Indiana nursing home responsiveness requirements

All alleged violations involving mistreatment, neglect, abuse, injuries of unknown source, or misappropriation of resident property must be reported immediately to the administrator and to other officials including the state survey and certification agency (IDOH).

The facility must ensure that all alleged violations involving mistreatment, neglect, or abuse, including injuries of unknown source, and misappropriation of resident property, are reported immediately to the administrator of the facility and 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 IDOH within five working days of the incident, and verified violations require corrective action.

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

The administrator must immediately telephone IDOH's Division of Long-Term Care, then submit written notice within 24 hours, of any unusual occurrence that directly threatens resident welfare, safety, or health.

Immediately informing the division by telephone, followed by written notice within twenty-four (24) hours, of unusual occurrences that directly threaten the welfare, safety, or health of the resident or residents, including, but not limited to, any: (A) epidemic outbreaks; (B) poisonings; (C) fires; or (D) major accidents.

IDOH's operative reporting policy puts a clock on the word "immediately" in 410 IAC 16.2-3.1-28(c): not later than two hours after the allegation is made if the events involve abuse or result in serious bodily injury, and not later than 24 hours if they do not. Investigation results follow within five working days. Reports are filed through the IDOH Gateway Incident Reporting System; the policy's Comprehensive Care Facilities section cites 42 CFR 483.12(c)(1) and (c)(4) alongside 410 IAC 16.2-3.1-28(c)-(e) as the governing rules.

Immediately means as soon as possible, in the absence of a shorter state time frame requirement, but not later than two hours after the allegation is made, if the events that cause the allegation involve abuse or result in serious bodily injury, or not later than 24 hours if the events that cause the allegation do not involve abuse and do not result in serious bodily injury.

The facility must provide or arrange for physician services twenty-four hours a day in case of emergency. Under 410 IAC 16.2-3.1-22(h)(1), a breach of this subsection is an "offense" — the most serious violation class under IC 16-28-5-1.

The facility must provide or arrange for the provision of physician services twenty-four (24) hours a day, in case of emergency.

The facility must ensure that another physician supervises the medical care of residents whenever the attending physician is unavailable.

Another physician supervises the medical care of residents when their attending physician is unavailable.

The facility must staff nursing personnel 24 hours a day, provide at least 0.5 licensed nurse hours per resident per day averaged weekly, designate a licensed charge nurse on every tour of duty, and use an RN at least 8 consecutive hours a day, 7 days a week.

the facility must use the services of a registered nurse for at least eight (8) consecutive hours a day, seven (7) days a week.

As a condition of any waiver of the 8-hour RN requirement, the state must find that an RN or physician is obligated to respond immediately to telephone calls from the facility during any period registered nursing services are not available.

The state finds that, for any periods in which registered nursing services are not available, a registered nurse or physician is obligated to respond immediately to telephone calls from the facility.

Residents have a right to reasonable access to a telephone and to place calls that cannot be overheard.

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

Residents have a right to personal privacy that expressly extends to written and telephone communications.

(o) The resident has the right to personal privacy and confidentiality of his or her personal and clinical records. (p) Personal privacy includes the following: ... (3) Written and telephone communications.

The nurses' station must be equipped to receive resident calls via a communication system from resident rooms, toilet and bathing facilities, and activity, dining, and therapy areas.

The nurses' station must be equipped to receive resident calls through a communication system from the following: (1) Resident rooms. (2) Toilet and bathing facilities. (3) Activity, dining, and therapy areas.

The facility must maintain a quality assessment and assurance committee (DON, a facility-designated physician, and at least three other staff) that meets at least quarterly and develops and implements corrective plans of action.

A facility must maintain a quality assessment and assurance committee consisting of the following: (1) The director of nursing services. (2) A physician designated by the facility. (3) At least three (3) other members of the facility's staff. (b) The quality assessment and assurance committee shall do the following: (1) Meet at least quarterly to identify issues with respect to which quality assessment and assurance activities are necessary. (2) Develop and implement appropriate plans of action to correct identified issues.