HAR §17-1737-34
HAR §17-1737-34. Utilization control for NFs
Cite as Haw. Code R. § 17-1737-34
(a)
This section defines the utilization control process
UNOFFICIAL
1737-34
which shall be administered in accordance with state
and federal regulations to achieve optimal quality
control of the utilization of services provided under
the state plan.
(b) The provisions for utilization control are as
follows:
(1) Providers of NF services shall admit only
those recipients whose health care needs may
be met by the facility;
(2) Each resident shall receive the necessary
nursing, medical and psychosocial services to
attain and maintain the highest possible
mental and physical functional status, as
defined by the comprehensive resident
assessment and plan of care;
(3) The NF shall operate and provide services in
compliance with all state, federal, and local
laws, regulations, and codes and with
accepted professional standards and
principles that apply to professionals
providing services in the NF;
(4) The services provided by or arranged by the
NF shall meet professional standards of
quality and be provided by qualified persons
in accordance with each resident's written
plan of care; and
(5) The following requirements regarding nurse
aides shall be met:
(A) A nursing facility shall not use any
individual working in the facility as a
nurse aide for more than four months
unless the individual:
(i) Has completed a nurse aide training
and competency evaluation program
certified by the State; and
(ii) Is competent to provide such
services;
(B) A nursing facility shall provide for
individuals used as nurse aides a nurse
aide training competency and evaluation
program certified by the State and such
preparation as may be necessary to
complete such a program;
(C) A nursing facility shall not permit an
individual to serve as a nurse aide or
provide services of a type for which the
individual has not demonstrated
competency. A nursing facility shall
not use such an individual as a nurse
aide unless the facility has inquired of
UNOFFICIAL
1737-35
the state registry as to information in
the registry concerning the individual;
(D) A nursing facility shall not use any
individual as a nurse aide if there has
been a period of twenty-four consecutive
months during which no nursing or
nursing-related services were performed
by the individual for monetary
compensation. Such individual will need
to complete a new training and
competency evaluation program;
(E) A nursing facility shall provide regular
performance reviews and regular in-
service education to assure that
individuals used as nurse aides are
competent to perform services as nurse
aides, including training for
individuals providing nursing and
nursing-related services to residents
with cognitive impairments;
(F) Any findings of abuse or neglect of
residents or misappropriations of
residents' property by nurse aides shall
be reported to the state department of
health; and
(G) The State shall:
(i) Establish and maintain a registry
of all individuals who have
satisfactorily completed a nurse
aide training and competency
evaluation program certified by the
State;
(ii) The registry shall include specific
documented findings by the State of
resident neglect or abuse or
misappropriation of resident
property as well as any brief
statement of the individual
disputing the findings; and
(iii) When inquiries to the registry are
made concerning an individual
listed in the registry, any
information disclosed concerning
such a finding shall also include
disclosure of any such statement in
the registry relating to the
finding or a clear and accurate
summary of such a statement.
[Eff 08/01/94, am 08/25/07 ]
(Auth: HRS §346-14; 42 U.S.C.
UNOFFICIAL
1737-36
§§1395, 1396; Pub. L. No. 100-203;
42 C.F.R. §§431.10, 435.1009,
456.1, 483.1) (Imp: Pub. L. No.
100-203; 42 C.F.R. §§435.1009,
442.1, 456.1, 456.250, 483.1,
483.20, 483.25, 483.75)