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Rule 3701-17-01 | Definitions.
As used in rules 3701-17-01 to 3701-17-26 of the
Administrative Code: (A) "Accommodations" means
housing, meals, laundry, housekeeping, transportation, social or recreational
activities, maintenance, security, or similar services that are not personal
care services or skilled nursing care. (B) "Activities of daily
living" means bed mobility, locomotion and transfer, bathing, grooming,
oral hygiene, toileting, dressing, and eating. (C) "Administrator" means the
individual, licensed as a nursing home administrator under Chapter 4751. of the
Revised Code, who is responsible for planning, organizing, directing and
managing the operation of the nursing home. (D) "Chemical restraint" means any drug that is
used for discipline or staff convenience and not prescribed to treat medical
symptoms. (E) "Complex therapeutic diet" has the same
meaning as "therapeutic diet" as that term is defined in paragraph
(NN) of this rule. (F) "Department" means the department of health
of the state of Ohio. (G) "Dietitian" means an individual licensed
under Chapter 4759. of the Revised Code to practice dietetics. (H) "Director" means the director of the
department of health of the state of Ohio or the director's duly
authorized representative. (I) "Elopement" occurs when a
resident leaves a home or safe area without the facilities knowledge or without
supervision. A situation in which a resident with decision-making capacity
leaves the home will not be considered an elopement unless the home has reason
to suspect, or the circumstances surrounding the resident's departure
indicate, that the departure is unusual or atypical. (J) "Full-time" means an
individual works thirty hours or more per week. (K) "Habitable floor area" means the clear floor
area of a room and the floor area occupied by the usual bedroom furniture, such
as beds, chairs, dressers, and tables and does not include the floor area
occupied by wardrobes unless the wardrobe is of the resident's own choice
and it is in addition to the individual closet space in the resident's
room, and areas partitioned off in the room such as closets and toilet
rooms. (L) "Home" has the same meaning as in division
(A)(1) of section 3721.01 of the Revised Code. (M) "Hospice care program" or "hospice"
means an entity licensed under Chapter 3712. of the Revised Code. (N) "Lot" means a plot or parcel of land
considered as a unit, devoted to a certain use, or occupied by a building or
group of buildings that are united by a common interest and use, and the
customary accessories and open spaces belonging to the same. (O) "Licensed practical nurse" means a person
licensed under Chapter 4723. of the Revised Code to practice nursing as a
licensed practical nurse. (P) "Maximum licensed capacity" means the
authorized type and number of residents in a nursing home as determined in rule
3701-17-04 of the Administrative Code. (Q) "Mechanically altered food" means that the
texture of food is altered by chopping, grinding, mashing, or pureeing so that
it can be successfully chewed and safely swallowed. (R) "Mental impairment" means a condition in
which a part of a person's brain has been damaged or is not working
properly. Mental impairment does not mean mental illness as defined in section
5122.01 of the Revised Code or intellectual disability as used in Chapter 5123.
of the Revised Code. (S) "Nurse" means a registered nurse or a
licensed practical nurse. (T) "Nurse aide" means an individual as defined
in paragraph (A)(3) of rule 3701-17-07.1 of the Administrative
Code. (U) "Nursing home" has the same meaning as in
section 3721.01 of the Revised Code. (V) "Ohio building code" means the building
standards as adopted by the board of building standards pursuant to section
3781.10 of the Revised Code. (W) "On duty" means being in the nursing home,
awake, and immediately available. (X) "Operator" means the person, firm,
partnership, association, or corporation which is obligated by section 3721.05
of the Revised Code to obtain a license in order to open, maintain, or operate
a home. (Y) "Personal care services" means services
including, but not limited to, the following: (1) Assisting residents
with activities of daily living; (2) Assisting residents
with self-administration of medication, in accordance with rules adopted under
section 3721.04 of the Revised Code; (3) Preparing special
diets, other than therapeutic diets, for residents pursuant to the instructions
of a physician or a licensed dietitian, in accordance with rules adopted under
section 3721.04 of the Revised Code. "Personal care services" does not
include "skilled nursing care" as defined in paragraph (JJ) of this
rule. (Z) "Pharmacist" means an individual licensed
under Chapter 4729. of the Revised Code to practice pharmacy. (AA) "Physically restrained" means that residents
are confined or in the home in such a manner that the freedom for normal egress
from the home is dependent upon the unlocking or unbolting by others of one or
more doors or barriers, or the removal of physical restraints, except as
permitted under paragraph (B)(3) of rule 3701-17-15 of the Administrative
Code. (BB) "Physical restraint" means, but is not
limited to, any article, device, or garment that interferes with the free
movement of the resident and that the resident is unable to remove easily, a
geriatric chair, or a locked room door. (CC) "Physician" means an individual licensed
under Chapter 4731. of the Revised Code to practice medicine and surgery or
osteopathic medicine and surgery. (DD) "Resident" means an individual for whom the
nursing home provides accommodations. (EE) "Residential care facility" has the same
meaning as in section 3721.01 of the Revised Code. (FF) "Residential
facility" has the same meaning as in section 5119.34 of the Revised
Code. (GG) "Residents' rights advocate"
means: (1) An employee or
representative of any state or local government entity that has a
responsibility regarding residents and that has registered with the department
of health under division (B) of section 3701.07 of the Revised
Code; (2) An employee or
representative of any private nonprofit corporation or association that
qualifies for tax-exempt status under section 501(a) of the "Internal
Revenue Code of 1986," 100 Stat. 2085, 26 U.S.C.A. 1, as amended (2015),
and that has registered with the department of health under division (B) of
section 3701.07 of the Revised Code and whose purposes include educating and
counseling residents, assisting residents in resolving problems and complaints
concerning their care and treatment, and assisting them in securing adequate
services to meet their needs; (3) A member of the
general assembly. (HH) "Registered nurse" means an individual
licensed to practice nursing as a registered nurse under Chapter 4723. of the
Revised Code. (II) "Resident call system" means a set of devices
that are connected electrically, electronically, by radio frequency
transmission, or in a like manner that can effectively alert the staff member
or members on duty, at the nurses' station or at another point in the
nursing unit, of emergencies or resident needs and that can not be deactivated
from any location except from where the resident initiated the
call. (JJ) "Skilled nursing care" means procedures that
include technical skills and knowledge beyond those the untrained person
possesses and that are commonly employed in providing for the physical, mental,
and emotional needs of the ill or otherwise incapacitated. "Skilled
nursing care" includes, but is not limited to, the following: (1) Irrigations,
catheterizations, application of dressings, and supervision of special diets
and therapeutic diets; (2) Objective observation
of changes in the resident's condition as a means of analyzing and
determining the nursing care necessary and the need for further medical
diagnosis and treatment; (3) Special procedures
contributing to rehabilitation including programs that prevent falls and other
incidents that can result in loss of physical function; (4) Administration of
medication by any method ordered by a physician, such as hypodermically,
rectally, or orally, including observation of the resident after receipt of the
medication and including intravenously-administered medication; (5) Carrying out other
treatments prescribed by the physician that involve a similar level of
complexity and skill in administration. This is including but not limited
to: (a) Treatments and services to prevent or heal pressure
sores; (b) Tube feeding management; (c) Respiratory and trachea care management; (d) Suctioning; and (e) Pain management. (KK) "Special diet" means a therapeutic diet
limited to: (1) Nutrient adjusted diets, including
high protein, no added salt, and no concentrated sweets; (2) Volume adjusted diets, including
small, medium, and large portions; (3) The use of finger foods or bite-sized
pieces for a resident's physical needs; or (4) Mechanically altered
food. (LL) "Sponsor" means an adult relative, friend, or
guardian of a resident who has an interest or responsibility in the
resident's welfare. (MM) "Supervision" means the monitoring of a
resident to ensure that the health, safety, and welfare of the resident is
protected. (NN) "Therapeutic diet" means a diet ordered by a
health care practitioner: (1) As part of the
treatment for a disease or clinical condition; (2) To modify, eliminate,
decrease, or increase certain substances in the diet; or (3) To provide
mechanically altered food when indicated. (OO) "Toilet room" means a room or rooms
conforming to the Ohio building code, and including a water closet and a
lavatory which is located in or adjacent to the room in which the water closet
is located. (PP) "Volunteer" means an individual working in or
used by a home who does not receive or expect to receive any form of
compensation for services the individual performs other than reimbursement for
actual expenses.
Last updated July 17, 2025 at 7:45 AM
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Rule 3701-17-02 | Application of rules.
(A) All nursing homes will comply
with rules 3701-17-01 to 3701-17-26 of the Administrative Code and the
applicable provisions of Chapter 3721. of the Revised Code. (B) Nothing contained in rules
3701-17-01 to 3701-17-26 of the Administrative Code is to be construed as
authorizing the supervision, regulation, or control of the spiritual care or
treatment of residents in any nursing home who rely upon treatment by prayer or
spiritual means in accordance with the creed or tenets of any recognized church
or religious denomination; provided, however, each nursing home will otherwise
comply with rules 3701-17-01 to 3701-17-26 of the Administrative Code, and each
resident will otherwise be provided with the services and care obligated by
such rules.
Last updated July 17, 2025 at 7:46 AM
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Rule 3701-17-03 | Initial, renewal, and change of operator license applications; fees; issuance; revocation; notice.
(A) Initial application. Not less than
forty five days before the proposed opening of a nursing home, the operator of
a nursing home will submit, on a form prescribed by the director, a completed
initial application, and pay the non-refundable application fee specified in
division (E) of section 3721.02 of the Revised Code, with the fee made payable
to the "Treasurer, State of Ohio" in the form of a check or money
order to be deposited in the state treasury to the credit of the general
operations fund created by section 3701.83 of the Revised Code. A completed
application includes: (1) Disclosure
of: (a) The proposed operator, including the proposed
operator's name, address, electronic mail address, and telephone number,
and the following information: (i) All direct and
indirect owners owning at least five per cent of: (a) The
operator; (b) The owner of the
building or buildings in which the nursing home is housed, if the owner of the
building or buildings is a different person or government entity from the
entering operator; (c) The owner of the
legal rights associated with the ownership and operation of the nursing home
beds, if the owner of the legal rights is a different person or government
entity from the entering operator; and (d) Each related party
that provides or will provide services to the nursing home, through contracts
with any party identified in paragraph (A)(1)(a)(i) of this rule. (ii) The name, business
address, electronic mail address, and telephone number of the proposed
administrator of the nursing home, if different from the proposed
operator; (iii) The name and
business address of the statutory agent of the: (a) Proposed
operator; (b) Proposed owner of the
building or buildings in which the nursing home is housed, if the owner of the
building or buildings is a different person or government entity from the
entering operator; and (c) Proposed owner of the
legal rights associated with the ownership and operation of the nursing home
beds, if the owner of the legal rights is a different person or government
entity from the proposed operator. (b) Whether a person or government entity identified in
paragraph (A)(1)(a)(i) of this rule has or had a direct or indirect ownership
or operational interest in a current or previously licensed nursing home in
this state or another state, including disclosure of whether any of the
following occurred with respect to an identified nursing home within the five
years immediately preceding the date of application: (i) Voluntary or
involuntary closure of the nursing home; (ii) Voluntary or
involuntary bankruptcy proceedings; (iii) Voluntary or
involuntary receivership proceedings; (iv) License suspension,
denial, or revocation; (v) Injunction
proceedings initiated by a regulatory agency; (vi) The nursing home is
listed in table A, table B, or table D on the SFF list under the special focus
facility program; and (vii) A civil or criminal
action was filed against it by a state or federal entity. (2) An attestation that
the applicant: (a) Has the financial ability to staff, equip, and operate
the nursing home in accordance with Chapter 3721. of the Revised Code, and
rules 3701-17-01 to 3701-17-26 of the Administrative Code, and that the
applicant has sufficient capital or financial reserve to cover not less than
six months operation; (b) Has plans for quality assurance and risk management for
the operation of the nursing home; (c) Has general and professional liability insurance
coverage that provides coverage of at least one million dollars per occurrence
and three million dollars aggregate; (d) Has sufficient qualified staff, by training or
experience, who will be employed to properly care for the type and number of
nursing home residents; (e) Or any person identified in paragraph (A)(1)(a)(i) of
this rule: (i) Has not been
convicted of a felony or a crime involving moral turpitude; (ii) Is not violating any
of the rules adopted by the director of health or any order issued by the
director; (iii) Has not had a
license to operate the home revoked pursuant to section 3721.03 of the Revised
Code because of any act or omission that jeopardized a resident's health,
welfare, or safety nor has the applicant had a long-standing pattern of
violations of this chapter or rules adopted under it that caused physical,
emotional, mental, or psychosocial harm to one or more residents; (iv) Is or are suitable
financially and morally to operate a home; (v) Is equipped to
furnish humane, kind, and adequate treatment and care; (vi) The home does not
maintain or contain: (a) Facilities for the
performance of major surgical procedures; (b) Facilities for
providing therapeutic radiation; (c) An emergency
ward; (d) A clinical laboratory
unless it is under the supervision of a clinical pathologist who is a licensed
physician in this state; (e) Facilities for
radiological examinations unless such examinations are performed only by a
person licensed to practice medicine, surgery, or dentistry in this
state. (vii) The home does not
accept or treat outpatients, except upon the written orders of a physician
licensed in this state, maternity cases, boarding children, and does not house
transient guests, other than participants in an adult day-care program, for
twenty-four hours or less; and (viii) The home is in
compliance with sections 3721.28 and 3721.29 of the Revised Code. (3) A statement by the
applicant of the status of the proposed nursing home under any applicable
zoning ordinances or rules, or a statement by the applicant that there is no
zoning authority where the proposed home is to be located; (4) Copies of
the: (a) Inspection report of the state fire marshal or a
township, municipal, or other legally constituted fire department approved by
the state fire marshal, performed within the previous fifteen months, showing
zero uncorrected deficiencies; and (b) Certificate of use in accordance with paragraph (A) of
rule 3701-17-22 of the Administrative Code showing a I-1 or I-2 use
group. (B) Renewal application. The operator of
a nursing home will submit, on a form prescribed by the director, a completed
renewal application, and pay the non-refundable application fee specified in
division (E) of section 3721.02 of the Revised Code, with the fee made payable
to the "Treasurer, State of Ohio" to be deposited in the state
treasury to the credit of the general operations fund created by section
3701.83 of the Revised Code. A completed renewal application
includes: (1) Any necessary updates
of the information provided on the initial or last renewal application,
whichever is more recent; (2) Any required updates
to the disclosure required by paragraph (A)(1) of this rule; (3) Any required update
to the attestation required by paragraph (A)(2) of this rule; and (4) An inspection report
of the state fire marshal or a township, municipal, or other legally
constituted fire department approved by the state fire marshal, performed
within the previous fifteen months, showing zero uncorrected
deficiencies. (C) Notice of change of information.
