Oklahoma nursing home responsiveness requirements

All reports to OSDH are due within 24 hours of the reportable incident, with a follow-up report within 5 Department business days and a final report within 10 Department business days; abuse, neglect and misappropriation must be reported to the Department, a still-missing resident must be reported to local law enforcement within 2 hours, and suspected criminal acts causing physical harm must be reported immediately to police or the sheriff.

All reports to the Department shall be made within twenty-four (24) hours of the reportable incident unless otherwise noted. A follow-up report of the incident shall be submitted to the Department within five (5) Department business days after the incident. The final report shall be filed with the Department within ten (10) Department business days after the incident.

When a resident, representative or employee gives the administrator a written complaint of abuse, neglect or misappropriation, the facility must comply with the Protective Services for Vulnerable Adults Act, 43A O.S. §§ 10-101 through 10-110 — the separate adult-protective-services reporting track.

If a resident, resident's representative or facility employee submits to the administrator or designated complaint staff a written complaint concerning resident abuse, neglect or misappropriation of resident's property, the facility shall comply with the Protective Services for Vulnerable Adults Act, Title 43A O.S. Sections 10-101 through 10-110.

A nursing facility must maintain a written policy providing for physician services 24 hours a day, post a backup physician list at the nursing station for when the attending physician is unavailable, and arrange for one or more physicians to be available in an emergency — with mandatory transfer to a hospital emergency room if no physician can be reached.

(4) The facility shall have a written policy that provides for physician services to be available twenty-four hours per day. (5) A list of physicians shall be posted at the nursing station for use if the resident's attending physician is not available. (6) The facility shall arrange for one, or more, physicians to be available in an emergency and to advise the facility. The physician called at the time of any emergency shall be noted in the records. If unable to contact a physician, the resident shall be transferred to a hospital emergency room.

The facility must keep a licensed nurse or a physician on call to handle medical emergencies, and the charge person must notify that on-call person when a medical emergency arises (this appears in the subsection governing certified medication aides).

The facility shall have a licensed nurse or physician on-call to handle medical emergencies. The charge person shall notify the designated person when a medical emergency arises.

Every resident must be under the care of a licensed physician responsible for overall medical care, whose duties include an admission history and physical within two weeks of admission, prescribing diet/treatment/medication, and continuing supervision with progress notes at each visit and visits as needed.

Each resident shall be under the care of a licensed physician, who shall be responsible for the resident's overall medical care.

Two separate licensed-nurse duties apply: a licensed nurse must be on duty eight hours a day, seven days a week on the day shift, and, on top of that, a licensed nurse must be on duty twenty-four hours per day (a specialized facility for individuals with intellectual disabilities owes 24-hour nursing only when it has a resident with a medical care plan). A certified medication aide must be on duty on any shift not covered by a licensed nurse, and at least two direct care staff must be on duty and awake at all times regardless of census. The Department may waive the 24-hour licensed-nurse requirement only on a showing of diligent but unsuccessful recruiting and a finding that the waiver will not endanger residents.

There shall be a licensed nurse on duty twenty-four hours per day; provided however, that a facility licensed as a specialized facility for individuals with intellectual disabilities shall only be required to provide 24 hour nursing when it has a resident who has a medical care plan.

This is Oklahoma's express telephone-response duty: the director of nursing must be on duty on the day shift, and the director of nursing or a designee must be reachable by telephone whenever facility staff need them.

The director of nursing or designee shall be available by telephone when needed by facility staff.

Sufficient, adequately trained staff must be on duty 24 hours a day to meet all residents' needs, independent of and in addition to the minimum direct-care staffing ratios.

Sufficient, adequately trained staff shall be on duty, twenty-four hours a day, to meet the needs of all residents residing in the facility without regard to the direct staff ratios.

Every nursing home resident has a statutory right to private communications — expressly including telephone calls — and to visits and consultations with a physician, an attorney, family and resident groups, or any other person of the resident's choosing, plus unopened personal mail.

Every resident shall have the right to have private communications, including telephonic communications and visits and consultations with a physician or an attorney, and meetings of family and resident groups or any other person or persons of the resident's choice, and may send and promptly receive, unopened, the resident's personal mail

The administrative-code hook for the statutory rights: each resident or representative must receive a copy of the 63 O.S. § 1-1918 rights at admission, the rights must be posted conspicuously, and the facility must ensure staff know and observe them.

Each resident or resident's representative shall receive a copy of the resident statutory rights at the time of admission. A copy of the resident rights shall be posted in an easily accessible, conspicuous place in the facility. The facility shall ensure that its staff is familiar with, and observes, the resident rights.

Every nursing facility and specialized facility must have an emergency evacuation plan that is coordinated with and on file at the local emergency management agency and also filed with the State Department of Health; a facility lacking a written disaster plan or an emergency generator must disclose that in writing to each resident or caregiver at admission.

All nursing facilities, assisted living centers, residential care homes and specialized facilities shall have an emergency evacuation plan in place. Such plan shall be coordinated and on file at the local emergency management agency. Such plan shall also be filed with the State Department of Health.

The facility's administrative records, which must be kept in safe storage and be readily available to the Department on request, must include a written disaster plan / emergency evacuation plan.

Written disaster plan/emergency evacuation plan.

The emergency communication channel: during a response to a natural or man-made disaster the facility may route its communications, status reports and assistance requests through the local emergency response coordinator in lieu of filing individual incident reports, then file a final report with the Department within 10 days after the response ends.

In lieu of making incident reports during an emergency response to a natural or man-made disaster, the facility may coordinate its communications, status reports and assistance requests through the local emergency response coordinator, and file a final report with the Department within ten (10) days after conclusion of the emergency response.

Written facility policy must provide for emergency care in case of sudden illness or accident, including identifying the persons to be contacted in an emergency — Oklahoma's closest analog to the federal emergency contact list requirement.

Emergency care shall be provided to residents in case of sudden illness or accident, including persons to be contacted in case of an emergency.

Resident call system requirement: every resident room, toilet and bathing area must give residents a direct means of contacting nursing staff (audible or visual signals, electronic or wireless systems are allowed, and a wireless nurse call system may substitute for or run in parallel with a wired one), and each resident toilet, bath and shower must have an emergency call button usable by a collapsed resident lying on the floor — a pull cord satisfies this.

Each room, toilet and bathing area shall have a means for residents to directly contact nursing staff. This communication may be through audible or visual signs, electronic systems and may include "wireless systems." ... A nurse's call emergency button shall be provided for resident's use at each resident's toilet, bath, and shower room. Such button shall be usable by a collapsed resident lying on the floor (inclusion of a pull cord will satisfy this item.)

Oklahoma's QAA analog: the facility must maintain a quality assessment and assurance committee including the director of nursing, a facility-designated physician and at least one other appropriate staff member, meeting at least quarterly to identify QA activities and to develop and implement plans of action correcting identified quality deficiencies; committee records are shielded from Department disclosure demands and good-faith committee work cannot be used as a basis for sanctions.

The facility shall maintain a quality assessment and assurance committee to address facility and resident's needs. ... The quality assessment and assurance committee shall meet at least quarterly to identify quality assessment and assurance activities. ... The committee shall develop and implement appropriate plans of action to correct identified quality deficiencies.