New York nursing home responsiveness requirements

Alleged violations involving mistreatment, neglect or abuse, including injuries of unknown source, must be reported immediately to the facility administrator and to the Department of Health under Public Health Law § 2803-d and 10 NYCRR Part 81.

The facility shall ensure that alleged violations involving mistreatment, neglect or abuse, including injuries of unknown source, are reported immediately to the administrator of the facility and, when required by law or regulation, to the Department of Health in accordance with Section 2803-d of the Public Health Law and Part 81 of this Title through established procedures.

Abuse, mistreatment or neglect reports must be made immediately by telephone to the Department of Health and followed within 48 hours by a written report — New York's own reporting clock.

Reports of physical abuse, mistreatment or neglect made pursuant to this Part shall be made immediately by telephone and followed within 48 hours in writing to the New York State Department of Health, Office of Health Systems Management.

Everyone listed in Public Health Law § 2803-d(1) is a mandated reporter of physical abuse, mistreatment or neglect in residential health care facilities, and any other person may report.

All persons listed in subdivision (1) of section 2803-d of the Public Health Law are required to report, and all other persons may report, physical abuse, mistreatment or neglect in accordance with this Part.

The facility must have written policies prohibiting abuse, neglect and misappropriation, may not employ people with court findings or Nurse Aide Registry findings of abuse, must thoroughly investigate all allegations while preventing further abuse during the investigation, and must take corrective action on verified allegations.

The facility shall document that all alleged violations are thoroughly investigated and shall prevent further potential abuse while the investigation is in progress.

The nursing home must provide or arrange for physician services 24 hours a day in case of an emergency — a near-verbatim state counterpart to the federal emergency physician-availability duty.

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

The resident's responsible physician must give the resident and designated representative his or her name, office address and telephone number and must respond to calls from residents about their medical care — this is New York's express telephone-response duty, and it runs to the PHYSICIAN, not to nursing staff.

provides residents and designated representatives with his or her name, office address and telephone number and responds to calls from residents to discuss the resident's medical care;

The facility must ensure another physician supervises a resident's medical care whenever the attending physician is unavailable — the state's back-up/on-call coverage requirement.

another physician supervises the medical care of residents when the resident's attending physician is unavailable.

A registered professional nurse must be used for at least 8 consecutive hours a day, 7 days a week, or more often as needed to meet New York's minimum staffing hours; a full-time RN director of nursing and a charge nurse on every tour of duty are also required.

The facility shall use the services of a registered professional nurse for at least 8 consecutive hours a day, 7 days a week, or more often as necessary to comply with the minimum staffing requirements set forth in paragraph (2) of subdivision (b) of this Section.

New York exceeds the federal floor with a hard numeric staffing minimum: 3.5 nursing hours per resident per day, of which at least 2.2 must be CNA hours and at least 1.1 must be RN/LPN hours, enforced quarterly against CMS Payroll-Based Journal data with penalties up to $2,000 per day.

every nursing home shall maintain daily average staffing hours equal to 3.5 hours of care per resident per day by a certified nurse aide, registered professional nurse, or licensed practical nurse. Out of such 3.5 hours, no less than 2.2 hours of care per resident per day shall be provided by a certified nurse aide, and no less than 1.1 hours of care per resident per day shall be provided by a registered professional nurse or licensed practical nurse.

Each resident has the right to regular access to the private use of a telephone that is wheelchair accessible and usable by hearing- and vision-impaired residents.

regular access to the private use of a telephone that is wheelchair accessible and usable by hearing impaired and visually impaired residents.

Resident privacy expressly extends to written and telephone communications and to associations and communications with persons of the resident's choice, and residents must be given access to a private area for visits or solitude.

accommodations, medical treatment, written and telephone communications, personal care, associations and communications with persons of his or her choice, visits, and meetings of family and resident groups.

Outside a medical emergency, the facility must consult the resident immediately and notify the resident's physician and designated representative within 24 hours of an injury requiring professional intervention, a significant change in condition, a significant treatment change, or a transfer/discharge decision.

except in a medical emergency, consult with the resident immediately if the resident is competent, and notify the resident's physician and designated representative within 24 hours when there is:

The nursing home must keep a written disaster and emergency preparedness plan updated at least twice a year covering internal and external emergencies, must have written policies on missing residents, must train all employees in emergency procedures at hire, review the plan with staff at least annually, and run staff drills at least twice a year — but the rule contains NO express emergency communication plan or current-contact-list requirement equivalent to 42 CFR 483.73(c).

The nursing home shall have a written plan, updated at least twice a year, with procedures to be followed for the proper care of residents and personnel, and for the reception and treatment of mass casualty victims, in the event of an internal or external emergency resulting from natural or man-made causes including but not limited to earthquake, severe weather, flood, bomb threat, chemical spills, strike, interruption of utility services, nuclear accidents, fire or similar occurrences.

For nursing home construction approved between July 2, 1990 and December 31, 2010, every resident-occupied room must have at least one calling station and every resident a call device, calls must register with floor staff and light a visible signal in the corridor at the resident's door and in the clean workroom, soiled workroom and nourishment station, and an emergency call device is required at each resident toilet, bath and shower.

In resident occupied areas, each room shall be served by at least one calling station and each resident shall be provided with a call device. Two call devices serving adjacent beds may be served by one calling station. Calls shall register with the floor staff and shall activate a visible signal in the corridor at the residents' door, in the clean workroom, in the soiled workroom, and in the nourishment station of the nursing unit.

For older nursing home construction (approved between August 25, 1975 and July 1, 1990), a call button is required at each resident bedside calling to the nurse's station, with the same corridor/workroom/nourishment-station visible signalling, plus a nurses' call emergency button at each resident toilet, bath and shower room.

A call button shall be provided at each resident bedside, which calls to the nurse's station. Two call buttons serving adjacent beds may be served by one calling station.

For nursing home construction after December 31, 2010, New York does not write its own call system text — it incorporates by reference Chapter 4.2 of the FGI Guidelines for the Design and Construction of Health Care Facilities, 2010 edition, so the operative nurse call standard for newer buildings lives in a private copyrighted standard, not in the NYCRR.

Nursing home facilities shall also comply with the Chapter 4.2, "Specific Requirements for Nursing Facilities", of Part 4, "Residential Health Care Facilities", of Guidelines for the Design and Construction of Health Care Facilities, 2010 edition, except where such guidelines and standards are inconsistent with the requirements of this Subpart.

The facility must run a coordinated quality assessment and assurance program with a committee including the administrator, director of nursing, a designated physician, an unaffiliated governing-body member and at least three other staff, meeting at least quarterly, working from a written plan, consulting the Resident Council quarterly, documenting findings and corrective actions, and reporting to the governing body at least four times a year.

The facility shall establish and maintain a coordinated quality assessment and assurance program which integrates the review activities of all nursing home programs and services to enhance the quality of life and resident care and treatment.