Except as provided in paragraph (D) of this rule, the operator or administrator
will notify the director in writing or electronically of any changes in the
information contained in paragraph (A) or (B) of this rule not later than ten
days after the change occurs. (D) Change of operator (CHOP)
application. At least forty-five days before the proposed assignment or
transfer of a license to operate a nursing home, the entering operator of a
nursing home will submit a completed change of operator, on a form prescribed
by the director, and paying the non-refundable application fee of three
thousand and two hundred dollars payable to "Treasurer, State of
Ohio." The department will deposit the fee in the state treasury to the
credit of the general operations fund created by section 3701.83 of the Revised
Code. A completed change of operator application includes: (1) The disclosures,
attestations, inspection reports, and certificate of use specified in
paragraphs (A)(1), (A)(2), (A)(4) and (B)(4) of this rule. (2) Except for applications that
demonstrate that the entering operator, or a person or government entity that
directly or indirectly owns at least fifty per cent of the entering operator,
directly or indirectly owns at least fifty per cent of the nursing home and its
assets, a surety bond for an amount not less than the product of the number of
licensed beds in the nursing home, as reflected in the application, multiplied
by ten thousand dollars. (a) A surety bond supplied under this
paragraph: (i) May be provided by
either the entering operator or the property owner of the nursing home;
and (ii) Will be renewed,
replaced, or maintained for five years after the effective date of the change
of operator by the entering operator or the property owner of the nursing home,
as applicable. (b) The aggregate liability of a surety will not exceed the
sum of the bond, which is not cumulative from period to period;
and (c) If the bond or other financial security is not renewed,
replaced, or maintained in accordance with this division, the director will
revoke the nursing home operator's license after providing thirty
days' notice to the operator. (E) The entering operator will not
complete the change of operator until the director issues a notice of intent to
grant a change of operator license. (1) Within five days
after of completion of the change of operator, the applicant is obligated to
provide a copy of the completed bill of sale, operations transfer agreement,
member substitution agreement, or any other document evidencing the change of
operator; and (2) If the document(s)
presented do not evidence the change of operator as proposed in the change of
operator license application or reveal additional parties not disclosed by the
entering operator in the application, the director will deny the change of
operator license or revoke the license if previously issued. (F) CHOP denials. The director will deny
a change of operator license application if any of the following circumstances
exist: (1) The requirements
established by this rule are not satisfied; (2) The entering operator
or a person or government entity identified in paragraph (D)(1)(a)(i) of this
rule who directly or indirectly has twenty-five per cent or more ownership of
the entering operator meets both of the following criteria: (a) The entering operator or the person or government
entity has or had either of the following relationships to a currently or
previously licensed nursing home in this state or another state: (i) Fifty per cent or
more direct or indirect ownership in the nursing home; and (ii) Alone or together
with one or more other persons, operational control of the nursing
home. (b) Any of the following occurred with respect to the
current or previously licensed nursing home described in paragraph (F)(2)(a) of
this rule within the five years immediately preceding the date of
application: (i) Involuntary closure
of the nursing home by a regulatory agency or voluntary closure in response to
licensure or certification action; (ii) Voluntary or
involuntary bankruptcy proceedings that are not dismissed within sixty
days; (iii) Voluntary or
involuntary receivership proceedings that are not dismissed within sixty days;
and (iv) License suspension,
denial, or revocation for failure to comply with operating
standards. (3) If a change of
twenty-five per cent or more of the property ownership interest in a nursing
home occurs in connection with the change of operator, the person or government
entity who acquired the property ownership interest meets both of the following
criteria: (a) The person or government entity has or had either of
the following relationships to a currently or previously licensed nursing home
in this state or another state: (i) Fifty per cent or
more direct or indirect property ownership in the nursing home;
and (ii) Alone or together
with one or more other persons, operational control of the nursing
home. (b) Any of the following occurred with respect to the
current or previously licensed nursing home described in paragraph (F)(3)(a) of
this rule within the five years immediately preceding the date of
application: (i) Involuntary closure
of the nursing home by a regulatory agency or voluntary closure in response to
licensure or certification action; (ii) Voluntary or
involuntary bankruptcy proceedings that are not dismissed within sixty
days; (iii) Voluntary or
involuntary receivership proceedings that are not dismissed within sixty
days; (iv) License suspension,
denial, or revocation for failure to comply with operating
standards. (G) CHOP denial appeal. An applicant for
licensure may appeal the denial of a change of operator license application in
accordance with Chapter 119. of the Revised Code. (H) CHOP notices to the director. An
entering operator will: (1) Notify the director
immediately upon discovery of any error, omission, or change of information in
a change of operator license application. (2) Notify the director
within ten days of any change in the information or documentation required by
this section that occurs after the effective date of the change of
operator. (3) Truthfully supply any
additional information or documentation requested by the director. (4) If an entering
operator fails to notify the director or supply additional information or
documentation in accordance with this rule, the director will impose a civil
penalty of two thousand dollars for each day of noncompliance. (I) CHOP notices. The entering operator
will notify, the homes' residents and their sponsors or legal
representatives, the state long-term care ombudsman, and the regional long-term
care ombudsman program, designated under section 173.16 of the Revised Code,
serving the area where the home is located, in writing or electronically of any
change of operator not later than ten days after the receipt of the change of
operator license. (J) In the case of a change of operator,
the entering operator is responsible and liable for compliance with any notice
of proposed action or order issued under section 3721.08 of the Revised Code
prior to the effective date of the change of operator. (K) Alteration of the home or relocation
of beds within a home. If the nursing home alters its physical facilities in a
manner that affects bed capacity or proposes to relocate existing beds to a
unlicensed portion of the facility, the facility will provide the director with
written notice at least forty-five days prior to the date the facility wants to
commence filling the new beds or relocating existing beds. The nursing home
will not use the altered or unlicensed area until the department notifies the
facility, in writing, that the alteration or move complies with the applicable
provisions of Chapter 3721. of the Revised Code and rules 3701-17-01 to
3701-17-26 of the Administrative Code. The administrator will provide the
director with written notice of the relocation of beds within twenty-four hours
after the relocation of a bed or beds due to emergency circumstances. The
written notice from the facility will be written on company letterhead and
include: (1) A floor plan of the
area, including beds; (2) The results of the
inspection by the state fire marshal or a township, municipal, or other legally
constituted fire department approved by the state fire marshal for the
area; (3) A certificate of
occupancy for the area; and (4) Either an approved
certificate of need or a or reviewability determination noting the activity is
not reviewable. (L) An operator who operates one or more
nursing homes in more than one building will obtain a separate license for each
building except if such buildings are on the same lot and constitute a single
nursing home, such nursing home may be operated under a single license.
However, no nursing home will be licensed in the same building as another
nursing home. On or after the effective date of this rule, an operator who
operates a nursing home in more than one building, where the buildings are
intersected by a public roadway, will not be granted a license to operate the
buildings as a single nursing home, unless before the effective date of this
rule, the buildings were so licensed. (M) The license will be posted in a
conspicuous place in the nursing home. (N) Upon the issuance of any order of
revocation or denial, the person whose license is revoked or denied may appeal
in accordance with Chapter 119. of the Revised Code. (O) When closing a home, the operator
will provide the director written notification of closure at least ninety days
prior to the proposed closing date. This notice will include: (1) An address where the
operator may be reached after the closing of the home; (2) Assurances that the residents will be
transferred to the most integrated and appropriate facility or other setting in
terms of quality, services, and location, taking into consideration the needs,
choice, and best interests of each resident. (P) While providing a written
notification of closure, the operator will, in accordance with Chapter 3701-61
of the Administrative Code, also provide written notice of the proposed date of
closing of the home to its residents and their sponsors or legal
representatives, the state long-term care ombudsmen program, and the regional
long-term care ombudsman designated under section 173.16 of the Revised Code,
serving the area where the home is located. (Q) The nursing home will include in all
official correspondence with the department pertaining to the home, its name,
address, electronic mail address, and Ohio department of health issued license
number as it appears on the nursing home license. (R) Any person(s) identified in paragraph
(A)(1)(a)(i) or paragraph (D)(1)(a)(i) of this rule will notify the director
within ten days of commencement of a suit against them, meaning a party suing
has filed a written complaint or petition with the clerk of the court, the
result of which could be the nursing home or building housing the nursing home
being placed into receivership. (S) Beds in a home that has closed that are not subject to
a certificate of need are considered surrendered to the department the three
hundred sixty sixth day after the home has closed. (T) Any application submitted to the
department pursuant to paragraph (A) or (D) of this rule are considered
abandoned if the applicant or entering operator have not responded to requests
from the director for one hundred eighty days from the date of the
director's request. The director will withdraw this application, and the
applicant or entering operator will need to reapply and pay the applicable fee.
If the application was submitted under paragraph (D) of this rule, the director
will not accept the application until the entering operator pays the fine
assessed under paragraph (H) of this rule, if any.
Last updated July 17, 2025 at 8:23 AM
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Rule 3701-17-03.1 | Expedited inspections.
(A) For purposes of this rule,
"inspection" may be conducted either in-person or on-line using
remote conferencing technology. (B) An applicant for licensure as a
nursing home may request an expedited initial licensure inspection by providing
the department of health with the following: (1) A complete initial
nursing home application and fee required by paragraph (A) of rule 3701-17-03
of the Administrative Code; (a) An application will be deemed complete when the
department verifies all information contained therein is complete and accurate
and meets the requirements of paragraph (C) of rule 3701-17-03 of the
Administrative Code; (b) An applicant may elect an expedited initial licensure
inspection on the initial nursing home application and, if electing such an
inspection, provide a fee in addition to that required by paragraph (A) of rule
3701-17-03 of the Administrative Code, in the amount of two thousand two
hundred fifty dollars; (2) Certificate of need confirmation that all certificate
of need requirements are met, as applicable; and (3) Notice of readiness for
inspection. (C) The operator of an existing nursing home that is
seeking approval to increase or decrease the nursing home's licensed
capacity or to make any other change for which the director requires a
licensing inspection to be conducted may request an expedited licensure
inspection by providing the department of health with the
following: (1) A written notice that
includes, if applicable: (a) A floor plan of the area, including beds; (b) The results of the inspection by the state fire marshal
or a township, municipal, or other legally constituted fire department approved
by the marshal for the area; and (c) A certificate of occupancy for the area; (2) A fee in the amount
of two thousand two hundred fifty dollars; (3) Certificate of need confirmation that all certificate
of need requirements are met; and (4) Notice of readiness. (D) A fee collected by the department pursuant to this rule
shall be deposited in the state treasury to the credit of the general
operations fund created by section 3701.83 of the Revised Code, and the fee
shall not be refunded. (E) Upon receipt of a completed request for expedited
inspection made pursuant to this paragraph (B) or (C) of this rule, the
department will commence an inspection of the nursing home not later than ten
business days. Inspections under this rule will be scheduled in the order in
which the request for expedited inspection is determined to be
complete. (F) If the nursing home does not meet the requirements for
licensure upon the initial inspection requested under paragraph (B) of this
rule, the department of health may deny the license. (G) If an existing nursing home does not meet the
requirements for licensure upon the expedited inspection requested under
paragraph (C) of this rule, the department of health may refuse to approve the
increase or decrease in capacity, or refuse to license the previously
unlicensed space.
Last updated July 15, 2025 at 3:37 PM
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Rule 3701-17-04 | Type and number of residents in home; beds.
(A) The director will determine the type
and number of residents a nursing home can accommodate which will establish the
authorized maximum licensed capacity of a nursing home. Such determination will
be made on the basis of the physical facilities, personnel of the nursing home
and the services and care needed by the residents to be admitted or retained in
the nursing home, and the permitted occupancy approved by the department of
commerce. (B) In determining the number of
residents in a nursing home for the purpose of licensing, the director will
consider all the individuals for whom the home provides accommodations as one
group unless one of the following is the case: (1) The home is both a nursing home and a
residential facility as defined in paragraph (A)(42) of rule 5122-30-03 of the
Administrative Code. In that case, all individuals in the part or unit licensed
as a nursing home will be considered as one group and all the individuals in
the part or unit licensed as a residential facility will be considered as
another group; (2) The home maintains, in addition to a
nursing home, a separate and discrete part or unit that provides accommodations
to individuals who do not need or receive skilled nursing care and do not
receive personal care services from the home, in which case the individuals in
the separate and discrete part or unit will not be considered in determining
the number of residents in the home if the separate and discrete part or unit
is in compliance with the Ohio building code established by the board of
building standards under Chapters 3781. and 3791. of the Revised Code and the
home permits the director, on request, to inspect the separate and discrete
part or unit and speak with the individuals residing there, if they consent, to
determine whether the separate and discrete part or unit meets the standards of
this division; (3) The home provides an adult day care
program on the same site as the home, in which case the participants will not
be considered in determining the number of residents in the home if, except as
otherwise permitted in rules 3701-17-01 to 3701-17-26 of the Administrative
Code, the program is operated in a separate area which is not part of the
licensed home. (C) If the nursing home alters its
physical facilities in a manner that proposes to move existing beds to an area
of the home not previously used for this purpose or proposes to add new beds,
the home will notify the director, in writing, at least sixty days prior to the
date the home wants to commence filling the new beds or moving existing beds.
The home will not commence filling the new beds or moving existing beds until
the director notifies the home, in writing, that the alteration or move
complies with the applicable provisions of Chapter 3721. of the Revised Code
and rules 3701-17-01 to 3701-17-26 of the Administrative Code.
Last updated July 17, 2025 at 7:50 AM
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Rule 3701-17-05 | Prohibitions.
(A) No nursing home, except a nursing
home that is owned and operated by, and physically part of, a hospital licensed
under section 3722.06 of the Revised Code, may use the word
"hospital" in its name or letterhead. (B) No applicant for a license to operate
a nursing home is authorized to accept more than two residents, who are in need
of skilled nursing care or personal care services, before receiving a
license. (C) No operator, administrator, employee,
or other person will: (1) Interfere with the
inspection of a licensed nursing home by any state or local official who is
performing duties under Chapter 3721. of the Revised Code. All licensed nursing
homes shall be open for inspection. As used in this paragraph,
"interfere" means to obstruct directly or indirectly any individual
conducting an authorized inspection from carrying out his or her prescribed
duties. Interference includes, but is not limited to:, (a) Harassment; (b) Intimidation; (c) Delay of access to premises or records, including
electronic and video records; and (d) Refusal to permit the director or his authorized
representative upon presentation of official department identification, for the
purpose of inspecting or investigating the operation of a nursing home:
(i) To enter and inspect
at any time, a building or premise where a home is located; or (ii) To enter and inspect
records which are kept concerning the operation of the home for information
pertinent to the legitimate interest of the department including, but not
limited to, the records and reports set forth in rule 3701-17-19 of the
Administrative Code. (2) Use profane or
abusive language directed at or in the presence of residents or the director or
his authorized representatives. (3) Exceed the nursing
home's authorized maximum licensed capacity. (4) Knowingly falsify
records, or misrepresent information to the director. (5) Allow transient
guests to remain in a licensed part of a home for more than thirty-six hours in
any seventy-two hour period. Accommodations for transient guests may be
provided in an area or areas outside the licensed part of a home. (D) For purposes of this rule,
"transient guest" means an individual, whether related to a resident
or staff member or not, who stays in a home. "Transient guest" does
not include an individual who stays in a home for a period of time not
exceeding fourteen days and is: (1) Admitted to the home
for short term respite care; (2) Staying with a
resident upon admission to the home; or (3) Staying with a
resident receiving end-of-life care.
Last updated July 17, 2025 at 7:51 AM
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Rule 3701-17-06 | Responsibility of operator and nursing home administrator; quality assurance and performance improvement.
(A) The operator is responsible
for: (1) Operation of the
nursing home; (2) Payment of the annual
license renewal fee to the director; (3) Submission of reports
using an electronic system prescribed by the director, including the immediate
reporting of the following: (a) Real, alleged, or suspected abuse, neglect, or
exploitation of a resident, or misappropriation of the property of a
resident; (b) Elopement of a resident as defined in paragraph (J) of
rule 3701-17-01 of the Administrative Code; (c) Instances when the operator is subject to cash on
delivery requirements by any vendors or vendor-initiated contract or delivery
cancellations due to non-payment or delinquency; (d) Non-payment or delinquent payment of federal, state, or
local taxes; and (e) Inadequate food, medical, durable medical equipment,
incontinence, respiratory or pharmaceutical supplies at the nursing home.
(4) Compliance with Chapter 3721. of the
Revised Code, Chapters 3701-13 and 3701-61, and rules 3701-17-01 to 3701-17-26
of the Administrative Code, and all federal, state, and local laws applicable
to the operation of a nursing home. (B) Each operator will appoint an
administrator. The administrator is responsible for: (1) Daily operation of
the nursing home in accordance with rules 3701-17-01 to 3701-17-26 of the
Administrative Code; (2) Implementation of the
provisions of section 3721.12 of the Revised Code, including the development of
policies and procedure that ensure the rights of residents are not
violated; (3) Ensuring that
individuals used by the home are competent to perform their job
responsibilities and that services are provided in accordance with acceptable
standards of practice; (4) Notifying the
department of any of the following: (a) Interruption of essential services or a notice of
potential interruption of essential services, due to lack of payment. Essential
services include, but are not limited to, therapy, phone, internet service
provider, a utility, food delivery, fire alarm monitoring, and maintenance
contracts; (b) Inadequate staffing, meaning the nursing home does not
have enough staff available to meet the needs of residents based on the acuity
and/or number residents as per the facility's assessment; and (c) A known change in the control, ownership or operator of
the facility or a change in the company to which the administrator reports.
(5) If the nursing home is physically
part of a hospital, inform a prospective resident, prior to admission, that the
home is licensed as a nursing home and is not part of the acute care service of
the hospital. (C) Each nursing home will establish and
maintain an ongoing quality assurance and performance improvement (QAPI)
program to address all systems of care and management practices, including
clinical care, quality of life, and resident choice. As part of the QAPI
program, each home will, at minimum: (1) Ensure the
involvement of the following personnel in the QAPI program as
appropriate: (a) Medical director; (b) Nursing home administrator; (c) Director of nursing; (d) Activities director; (e) Social services director; (f) Dietary manager; (g) Infection control coordinator; (h) A representative from the nursing home's
contracted pharmacy; (i) A representative from the nursing home's nurse
aides staff; and (j) After QAPI meetings or discussions, make the resident
council president or their designee aware of necessary items directly
concerning them when applicable. (2) Establish an
effective system to obtain and use feedback and input from residents and
resident representatives on an ongoing basis and communicate QAPI priorities
with the resident council on a regular basis. (3) Establish a quality assurance
committee that will meet on an ongoing basis, but at least quarterly to
systematically: (a) Monitor and evaluate the quality of care and quality of life
provided in the home; (b) Track, conduct a root cause analysis, investigate, and
monitor incidents, accidents, and events that have occurred in the
home; (c) Track and monitor the effectiveness of the infection control
program; (d) Identify problems and trends; and (e) Develop and implement appropriate action plans to correct
identified problems. (D) The records of meetings of the
quality assurance committee are not subject to be disclosed to the director.
