The Housing and Special-care Homes Regulations

Transcription

1 1 The Housing and Special-care Homes Regulations being Saskatchewan Regulations 34/66 (effective February 15, 1966) as amended by Saskatchewan Regulations 170/66, 287/66, 625/68, 94/69, 97/69, 274/69, 243/71, 61/73, 225/73, 82/74, 226/74, 69/75, 73/75, 265/75, 73/76, 83/76, 65/80, 134/81, 186/83, 97/85, 15/2000, 88/2000, 117/2003 and 22/2004. NOTE: This consolidation is not official. Amendments have been incorporated for convenience of reference and the original statutes and regulations should be consulted for all purposes of interpretation and application of the law. In order to preserve the integrity of the original statutes and regulations, errors that may have appeared are reproduced in this consolidation.

2 2 Table of Contents 1 Interpretation PART I PART II Administrative Procedures for Special-care Homes 1 Licensing 1A to 1C Repealed 2 to 2.3 Repealed 3 Accounting procedures 4 Staff employed in homes 5 Health requirements for staff 6 Admissions and nursing services 7 Medical coverage 8 Medications 8.1 Repealed 9 Guest records 10 Physical, recreational and diversional activities 11 Food services 11.1 Food services operations 12 to 14 Repealed PART III Administrative Procedures Self-contained Housing Units Repealed PART IV Design and Construction of Special-care Homes Repealed PART V Design and Construction of Self-contained Housing for the Aged Repealed

3 3 SASKATCHEWAN REGULATION 34/66 under The Housing and Special-care Homes Act THE REGULATIONS Interpretation 1 In these regulations: PART I (1) Act means The Housing and Special-care Homes Act; (2) applicant means a person who has applied, for a licence to conduct or operate a special-care home for the care or accommodation of persons who are unable to fully care for themselves and who require prolonged care; (3) Repealed. 3 Nov 2000 SR 88/2000 s2. (4) Repealed. 7 Apr 2000 SR 15/2000 s3. (5) department means the Department of Health; (6) director means the employee of the department who is responsible for the administration of these regulations; (7) Repealed. 7 Apr 2000 SR 15/2000 s3. (8) guest for the purpose of these regulations means a guest, patient, inmate, boarder, roomer, boarder and roomer, or resident for whom the operator for compensation is providing supervisory, personal or nursing care, or any combination thereof; (9) home means a special-care home; (9.1) intensive personal or nursing care means care that is carried out under the supervision of a registered nurse or registered psychiatric nurse at the direction of the resident s physician or a nurse practitioner and that is provided to a resident who has an advanced physical or mental illness that is reasonably stabilized and that is not expected to deteriorate in the near future in the absence of an additional disease or accident; (10) licence means a licence issued pursuant to Section 22 of the Act and in accordance with the conditions set forth in these regulations; (10.1) Repealed. 3 Nov 2000 SR 88/2000 s2. (10.2) limited personal care means care provided to a resident whose full mental or physical capabilities are restricted to the extent that the resident requires supervision and some assistance with the activities of daily living;

