Alabama nursing home responsiveness requirements

All alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source and misappropriation of resident property, must be reported IMMEDIATELY to the facility administrator and to other officials under State law, including the State survey and certification agency.

The facility must ensure that all alleged violations involving mistreatment, neglect, or abuse, including injuries unknown source and misappropriation of resident property are reported immediately to the administrator of the facility and to other officials in accordance with State law through established procedures (including to the State survey and certification agency).

Investigation results must be reported to the administrator and to other officials under State law, including the State survey and certification agency, within 5 working days of the incident, with corrective action if the allegation is verified.

The results of all investigations must be reported to the administrator or his designated representative and to other officials in accordance with State law (including to the State survey and certification agency) within 5 working days of the incident, and if the alleged violation is verified appropriate corrective action must be taken.

Catastrophes and unusual occurrences threatening resident, staff, or visitor welfare, safety, or health must be documented within 24 hours, retained 2 years, made immediately available to ADPH surveyors on request, and include life-threatening burns and deaths under unusual circumstances.

Unusual Occurrences. Occurrences such as catastrophes and unusual occurrences which threaten the welfare, safety or health of residents, personnel, or visitors shall be documented within 24 hours of the incident or occurrence.

Evidence of fraud or misrepresentation to obtain money or property from residents or applicants, or misappropriation or conversion of resident money or property, must be reported to the proper authorities at the Alabama Department of Public Health.

Whenever there is found to be evidence of fraud or misrepresentation to secure money or property from residents, or applicants, or there is any evidence of misappropriation or conversion of money or property of residents or applicants, this must be reported to the proper authorities at the Alabama Department of Public Health.

The facility must provide or arrange for physician services 24 hours a day for emergencies, and a physician may delegate tasks to a PA, NP, or clinical nurse specialist who has signed facility protocols, is within scope of practice, and is under physician supervision.

Availability of physicians for emergency care. The facility must provide or arrange for the provision of physician services 24 hours a day, in case of an emergency.

Each resident's medical care must be supervised by a physician, and another physician must supervise that care whenever the attending physician is unavailable.

Physician supervision. The facility must ensure that-- (a) The medical care of each resident is supervised by a physician; and (b) Another physician supervises the medical care of residents when their attending physician is unavailable.

The facility must staff licensed nurses and other nursing personnel on a 24-hour basis, use an RN at least 8 consecutive hours a day 7 days a week, and designate a full-time RN director of nursing who may serve as charge nurse only at facilities averaging 60 or fewer residents.

Sufficient staff. The facility must provide services by sufficient numbers of licensed nurses and other nursing personnel on a 24-hour basis to provide nursing care to all residents in accordance with resident care plans: (a) The facility must use the services of a registered nurse for at least 8 consecutive hours a day, 7 days a week.

A resident has the right to reasonable access to a telephone where calls can be placed without being overheard.

Telephone. The resident has the right to have reasonable access to the use of a telephone where calls can be made without being overheard.

The facility must immediately inform the resident, consult the resident's physician, and notify the legal representative or interested family member upon an injury accident with potential need for physician intervention, a significant change in status, a significant treatment change, or a transfer/discharge decision.

Notification of changes. A facility must immediately inform the resident; consult with the resident's physician; and if known, notify the resident's legal representative or an interested family member when there is:

The facility must maintain detailed written plans and procedures for all potential emergencies and disasters (fire, severe weather, missing residents), train every employee in emergency procedures at hire, periodically review them with existing staff, and run unannounced staff drills.

Disaster and emergency preparedness. The facility must have detailed written plans and procedures to meet all potential emergencies and disasters, such as fire, severe weather, and missing residents.

This is Alabama's closest analog to the federal current-emergency-contact-list duty: the facility must record and periodically update the address and phone number of each resident's legal representative or interested family member.

The facility must record and periodically update the address and phone number of the resident's legal representative or interested family member.

Every bed must have an electrical nurse call station producing an audible signal and a visual signal on the nurses' station annunciator panel until deactivated (facilities licensed after the rules' effective date must keep both signals active in the resident room until deactivated); a distinct emergency call signal is required in each resident toilet and bathroom, turned off only at the calling station, and new systems need supplemental visible signals at corridor intersections where room call lights are not visible from the nurses' station.

Existing nursing facilities shall have an electrical nurse call system at the side of each bed which will provide an initial audible signal and a visual signal on an annunciator panel at the nurses' station until deactivated.

An electrical nurse call system must be provided in each resident toilet and bathroom, with a signal distinct from the regular nurse call signal that can be turned off only at the emergency calling station.

An electrical nurse call system shall be provided in each resident toilet and bathroom and in additions to existing buildings and in remodeling after the effective date of these rules. This signal shall be distinct from the regular nurse call signal and turned off only at the emergency calling station.

The facility must maintain a quality assessment and assurance committee made up of the director of nursing services, a facility-designated physician, and at least three other staff members; it must meet at least quarterly to identify issues needing QA activity and must develop and implement plans of action to correct identified quality deficiencies, and its records are generally shielded from compelled disclosure.

Quality assessment and assurance. A facility must maintain a quality assessment and assurance committee consisting of: (a) The director of nursing services; (b) A physician designated by the facility; and (c) At least three other members of the facility's staff.