The nursing home will document, and the director will verify through interviews
with committee members and, as necessary, direct care staff, that: (1) The home has a
quality assurance committee which addresses quality concerns; (2) Staff know how to
access that process; and (3) The committee has
established a protocol or method for addressing specific quality problems in
the nursing home that the home believes to have now been resolved. (E) Good faith attempts by the committee
to identify and correct quality deficiencies will not be used as a basis for
sanctions. (F) The administrator is obligated to
ensure that the nursing home participate in at least one quality improvement
project every two years per section 3721.07 of the Revised Code.
Last updated July 17, 2025 at 7:51 AM
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Rule 3701-17-07 | Qualifications and health of personnel.
(A) Every nursing home administrator will
be licensed pursuant to Chapter 4751. of the Revised Code, unless specifically
exempted from licensing under that chapter. (B) No person with a disease which may be
transmitted in the performance of the person's job responsibilities will
work in a nursing home during the stage of communicability unless the person is
given duties that minimize the likelihood of transmission and follows infection
control precautions and procedures. (C) No person is allowed to work in a
nursing home under either of the following circumstances: (1) Under the influence
of alcohol, intoxicants or illegal drugs; or (2) When the person is
using medications to the extent that the use adversely affects the performance
of their duties or the health or safety of any resident of the
home. (D) No individual is allowed to work in a
nursing home in any capacity for ten or more hours in any thirty-day period
unless the individual has been examined within thirty days before commencing
work, or on the first day of work, by a physician or other licensed health
professional acting within their applicable scope of practice and certified as
medically capable of performing their prescribed duties. Operators will retain
documentation evidencing compliance with this paragraph and furnish such
documentation to the director upon request. This paragraph does not apply to
volunteers. (E) Employees of temporary employment
services or, to the extent applicable, paid consultants working in a nursing
home, will have medical examinations in accordance with paragraph (D) of this
rule, except that a new medical certification is not obligated for each new
assignment. Each nursing home in which such an individual works will obtain
verification of the medical certification result, as applicable, from the
employment agency or consultant before the individual begins work and maintain
this documentation on file. (F) Individuals used by an adult day care
program provided by and on the same site as the nursing home will have medical
examinations in accordance with paragraph (D) of this rule if the adult day
care program is located or shares space within the same building as the nursing
home or if there is a sharing of staff between the nursing home and adult day
care program. (G) The individual responsible for the
comprehensive activities program set forth inparagraph (A) of rule 3701-17-09
of the Administrative Code to direct the activities program will meet one of
the following qualifications: (1) Has two years of
experience in a social or recreational program within the five years preceding
the date of hire, one year of which was full-time in a resident activities
program in a health care setting; (2) Is licensed as an
occupational therapist under Chapter 4755. of the Revised Code; (3) Is licensed as an
occupational therapy assistant under Chapter 4755. of the Revised
Code; (4) Is certified by a
nationally recognized accrediting body as a therapeutic recreation specialist
or activities professional; or (5) Has successfully
completed training covering activities programming from a technical or
vocational school, college, university, or other educational institution, and
has one year of experience in recreational or activities services. Training may
also be provided by an out-of-state provider certified in the state in which
the provider is located to offer technical or vocational programs or to offer
degrees and college credits. For individuals hired after April 18, 2002, the
minimum amount of training needed to meet this requirement is ninety
hours. (H) A food service manager designated
pursuant to paragraph (J) of rule 3701-17-18 of the Administrative Code who has
supervisory and management responsibility and the authority to direct and
control food preparation and service will obtain the level two certification in
food protection according to rule 3701-21-25 of the Administrative
Code. (I) All individuals used by the nursing
home who function in a professional capacity will meet the standards applicable
to that profession, including but not limited to, possessing a current Ohio
license, registration, or certification, if mandated by law. (J) The operator or administrator will
ensure that each staff member, consultant and volunteer used by the nursing
home receives orientation and training to the extent necessary to perform their
job responsibilities prior to commencing such job responsibilities
independently that includes orientation and training about residents rights,
person-centered care, the physical layout of the nursing home, the applicable
job responsibilities, the home's policies and procedures applicable to
assuring safe and appropriate resident care, infection control, emergency
assistance procedures, and the disaster preparedness plan. (K) No nursing home is allowed to employ
or continue to employ a person who applies for a position that involves the
provision of direct care to an older adult, if the person: (1) Has been convicted of
or pleaded guilty to an offense listed in division (C)(1) of section 3721.121
of the Revised Code, unless the individual is hired under the personal
character standards set forth in rule 3701-13-06 of the Administrative
Code; (2) Fails to complete the
form(s) or provide fingerprint impressions in accordance with division (B)(3)
of section 3721.121 of the Revised Code; (3) Is the subject of a
finding of abuse, neglect, or exploitation of a resident, or misappropriation
of the property of a resident on the nurse aide registry, established pursuant
to section 3721.32 of the Revised Code; (4) Is the subject of a
finding of abuse, neglect, or exploitation of a resident, or misappropriation
of the property of a resident on the nurse aide registry established by another
state where the home believes or has reason to believe the person resides or
resided; or (5) Has a disciplinary
action that is currently in effect and has been taken out against a
professional license by a state licensure body as a result of a finding of
abuse, neglect, or exploitation of a resident, or misappropriation of the
property of a resident.
Last updated July 17, 2025 at 7:52 AM
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Rule 3701-17-07.1 | Required training and competency evaluation for nurse aides working in long-term care facilities.
(A) For the purposes of this
rule: (1) "Competency
evaluation program" means a program conducted by the director or the
director's designee under division (C) of section 3721.31 of the Revised
Code and rule 3701-18-22 of the Administrative Code. (2) "Licensed health
professional" means all of the following: (a) An occupational therapist or occupational therapy assistant
licensed under Chapter 4755. of the Revised Code; (b) A physical therapist or physical therapy assistant licensed
under Chapter 4755. of the Revised Code; (c) A physician as defined in section 4730.01 of the Revised
Code; (d) A physician's assistant for whom a physician holds a
valid certificate of registration issued under section 4730.04 of the Revised
Code; (e) A registered nurse, including those authorized to practice in
an advance practice role, or a licensed practical nurse licensed under Chapter
4723. of the Revised Code; (f) A social worker or independent social worker licensed, or
social work assistant certified under Chapter 4757. of the Revised
Code; (g) A speech pathologist or audiologist licensed under Chapter
4753. of the Revised Code; (h) A dentist or a dental hygienist licensed under Chapter 4715.
of the Revised Code; (i) An optometrist licensed under Chapter 4725. of the Revised
Code; (j) A pharmacist licensed under Chapter 4729. of the Revised
Code; (k) A psychologist licensed under Chapter 4732. of the Revised
Code; (l) A chiropractor licensed under Chapter 4734. of the Revised
Code; (m) A nursing home administrator licensed or temporarily licensed
under Chapter 4751. of the Revised Code; (n) A dietitian licensed under Chapter 4759. of the Revised
Code; (o) A respiratory care professional licensed under Chapter 4761.
of the Revised Code; and (p) A massage therapist licensed under section 4731.17 of the
Revised Code. (3) "Long-term care facility"
or "facility" means either of the following: (a) A nursing home as defined in section 3721.01 of the Revised
Code, other than a nursing home or part of a nursing home certified as an
intermediate care facility for the mentally retarded under Title XIX of the
Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended;
or (b) A facility or part of a facility that is certified as a
skilled nursing facility or a nursing facility under Title XVIII or XIX of the
Social Security Act. (4) "Nurse aide" means an
individual who provides nursing and nursing-related services to residents in a
long-term care facility, other than a licensed health professional practicing
within the scope of his or her license or an individual who provides nursing or
nursing-related services as a volunteer without monetary
compensation. (5) "Nursing and nursing-related
services" when performed by a nurse aide in a long term care facility,
means activities including attending to the personal care needs of residents,
and providing personal care services and activities delegated by a nurse which
may include implementation of portions of the nursing regimen, as defined in
section 4723.01 of the Revised Code, for residents whose care does not need a
nursing assessment or the judgment of a nurse during the performance of the
delegated activity. "Nursing and nursing-related services" does not
include activities that are part of the nursing regimen which demand the
specialized knowledge, judgment, and skill of a registered nurse or the
application of the basic knowledge and skill of a licensed practical nurse
licensed under Chapter 4723. of the Revised Code or any other activities that
need to be performed by a licensed nurse under Chapter 4723. of the Revised
Code. "Nursing and nursing-related services" does not include
assisting residents with feeding when performed by a dining assistant pursuant
to rule 3701-17-07.2 of the Administrative Code. (6) To "use an individual as a nurse
aide" means to engage the individual to perform nursing and
nursing-related services in and on behalf of a long-term care
facility. (7) "Training and
competency evaluation program" means a program of nurse aide training and
evaluation of competency to provide nursing and nursing-related services
approved by the director under division (A) of section 3721.31 of the Revised
Code and Chapter 3701-18 of the Administrative Code. (B) No long-term care facility is allowed
to use an individual as a nurse aide for more than four months unless the
individual is competent to provide the services he or she is to provide; the
facility has received from the nurse aide registry, established under section
3721.32 of the Revised Code, the information concerning the individual provided
through the registry; and one of the following is the case: (1) The individual was
used by a facility as a nurse aide on a full-time, temporary, per diem, or
other basis at any time during the period commencing July 1, 1989, and ending
January 1, 1990, and successfully completed, not later than October 1, 1990, a
competency evaluation program conducted under former rule 3701-18-07 of the
Administrative Code, in effect prior to October 1, 1990; (2) The individual either
has successfully completed a training and competency evaluation program or has
satisfied the demands of paragraphs (B)(2)(a) and (B)(2)(b) of this rule and,
in either case, also has completed successfully the competency evaluation
program. An individual will be considered to have successfully completed a
training and competency evaluation program if the individual meets both of the
following: (a) The individual, as of July 1, 1989, completed at least sixty
hours divided between skills training and classroom instruction in the topic
areas described in divisions (B)(1) to (B)(8) of section 3721.30 of the Revised
Code; and (b) The individual received, as of that date, at least the
difference between seventy-five hours and the number of hours actually spent in
training and competency evaluation in supervised practical nurse aide training
or regular in-service nurse aide education. For an individual to satisfy the
demands of this paragraph, the combination of skills training, classroom
instruction, supervised practical nurse aide training and in-service nurse aide
education will have addressed the topic areas and subject matter components
prescribed by former rule 3701-18-07 of the Administrative Code and its
appendix in effect at the time of the determination. (3) Prior to July 1,
1989, if the long-term care facility is certified as a skilled nursing facility
or a nursing facility under Title XVIII or XIX of the Social Security Act, 49
Stat. 620 (1935), 42 U.S.C. 301, as amended, or prior to January 1, 1990, if
the facility is not so certified, the individual completed a program that the
director determines included a competency evaluation component no less
stringent than the competency evaluation program conducted under former rule
3701-18-07 of the Administrative Code in effect at the time of the
determination and was otherwise comparable to approved training and competency
evaluation programs; (4) The individual is
listed in a nurse aide registry maintained by another state and that state
certifies that its program for training and evaluation of competency of nurse
aides complies with Titles XVIII and XIX of the Social Security Act, 49 Stat.
620 (1935), 42 U.S.C. 301, as amended, and regulations adopted
thereunder; (5) Prior to July 1,
1989, the individual was found competent to serve as a nurse aide after the
completion of a course of nurse aide training of at least one hundred
hours' duration. The determination of competency will have been made by
the director or by an instructor of the course of nurse aide
training; (6) The individual is
enrolled in a prelicensure program of nursing education approved by the board
of nursing or by an agency of another state that regulates nursing education,
has provided the long-term care facility with a certificate from the program
indicating that the individual has successfully completed the courses that
teach basic nursing skills including infection control, safety and emergency
procedures and personal care, and has successfully completed the competency
evaluation program; or (7) The individual has
the equivalent of twelve months or more of full-time employment in the
preceding five years as a hospital aide or orderly and has successfully
completed a competency evaluation program. (8) The individual has
successfully completed a prelicensure program of nursing education approved by
the board of nursing under section 4723.06 of the Revised Code or by an agency
of another state that regulates nursing education and has passed the
examination accepted by the board of nursing under section 4723.10 of the
Revised Code, which will be deemed as the successful completion of a competency
evaluation program conducted by the director under division (C) of section
3721.31 of the Revised Code. Before allowing an individual to serve as a
nurse aide for more than four months in accordance with this paragraph, a
facility will conduct a registry verification that the individual has met the
competency demands under this paragraph unless the individual can prove that
they have recently met the demands and has not yet been listed on the registry.
In the event that an individual has not yet been listed on the registry,
facilities will follow up by contacting the nurse aide registry to ensure that
such an individual actually becomes listed on the registry. Once the facility
receives written registry verification, it will maintain such verification on
file. (C) During the four month period provided
for in paragraph (B) of this rule, during which a long-term care facility may,
subject to paragraph (H) of this rule, use as a nurse aide an individual who
does not have the qualifications specified in paragraphs (B)(1) to (B)(7) of
this rule, a facility will demand the individual to participate in one of the
following: (1) If the individual has
successfully completed a training and competency evaluation program, a
competency evaluation program conducted by the director; (2) If the individual is
enrolled in a prelicensure program of nursing education described in paragraph
(B)(6) of this rule, and has completed or is working toward completion of the
courses described in that paragraph, or the individual has the experience
described in paragraph (B)(7) of this rule, a competency evaluation program;
or (3) A training and
competency evaluation program and the competency evaluation
program. (D) No long-term care facility is allowed
to continue to use as a nurse aide for longer than four months, an individual
who previously met the demands of paragraph (B) of this rule but since most
recently doing so has not performed nursing and nursing-related services for
monetary compensation for twenty-four consecutive months, unless the individual
successfully completes additional training and competency evaluation by
complying with paragraphs (D)(1) and (D)(2) of this rule: (1) Doing one of the
following: (a) Successfully completing a training and competency evaluation
program; (b) Successfully completing a training and competency evaluation
program described in paragraph (B)(4) of this rule; or (c) Meeting the demands specified in paragraph (B)(6) or (B)(7)
of this rule; and (2) In the case of an
individual who is described in paragraph (D)(1)(a) or (D)(1)(c) of this rule,
successfully completing the competency evaluation program. (E) During the four-month period provided
for in paragraph (D) of this rule during which a long-term care facility may,
subject to paragraph (H) of this rule, use as a nurse aide an individual who
does not have the qualifications specified in paragraphs (D)(1) and (D)(2) of
this rule, a facility will demand the individual to participate in one of the
following: (1) If the individual has
successfully completed a training and competency evaluation program, a
competency evaluation program conducted by the director; (2) If the individual is
enrolled in a prelicensure program of nursing education described in paragraph
(B)(6) of this rule and has completed or is working toward completion of the
courses described in that paragraph or the individual has the experience
described in paragraph (B)(7) of this rule, a competency evaluation program;
or (3) A training and
competency evaluation program and, in addition, a competency evaluation
program. (F) For the purposes of paragraphs (C)
and (E) of this rule, an individual will be considered to be participating in a
training and competency evaluation program or a competency evaluation program,
as applicable, if, at minimum, the individual has a document signed by a
representative of the program attesting that the individual is scheduled to
attend the program. (G) The four month periods provided for
in paragraphs (B) and (D) of this rule include any time, on or after June 1,
1990, that an individual is used as a nurse aide on a full time, temporary, per
diem or other basis by the facility or any other long-term care
facility. (H) A long-term care facility is not
allowed to permit an individual used by the facility as a nurse aide while
participating in a training and competency evaluation program to provide
nursing and nursing-related services unless both of the following are the
case: (1) The individual has
completed the number of hours of training that they are mandated to complete
prior to providing services to residents as prescribed by paragraph (A)(4) of
rule 3701-18-05 of the Administrative Code through the program in which the
individual is enrolled; and (2) The individual is
under the personal supervision of a registered or licensed practical nurse
licensed under Chapter 4723. of the Revised Code. An individual used by a long-term care facility
as a nurse aide while participating in a training and competency evaluation
program will wear a name pin at all times that clearly indicates that the
individual is a trainee. As used in this paragraph, "personal
supervision" means being present physically on the floor where the
individual is providing services, being available at all times to respond to
requests for assistance from the individual, and being within a distance which
allows the nurse periodically to observe the individual providing
services. (I) No long-term care facility is allowed
to impose on a nurse aide any charge for participation in any competency
evaluation program or training and competency evaluation program, including any
charge for textbooks, other needed course materials or a competency
evaluation. (J) No long-term care facility is allowed
to mandate that an individual used by the facility as a nurse aide or seeking
employment as a nurse aide pay or repay, either before or while the individual
is employed by the facility or when the individual leaves the facility's
employ, any costs associated with the individual's participation in a
competency evaluation program or training and competency evaluation
program. (K) In addition to competency evaluation
programs and training and competency evaluation programs demanded by this rule,
each long-term care facility will provide all of the following to each nurse
aide it uses: (1) An orientation
program that includes at least an explanation of the organizational structure
of the facility, its policies and procedures, its philosophy of care,
principles of person-centered care, a description of its resident population,
and an enumeration of its employee rules. The orientation program will be of
sufficient duration to cover the topics enumerated in this paragraph adequately
in light of the size and nature of the facility, its resident population, and
the anticipated length of employment of the nurse aide. The orientation program
for nurse aides permanently employed by the long-term care facility will be at
least three hundred and sixty minutes in length to occur during the first forty
hours worked, with one hundred and eighty minutes occurring before the nurse
aide has any resident contact; (2) Regular performance
review to assure that individuals working in the facility as nurse aides are
competent to perform the nursing and nursing-related services they perform.