4 4 (10.3) Repealed. 3 Nov 2000 SR 88/2000 s2. (11) minister means the Minister of Health; (12) Repealed. 2 Dec 83 SR 186/83 s3. (13) measured capacity means the maximum number of beds in a special-care home permissible under these regulations to ensure that the facilities of the home may be most effectively and efficiently utilized; (13.1) nurse practitioner means a registered nurse who is entitled pursuant to The Registered Nurses Act, 1988 to practise in the nurse practitioner category; (14) Repealed. 3 Nov 2000 SR 88/2000 s2. (15) operator means the person, board of directors or governing body which assumes responsibility for the operation of a special-care home; (16) Repealed. 3 Nov 2000 SR 88/2000 s2. (17) registered nurse means a person who is currently registered with the Saskatchewan Registered Nurses Association; (18) registered psychiatric nurse means a person who is currently registered with the Saskatchewan Registered Psychiatric Nurses Association; (19) Repealed. 7 Apr 2000 SR 15/2000 s3. (20) Repealed. 2 Dec 83 SR 186/83 s3. (21) Repealed. 17 Oct 2003 SR 117/2003 s3. (22) supervisory care means the provision of guidance or supervision in the activities of daily living to a resident who is essentially independent; (23) Repealed. 3 Nov 2000 SR 88/2000 s2. (24) Repealed. 7 Apr 2000 SR 15/2000 s3. (25) Repealed. 7 Apr 2000 SR 15/2000 s3. 25 Feb 66 Part I s1; 8 Oct 71 SR 243/71; 30 Mar 73 SR 61/73 s1; 26 Jne 81 SR 134/81 s3; 2 Dec 83 SR 186/83 s3; 7 Apr 2000 SR 15/2000 s3; 3 Nov 2000 SR 88/2000 s2; 17 Oct 2003 SR 117/2003 s3; 7 May 2004 SR 22/2004 s3. PART II Administrative Procedures for Special-care Homes Licensing 1 Repealed. 7 Apr 2000 SR 15/2000 s4. (b) Applicants for a licence shall furnish such information, documents, plans and specifications, and complete such forms as the minister may from time to time prescribe.

5 5 (c) The minister may grant a licence to an applicant who has complied with the Act and these regulations if he is satisfied that there is a need for the operation of the special-care home mentioned in the application, that such home will be of benefit to persons who may be cared for therein, and that the operation of such a home will be in the public interest. (d) Every licence shall contain: (i) name of the home, (ii) location of the home, (iii) measured capacity of the home, (iv) type of accommodation, and (v) any other matter the minister, from time to time deems advisable, and shall expire at midnight on the thirty-first day of December in the year in which it is issued. (e) There shall be no fee for the issue of a licence. (f) Every licensee shall display his licence and keep it continuously displayed in a conspicuous place on the premises in respect of which it is issued. (g) The licence shall automatically expire upon transfer of ownership of the home. (h) Repealed. 7 Apr 2000 SR 15/2000 s4. (i) Repealed. 7 Apr 2000 SR 15/2000 s4. 25 Feb 66 Part II s1; 29 Nov 68 SR 625/68 s1; 28 Sep 73 SR 225/73 s2; 5 Dec 75 SR 265/75; 7 Apr 2000 SR 15/2000 s4. 1A to 1C Repealed. 26 Jne 81 SR 134/81 s4. 2 Repealed. 7 Apr 2000 SR 15/2000 s5. 2A Repealed. 3 Apr 80 SR 65/ to 2.3 Repealed. 7 Apr 2000 SR 15/2000 s5. Accounting procedures 3(a) Repealed. 7 Apr 2000 SR 15/2000 s6. (b) Repealed. 7 Apr 2000 SR 15/2000 s6. (c) Safekeeping of guest s valuables. (i) Cash turned over to the operator of the home for safekeeping shall be deposited in a banking institution and the account designated as the guests trust account, a receipt given to the guest or his representative and proper records maintained of the trust account. (ii) If bonds, documents and other valuables are turned over to the operator of the home by the guest for safekeeping, the operator shall maintain a clear and accurate record of the same.

