Hawaii nursing home responsiveness requirements

All alleged violations involving mistreatment, neglect, or abuse — including injuries of unknown source and alleged misappropriation of resident property — must be reported immediately to the facility administrator and to other officials under state law, the resident and family/guardian must be told of the allegation and investigation, and the results of every investigation must reach the administrator and the Department of Health within five working days of the incident.

All alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source or origin, and alleged misappropriation of resident property shall be reported immediately to the administrator of the facility, and to other officials in accordance with state law through established procedures.

Requires every resident to be under the care of a physician of the resident's choosing, requires the facility to arrange all physician/PA/APRN visits and services, sets a minimum visit schedule (at least every thirty days for the first ninety days, then no less than quarterly), and requires prompt notification of the practitioner on any accident, injury, or change in condition — but it contains no express "available 24 hours a day for emergencies" or on-call coverage clause.

The facility shall promptly notify the physician, physician assistant, or APRN of any accident, injury, or change in the resident's condition.

Sets Hawaii's licensed-nurse coverage floor — sufficient nursing staff plus at least one RN full-time on the day shift eight consecutive hours seven days a week and at least one licensed nurse on evening and night shifts — and requires an RN to be designated director of nursing; it imposes no duty on an RN or physician to respond to telephone calls, though § 11-94.2-39(e)(1)(B) requires written emergency procedures covering "Notification of the attending physician and other persons responsible for the resident."

There shall be at least one registered nurse at work full-time on the day shift, for eight consecutive hours, seven days a week, and at least one licensed nurse at work on the evening and night shifts, unless otherwise determined by the department.

Hawaii's resident-rights rule guarantees communication with and access to persons and services inside and outside the facility, personal privacy and confidentiality of records, and a right to the names, addresses, and telephone numbers of resident advocacy groups — but it contains NO express right of reasonable access to a telephone or to private telephone communication.

The right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility;

Requires written emergency policies covering rapid primary-care-provider assistance, transportation/hospitalization arrangements, an emergency preparedness kit, and all-hazards planning (hurricane, tsunami, volcanic eruption and lava flow, fire, medical emergencies, terrorist threat, pandemic flu, public health emergencies), plus a written disaster preparedness plan consistent with state and local civil defense guidelines kept readily available in the facility at all times — but it prescribes no separate emergency communication plan and no current emergency contact list.

Arranging for rapid primary care provider assistance;

The physical-plant rule requires three separate call-system elements: an effective signal call system at each resident's bedside (§ 11-94.2-65(e)(8)(E)); a call system in each toilet and bath facility that lets the occupant signal the nursing station in an emergency (§ 11-94.2-65(d)(7)); and a nurses' call system at each nursing station that registers calls within hearing range and is directly visible to on-duty personnel (§ 11-94.2-65(p)(2)).

An effective signal call system at the resident's bedside.

Hawaii's QAPI analog requires a written, data-driven quality assurance and performance improvement program focused on care-outcome and quality-of-life indicators across the full range of services, for which the administrator is personally responsible and accountable and which the governing body must approve annually.

The facility shall develop, implement, and maintain an effective, comprehensive, data-driven quality assurance and performance improvement program that focuses on indicators of the outcomes of care and quality of life for the full range of care and services provided by the facility.