Performance reviews will be conducted at least ninety days after the nurse aide
completes successfully the competency evaluation program or commences work in
the facility and annually thereafter. The performance review will be conducted
by the aide's immediate supervisor or a nurse designated by the facility
to conduct the performance evaluations and consist, at minimum, of an
evaluation of the nurse aide's working knowledge, application of the
principles of person-centered care, and clinical performance. The facility will
maintain a written record of each performance review; and (3) Regular in-service
education, both in groups and, as necessary in specific situations, on a
one-to-one basis, based on the outcome of performance reviews demanded by
paragraph (K)(2)(a) of this rule. For the purposes of this provision,
"specialty unit" means a discrete part of the nursing home that
houses residents who have common specialized care needs, including, but not
limited to, dementia care, hospice care, or mental health care
units. (a) Formal in-service education will include an instructional
presentation and may include skills demonstration with return demonstration and
in-service training. In-service training may be provided on the unit as long as
it is directed toward skills improvement, is provided by trained individuals
and is documented. (b) In-service education will be sufficient to ensure the
continuing competence of nurse aides and address areas of weakness as
determined in nurse aides' performance reviews and address the assessed
needs of residents as determined by their care plan. It also shall include, but
is not limited to, training for nurse aides providing nursing and
nursing-related services to residents with cognitive impairment. The in-service
education for nurse aides working in specialty units shall address the assessed
needs of the residents in the unit. (c) The facility will assure that each nurse aide receives at
least twelve hours of formal in-service education each year. In-service
education may be obtained through web-based training programs. For purposes of
this paragraph, the year within which a nurse aide will receive continuing
education is calculated based on the commencement of employment. (d) The facility will maintain a written record of each formal
in-service session including a description of the subject matter, the identity
of the individual or individuals providing the in-service education, a list of
the nurse aides and other individuals attending the session that is signed by
each attendee and the duration of the session. (4) In addition to the
demands of this paragraph, a nursing home that holds itself out as providing
specialty care to residents will ensure each nurse aide who provides specialty
care receives sufficient additional hours of training each year to ensure
competency and to meet the individual needs of the residents. For purposes of
this paragraph, a nursing home or part thereof is considered to "hold
itself out as providing specialty care" when it advertises the home
provides specialty care, represents to the department or the public that it
provides specialty care, or admits ten or more individuals with common
specialized care needs. "Specialty care" includes, but is not limited
to, dementia care, behavioral care, mental health care, or hospice
care.
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Rule 3701-17-07.2 | Dining assistants.
(A) For purposes of this
rule: (1) "Long term care
facility" has the same meaning as in rule 3701-17-07.1 of the
Administrative Code. (2) "Dining
assistant" means an individual who meets the standards specified in this
rule and who is paid to feed long term care facility residents by a long term
care facility or who is used under an arrangement with another agency or
organization. (3)
"Supervision" means that the nurse is in the unit where the feeding
assistance is furnished and is immediately available to provide help in an
emergency. (4) "Suspension of
approval" means that a dining assistant training course is not authorized
to provide training to individuals under this rule until the suspension is
lifted pursuant to paragraph (K) of this rule. (5) "Training and
competency evaluation program" has the same meaning as in rule
3701-17-07.1 of the Administrative Code. (6) "Withdrawal of approval"
means that a dining assistant training course is no longer eligible to provide
training under this rule, but does not prevent the submission of a new
application for approval. (B) A long term care facility may use
dining assistants to feed residents who, based on the charge nurse's
assessment of the resident and the most recent resident assessment performed
pursuant to rule 3701-17-10 of the Administrative Code and plan of care
developed pursuant to rule 3701-17-14 of the Administrative Code, meet the
following conditions: (1) Need assistance or
encouragement with eating and drinking; (2) Do not have a
complicated feeding problem, such as the need for tube or parenteral feeding,
recurrent lung aspirations or difficulty swallowing that necessitates
assistance with eating and drinking by a registered nurse, licensed practical
nurse, or nurse aide. (C) If a facility uses a dining assistant
the facility will ensure that the dining assistant meets the following
criteria: (1) Except as provided in
paragraph (D) of this rule, has successfully completed a dining assistant
training course approved by the director as specified in paragraph (G) of this
rule; (2) Is not the subject of
a finding of abuse or neglect of a resident or misappropriation of the property
of a resident on the nurse aide registry, established pursuant to section
3721.32 of the Revised Code; and (3) Performs duties only
for residents who do not have a complicated feeding problem, and under the
supervision of a registered nurse or licensed practical nurse. (D) A person who has successfully
completed a training course for dining assistants and has not worked in a long
term care facility as a dining assistant for a period of twelve consecutive
months is not allowed to be used as a dining assistant in a long term care
facility until the person successfully retakes the training course. The
facility will maintain a record of all individuals, used by the facility as
dining assistants. (E) The training course for dining
assistants will provide a combined total of at least nine hours of instruction,
including a one hour clinical portion. The eight hours of didactic instruction
may be presented online with the instructor being available at the end of the
class for discussion and questions. The clinical portion will be provided for
no more than eight participants at one time. The training course will follow
the curriculum specified in the appendix attached to this rule and address the
following topics: (1) Feeding
techniques; (2) Assistance with
feeding and hydration, including the use of assistive devices; (3) Communication and
interpersonal skills; (4) Appropriate responses
to resident behavior; (5) Safety and emergency
procedures, including the abdominal thrust; (6) Infection
control; (7) Residents
rights; (8) Recognizing changes
in residents that are inconsistent with their normal behavior and the
importance of reporting those changes to the supervisory nurse; (9) Special diets and
therapeutic diets; (10) Documentation of
type and amount of food intake; and (11) Meal observation and
actual feeding assistance to a resident. (F) The instructor or instructors for a
dining assistant course will have appropriate experience and one of the
following qualifications: (1) A current valid
license issued under Chapter 4723. of the Revised Code to practice as a
nurse; (2) A current valid
license issued under Chapter 4759. of the Revised Code to practice as a
dietitian; (3) A current valid
license issued under Chapter 4753. of the Revised Code to practice as a
speech-language pathologist; or (4) A current valid
license issued under Chapter 4755. of the Revised Code to practice as an
occupational therapist. (G) A long term care facility, employee
organization, person, governmental entity, or a training and competency
evaluation program seeking approval of a dining assistant training course will
make an application to the director on a form prescribed by the director and
provide any documentation or additional information requested by the director.
A complete application includes: (1) An attestation that
the information contained in the curriculum attached as appendix A to this rule
is understood and will be adhered to; and (2) The name and
documentation of the qualifications of the instructor or instructors, as
specified in paragraph (F) of this rule. (H) The director will approve an
application of a dining assistant training course that demonstrates compliance
with the standards of this rule and, if the course is operated by or in a long
term care facility, the facility is not the subject of an action listed in
paragraph (I)(2) of this rule. An approved dining assistant training course is
not necessary to renew an approval provided that the director is notified of
any changes to the information provided in the original
application. (I) The director may suspend or withdraw
approval of a dining assistant training course if at least one of the following
applies: (1) The course is not
operated in compliance with this rule; or (2) The course is
operated by or in a long term care facility and one of the following
applies; (a) The director has notified the facility of a real and present
danger under section 3721.08 of the Revised Code; (b) An action has been taken against the facility under section
5165.77 of the Revised Code; or (c) The license of the facility is revoked under section 3721.03
of the Revised Code. (J) Suspension or withdrawal of approval
is not subject to appeal. If the director determines that one of the criteria
listed in paragraph (I) of this rule applies to a dining assistant training
course the director may, upon written notice, immediately suspend the approval
of the training course. The written notice to the dining assistant training
course will provide the following: (1) The criteria listed
in paragraph (I) of this rule giving rise to the suspension or proposed
withdrawal of approval; (2) An opportunity to
submit documentation demonstrating that the matter giving rise to the
suspension has been corrected; (3) An opportunity to
request an informal review; (4) An indication of
whether the director proposes to withdraw the approval. (K) If the director determines that the
training course has satisfactorily demonstrated that the matter which gave rise
to the suspension has been satisfactorily corrected or otherwise does not apply
to the training course, the director will lift the suspension and, if
applicable, rescind the proposal to withdraw. (L) If the director determines that the
training course has not satisfactorily demonstrated that the matter which gave
rise to the suspension has been corrected the director will withdraw the
training course approval.
View Appendix
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Rule 3701-17-07.3 | Nurse aide registry.
(A) The director will maintain a nurse
aide registry listing all individuals who have met the competency standards of
division (A) of section 3721.32 of the Revised Code. The registry also will
include both of the following: (1) The statement
necessitated by section 3721.23 of the Revised Code detailing findings by the
director under that section regarding alleged abuse or neglect of a resident or
misappropriation of resident property; (2) Any statement
provided by an individual under section 3721.23 of the Revised Code disputing
the director's findings. (B) The department will not continue to
list an individual on the registry as eligible to work in a long-term care
facility unless the department has received verification in accordance with
paragraph (C) of this rule that the individual provided at least seven and
one-half consecutive hours or eight hours in a forty-eight-hour period of
nursing and nursing-related services for compensation during the twenty-four
month period immediately following either the date that the individual was
placed on the registry or the most recent date of verified work. As used in
this rule, "nursing and nursing-related services" means: (1) Attending to the
personal care needs of individuals; (2) Providing personal
care services as defined at divisions (A)(5)(a)(i) to (A)(5)(a)(iii) of section
3721.01 of the Revised Code; and (3) Performing activities
delegated by a nurse which may include implementation of portions of the
nursing regimen, as defined by section 4723.01 of the Revised Code, for
individuals whose care does not need nursing assessment or the judgment of a
nurse during the performance of the delegated activity, but does not include
activities that are part of the nursing regimen which need the specialized
knowledge, judgment, and skill of a registered nurse or the application of the
basic knowledge and skill needed of a licensed practical nurse licensed under
Chapter 4723. of the Revised Code or any other activities that are set forth to
be performed by a licensed nurse under Chapter 4723. of the Revised
Code. (C) If an individual desires to remain on
the registry as eligible to work as a nurse aide but is not eligible because
more than twenty-four consecutive months have passed since the last date of
verified work, the individual will do one of the following: (1) Submit documentation
showing that he or she has provided at least seven and one-half consecutive
hours or eight hours in a forty-eight-hour period of nursing and
nursing-related services for compensation during that twenty-four month period;
or (2) Successfully complete
additional training and competency evaluation by complying with paragraphs
(D)(1) and (D)(2) of rule 3701-17-07.1 of the Administrative Code. (D) The documentation set forth in
paragraph (C)(1) of this rule will include either of the
following: (1) In the case of a
facility, agency, or any other health care provider that is authorized under
applicable law to provide services that include implementation of portions of a
nursing regimen, as defined by section 4723.01 of the Revised Code, a statement
verifying the dates and hours that the individual performed nursing and
nursing-related services for compensation; or (2) A statement by a
physician or nurse verifying that he or she has personal knowledge that the
individual provided nursing and nursing-related services to a patient under the
physician's or nurse's care. The statement will further
verify: (a) The name of the individual that provided nursing and
nursing-related services for such patient; (b) The nature of the nursing and nursing-related services and
the date or dates the individual last provided seven and one-half consecutive
hours or eight hours in a forty-eight-hour period of nursing and
nursing-related services; (c) That the individual received compensation for the services
specified in paragraph (D)(2)(b) of this rule. If the physician or nurse is
unable to verify that the individual was compensated for those services, the
individual will provide further proof that he or she received compensation for
the specified services. (E) No long-term care facility will
continue for longer than four months to use as a nurse aide an individual who
previously met the standards set forth in paragraph (B) of rule 3701-17-07.1 of
the Administrative Code but is not able to verify in accordance with this rule
that he or she is currently eligible to work in a long-term care facility,
unless the individual successfully completes additional training and competency
evaluation by complying with paragraphs (D)(1) and (D)(2) of rule 3701-17-07.1
of the Administrative Code.
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Rule 3701-17-08 | Personnel requirements.
(A) Each nursing home with fewer than a
one hundred beds licensed capacity will arrange for the services of an
administrator who will be present in the home to the extent necessary for
effectively managing the home and assuring that needs of the residents are
being met, but not less than sixteen hours during each calendar week. For
nursing homes with a one hundred or more bed licensed capacity, the
administrator will be present in the home on a full-time basis as defined in
paragraph (K) of rule 3701-17-01 of the Administrative Code. The administrator
will designate another staff member to be the point of contact of the nursing
home when the administrator is absent from the nursing home due to illness,
vacation or an emergency situation. (B) Each nursing home will: (1) Employ a registered
nurse to serve as director of nursing: (a) This standard may be met by two registered nurses who share
the position as co-directors of nursing. (b) The director of nursing or co-directors of nursing will be on
duty five days per week, eight hours per day predominantly between the hours of
six a.m. and six p.m. to direct the provision of nursing services. (c) The nursing home will post the name of the director of
nursing in a place easily accessible to residents, resident's families or
sponsors, and staff. (2) Designate another
registered nurse in its employ to serve as acting director of nursing in the
event the director of nursing or co-directors of nursing are absent from the
nursing home due to illness, vacation or an emergency situation. The nursing
home will post the name of the acting director of nursing in a place easily
accessible to residents, residents' families or sponsors, and
staff. (C) Each nursing home will have
sufficient direct care staff on each shift to meet the needs of the residents
in an appropriate and timely manner and have the following individuals provide
a minimum daily average of two and one-half hours of direct care and services
per resident per day as follows: (1) Nurse
aides; (2) Registered nurses,
including registered nurses who perform administrative and supervisory duties;
and (3) Licensed practical
nurses, including licensed practical nurses who perform administrative and
supervisory duties. (D) Each nursing home will have a
registered nurse on call whenever one is not on duty in the home. The nursing
home will post the name of the registered nurse who is on call in a place
easily accessible to residents, residents' families or sponsors, and
staff. (E) Each nursing home will have the
following staff who are competent to perform the duties they are
assigned: (1) Activities program
staff as set forth in paragraph (A) of rule 3701-17-09 of the Administrative
Code; (2) Dietary staff as as
set forth in paragraph (J) of rule 3701-17-18 of the Administrative
Code; (3) Pharmacy services
staff as set forth in paragraph (A)(1) of rule 3701-17-17 of the Administrative
Code; (4) Social services staff
to assist the home in meeting the medically-related social service needs of the
residents and the standards of rule 3701-17-09 of the Administrative Code. Each
nursing home with more than one hundred twenty beds will employ, on a full-time
basis, one individual licensed as a social worker under Chapter 4757. of the
Revised Code; and (5) A designated
infection prevention and control coordinator in accordance with paragraph (A)
of rule 3701-17-11 of the Administrative Code. (F) In addition to complying with the
standards in this rule, each nursing home will conduct an assessment of the
residents admitted to the facility, based on the residents' plans of care,
to determine the staffing level needed to provide, in a timely manner, adequate
services and care to meet the needs of the residents admitted to or retained in
the nursing home and to properly operate the dietary, housekeeping, laundry,
and nursing home maintenance facilities. (1) The nursing home will
determine the number and type of additional staff needed based on the services
needing to be performed as identified in the plans of care set forth by rule
3701-17-14 of the Administrative Code, and authorized scopes of
practice. (2) The additional staff
will meet the applicable qualifications of rules 3701-17-07 and 3701-17-07.1 of
the Administrative Code and provide services in accordance with applicable
scopes of practice. (G) With input from the medical director
and the director of nursing, the nursing home may adjust the staffing levels
based on the needs and acuity levels of the residents, but in no event will the
staffing fail to meet the standards of this rule. (H) The nursing home will establish a
protocol for staff coverage that includes coverage during vacations, emergency
situations, and long-term absences due to illness and unexpected absences and a
contingency plan for back-up coverage. (I) A nursing home that is physically
located in the same building or on the same lot as a licensed residential care
facility, or a home certified as a intermediate care facility for individuals
with intellectual disabilities that are owned and operated by the same entity,
or that provides an adult day care program in the nursing home, may use staff
from the nursing home to provide services in the licensed residential care
facility, certified intermediate care facility for individuals with
intellectual disabilities, or adult day care program or use appropriate and
qualified staff from the licensed residential care facility, certified
intermediate care facility for individuals with intellectual disabilities, or
adult day care program to meet part or all of the staffing standards of this
rule, if all of the following criteria are met: (1) The nursing home
meets the minimal staffing levels of this rule at all times. No staff
simultaneously assigned to the staffing schedules of the nursing home and the
residential care facility, certified intermediate care facility for individuals
with intellectual disabilities, or adult day program will be counted towards
meeting the staffing standards of this rule; (2) The other licensed
residential care facility or certified intermediate care facility for
individuals with intellectual disabilities, meet their applicable staffing
levels at all times. Shared nursing home staff may not be counted towards
meeting the minimum staffing levels for the other licensed residential care
facility; (3) Separate staffing
schedules are maintained for the nursing home, residential care facility,
certified intermediate care facility for individuals with intellectual
disabilities, and adult day care program; (4) The sharing of staff
does not adversely affect the quality and timeliness of meeting the care needs
of the nursing home, residential care facility, or intermediate care facility
for individuals with intellectual disabilities residents and the participants
of the adult day care program; (5) The nursing home,
residential care facility, intermediate care facility for individuals with
intellectual disabilities and adult day care program are within two minutes or
less response time from each other; and (6) The monitoring of the
call signal systems in the nursing home and residential care facility are not
disrupted and the use of call signal systems is not limited to emergency use
only. (J) Each nursing home will maintain
records necessary for the director to ascertain compliance with the standards
set forth in this rule. (K) Nothing in this rule is to be
construed as authorizing an unlicensed individual to provide services that
entail licensure under Title 47 of the Revised Code or a health care
professional to provide services outside the professional's licensed scope
of practice.