6 6 (d) No operator, member of the management, nor person employed by the operator or management of a home shall accept, without permission from the director, a power of attorney from a guest in the said home. 25 Feb 66 SR 65/66 Part II s3; 26 Jne 81 SR 134/81 s6; 7 Apr 2000 SR 15/2000 s6. Staff employed in homes 4(a) Nursing care requirements: (b) (i) (ii) (iii) Intensive personal or nursing care accommodation. The care of the guests is to be carried out by or under the direction of a registered nurse or registered psychiatric nurse and supervision by the guest s personal physician or a nurse practitioner. Sufficient staff, excluding dietary, laundry and maintenance staff, shall be employed to provide at least 2 hours of personal or nursing care per guest per day, with nursing staff ratio of one registered nurse or one registered psychiatric nurse to seven ancillary nursing staff such as nursing aides, orderlies, etc. The home shall employ at least one full time registered nurse or registered psychiatric nurse. Nursing staff shall be provided on a 24-hour basis. Limited personal care accommodation: The care of the guest is to be carried out by or under the direction of an operator having practical nursing experience. Sufficient staff, excluding dietary, laundry and maintenance staff, shall be employed to provide at least 45 minutes personal care per guest per day. Not less than one staff member shall be dressed and on duty at all times. Supervisory care accommodation: The care of the guests is to be carried out by, or under supervision of an operator having practical nursing experience. Sufficient staff, excluding dietary, laundry and maintenance staff, shall be employed to provide not less than 20 minutes direct supervisory care per guest per day. The operator shall have staff in the home who shall be available at all times. Food service requirements: (i) Every home providing care to 10 or more guests and preparing meals within the home shall employ at least one staff member whose primary responsibility is food preparation. (ii) Sufficient staff shall be employed to assure adequate standards of food service.

7 7 (c) Repealed. 17 Oct 2003 SR 117/2003 s4. (d) Training of staff: The operator shall encourage and facilitate in-service training of staff in the home and participation of staff in approved courses or seminars which may become available from time to time. 25 Feb 66 Part II s4; 7 Nov 69 SR 274/69; 17 Oct 2003 SR 117/2003 s4; 7 May 2004 SR 22/2004 s4. Health requirements for staff 5(1) The board must, in consultation with the medical health officer responsible for the area in which the special-care home is located, establish a written policy with respect to employee health and requirements for the clinical testing and immunization of employees for the purpose of protecting guests and staff against communicable diseases and the transmission of communicable diseases. (2) The policy required by subsection (1) must provide for: (a) creating and maintaining accurate records of all immunizations, medical examinations and tests carried out pursuant to the policy; and (b) retaining the records described in clause (a) with respect to each employee for a period of not less than two years after he or she ceases to be an employee. 7 Apr 2000 SR 15/2000 s7. Admissions and nursing services 6(a) The operator shall offer and continue to provide accommodation only to guests for whom he can assure safe and adequate care, considering the available staff and physical facilities of the home. An admission procedure acceptable to the director shall be established to ensure that persons in need of the level of care which is available in the home are admitted. For guests whose needs exceed the level of care available in the home, arrangements shall be made for prompt transfer to a general hospital, psychiatric hospital, geriatric hospital, or any other home appropriate for the needs of the guest. (b) Guests shall, at all times, show evidence of adequate care. Criteria for determining adequate care shall include: (i) appearance of good personal hygiene, such as a clean healthy-appearing skin, clean trimmed finger-nails and toe-nails, clean and neatly groomed hair, clean teeth and mouth, and an absence of cracked lips; (ii) evidence of good nutritional practices, well-balanced menus, knowledge of nutritional values, the use of self-help feeding devices as needed, adherence to special diet as ordered by the physician or a nurse practitioner; (iii) evidence of proper positioning of guests for the prevention of contractures and pressure sores;

