, including items of recipient's washable personal clothing; (8) Basic nursing and treatment supplies, such as soap, skin lotion, alcohol, powder, applicator, tongue depressor, cotton ball, gauze, adhesive tape, band aids, incontinent pad, V-pad, thermometer, blood pressure apparatus, plastic or rubber sheet, enema equipment, and douche equipment; (9) Durable medical equipment and supplies used by residents but which are reusable, such as ice bag, hot water bottle, urinal, bedpan, commode, cane, crutch, walker, wheelchair, and siderail and traction equipment; (10) Activities of the resident's choice (including religious activities) that are designed to provide normal pursuits for physical and psychosocial well-being; (11) Social services provided by qualified personnel; (12) A review of the drug regimen of each resident at least once a month by a licensed pharmacist, as required for a nursing facility to participate in Medicaid; (13) Nonrestorative or nonrehabilitative therapy, or both, provided by nursing staff; and (14) Provision of and payment for, through contractual agreements with appropriate skilled technical or professional personnel, other medical and remedial services ordered by the attending physician which are not regularly provided by the provider. Other services that may be needed, such as transportation to realize the provision of services ordered by the attending physician, shall also be arranged through contractual agreements. The contractual agreement shall stipulate the responsibilities, functions, objectives, service fee, and other terms agreed to by the NF and the person or entity that contracts to provide the service. (15) Feeding assistance performed by a feeding assistant, nurse aide, or nurse. The feeding assistant must work under the supervision of a registered nurse or licensed practical nurse who is licensed to practice in Hawaii. [Eff 08/01/94; am 02/10/97; am 05/05/05; am 05/24/07] (Auth: HRS §346-14; 42 C.F.R. §§430.10, 431.10, 483.1) (Imp: 42 C.F.R. UNOFFICIAL 1737-28 §§440.40, 483.1, 483.20, 483.30, 483.35, 483.160)