§270.2100. Patient Care Services

a)         The licensee shall provide physician supervision consistent with the needs of the patients, on a continual basis. (Section 35 of the Act)

 

1)         There shall be frequent, consistent contact between physicians and the patient and between physicians and other facility personnel, to provide medical direction for the comprehensive care plan.

 

2)         There shall be one or more direct physician to patient contacts per week.

 

3)         Other contacts may be made through a combination of visits and status reports by other personnel caring for the patient.

 

b)         The licensee shall provide registered nursing on a continual basis through the onsite availability of registered nurses for hands-on care 24 hours per day. (Section 35 of the Act)

 

c)         The licensee shall provide physiological monitoring on a continual Basis, as necessary to meet the needs of each patient, such as continual electronic monitoring of breathing, cardiovascular functioning or biochemical functioning. (Section 35 of the Act)

 

d)         The licensee shall provide 24-hour-per-day access to diagnostic support services consistent with the patient's comprehensive care plan.

 

e)         The licensee shall provide adequate auxiliary and support services to meet each patient's comprehensive care plan.

 

f)         A program manager shall be designated for each patient.  A program manager may serve one or more patients.  The provision of services to each patient shall be organized through the patient's manager who shall:

 

1)         Assume responsibility for implementation of the comprehensive care plan;

 

2)         Assist the patient in becoming oriented to his/her program;

 

3)         Enable the patient's program to proceed in an orderly, purposeful, and goal-oriented manner;

 

4)         Promote the program's responsiveness to the needs and preferences of the patient;

 

5)         Promote the participation of the patient on an ongoing basis in discussions of plans, goals, status, etc;

 

6)         Participate consistently in team conferences concerning the patient; and

 

7)         Facilitate the discharge process and arrangements for follow-up and supportive services.

 

g)         The licensee shall provide other services as necessary to implement and support the patient's comprehensive care plan and overall needs, including provisions for:

 

1)         Case management;

 

2)         Fostering maximum patient independence;

 

3)         Protection of patient rights, privacy and dignity;

 

4)         Assisting the patient and patient's representative in understanding and adjusting to the patient's current condition, prognosis and future needs; and

 

5)         Discharge planning.

 

h)         A Subacute Care Hospital Model licensee that is not licensed under the Hospital Licensing Act as a general acute care hospital shall have a transfer agreement with at least one general acute care hospital in order to handle cases of complications, emergencies or exigent circumstances. (Section 35 of the Act)

 

i)          A licensee shall develop a written policy to the extent possible, to link and integrate its services with nearby health care facilities to meet the needs of the patients.  (Section 30(e) of the Act)

 

j)          If the facility is licensed under the Hospital Licensing Act, the Hospital Licensing Requirements shall apply to blood transfusions.  If the facility is licensed under the Nursing Home Care Act or is a Designated Site, blood transfusions may be given to patients receiving subacute care only if the facility has a transfusion protocol that is approved by the medical director, director of nursing services and the administrator.  The protocol must be followed and must address, at least, the following to assure the safety of the patient:

 

1)         Acquisition, transportation and storage of the blood or blood products;

 

2)         Supervision by a physician;

 

3)         The supplies necessary for the transfusion and response to emergencies;

 

4)         Administration of the blood or blood products;

 

5)         Monitoring of the patient during and after the transfusion;

 

6)         The qualifications of the staff responsible for implementing subsections (j)(1), (3), (4) and (5) above; and

 

7)         Arrangements with a licensed hospital to have all blood transfusions and transfusion reactions reviewed in accordance with Section 250.520(i) and (j) of the Hospital Licensing Requirements.

 

(Source:  Amended at 19 Ill. Reg. 6315, effective May 1, 1995)