8 8 (iv) evidence that guests are encouraged to be up and dressed in their own personal clothing for at least a brief period every day, unless the physician or a nurse practitioner has ordered otherwise; (v) evidence of adequate equipment such as walkers, overbed frames, side rails, etc., to meet the needs of guests; (vi) evidence of safety measures such as grab-bars in bathrooms and shower rooms, rails in corridors, etc.; (vii) evidence of an attempt to create as cheerful and home-like an environment as possible; (viii) evidence of kind and considerate care; (ix) evidence that restraints are used in an emergency only and on the order of a physician. (c) The operator shall, whenever possible, segregate guests in a home to accommodate them with guests who have similar interests and are in a comparable state of health and aging. 25 Feb 66 Part II s6; 7 May 2004 SR 22/2004 s5. Medical coverage 7(a) Every guest or his guardian, or failing this, the agency responsible for his care, shall designate a licensed medical practitioner for the provision of medical care and treatment of the guest during his stay in the home. (b) Every guest in a home shall be examined by a licensed medical practitioner on admission to the home; thereafter, the guest shall receive medical attention as often as his condition requires, but in any event not less than once every year. The results of all examinations shall be recorded on the medical record of the guest. (c) A physician shall at all times be on call for emergency care in the home. (d) In case of serious illness or accident, the nurse in charge at the time that an emergency arises shall be responsible for securing immediate medical care by a physician or a nurse practitioner for guests in the home. Arrangement for prompt transfer to a hospital shall be made as recommended by the attending physician or a nurse practitioner. (e) In case of serious illness or accident the next of kin shall be notified immediately. (f) Guests having or suspected of having a communicable disease, either at the time of admission or after admission, may be isolated on the recommendation of a physician or a nurse practitioner and may be transferred to an appropriate facility on the recommendation of a physician. 25 Feb 66 Part II s7; 7 May 2004 SR 22/2004 s6.

9 9 Medications 8(a) Subject to clause (a.1), all medications and treatments shall be given only on the written order of a physician or a nurse practitioner. (a.1) If it is necessary to take the order of a physician or a nurse practitioner over the telephone: (i) the person who takes the order: (A) shall, on the form provided for the purpose pursuant to clause 9(g), write the order, the name of the physician or nurse practitioner who gave the order and the date and time of the order; and (B) shall sign the form; and (ii) the physician or nurse practitioner who gave the order shall verify the order by signing the form on his or her next visit to the home. (b) All medications shall be kept in locked cabinets. Medications requiring refrigeration shall be kept in a refrigeration unit. If the refrigeration unit is to be used for storing foods, the medications shall then be kept in a special locked tray or container that is clearly marked. (c) All medications shall be retained in their original container. (d) The medication container of every guest shall have a clear and adequate label of the issuing pharmacy. This label shall include such items as prescription number, name of guest, name of physician or nurse practitioner, directions for administration of the drug, date of issue and name of the pharmacy. Any medication container having a soiled or damaged label shall be returned to the issuing pharmacy for re-labelling. (e) If the attending physician so authorizes in writing, pharmaceuticals belonging to guests shall be given to them when discharged or transferred. Unused quantities of prescription drugs not given to a discharged guest or remaining in the home after a guest has expired, shall be destroyed or otherwise disposed of in accordance with pharmaceutical regulations. Narcotics or controlled drugs left by a discharged or deceased guest shall be disposed of in accordance with existing laws. (f) A home may stock, or have on hand, only those medications that are regularly available without prescription at a commercial pharmacy. 25 Feb 66 Part II s8; 7 May 2004 SR 22/2004 s Repealed. 7 May 2004 SR 22/2004 s8.

10 10 Guest records 9 The following records shall be kept for all guests admitted to a home: (a) Admission record. This shall be completed prior to, or at time of admission. It shall contain information such as: name of guest, former address, age, sex, marital status, religion, name and address of attending physician, name and address of next of kin or responsible party, diagnosis by physician, and the date of admission to the home. (b) Medical and social assessment. A copy of the medical and social assessment of the guest, completed prior to, or at time of admission. (c) Financial agreement. A copy of the financial agreement between the guest and the home, signed by the operator and the guest or the responsible party. (d) Separation sheet. This section shall include information concerning discharge of the guest from the home such as reason for discharge, condition of health of guest at time of discharge, whether discharged with or without consent of physician, where and to whom discharged, if death, the time, place and cause of death, and other information of this nature shall be recorded. (e) The operator shall keep such other records as the director may from time to time prescribe. In intensive personal or nursing care accommodation the following additional records shall be maintained: (f) Inventory of personal effects. A list of the guest s nonexpendable personal effects shall be prepared at the time of admission. The list shall be dated and signed by the operator of the home and the guest, or his representative. Should a guest dispose of any of his effects or acquire any new articles, such should be noted on the inventory sheet. (g) Orders and progress notes of the physician or nurse practitioner. Special forms shall be provided for notes of the physician or nurse practitioner and kept in the personal file of the guest. Each entry shall be dated and signed by the physician or nurse practitioner who made the entry. (h) Nurses notes. There shall be a special form to record treatment, medications and diets, pertinent information regarding the condition of guests and reports of unusual incidents. Entries shall be dated and signed. 25 Feb 66 Part II s9; 7 May 2004 SR 22/2004 s9.