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Rule 3701-17-09 | Resident life enrichment.
(A) All nursing homes will provide a
comprehensive activity program designed to meet the physical, mental,
emotional, psycho-social well-being and personal interests of each resident.
Activities will be provided based on the needs and preferences of each resident
as identified on their comprehensive assessment and care plan will by rules
3701-17-10 and 3701-17-14 of the Administrative Code, respectively, and needs
and preferences identified during resident's time in the home. Activities
will be implemented and adjusted based on resident input and residents'
changes in abilities, physical and mental status. Activities will be scheduled
for day time, week end, evening, and include the community to the extent
possible. (B) All nursing homes will provide social
services to: (1) Meet the
medically-related social service needs of each resident; (2) Meet the physical,
mental, and psycho-social well-being of each resident; and (3) Assist each resident
in attaining or maintaining the highest practicable level of
functioning. (C) Residents may receive visitors of
their choice at any time. The nursing home may establish reasonable policies to
ensure that visits will not unduly disturb other residents or interfere with
the operation of the home and provide or arrange for private space for
visitation. (D) Residents may keep pets if allowed by
facility policy. If a nursing home allows residents to keep animals or pets, or
has facility pets, the nursing home will consult with the medical director and
a veterinarian licensed to practice veterinary medicine under Chapter 4741. of
the Revised Code, and develop and implement a written protocol regarding
animals and pets that protects the health and safety and rights of residents.
At a minimum, the written protocol will include: (1) An annual physical
examination, including an examination for internal and external
parasites; (2) Vaccinations for
common infectious agents, including rabies; (3) Any other preventive
care necessary to protect the health, safety and rights of
residents; (4) Procedure to follow
if an animal: (a) Bites a person; or (b) Becomes ill or injured; (5) For resident pets, if
the resident is transferred, discharged or otherwise unable to care for the
pet, responsibilities for care of the pet until a family member or sponsor can
retrieve the pet; (6) In the case of a
facility pet, the name of the designated member or members of the staff
responsible for the care of the animal and for maintaining the protocol,
including medical records for the animal; and (7) An evaluation of the
medical needs of residents. (E) Residents will have reasonable access
to various methods of communication. The administrator will ensure
that: (1) Each resident
receives all mail, electronic mail, or other communications addressed to the
resident unopened and unread immediately upon receipt at the nursing home, and
opened and read to the resident after delivery if the resident so
requests; (2) Each resident's
outgoing mail is to be delivered unscreened, unopened, and unread to the
regular postal channels promptly upon its receipt from the resident except when
there is no regularly scheduled postal delivery or pick-up service in which
case it is to be placed into the next regularly scheduled delivery or pick-up.
The nursing home will assist a resident in writing a letter or have a letter
written for them if the resident so requests; (3) Each resident has
access to telephone or a device for video conferencing services that meet the
needs of the resident in an area where calls can be made in a manner which
ensures privacy; (4) Each resident can use
their cellular phone, computer, or other technological or video device unless
the use of that device is not medically advisable or is disruptive to other
residents or the safe and orderly operation of the home; and (5) Each resident that is
determined to need assistance with communication devices, receives assistance
in a timely manner as staffing allows. (F) The nursing home will have a plan and
procedures to provide appropriate visitation in the event of a facility
emergency or a public health emergency.
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Rule 3701-17-10 | Resident assessments; advanced care planning.
(A) Each nursing home, in accordance with
this rule, will conduct a written initial and periodic assessments of all
residents. The different components of the assessment may be performed by
different licensed health care professionals, consistent with the type of
information needed and the professional's scope of practice, as defined by
applicable law, and be based on personal observation and judgment. This
paragraph does not forbid the licensed health professional from including in
the assessment resident information obtained by or from unlicensed staff
provided the evaluation of such information is performed by that licensed
health professional in accordance with the applicable scope of
practice. (B) Prior to admission, the nursing home
will obtain from the prospective resident's physician, other appropriate
licensed health professionals acting within their applicable scope of practice,
or the transferring entity, the current medical history and physical of the
prospective resident, including the discharge diagnosis, admission orders for
immediate care, the physical and mental functional status of the prospective
resident, and sufficient additional information to assure care needs of and
preparation for the prospective resident can be met. This information will have
been updated no more than five days prior to admission. (C) Upon admission, the nursing home will
assess each resident in the following areas: (1) Cardiovascular,
pulmonary, neurological status including auscultation of heart and lung sounds,
pulses and vital signs; and (2) Hydration and
nutritional status, including allergies and intolerances; (3) Presenting physical,
psycho-social and mental status; (4) Ability to conduct
the activities of daily living; (5) Head to toe skin
status assessment; (6) Risk for elopement;
and (7) Preferences related
to discharge timeline. The nursing home will also review each
resident's admission orders to determine if the orders are consistent with
the resident's status upon admission as assessed by the nursing home and
reconfirm, as applicable, the orders with the attending physician or other
licensed health care professional acting within the applicable scope of
practice. The nursing home will obtain any special equipment, furniture or
staffing that is needed to address the presenting needs of the resident. The
nursing home will develop a baseline care plan to meet the specific needs of
each resident identified through this admission assessment until such time as
the care plan obligated by rule 3701-17-14 of the Administrative Code is
developed and implemented. (D) The nursing home will perform a
comprehensive assessment meeting the criteria of paragraph (E) of this rule on
each resident as follows: (1) The comprehensive
assessment will be performed within fourteen days after the individual begins
to reside in the facility. (2) Subsequent to the initial
comprehensive assessment, a comprehensive assessment will be performed at least
annually thereafter. The annual comprehensive assessment will be performed
within thirty days of the anniversary date of the completion of the
resident's last comprehensive assessment. (E) The comprehensive assessment will
include documentation of the following: (1) Preferences of the
resident including hobbies, usual activities, bathing, sleeping patterns,
socialization and religious; (2) Medical
diagnoses; (3) Psychological, and intellectual
disabilities and developmental diagnoses and history, if
applicable; (4) Health history and physical,
including cognitive functioning, sensory and physical impairments, and the risk
of falls; (5) Psycho-social history; (6) Prescription and over-the-counter
medications; (7) Nutritional and dietary needs, food
preferences, and need for any adaptive equipment, and needs for assistance and
supervision of meals; (8) Height, weight and history of weight
changes; (9) A functional assessment which
evaluates the resident's ability to perform activities of daily
living; (10) The resident's risk of
falls; (11) Vision, dental and hearing function,
including the need for eyeglasses or other visual aids; (12) Dental function; including the need
for dentures or partial dentures; (13) Hearing function, including the need
for hearing aids or other hearing devices; (14) Head to toe skin
status assessment; (15) Ability to conduct
activities of daily living; (16) Any other alternative remedies and
treatments the resident is taking or receiving; and (17) Risk of
elopement. The documentation needed by this paragraph will
include the name and signature of the individual performing the assessment, or
component of the assessment, and the date the assessment was completed. (F) Subsequent to the initial
comprehensive assessment, the nursing home will periodically reassess each
resident, at minimum, every three months, unless a change in the
resident's physical or mental health or cognitive abilities necessitates
an assessment sooner. The nursing home will update and revise the assessment to
reflect the resident's current status. This periodic assessment will
include documentation of at least the following: (1) Changes in medical
diagnoses; (2) Updated nutritional
needs and needs for assistance and supervision of meals; (3) Height, weight and
history of weight changes; (4) Prescription and
over-the-counter medications; (5) A functional
assessment as described in paragraph (E)(9) of this rule; (6) The resident's
risk of falls; (7) Any changes in the resident's
psycho-social status or preferences as described in paragraph (E)(5) of this
rule; (8) Any changes in cognitive,
communicative or hearing abilities or mood and behavior patterns; (9) Head to toe skin
assessment; (10) Ability to conduct
activities of daily living; and (11) Risk of
elopement. (G) Nursing homes that conduct resident assessments in accordance
with 42 C.F.R. 483.20, using the resident assessment instrument specified by
rule 5160-3-43.1 of the Administrative Code, will be considered in compliance
with paragraphs (D), (E) and (F) of this rule. (H) Each nursing home will participate
in advance care planning with each resident or the resident's sponsor if
the resident is unable to participate, on admission to the nursing home and
thereafter, for each resident, on a quarterly basis each year. For purposes of
this paragraph, "advance care planning" means providing an
opportunity to discuss the goals that may be met through the care provided by a
nursing home. (I) If the nursing home has a designated
smoking area, the nursing home will include the following in the assessment
conducted in accordance with paragraphs (D), (E), and (F) of this rule for each
resident that smokes; (1) An assessment of the
resident's ability to smoke without supervision and without a smoking
apron; and (2) An evaluation of and
changes to cognitive, communicative, mood, or behavioral patterns associated
with smoking.
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Rule 3701-17-11 | Infection control; tuberculosis control plan.
(A) Each nursing home will establish and
implement appropriate written policies and procedures to assure a safe,
sanitary and comfortable environment for residents and to prevent and control
the development and transmission of infections and diseases. Each nursing home
will establish an infection prevention and control program to monitor
compliance with the home's infection prevention and control policies and
procedures, to investigate, control and prevent infections in the home, and to
institute appropriate interventions. The nursing home will designate an
appropriately licensed health professional with competency in infection
prevention and control to serve as the infection prevention and control
coordinator who performs part-time infection control duties in the nursing home
each week, and participates in the nursing home's quality control and
performance improvement (QAPI) committee. The infection prevention and control
coordinator will: (1) Have completed
post-secondary education in a health-related field including but not limited to
medicine, nursing, laboratory technology, public health, or
biology; (2) Work at least
part-time at the facility; (3) Have education,
training, or experience in infection control; and (4) Have completed
specialized training in infection prevention and control
including: (a) Identification of infectious disease processes,
including modes of transmission, signs and symptoms; (b) Surveillance and epidemiologic investigation, including
syndromic surveillance; (c) Preventing and controlling the transmission of
infectious agents, including standard precautions and transmission-based
precautions; (d) Environment of care; and (e) Cleaning, disinfection, asepsis, and sterilization best
practices. (B) An effective infection control
program includes: (1) A tuberculosis
control plan that meets the standards set forth in rule 3701-15-03 of the
Administrative Code; (2) A written
surveillance plan outlining the activities for monitoring/tracking infections
based on nationally-recognized surveillance criteria such as McGeer criteria
and: (a) Includes a surveillance system that includes a data
collection tool; (b) Uses surveillance data to: (i) Implement timely
corrective action when a greater than expected number healthcare-associated
infections are detected; and (ii) Implement timely
corrective actions when transmission of targeted MDROs (e.g., CRE, Candida
auris) are detected. (3) Written standards,
policies, and procedures for the program, which must include, but are not
limited to: (a) Standard and transmission-based precautions to be
followed to prevent spread of infections; (b) When and to whom possible incidents of communicable
disease or infections should be reported; (c) When and how isolation should be used for a resident;
including but not limited to: (i) The type and duration
of the isolation, depending upon the infectious agent or organism involved; and
(ii) A condition that the
isolation should be the least restrictive possible for the resident under the
circumstances. (4) Written standards,
policies, and procedures under which the facility will prohibit employees with
a communicable disease or infected skin lesions from direct contact with
residents or their food, if direct contact will transmit the disease;
(5) The hand hygiene
procedures to be followed by staff involved in direct resident contact,
including, but not limited to: (a) Washing hands for twenty seconds with soap and water:
(i) After using the
toilet; (ii) Before direct
contact with a resident, dispensing medication, or handling food; (iii) Immediately after
touching body substances including blood, semen, saliva, vaginal secretions,
feces, urine, wound drainage, emesis and any other secretion or excretion of
the human body except tears and perspiration; (iv) After handling
potentially contaminated objects; (v) Between direct
contact with different residents; and (vi) After removing
gloves; or (b) Cleaning of hands with an alcohol-based product used
according to manufacturer's directions or other alternative methods
accepted by the United States centers for disease control and prevention or US
food and drug administration, as being an effective alternative, or handwashing
with soap and water. (6) Written standards,
policies, and procedures for laundry to ensure personnel handle, store,
process, and transport linens so as to prevent the spread of infection
including: (a) Handling soiled laundry as little as
possible; (b) Placing of laundry that is wet or soiled with body
substances in impervious bags that are secured to prevent spillage;
and (c) Wearing of impervious gloves and impervious gowns by
individuals performing laundry services, and, if handling soiled or wet laundry
on the unit, the wearing of gloves and, if appropriate, other personal
protective equipment; (7) Written standards,
policies and procedures to ensure infection prevention and control in the event
of an emergency or disaster needing evacuation or other movement of
residents. (C) If any resident, or individual used
by the nursing home, exhibits signs and symptoms of a disease listed in rule
3701-3-02 of the Administrative Code, the nursing home will ensure that
appropriate interventions and follow-up are implemented and make reports to the
appropriate local public health authority. (D) Each nursing home will establish and
implement an effective water management program to identify hazardous
conditions, and take steps to manage the risk of occurrence and transmission of
waterborne pathogens, including but not limited to legionella, in building
water systems in accordance with guidance from the United States centers for
disease control and prevention (available at
https://www.cdc.gov/legionella/wmp/overview.html) and recommendations of the
United States centers for disease control and prevention healthcare infection
control practices advisory committee, "Environmental Infection Control
Guidelines" (2019) or its successors. (E) If the nursing home provides an adult
day care program which is located, or shares space, within the same building as
the nursing home, shares staff between the program and the home, or where the
day care participants at any time intermingle with residents of the home, the
standards of this rule are also applicable to participants of the adult day
care program.
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Rule 3701-17-12 | Notification and reporting of changes in health status, illness, injury and death of a resident.
The nursing home administrator or the
administrator's designee will: (A) Immediately inform the resident,
consult with resident's physician or other licensed health professional
acting within the applicable scope of practice, or the medical director, if the
resident's physician or other licensed health professional is not
available, and notify the resident's sponsor or authorized representative,
with the resident's permission, and other proper authority, in accordance
with state and local laws and regulations when there is: (1) An accident involving
the resident which results in injury and has the potential for needing
physician intervention; (2) A significant change
in the resident's physical, mental, or psycho-social status such as a
deterioration in health, mental, or psycho-social status in either
life-threatening conditions or clinical complications; (3) A need to alter
treatment significantly such as a need to discontinue an existing form of
treatment due to adverse consequences, or to commence a new form of
treatment. The nursing home administrator or
administrator's designee is obligated to assure that the notification and
documentation of the occurrence includes a description of the circumstances and
cause, if known, of the illness, injury or death in the notification and
document the change in health status and any intervention taken in the
resident's medical record. If the resident is a patient of a hospice care
program, the notifications are the responsibility of the hospice care program
unless otherwise indicated in the coordinated plan of care obligated under
paragraph (H) of rule 3701-17-14 of the Administrative Code. (B) Report the death of a resident within
twenty-four hours to the appropriate third-party payer; or, if the office is
closed, as soon thereafter as it is open. (C) Report any incident of fire, damage
due to fire and any incidence of illness, injury or death due to fire or smoke
inhalation of a resident within twenty-four hours to the office of the state
fire marshal and to the director. (D) Report the diseases obligated to be
reported under Chapter 3701-3 of the Administrative Code in the manner
specified by that chapter.
