Mississippi nursing home responsiveness requirements

Mississippi's abuse-reporting duty for nursing facilities sits in statute, not in the licensure chapter. Any person who, within the scope of employment at a care facility (defined by § 43-47-5(b) to include any institution for the aged or infirm licensed under § 43-11-1 et seq.), or in a professional or personal capacity, has knowledge of or reasonable cause to believe a patient or resident has been the victim of abuse, neglect or exploitation must report it immediately. The facility must report orally or telephonically within 24 hours of discovery, excluding Saturdays, Sundays and legal holidays, and in writing within 72 hours of discovery, to BOTH the Mississippi State Department of Health and the Medicaid Fraud Control Unit of the Attorney General's office (MFCU abuse line 1-800-852-8341). Copies of §§ 43-47-7 and 43-47-37 must be posted prominently in every health care facility, good-faith reporters are immune and protected from retaliation, and knowingly failing to report is a misdemeanor punishable by up to a $500 fine and/or six months in county jail.

By all other care facilities, orally or telephonically, within twenty-four (24) hours of discovery, excluding Saturdays, Sundays and legal holidays, to the State Department of Health and the Medicaid Fraud Control Unit of the Attorney General's office.

A nursing facility must arrange for physician or nurse practitioner/physician assistant services to be available twenty-four hours a day in case of emergency, and under R. 45.22.2 must designate a substitute practitioner whenever the resident's designated physician is unavailable.

The facility shall arrange for the provision of physician or nurse practitioner/physician assistant services twenty-four (24) hours a day in case of an emergency.

Nursing facilities must provide at least 2.80 hours of direct nursing care per resident per 24 hours, with seven-day day-shift RN coverage, a full-time RN Director of Nursing, a charge nurse (RN or LPN) on the 7 a.m.-3 p.m. and 3 p.m.-11 p.m. shifts, and a medication/treatment nurse for each nurses' station on all shifts - though on the 11 p.m.-7 a.m. shift one nurse may serve as both roles, and in facilities over 60 beds the charge nurse may not also be the DON or the medication/treatment nurse; the definitional rule R. 45.2.23 independently requires that an RN or LPN be on active duty at all times.

Minimum requirements for nursing staff shall be based on the ratio of two and eight-tenths (2.80) hours of direct nursing care per resident per twenty-four (24) hours.

Each facility's residents' rights policies must ensure the resident may associate and communicate privately with persons of his or her choice and send and receive personal mail unopened unless medically contraindicated - but Mississippi's rule does NOT expressly name telephone access the way 42 CFR 483.10(g)(6) does.

May associate and communicate privately with persons of his choice, may join with other residents or individuals within or outside of the facility to work for improvements in resident care, and send and receive his personal mail unopened, unless medically contraindicated

Every licensed facility must maintain a written Emergency Operations Plan on the MSDH Office of Emergency Planning and Response template addressing nine critical areas of which Communications is the first, must exercise the plan at least twice a year and review it annually, and must submit written evidence of MSDH review with every license renewal application.

Communications - Facility status reports shall be submitted in a format and a frequency as required by the Office of Emergency Planning and Response

A nurse call system with audible and visual signals must be in place at the nurses' station to receive resident calls from bedrooms, toilets and bathing facilities, and each resident's bed accommodations must include a means at the bedside for signaling attendants.

A call system shall be in place at the nurses' station to receive resident calls through a communication system to include audible and visual signals from bedrooms, toilets, and bathing facilities.