11 11 Physical, recreational and diversional activities 10(a) The home shall arrange for or provide individual and group activities, recreational and diversional opportunities suited to the needs and interest of its guests. Participation in any activity shall be voluntary. (b) Guests shall have free access to the recreational areas and shall not be required to remain in their rooms, unless so ordered by their physicians or by a nurse practitioner. Some activities and recreational opportunities shall be made available to guests who are unable to leave their rooms. (c) The home shall co-operate with the clergy in the community in meeting the spiritual needs of the guests, having regard to the size of the home and circumstances permitting utilization of space for religious services. Guests shall be free to attend, or not to attend, religious services inside or outside the home. (d) Guests shall be permitted to leave the home to visit, shop, or engage in other social activities unless good cause can be shown for refusing such permission. 25 Feb 66 Part II s10; 7 May 2004 SR 22/2004 s10. Food services 11(a) Meal service: (i) Basic daily food requirements for each guest shall be provided in accordance with Canada s Food Guide as approved by the Canadian Council on Nutrition. (ii) Special diets shall be served to a guest when ordered by the attending physician or by a nurse practitioner. (iii) At least three meals shall be served each day with no more than a 15-hour span between a substantial supper and breakfast. Supplementary feeding shall be provided as required. (iv) Menus shall be planned and written at least one week in advance and shall be posted in an accessible place. Records of menus as served shall be filed for at least 3 months and made available for inspection. (v) Records of foods purchased shall be retained on file for at least 3 months and made available for inspection. (vi) Guests shall be encouraged and assisted in taking their meals in the dining room. Tray service shall be provided for guests incapable of eating in the dining room and provision made for hot foods to be served hot, and cold foods to be served cold. (b) Repealed. 7 Apr 2000 SR 15/2000 s8. 25 Feb 66 Part II s11; 7 Apr 2000 SR 15/2000 s8; 7 May 2004 SR 22/2004 s11.

12 12 Food service operations 11.1(1) Sections 9, 10 and 11 of The Public Eating Establishments Regulations apply, with any necessary modification, to the operator of a special-care home, whether or not the operator is required to be licensed pursuant to those regulations. (2) In addition to the requirements of subsection (1) and section 11 of this Part, the operator of a special-care home must comply with the requirements set out in sections 3.0 and 5.0 to 8.0 of the document entitled Provincial Public Eating Establishment Standards and dated May 7, 1997 that is published and distributed by the department. 7 Apr 2000 SR 15/2000 s9. 12 to 14 Repealed. 7 Apr 2000 SR 15/2000 s10. PART III Administrative Procedures Self-contained Housing Units Repealed. 7 Apr 2000 SR 15/2000 s11. PART IV Design and Construction of special-care Homes Repealed. 17 Oct 2003 SR 117/2003 s4. 1C to 21 Repealed. 7 Apr 2000 SR 15/2000 s13. PART V Design and Construction of Self-contained Housing for the Aged Repealed. 7 Apr 2000 SR 15/2000 s14. REGINA, SASKATCHEWAN Printed by the authority of THE QUEEN S PRINTER Copyright 2004