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Rule 3701-17-13 | Medical supervision.
(A) Each nursing home operator will
arrange for the services of a physician to serve as the home's medical
director, and the medical director will: (1) Collaborate with the
administrator, the nursing director, and other health professionals to develop
formal resident care policies for the nursing home that: (a) Provide for the total medical and psycho-social needs of the
resident, including admissions, transfer, discharge planning, range of services
available to the resident, emergency procedures and frequency of physician
visits in accordance with resident needs and the applicable provisions of
Chapter 3721. of the Revised Code and of rules 3701-17-01 to 3701-17-26 of the
Administrative Code. (b) Promote resident rights as enumerated in section 3721.13 of
the Revised Code. (2) Make available
medical care for residents not under the care of their own physicians and to
make available emergency medical care to all residents, provided their personal
physicians are not readily available. (3) Meet periodically
with nursing and other professional staff to discuss clinical and
administrative issues, including the need for additional staff, specific
resident care problems and professional staff needs for education or
consultants to assist in meeting special needs such as dentistry, podiatry,
dermatology, and orthopedics, offer solutions to problems, and identify areas
where policy should be developed. In carrying out this function, the medical
director will: (a) Observe residents and facilities at least quarterly or more
frequently as needed; (b) Review pharmacy reports, at least quarterly, including
summaries of the drug regimen reviews set forth in paragraph (I) of rule
3701-17-17 of the Administrative Code and the quality assurance activities set
forth in paragraph (C) of rule 3701-17-06 of the Administrative Code, and take
appropriate and timely action as needed to implement recommendations;
and (c) The medical director will ensure medical standards are
adhered to during facility emergencies, voluntary closures, and decertification
or licensure actions and this can be performed either in-person or
virtually. (4) Monitor the clinical
practices of, and discuss identified problems with, attending physicians; act
as a liaison between the attending physicians and other health professionals
caring for residents and the residents' families; and intervene as needed
on behalf of residents or the home's administration. (5) Maintain surveillance
of the health of the nursing home's staff to avoid the spread of
infectious diseases. (6) Assist the
administrator and professional staff in ensuring a safe and sanitary
environment for residents and staff by reviewing incidents and accidents,
identifying hazards to health and safety, and advising about possible
correction or improvement of the environment. (7) Review all deficiency
statements issued to the nursing home concerning the medical
director. (B) The nursing home is not authorized to
administer any medication to any resident unless ordered by a physician or
other licensed health professionals acting within the applicable scope of
practice. If orders are given by telephone, the order will be documented with
the licensed health professional's name, date, and the order and be signed
by the person who accepted the order. All orders, including facsimile,
telephone, electronic mail, or verbal orders, are to be accepted and documented
in accordance with United States drug enforcement administration and board of
pharmacy of the state of Ohio provisions. (C) The nursing home is not authorized to
administer any treatment to any resident unless ordered by a physician or other
licensed health professionals acting within the applicable scope of practice.
If orders are given by telephone, the order will be documented with the
licensed health professional's name, date, and the order and be signed by
the person who accepted the order. All orders, including facsimile, telephone,
electronic mail, or verbal orders, are to be signed and dated by the physician
or other licensed health professional working in collaboration with the
physician who gave the order within fourteen days after the order was
given. (1) Telephone orders are
not authorized to be accepted by a person other than a licensed nurse on duty,
another physician or a pharmacist, except that a licensed physical,
occupational or respiratory therapist, audiologist, speech pathologist,
dietitian, or other licensed health professional may receive, document and date
treatment orders concerning that individual's specific discipline for
residents under their care, to the extent permitted by applicable licensing
laws. (2) The nursing home may
accept signed orders issued by a licensed health professional by electronic
mail or facsimile transmission only if the home has instituted procedural
safeguards for authenticating and maintaining confidentiality of the facsimile
order, and for handling it in an expedient and priority manner. (3) An entry that is an
electronic record as defined in section 3701.75 of the Revised Code may be
authenticated by an electronic signature in accordance with section 3701.75 of
the Revised Code, if allowed by law. (D) Each resident of a nursing home will be under the supervision
of a physician and be evaluated by a physician or other licensed health
professionals acting within the applicable scope of practice at least once
every thirty days for the first ninety days after admission, or after three
evaluations. After this period, each resident of a nursing home will be
evaluated by a physician or other licensed health professionals acting within
the applicable scope of practice at least every sixty days, except that if the
attending physician documents in the medical record why it is appropriate, the
resident may be evaluated no less frequently than once every one hundred twenty
days. (1) The evaluations
obligated by this rule will be made in person and the physician or licensed
health professional will solicit resident input to the extent of the
resident's capabilities during the evaluation. (2) The physician or
licensed health professional will write a progress note after each evaluation
depicting the current condition of the resident based upon consideration of the
physical, mental and emotional status of the resident. (3) A physician or
licensed health professional visit is considered timely if it occurs no later
than ten calendar days after the date the visit was scheduled. (E) On an annual basis, each nursing home
will offer to each resident a vaccination against influenza and a vaccination
against pneumococcal pneumonia as set forth in section 3721.041 of the Revised
Code.
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Rule 3701-17-14 | Plan of care; treatment and care: discharge planning, bathing.
(A) The nursing home will ensure that
development of a plan of care is initiated upon admission and completed and
implemented for each resident within seven days of completion of the initial
comprehensive assessment, conducted in accordance with rule 3701-17-10 of the
Administrative Code. A resident-focused and goal driven plan will be prepared
by an interdisciplinary team that includes the attending physician or other
licensed health professional acting within the applicable scope of practice, or
both, a registered nurse with responsibility for the resident and other
appropriate staff in disciplines as determined by the needs of the resident
including, but not limited to dietary, recreation, and social work staff. The
home will offer opportunities for the resident, the resident's sponsor,
and those of the resident's choice to participate in the care planning
process and will provide necessary information, support, and options for
engaging in the process to ensure that the resident/sponsor directs the process
to the maximum extent possible and is enabled to make informed choices and
decisions. (1) The plan of care will
be consistent with the comprehensive assessment with recognition of the
capabilities, preferences and goals of the resident, and contain a written
description of what services, supplies and equipment, are needed, when, how
often, and by whom services, supplies and equipment will be provided and the
measurable goals or outcomes. (2) The plan of care will
be reviewed whenever there is a change in the resident's condition, needs,
or preferences that warrant a change in the services, supplies or equipment to
be provided, and at least quarterly, by the nursing home and the resident, or
sponsor, or both, and be updated, as appropriate. (3) Each resident is
authorized to have access to his or her assessment and plan of care at any time
upon request. (B) All skilled nursing care will be
provided by a nurse except a nurse may delegate certain tasks as authorized by
Chapter 4723. of the Revised Code in accordance with the applicable rules
adopted under that chapter. (C) The nursing home will provide each
resident who cannot give themselves adequate personal care with such care as is
necessary to keep them clean, comfortable, and well groomed. (D) Each nursing home will provide
adequate supervision of residents who are assessed for risk of falls, or
elopement, or both. (E) All services, supplies and equipment provided or arranged for
by the nursing home is to be be provided, in accordance with acceptable
standards of practice and the written plans of care, by individuals who meet
the applicable qualifications of this chapter. (F) The nursing home will ensure that all residents receive
adequate, kind, and considerate care and treatment at all times. (G) The nursing home will transfer or discharge a resident in an
orderly, dignified, and safe manner in accordance with Chapter 3701-61 of the
Administrative Code. In anticipation of a discharge, the nursing home
will: (1) Prepare the following
information to be shared with appropriate persons and agencies upon consent of
the resident, except the resident's right to refuse release of such
information does not apply in the case of transfer to another home, hospital,
or health care system, if the release is needed by law or rule or by a
third-party payment contract; (a) An updated assessment that addresses the criteria outlined in
paragraph (E) of rule 3701-17-10 of the Administrative Code and accurately
identifies the resident's condition and continuing care need at the time
of transfer and discharge; (b) A plan that is developed with the resident and any persons of
the resident's choice, that indicates where the individual plans to
reside, and any arrangements that have been made for the resident's follow
up care and any post-discharge medical and non-medical services. The plan will
also identify need for the resident and care givers' education, including
resident and care giver instruction on the proper use of grab rails and other
safety devices, and any accommodations to the physical environment to meet the
needs of the resident; (2) Provide for drugs to
be sent with or arranged for the resident pursuant to paragraph (F)(2) of rule
3701-17-17 of the Administrative Code. (3) With the consent of
the resident, arrange and confirm the services, equipment and supplies in
advance of discharge or transfer of the resident. (4) The nursing home will
begin discharge planning for any resident for whom the initial and subsequent
assessment indicated an interest in discharge. (H) If the nursing home resident is also a patient of a hospice
care program, the nursing home will communicate and work with the hospice care
program in the development and implementation of a coordinated plan of care
between the nursing home and the hospice care program. The nursing home will
allow the hospice care program to retain professional management responsibility
for directing the implementation of the resident's plan of care related to
the resident's terminal illness and related conditions pursuant to Chapter
3701-19 of the Administrative Code as long as the resident is receiving hospice
care. The coordinated plan of care will: (1) Reflect the hospice
philosophy; (2) Be based on the
assessment of the resident and the unique living situation in the nursing home;
and (3) Identify the
services, supplies, and equipment to be provided by the nursing home and those
to be provided by the hospice care program. (I) The nursing home will ensure that the
privacy and dignity of residents is protected when residents are transported to
and from bathing facilities, when residents are preparing for bathing, and
during resident bathing. (J) Upon a resident's transfer,
discharge, or death, the nursing home will make an accounting of all that
resident's monies held by the facility and convey any remaining funds
immediately to the resident or within thirty days to the resident's estate
unless otherwise directed by law.
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Rule 3701-17-15 | Restraints.
(A) For purposes of this
rule: (1) "Attending
physician" means the physician with the most significant role in the
determination and delivery of medical care to the individual at the time of a
restraint order, which may include, the resident's physician, the medical
director of the home, or another physician on the staff of the
home. (2) "Prone
restraint" means all items or measures used to limit or control the
movement or normal functioning of any portion, or all, of an individual's
body while the individual is in a face-down position for an extended period of
time. Prone restraint includes physical or mechanical restraint. (3) "Transitional hold" means a
brief physical positioning of an individual face-down for the purpose of
quickly and effectively gaining physical control of that individual in order to
prevent harm to self and others, or prior to transport to enable the individual
to be transported safely. (B) Except as provided in paragraph (F)
of this rule for emergency situations, the nursing home is not allowed to
physically or chemically restrain a resident or subject a resident to prolonged
isolation except on written order of an attending physician which includes the
date, means of restraint to be used, medical reason for restraint, and duration
of restraint. Such written orders will be made a part of the resident's
record. (1) The nursing home is
not authorized to use a physical or chemical restraint or isolation for
punishment, incentive, or convenience. (2) The use of prone
restraints and transitional holds is forbidden in nursing homes. (3) A nursing home's
use of the following for the purposes stated in this paragraph is not be
construed as physically or chemically restraining a resident or subjecting a
resident to prolonged isolation: (a) Devices that assist a resident in the improvement of the
resident's mental and physical functional status and that do not restrict
freedom of movement or normal access to one's body; (b) Medications that are standard treatment or a documented
exception to standard treatment for the resident's medical or psychiatric
condition which assist a resident in attaining or maintaining the
resident's highest practicable physical, mental, and psycho-social
well-being; and (c) Placement of residents in a unit who are assessed to need
specialized care that restricts their freedom of movement throughout the home
if: (i) The home has made the
determination to place each resident in such unit in accordance with paragraph
(C) of this rule; (ii) Care and services
are provided in accordance with each resident's individual needs and
preferences, not for staff convenience; (iii) The need for the
resident to remain in the locked unit is reviewed during each periodic
assessment conducted in accordance with paragraph (F) of rule 3701-17-10 of the
Administrative Code and during the continuing care planning conducted in
accordance with rule 3701-17-14 of the Administrative Code; (iv) The locked unit
meets the provisions of the state building and fire codes; and (v) Residents who are not
cognitively impaired are able to enter and exit the unit without
assistance. (C) Except as provided in this paragraph,
and paragraph (F) of this rule for emergency situations, prior to authorizing
the use of a physical or chemical restraint on any resident, the nursing home
will ensure that the attending physician: (1) Makes a personal
examination of the resident and an individualized determination of the need to
use the restraint on that resident; and (2) In conjunction with
an interdisciplinary team of health professionals and other care givers,
conducts an individualized comprehensive assessment of the resident. This
assessment will: (a) Identify specific medical symptoms that warrant the use of
the restraint; (b) Determine the underlying cause of the medical symptom and
whether that underlying cause can be mitigated; (c) Investigate and determine if possible alternative
interventions have been attempted and found unsuccessful. Determine the least
restrictive device that is most appropriate to meet the needs of the resident,
taking into consideration any contraindications; (d) Discuss with the resident or authorized representative, and
any other individual designated or authorized by the resident, the risks and
benefits of the restraint; and (e) Obtain written consent from the resident or the
resident's authorized representative. A nursing home may restrain or isolate a
resident transferred from another health care facility based on the
resident's transfer orders if such orders include restraint use or
isolation authorization and the home complies with the provisions of this
paragraph within twenty-four hours of the resident's admission or
readmission to the home. (D) If a physical restraint is ordered,
the nursing home will select the restraint appropriate for the physical build
and characteristics of the resident and follow the manufacturer's
instructions in applying the restraint. The nursing home will ensure that
correct application of the restraint is supervised by a nurse and that the
restrained resident is monitored at least every thirty minutes. The visual
monitoring of the restrained resident may be delegated as permitted under state
law. Jackets, sheets, cuffs, belts, or mitts made with unprotected elements of
materials such as heavy canvas, leather, or metal are not authorized to be used
as restraints. (E) The attending physician or a staff
physician may authorize continued use of physical or chemical restraints for a
period not to exceed thirty days and, at the end of this period and any
subsequent period, may extend the authorization for an additional period of not
more than thirty days. The use of physical or chemical restraints is not
allowed to be continued without a personal examination of the resident and the
written authorization of the attending physician stating the reasons for
continuing the restraint. (F) Physical or chemical restraints or
isolation may be used in an emergency situation without authorization of, or
personal examination by, the attending physician only to protect the resident
from injury to self or others. Use of the physical or chemical restraint or
isolation is not allowed to be continued for more than twelve hours after the
onset of the emergency without personal examination and authorization by the
attending physician. (G) When isolation or confinement is
used, the nursing home will ensure that: (1) The resident is
continually monitored and periodically reassessed for continued use and need of
this method of intervention; (2) The door is secured
in such a way as to be readily opened in case of an emergency; (3) The resident is
isolated or confined for the least amount of time to achieve desired
outcome. (H) Members of the nursing home's
quality assurance committee, as set forth in rule 3701-17-06 of the
Administrative Code, will review the use of restraints and isolation and any
incidents that resulted from their use, as well as incidents which resulted in
the use of restraints or isolation on a monthly basis. The review will include
an identification of any trends, increases, or problems, and the need for
additional training, consultations or corrective action which will be discussed
and reflected in the minutes of the next quality assurance committee
meeting.
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Rule 3701-17-16 | Equipment and supplies.
