Arkansas nursing home responsiveness requirements

Nursing homes must report alleged, suspected, or witnessed abuse, neglect, verbal abuse, sexual abuse, exploitation, misappropriation of resident property, and resident-on-resident physical altercations causing injury to DHS electronically through the Enterprise Licensing System by 11:00 a.m. the next business day after discovery, and must report suspected abuse or neglect of an adult resident immediately to the local law enforcement agency where the facility is located.

The following events shall be reported to the department via ELS no later than 11:00 a.m. on the next business day following discovery by the facility

The facility is directed to arrange, by written agreement signed by the physician and the administrator, for backup physician coverage when the attending physician cannot be located — Arkansas's counterpart to the federal 24-hour emergency physician availability duty, though it is written in permissive 'should' language rather than 'shall'.

The facility should make arrangements for emergency coverage by a physician if the attending physician or his or her attendant cannot be located.

Every nursing home must have a written policy placing the health care of each resident under the supervision of a physician who prescribes a planned regimen of total care based on a medical evaluation.

The facility shall have a written policy indicating that the health care of every patient is under the supervision of a physician who, based on a medical evaluation of the patient's immediate and long-term needs, prescribes a planned regimen of total care.

A licensed registered nurse must be employed full time as director of nursing services and normally work the day shift, with RN relief required for the DON's off days in skilled nursing facilities.

A licensed registered nurse shall be employed full time as the director of nursing services and normally work on the day shift.

A charge nurse (RN, LPN, or licensed psychiatric technician nurse) must be designated for every shift, and the charge nurse's enumerated minimum duties expressly include taking telephone orders from physicians or dentists — the closest Arkansas analog to a licensed-nurse duty to handle physician telephone traffic.

The charge nurse's duties shall include as a minimum: ... (6) Taking phone orders from physicians or dentists;

Arkansas imposes its own minimum staffing floor on certified nursing facilities of 3.36 average direct care hours per resident day each month, with electronic reporting of actual hours to DHS by the 15th of the following month.

Provide each month direct care services by direct care staff equivalent to at least three and thirty-six hundredths (3.36) average direct care hours per resident day

Residents may associate and communicate privately with anyone they choose and may send and receive personal mail unopened, unless the physician documents a medical contraindication in the record; the rule does not separately name telephone access.

Residents may associate or communicate privately with persons of their choice, and may send or receive personal mail unopened, unless medically contraindicated and documented by the physician in the medical record.

The administrator must keep current emergency call data posted conspicuously and immediately available to all staff, including fire and police numbers, ambulance, poison control, every employee to be called in a fire or emergency (administrator and DON included), and a physician available to furnish emergency medical care.

The administrator shall be responsible for ensuring that emergency call information is posted in a conspicuous place so as to be immediately available to all personnel of the nursing home.

New-employee orientation must cover the facility's disaster plan; at least 90% of personnel on each shift must be trained quarterly on firefighting equipment, evacuation, and fire/explosion procedures, and disaster drills including tornado drills are to be run semiannually per shift with signed drill records retained.

Disaster drills, including tornado drills, should be conducted semiannually for each shift.

Existing nursing home buildings must have a nurses' call system whose call location is identifiable from both the corridor and the nurses' station, plus emergency call stations in every resident bath, toilet, and shower area; wireless systems may substitute if they meet § 400-818.

A nurses' call system comprised of an electric buzzer or light system shall be so designed that the location of a call can be determined from the corridor and nurses' station.

New construction must provide a call button at every bed and an emergency call button at every resident toilet, bath, and shower, with calls registering at the nurses' station and producing a visible signal at the room and an audible signal at the station; wireless systems must additionally cover the entire facility and grounds, display the originating location on staff devices, and escalate unanswered calls to other stations or staff.

Calls shall: (A) Register with the floor staff at the nurses' station; and (B) Activate a visible signal at the patient's room and audible signal at the nursing station.