(A) Each resident, if the resident so
chooses, will be provided with an individual bed not less than thirty-six
inches wide, a clean comfortable flame-resistant mattress suitable for the size
of the resident, and clean pillows, sheets, and covering suitable for the
resident's comfort. A nursing home will arrange for the provision of at
least a double size bed, upon request of a married couple or other consenting
adult residents sharing a room in accordance with the nursing home's
policy, unless there is an overriding documented medical reason that puts one
of the consenting parties at risk of health and safety or there is a risk to
other residents. Mattresses will be protected with waterproof material unless
otherwise ordered by a physician. Roll away beds, cots, double deck beds,
stacked bunk beds, hide-a-bed couches, or studio couches are not authorized to
be used as a substitution for the beds obligated by this rule. All mattresses
purchased or obtained by the nursing home, or brought to the nursing home by
residents, will be in safe condition. If the resident chooses to sleep on an
alternate piece of furniture, such as a reclining chair, the nursing home will
ensure that a bed meeting the provisions of this rule remains available to the
resident upon request; (B) Unless otherwise ordered by a
physician or other licensed health professional acting with the applicable
scope of practice, each resident will be provided with a bedside table, a
bedside light that is sufficient for reading and staff rendering of bedside
care, a bureau or equivalent, a waste basket with liners, a comfortable chair,
and adequate closet or wardrobe space for the storage of personal clothing in
the resident's room. A nursing home may provide additional storage space
for resident belongings elsewhere in the nursing home. Resident rooms are to be
designed or equipped to assure full visual privacy for each resident including
blinds, shades, or curtains for each exterior window in a resident's room
that the resident may open and close or have opened or closed for them upon
request. For the purposes of this paragraph, "full visual privacy"
means that the resident has a means of completely withdrawing from public view
while occupying their bed through such means as a curtain, movable screens or a
private room. (C) Each nursing home will have a call
signal system in good working order, is accessible directly or through
assistive devices assessed to be most appropriate for the resident's
physical and cognitive capacity, and is within reach of the resident that, at
minimum, provides for the transmission of calls from resident rooms and toilet
and bathing facilities. (D) Supplies such as hypodermic syringes,
needles, and lancets will be discarded after use in accordance with state and
federal provisions. Reusable items will be cleaned and disinfected according to
manufacturer's directions and in accordance with applicable state and
federal law and regulations. (E) All nursing homes will, at all times,
have the supplies and equipment necessary to provide the services and nursing
care needed by the type of residents admitted to or residing in the nursing
home. Wheelchairs, gerichairs, quad canes, adaptive eating equipment and
utensils, and other assistive devices are to be maintained in good and safe
working condition and be equipped properly for the specific needs of each
resident. (1) All equipment and
supplies in a nursing home are to be kept clean and usable and be
satisfactorily stored when not in use. (2) In selecting supplies
and equipment, the home will consider resident needs. (F) Within areas generally accessible to
residents, all disinfectants, pesticides, and poisons will be kept in a locked
area separate from medications and food. (G) The nursing home will provide a safe,
clean, comfortable and homelike environment allowing each resident to use
personal belongings to the extent possible. Residents may refuse furnishings,
equipment and supplies provided by the nursing home. The nursing home will
allow residents to bring their own furnishings and other personal items into
the home to personalize their individual environment if the furnishings and
items do not create a health and safety risk, are not medically inadvisable, or
infringe upon the rights of other residents. Upon request, the nursing home
will assist the resident in obtaining essential furnishings and
supplies.
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Rule 3701-17-17 | Medicines and drugs.
(A) The nursing home will provide or
obtain routine and emergency medicines, drugs and biologicals for its resident
except if restricted by state or federal law. The nursing home is obligated to
permit residents to use and continue to obtain medicines, drugs and biologicals
dispensed to them from a pharmacy of choice provided the medicines, drugs and
biologicals meet the standards of this rule. (1) Each nursing home
will provide pharmacy services by employing a pharmacist on either a full-time,
part-time, or consultant basis or by contracting with a pharmacy service. The
pharmacist or pharmacy service is responsible for maintaining supervision and
control of the stocking and dispensing of drugs and biologicals in the home in
accordance with state pharmacy rules. (2) The nursing home, in
conjunction with the pharmacist or pharmacy service, will: (a) Maintain an emergency and contingency drug supply for use in
the absence of the pharmacist; and (b) Ensure that the contingency drug supply is maintained in
accordance with state pharmacy rules. (B) Medicines and drugs are to be given
only to the individual resident for whom they are prescribed, be given in
accordance with the directions on the prescription or the physician's
orders, provided in a manner to ensure the privacy of the resident, and be
recorded on the resident's medication administration record. (C) Every container of medicine and drugs
prescribed for a resident will be properly and clearly labeled in accordance
with applicable state regulations as to the following: (1) Date
dispensed. (2) Name of
resident. (3) Directions for
use. (4) Name of the
prescriber. (5) Name of the drug,
strength, and prescription number if there is one. (D) Containers too small to bear a
complete prescription label will be labeled with at least the prescription
number and the name of the resident, unless application of this label would
impair the functioning of the product, and be dispensed in a container bearing
a complete prescription label. (E) The nursing home will ensure that:
(1) All medications and
drugs are stored under proper temperature controls and secured against
unauthorized access; (2) All medicines and
drugs, including those needing refrigeration, will be kept in locked storage
areas and separate from materials that may contaminate the medicines and drugs
such as poisonous substances; and (3) Where a pharmacist is
not present twenty-four hours-a-day, keys to locked contingency drug supplies
are made available to a health care professional licensed under Chapter 4723.
or 4731. of the Revised Code and authorized by such chapters to administer
drugs. (F) Each nursing home will ensure that
the following standards regarding individual resident's drugs are
met: (1) Appropriate drugs for
an individual resident, upon order of a prescriber, are sent with or arranged
for the resident upon temporary absence other than for hospital
leave. (2) At the order of a
prescriber, a resident's drugs are sent with or arranged for the resident
upon transfer and discharge. Drugs not so ordered by the prescriber upon
transfer or discharge are to be returned to the pharmacy or disposed of in
accordance with any applicable state or federal laws, rules and
regulations. (3) Upon death of a
resident all drugs are to be returned to the pharmacy, or disposed of in
accordance with any applicable state or federal laws, rules, and
regulations. (4) Prior to admission,
the nursing home will ensure that a prospective resident's medications
will be available without an interruption in the timely administration of the
medication in accordance with the resident's treatment plan as disclosed
to the nursing home. If the nursing home is notified of a change in medication
in a resident's plan of care during the admission process or a medication
is not available in house or will not be available through the nursing
home's pharmacy supplier in time for the resident's next scheduled
dose, the nursing home will: (a) Contact the prescriber to obtain additional
instructions and/or a prescription for an appropriate alternative medication to
be provided to the resident while waiting on the original prescription to be
filled and be made available to the facility; or (b) If the original prescriber is not available, the
nursing home will contact the nursing home medical director for the same
assistance. (G) Paragraph (F) of this rule does not
preclude a nursing home from charging a resident for medications and drugs
provided to the resident upon discharge for which the resident has not already
paid. (H) Controlled substances will be ordered, dispensed,
administered, and disposed of in accordance with state and federal laws and
regulations. (I) The nursing home will ensure that the pharmaceutical needs of
each resident are met and that the drug regimen of each resident is reviewed
and documented at least once a month by a pharmacist. (J) The nursing home will coordinate the ordering of medicines,
drugs and biologicals for hospice patients with the appropriate hospice care
program. (K) The nursing home will have a plan for
making sufficient medications and records of residents' orders available
to ensure continuity of care in the event of an emergency evacuation or
closure.
Last updated July 17, 2025 at 7:56 AM
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Rule 3701-17-18 | Food and nutrition.
Effective:
January 1, 2018
(A) Each nursing home shall have a
kitchen and other food service facilities which are adequate for preparing and
serving food for all residents. The nursing home shall develop and implement a
policy addressing its method for accommodating religious, ethnic and cultural
and personal preferences. (B) The nursing home shall store,
prepare, distribute and serve food under sanitary conditions and in a manner
that protects it against contamination and spoilage in accordance with food
service requirements of Chapter 3717-1 of the Administrative Code. (C) Each nursing home shall provide at least three
nourishing, palatable, and appetizing meals daily to all residents at regular
hours comparable to normal mealtimes in the community. The meals shall be
varied and meet the nutritional needs of the residents and be capable of
providing the dietary referenced intake of the "Food and Nutrition
Board" of the "National Academy of Science." Food shall be
prepared and served in a form that meets the resident's individual needs
based on the assessment conducted pursuant to rule 3701-17-10 of the
Administrative Code, the plan of care required by rule 3701-17-14 of the
Administrative Code, allow for resident choice, and accommodate religious,
ethnic, cultural and personal preferences. There shall be no more than sixteen
hours between the evening meal and breakfast. Each nursing home shall offer a
nourishing snack, consisting of a choice of beverages and a food item from a
basic food group, after the evening meal. Food substitutes of similar nutritive
value shall be offered to residents who refuse the food served and serving size
may be adjusted according to resident preference. The nursing home shall
accommodate a resident's preference or medical need to eat at different
intervals. (D) A nursing home may provide any alternate format of meal
service that otherwise meets the requirements of this rule, if the residents
agree to participate in the meal service and the home: (1) Ensures safe food
handling practices to prevent contamination of food being served;
and (2) Assists residents
when necessary. (E) Each nursing home shall maintain at all times
sufficient food supplies for residents. The home shall maintain at least two
days' supply of perishable food items and at least one week's supply
of staple food items. The amount of such supplies shall be based on the number
of meals that the nursing home provides and the nursing home's
census. (F) Each nursing home shall have planned menus for all
meals that are approved by the dietitian required by paragraph (K) of this
rule, for all meals at least one week in advance. The nursing home shall
maintain records for all meals, including therapeutic diets, as served. The
meal records shall be kept on file in the nursing home for at least three
months after being served and made available to the director upon request. The
records shall indicate the date that each meal was served along with any food
substitutions from the menu. (G) Safe, fresh, and palatable drinking
water shall be accessible for residents at all times. (H) All diets shall be: (1) Ordered by a
physician or other licensed health professional acting within their scope of
practice; (2) Prepared and provided
in accordance with the instructions of a dietitian pursuant to the diet order;
and (3) Adjusted as ordered by a physician,
dietitian or other licensed health professional acting within their scope of
practice. (I) The nursing home shall monitor each
resident's nutritional intake and make adjustments in accordance with the
resident's needs. Notification of any significant unplanned or undesired
weight change shall be made to the resident's attending physician and the
dietitian required by paragraph (K) of this rule. "Significant unplanned
or undesired weight change" means a five per cent weight gain or loss over
a one month period, a seven and one-half per cent or more weight gain or loss
over a three month period, or a ten per cent or more weight gain or loss over a
six month period. (J) Each nursing home shall employ a dietitian, who may be
hired on a full-time, part-time or consultant basis, to plan, direct and
implement dietary services that meet the residents' nutritional needs and
comply with the requirements of this rule. If the home does not have the
full-time equivalent of a dietitian, the nursing home shall designate a person
who meets the qualifications specified in paragraph (H) of rule 3701-17-07 of
the Administrative Code, to serve as the food service manager. The part-time or
consultant dietitian, at a minimum, shall consult monthly, or sooner, if
needed, with the food service manager. Each nursing home shall ensure that the
dietitian performs the following functions: (1) Assesses, plans,
monitors and evaluates nutritional services that meet the needs of the
residents; (2) Oversees the
development and implementation of policies and procedures which assure that all
meals are prepared and served as ordered and that food service personnel
maintain safe and sanitary conditions in procurement, storage, preparation,
distribution and serving of food; (3) Monitors food
preparation staff and staff responsible for carrying out the duties specified
in this rule; (4) For each resident
receiving a therapeutic diet, on an on-going basis: (a) Determine that the diet ordered is appropriate
according to the resident's individual nutritional care plan; (b) Monitor the resident's nutritional intake and
acceptance of the diet; (c) Evaluate the home's compliance in the provision of
the diet; and (d) Adjust nutritional care plans and diets as
needed. (5) Oversees, or arranges
for, the training of staff in performing the duties specified in this rule and
in the preparation of foods for all diets. Trained unlicensed staff, including
the dietary manager, may perform routine tasks that: (a) May be assigned pursuant to Chapter 4759. of the Revised Code
and this rule; and (b) Do not require professional judgment or
knowledge. (K) Tube feedings and parenteral nutrition shall be ordered
by a physician or other licensed health professional acting within their scope
of practice and administered by the appropriate licensed health professionals
in accordance with acceptable standards of practice. Tube feedings shall not be
used for convenience or when in conflict with treatment decisions, or a
resident's advance directive, in accordance with applicable provisions of
Chapters 1337. and 2133. of the Revised Code.
Last updated June 24, 2025 at 3:25 PM
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Rule 3701-17-19 | Records and reports.
(A) Nursing homes will keep the following
records and such other records as follows: (1) An individual medical
record will be maintained and routinely updated for each resident. Such record
will be started immediately upon admission of a resident to the home and
contain the following: (a) Identification record: Name, residence, age, gender,
race/ethnicity, religion, date of admission, name and address of nearest
relative or legal guardian, admission diagnoses from referral record and name
of the resident's physician and, if applicable, other licensed health
professional acting within the applicable scope of practice. If applicable, the
contact information of the nearest relative or legal guardian is obligated to
be reviewed and updated every six months to ensure appropriate notification in
the event of an emergency, quarantine, or closure. (b) Referral record. All records, reports, and orders which
accompany the resident in accordance with rule 3701-17-10 of the Administrative
Code. (c) Nursing notes and care notes. A note of the condition of the
resident on admission and subsequent notes as indicated to describe changes in
condition, unusual events or accidents. Other individuals rendering services to
the resident may enter notes regarding the services they render. (d) Medication administration record. A doctor's order sheet
upon which orders are recorded and signed by the physician or other licensed
health professional acting within the applicable scope of practice, including
telephone orders in accordance with rule 3701-17-13 of the Administrative Code;
a nurse's treatment sheet upon which all treatments or medications are
recorded as given, showing what was done or given, the date and hour, and
signed by the nurse giving the treatment or medication; or other documentation
authenticating who gave the medication or treatment. (e) Resident progress notes. A sheet or sheets upon which the
doctor, dentist, advanced practice nurse and other licensed health
professionals may enter notes concerning changes in diagnosis or condition of
the resident including a resident's refusal of treatment and services.
(f) Resident assessment record. All assessments and information
in accordance with rule 3701-17-10 of the Administrative Code. (g) Care plan. The plan of care set forth in rule 3701-17-14 of
the Administrative Code. (h) Photograph. A photograph is necessary for residents who have
been identified as being a elopement risk. The photograph of the resident will
be updated annually. (2) The nursing home will
maintain all records obligated by state and federal laws and regulations, as to
the purchase, delivery, dispensing, administering, and disposition of all
controlled substances including unused portions. (3) The nursing home will maintain a
record of all residents admitted to or discharged from the nursing
home. (B) A record will be kept showing the
name and hours of duty of all persons who work in the home. (C) All records and reports maintained in
accordance with rules 3701-17-01 to 3701-17-26 of the Administrative Code will
be prepared, maintained, filed, and transmitted as necessary, and be made
available for inspection at all times when requested by the director or the
director's authorized representative. The records may be maintained in
electronic format, microfilm, or other method that assures a true and accurate
copy of the records are available. (1) The nursing home will
maintain the records and reports set forth in paragraph (A)(1) of this rule in
the following manner: (a) Safeguard the records and reports against loss, destruction,
or unauthorized use and store them in a manner that protects and ensures
confidentiality. (b) Maintain the records and reports for seven years following
the date of the resident's discharge, except if the resident is a minor,
the records will be maintained for three years past the age of majority but not
less than seven years. (c) Upon closure of the home, the operator will provide and
arrange for the retention of records and reports in a secured manner for not
less than seven years and notify the director of the location where the records
will be stored. (2) The nursing home will
maintain all other records and reports as set forth in rules 3701-17-01 to
3701-17-26 of the Administrative Code for seven years. (3) Upon the request of
the resident or former resident, or the resident's or former
resident's legal representative, the nursing home will
provide: (a) Access to medical and financial records and reports
pertaining to the resident within twenty-four hours, excluding holidays and
weekends; and (b) Photocopies of any records and reports, or portions thereof,
at a cost not to exceed the community standard for photocopying, unless
otherwise specified by law, upon two working days advanced notice. (D) All records and reports mandated by
Chapter 3701-13 of the Administrative Code will be maintained and made
available in accordance with that chapter. (E) Upon the change of operator of a
nursing home, the records kept pursuant to this rule will be transferred to the
new operator of the home.
Last updated July 17, 2025 at 7:57 AM
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Rule 3701-17-20 | Smoking or use of flame producing devices; waste containers and ash trays.
(A) No employee, resident of a nursing
home, visitors, or other persons in the nursing home will be permitted to
smoke, use an electronic smoking device as defined in section 2927.02 of the
Revised Code, carry a lighted cigarette, cigar or pipe or use any spark or
flame producing device in any room or area in a nursing home where oxygen is
stored or in use. Approved terminals of a piped oxygen supply does not
constitute storage. (B) "No smoking" signs will be
posted in areas and on doors of rooms where oxygen is stored or in
use. (C) Except as provided for in paragraph
(D) of this rule, indoor resident smoking will only be permitted in separately
enclosed and separately ventilated designated areas as allowed for in division
(D) of section 3794.03 of the Revised Code that accommodate the needs of the
smokers. Nursing homes that allow outdoor resident smoking will make
accommodations for residents during adverse weather conditions, public health
emergencies, incidents of isolation, or quarantine. (1) The nursing home is
not allowed to designate as resident smoking areas the dining and recreation
area or room, resident rooms, and areas or rooms where oxygen is stored, except
smoking may be permitted in the dining and recreation areas or rooms when such
areas or rooms meet the provisions of division (D) of section 3794.03 of the
Revised Code and are not being used for their stated purpose. (2) The nursing home will
post smoking signs at all designated resident smoking areas and take reasonable
precautions to ensure the safety of all residents when residents
smoke. (D) The nursing home may establish a
smoke-free environment if all residents are notified of the policy prior to
admission. If a nursing home establishes a policy of this nature, the nursing
home will continue to accommodate the needs of smokers living in the home on
the effective date of the smoke-free policy by complying with the provisions of
paragraph (C) of this rule. (E) Ash trays, waste baskets or
containers where burnable materials may be placed cannot be made of materials
which are flammable, combustible or capable of generating quantities of smoke
or toxic gases. Ash trays and waste baskets and containers where burnable
materials may be placed will be noncombustible or carry a fire resistant
"UL" or "FM" rating. (F) Ash trays will be provided in all
designated resident smoking areas, be either self-closing or have a cigarette
island in the middle, and not have any cigarette holders located around the
outside rim of the tray.
Last updated July 17, 2025 at 7:57 AM
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Rule 3701-17-21 | Dining and recreation rooms; utility rooms; toilet rooms.
(A) Every building occupied as a nursing
home on and in continuous operation since December 22, 1964 will have not less
than one room or suitable area which which is used for no other purposes than
dining and recreation by the residents. Such room or area will be located and
of such size as to meet the needs of the residents and is not authorized to be
used for adult day care participants or residential care facility residents
unless the home meets the square footage provisions of paragraph (B) of this
rule. Any building occupied as a nursing home on December 22, 1964, that is
discontinued for such use and then use of the building is resumed will comply
with paragraph (C) of this rule. (B) Every building erected or converted
to use as a nursing home after and in continuous operation since December 22,
1964, and before July 17, 2002, will have a room or suitable area which will be
used for no other purposes than dining and recreation. The dining and
recreation room or area will have a minimum total area of twenty-five square
feet per resident for seventy-five per cent of the nursing home's licensed
capacity. Any building licensed by the state as a nursing home on or after
December 22, 1964, that is discontinued for such use and then use of the
building is resumed is obligated to, comply with paragraph (C) of this rule.
Any building licensed by the state as a nursing home who builds an addition or
expands into previously unlicensed space will comply with paragraph (C) of this
rule. Each nursing home that shares the dining and
recreation room or area with participants of an adult day-care program,
residents of a residential care facility, or both, will provide an additional
twenty-five square feet per participant, resident, or both, for seventy-five
per cent of the total number of adult day-care program participants, the
licensed capacity of the residential care facility, or both. (C) Every building erected or converted
to use as a nursing home after July 17, 2002, will have a room or suitable area
or areas for dining purposes and a separate room or rooms, or suitable area or
areas to be used for recreational purposes. A nursing home may use the dining
room or area for recreational purposes when the room or area is not being used
for dining, but does not count towards the needed square footage listed in this
paragraph. (1) Dining room or area:
Twenty-five square feet per resident for the nursing home's licensed
capacity. Each nursing home that shares the dining room
or area with participants of an adult day-care program, residents of a
residential care facility, or both, will provide an additional twenty-five
square feet per participant, resident, or both, for the total number of adult
day-care program participants, the licensed capacity of the residential care
facility, or both. (2) Recreational room or
area: Twenty-five square feet per resident for seventy-five per cent of the
nursing home's licensed capacity. Each nursing home that shares the recreation
room or area with participants of an adult day-care program, residents of a
residential care facility, or both, will provide an additional twenty-five
square feet per participant, resident, or both, for seventy-five per cent of
the total number of adult day-care program participants, the licensed capacity
of the residential care facility, or both. (D) Every nursing home will employ
methods and have adequate facilities and supplies for clean and soiled laundry
in accordance with prevailing infection control practices. (E) Bathrooms and toilet rooms will conform to the Ohio building
code. (F) Bathrooms and all fixtures therein
will ensure resident privacy and dignity in accordance with paragraph (I) of
rule 3701-17-14 of the Administrative Code. (G) Bathrooms, toilet rooms and all the facilities therein will,
at all times, be kept in good repair, in a clean and sanitary condition, free
from filth and accumulation of waste, and provide a supply of toilet tissue.
Each hand washing basin will be provided with a soap dispenser. Bathrooms and
toilet rooms will be designed or equipped to assure full visual privacy for
each resident. (H) Grab rails and other safety devices such as non-slip surfaces
will be provided and maintained in good repair. (I) In every building or addition to a building constructed or
converted to use as a nursing home on or after the effective date of this rule,
each resident room will have a toilet room directly accessible from each
resident sleeping room, except the hand washing basin may be located in either
the room containing the toilet or the sleeping room. Toilet rooms are not to be
shared between rooms. (J) For purposes of this rule, "bathroom" means a room
or rooms conforming to the Ohio building code containing a group of fixtures
consisting of a water closet, lavatory, bathtub or shower, including or
excluding a bidet, an emergency floor drain, or both.
Last updated July 17, 2025 at 7:57 AM
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Rule 3701-17-22 | General building and sanitation requirements; overhead paging.
(A) The building or buildings in which a
nursing home is located will be in compliance with the applicable provisions of
the Ohio building code and have a certificate of use issued by the appropriate
building authority. (B) All plumbing will be so installed and
maintained as to be free of leakage and odors and as to reasonably ensure
adequate health and safety protection. Plumbing fixtures in nursing homes or
additions to nursing homes constructed, erected, altered or relocated after
September 10, 1984, and plumbing fixtures in buildings converted into nursing
homes after September 10, 1984, will conform to the applicable provisions of
the Ohio building code. (C) Lavatories, bathing facilities, and
shower facilities will be supplied with hot and cold running water and be
regulated by approved devices for temperature control. The hot water
temperature in areas used by residents will be a minimum of one hundred five
degrees Fahrenheit and not exceed one hundred and twenty degrees
Fahrenheit. (D) The nursing home's water supply
will be adequate in quantity and of suitable chemical and bacteriological
quality for drinking, culinary, and cleaning purposes. The water supply for a
nursing home will be taken from a public supply, if available. If from a source
of supply other than a public supply, the water supply will comply with all
applicable local and state regulations regarding the construction, development,
installation, alteration, and use of private water systems. (E) All liquid wastes from nursing homes
will be discharged into a public sanitary sewerage system, if available. Where
not available, such wastes will be discharged into a sewage disposal system
that meets all applicable local and state regulations regarding the
construction, development, installation, alteration, and use of private
household sewage disposal systems. The nursing home will properly maintain its
sewage disposal system in good, safe working condition. (F) Heating, cooling, electrical, and
other building service equipment will be maintained in good working and safe
condition. (G) The buildings and grounds will be
maintained in a clean and orderly manner. (H) All garbage and other refuse will be
disposed of immediately after production, or be stored in leak-proof containers
with tight fitting covers until time of disposal, and all wastes are to be
disposed of in a satisfactory manner. (I) Adequate measures will be taken to
prevent the entrance of insects, rodents, and pests into any building used for
a nursing home or part thereof and to prevent their infestation of the
premises. Extermination of pests should be considered urgent and remediation is
obligated to commence as soon as possible. (J) The extermination of insects, rodents, and pests will be done
in such a manner as not to create a fire or health hazard.
Last updated July 17, 2025 at 7:58 AM
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Rule 3701-17-23 | Space requirements; limitation of number in wards.
(A) In every building where there is a
nursing home, the premises of which were initially licensed by the state as a
nursing home prior to December 22, 1964 and have been in continuous operation
since being initially licensed, every room occupied for sleeping purposes by
one person will have a habitable floor area of not less than eighty square feet
and every room occupied for sleeping purposes by more than one person will have
a habitable floor area of not less than eighty square feet per person. Any
building licensed by the state as a nursing home prior to December 22, 1964
that is discontinued for such use and then use of the building is resumed is
obligated to comply with paragraph (B) of this rule. (B) In every building or addition to a
building, erected or converted to use or initially licensed as a home after
December 22, 1964, every room occupied for sleeping purposes by one person will
have a habitable floor area of not less than one hundred square feet and every
room occupied for sleeping purposes by more than one person will have a
habitable floor area of not less than eighty square feet per person. In every
building occupied as a nursing home on December 22, 1964, every room added for
sleeping purposes will comply with this paragraph. (C) Any building licensed by the state
as a nursing home on or after December 22, 1964 that is discontinued for such
use and then use of the building is resumed is obligated to comply with
paragraph (D) of this rule. (D) In every building or addition to a building, erected or
converted to use or initially licensed as a home on or after July 17, 2002,
every room occupied for sleeping purposes by residents will be occupied by no
more than two residents and be designed to assure full visual privacy, as
defined in paragraph (B) of rule 3701-17-16 of the Administrative Code, for
each resident.
Last updated July 17, 2025 at 7:58 AM
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Rule 3701-17-24 | Temperature regulation in homes.
(A) For the purposes of this
rule: (1) "Resident
area" means any area within a nursing home that is occupied at any time by
a resident except for an area, such as a greenhouse, that is specifically
designed to be kept a higher temperature. (2) "Temperature
range" means between seventy-one degrees fahrenheit and eighty-one degrees
fahrenheit. (B) Each nursing home will maintain the
temperature within the temperature range and the humidity in resident areas at
a safe and comfortable level and have a device, such as a hand held hygrometer
or infrared thermometer, to check the ambient temperature of the
rooms. (C) Residents in rooms containing
separate heating and cooling systems who are capable of controlling them may
maintain the temperature of their rooms at any level they desire except the
nursing home will take appropriate intervention if a resident's desired
temperature level adversely affects or has potential for adversely affecting
the health and safety of the resident or the health, safety and comfort of any
other resident sharing the resident room. (D) Each nursing home in consultation
with its medical director, will develop written policies and procedures for
responding to temperatures in resident areas that are outside the temperature
range as defined in paragraph (A) of this rule. The policies and procedures
will be signed by the medical director and include at least the
following: (1) An identification of
available sites within or outside the nursing home to which residents can be
relocated temporarily and of other suitable health care facilities that will be
available to receive transfers of residents if the temperature level adversely
affects or has potential for adversely affecting the health and safety of
residents; (2) Measures to be taken
to assure the health, safety and comfort of residents who remain in the nursing
home when temperatures are outside the temperature range as defined in
paragraph (A)(2) of this rule; and (3) Identification of the
circumstances that need notification of the medical director or a
resident's attending physician or that need medical examinations or other
medical intervention and appropriate time frames for these
actions. (E) Whenever the temperature in any
resident area is outside the temperature range as defined in paragraph (A)(2)
of this rule, the nursing home will immediately evaluate the situation and
monitor residents at risk and take appropriate action to ensure the health,
safety and comfort of its residents, including but not limited to
implementation of the policies and procedures developed under paragraph (D) of
this rule. The nursing home will document all action taken under this paragraph
and maintain, on site, documentation of action taken during the current
calendar year and during the preceding calendar year. (F) Each nursing home will maintain
appropriate arrangements with qualified persons that provide for emergency
service in the event of an electrical, heating, ventilation or air conditioning
failure or malfunction and maintain documentation of the arrangements such as
employment or other written agreements. The nursing home will ensure that all
necessary repairs are completed within forty-eight hours or less. If, for
reasons beyond the nursing home's control, repairs cannot be completed
timely, the nursing home will take any necessary action, as specified in
paragraph (E) of this rule, and will provide for the repairs to be completed as
soon as possible.
Last updated July 17, 2025 at 7:58 AM
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Rule 3701-17-25 | Disaster preparedness, fire and carbon monoxide safety.
(A) Each operator will provide, maintain,
and keep current a written disaster preparedness plan to be followed in case of
emergency or disaster. A copy of the plan will be readily available at all
times within the nursing home. The nursing home will ensure that each staff
member, consultant and volunteer is trained and periodically updated about the
home's disaster preparedness plan and understands their role in the event
of fire or other disaster or emergency. The plan will include the
following: (1) Procedures for
evacuating all individuals in the nursing home, including: (a) Provisions for evacuating residents with physical or
cognitive impairments; (b) Provisions for transporting all of the residents of the
nursing home to a predetermined appropriate facility or facilities that will
accommodate all the residents in the event a disaster necessitates long-term
evacuation of the nursing home; (c) A written transfer agreement, renewed biannually, with the
appropriate facility or facilities for accommodating all of the residents of
the nursing home in case of a disaster needing evacuation of the nursing home;
and (d) A paper and electronic copy of the disaster
preparedness plan will be maintained off-site to ensure access by the nursing
home director or nursing home staff in the event of an emergency. (2) A plan for protection
of all persons in the event of fire and when the fire alarm or sprinkler system
is undergoing maintenance or inoperative, and procedures for fire control and
evacuation, including a fire watch in accordance with rule 1301:7-7-09 of the
Administrative Code; (3) Procedures for locating missing
residents, including notification of local law enforcement. (4) Procedures for ensuring the health
and safety of residents during severe weather situations, such as tornadoes and
floods, and designation of tornado shelter areas in the home; (5) Procedures, as appropriate, for
ensuring the health and safety of residents in nursing homes located in close
proximity to areas known to have specific disaster potential, such as airports,
chemical processing plants, and railroad tracks; and (6) Policies and
procedures to ensure infection prevention and control in the event of an
emergency or disaster needing evacuation or other movement of
residents. (B) Each operator will conduct the
following drills, unless the state fire marshal allows a home to vary from this
standard and the nursing home has written documentation to this effect from the
state fire marshal: (1) Twelve fire exit
drills every year, approximately every three months on each shift to
familiarize nursing home personnel with signals and emergency action necessary
under varied times and conditions. Fire exit drills will include the
transmission of a fire alarm signal to the appropriate fire department or
monitoring station, verification of receipt of that signal, and simulation of
emergency fire conditions except that the movement of infirm and bedridden
residents to safe areas or to the exterior of the structure is not necessary.
Drills conducted between nine p.m. and six a.m. may use a coded announcement
instead of an audible alarm. The nursing home will reset the alarms after each
drill; and (2) At least two disaster
preparedness drills per year, one of which will be a tornado drill during the
months of March through July. (C) Each operator will keep a written
record and evaluation of each conducted drill and practice which includes the
date, time, employee attendance, effectiveness of the plan, and training format
used. This record will be on file in the nursing home for three
years. (D) Each operator will provide and post
in a conspicuous place in each section and on each floor of the nursing home a
correctly-oriented, wall-specific floor plan designating room use, locations of
alarm sending stations, fire extinguishers, fire hoses, exits and flow of
resident evacuation. (E) Each operator will provide for
annual training in fire prevention for regularly scheduled staff members on all
shifts, to be conducted by the state fire marshal or township, municipal, or
local legally constituted fire department. Semi-annually, the operator will
ensure that all staff members are instructed in the home's fire control
and evacuation and disaster procedures and kept informed of their duties under
the evacuation plan. (F) Each operator will conduct at least
monthly a fire safety inspection which is recorded on forms provided by the
department and kept on file in the nursing home for three years. (G) If applicable, each nursing home will
install and maintain carbon monoxide alarms or carbon monoxide detectors in
accordance with the Ohio fire code section 1103.9. (H) Each nursing home will notify the director by phone or
electronic mail when there is an interruption affecting the resident health and
safety due to an emergency or a disaster involving the nursing
home.
Last updated July 17, 2025 at 7:59 AM
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Rule 3701-17-26 | Variances.
(A) The director may grant a variance
from the standards of rules 3701-17-01 to 3701-17-26 of the Administrative Code
as will not be contrary to the public interest, where the operator shows that
because of practical difficulties or other special conditions, their strict
application will cause unusual and unnecessary hardship. However, no variance
will be granted: (1) That will defeat the
spirit and general intent of these rules, adversely affect the health or safety
of the residents, or otherwise not be in the public interest; or (2) For a standard that
is mandated by statute. (B) A request for a variance from the
standards of rules 3701-17-01 to 3701-17-26 of the Administrative Code will be
made in writing to the director, specifying the following: (1) The rule standards
for which the variance is requested; (2) The time period for
which the variance is requested; (3) The specific
alternative action which the nursing home proposes; (4) The reason for the
request; and (5) An explanation of the
anticipated effect granting of the variance will have on
residents. (C) The director will notify the
operator, in writing, of the director's determination regarding a variance
request. The director may establish conditions that the nursing home will meet
for a variance to be operative, a time frame for which the variance will be
effective, or both. (D) The director will notify the
operator, in writing, of the director's determination to revoke a granted
variance. The director may revoke a variance if the director determines
that: (1) The variance is
adversely affecting the health and safety of the residents; (2) The nursing home has
failed to comply with the variance as granted; (3) The operator or
administrator notified the department that the owner or administrator wishes to
relinquish the variance; or (4) The variance
conflicts with a statutory change thus rendering the variance
invalid. (E) The refusal of the director to grant
or revoke a variance or waiver, in whole or in part, will be final and not be
construed as creating any rights to a hearing under Chapter 119. of the Revised
Code. (F) A
variance or waiver approved by the director does not serve as precedent for
other variance or waiver requests.
Last updated July 17, 2025 at 7:59 AM
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