TITLE 8 SOCIAL SERVICES
CHAPTER 371 DEVELOPMENTAL DISABILITIES
PART 2 REQUIREMENTS FOR INTERMEDIATE CARE FACILITIES FOR THE
MENTALLY RETARDED
8.371.2.1 ISSUING AGENCY:
New Mexico Health Care Authority.
[8.371.2.1
NMAC - N, 7/1/2024}
8.371.2.2 SCOPE: These
regulations apply to any facility providing services as outlined by these
regulations and any facility which by federal regulation must be licensed by
the state of New Mexico to obtain or maintain full or partial permanent or
temporary federal funding as an intermediate care facility for the mentally
retarded (ICF/MR). All facilities
licensed after the effective date of these regulations shall be limited to a
capacity of no greater than four clients, except as provided herein in
Subsection C of 8.371.2.21 NMAC.
[8.371.2.2
NMAC - N, 7/1/2024}
8.371.2.3 STATUTORY AUTHORITY:
The regulations set forth herein are promulgated pursuant to
the general authority granted under Subsection E of Section 9-8-6 NMSA 1978;
and the authority granted under Subsection D of Section 24-1-2, Subsection I of
Section 24-1-3, and Section 24-1-5 of the Public Health Act, NMSA 1978, as
amended. Section 9-8-1 et seq. NMSA 1978 establishes the health care
authority (authority) as a single, unified department to administer laws and
exercise functions relating to health care purchasing and regulation..
[8.371.2.3
NMAC - N, 7/1/2024}
8.371.2.4 DURATION: Permanent.
[8.371.2.4
NMAC - N, 7/1/2024}
8.371.2.5 EFFECTIVE DATE:
July 1, 2024, unless a different date is cited at the end of
a section.
[8.371.2.4
NMAC - N, 7/1/2024}
8.371.2.6 OBJECTIVE: The
purpose of these regulations is to:
A. Establish professional minimum
standards for ICF/MR facilities in the state of New Mexico which were formerly
licensed under regulations governing long term care facilities.
B. Monitor ICF/MR facilities with these
regulations through surveys to identify any areas which could be dangerous or
harmful to the clients or staff.
C. Encourage the maintenance of ICF/MR
facilities that provide quality services which maintain or improve the health
and quality of life to the clients.
D. Expand the availability of ICF/MR
programs to assure timely placement for persons who need residential services.
E. Assure integrated active treatment
programs, homelike living arrangements, and consumer protections for ICF/MR
clients.
F. Promote access and availability
statewide.
G. Recognize specialized ICF/MR
programs to serve individuals with intense needs.
[8.371.2.6
NMAC - N, 7/1/2024}
8.371.2.7 GENERAL DEFINITIONS:
For purposes of these regulations the following shall apply:
A. “Active
treatment” means the consistent, aggressive, accountable, and continuous
application of competent interactions between caregivers and persons with
developmental disabilities whom they serve in structured and unstructured
settings alike, directed toward each individual's developmental progress
through the life cycle.
B. “Applicant”
means the individual who, or organization which, applies for a license. If the applicant is an organization, then the
individual signing the application on behalf of the organization, must have
authority from the organization. The
applicant must be the owner.
C. “Client”
means an individual living in and receiving services from an ICF/MR licensed
pursuant to these regulations.
D. “Community
supports” means community services such as recreational activities, social
clubs, religious services, employment services, and transportation, as well as
other supportive services that are available to the general population and not
designated to serve only persons with disabilities.
E. “Dietitian”
means a person eligible or required to be licensed under the New Mexico
Nutrition and Dietetics Practice Act, Sections 61-7A-1 through 61-7A-15 NMSA
1978, effective July 1, 1989.
F. “Facility”
means a building or buildings in which clients live and ICF/MR services are
provided and is licensed or required to be licensed pursuant to these
regulations.
G. “Governing
body” means the governing authority of a facility which has the ultimate
responsibility for all planning, direction, control and management of the
activities and functions of a facility licensed pursuant to these regulations.
H. “ICF/MR”
means an intermediate care facility that provides food, shelter, health or
rehabilitative and active treatment for the mentally retarded or persons with
related conditions.
I. “License” means the document issued by the licensing authority
pursuant to these regulations granting the legal right to operate for a
specified period of time, not to exceed one year.
J. “Licensee” means the person(s) who, or organization which, has an
ownership, leasehold or similar interest in the ICF/MR facility and in whose
name a license has been issued and who is legally responsible for compliance
with these regulations.
K. “Licensing
authority” means the New Mexico health care authority.
L. “NMSA”
means the New Mexico Statutes Annotated 1978 compilation and all the revisions
and compilations thereof.
M. “Nurse”
is an individual who is currently licensed/registered in the state of New
Mexico.
N. “Occupational
therapist” is an individual who is eligible for certification by the
American occupational therapy association or another comparable body.
O. “Physical
therapist” is an individual who is eligible for certification as a physical
therapist by the American physical therapy association or another comparable
body.
P. “Plan
of correction” means the plan submitted by the licensee or representative
of the licensee addressing how and when deficiencies identified at time of a
survey will be corrected.
Q. “Policy”
means a statement of principle that guides and determines present and future
decisions and actions.
R. “Premises”
means all parts of buildings, grounds, and equipment of a facility.
S. “Procedure” means the action(s) that must be taken in order to
implement a policy.
T. “Psychologist”
is an individual who has at least a master's degree in psychology from an
accredited school.
U. “Social
worker” means a person required to be licensed under the Social Work
Practice Act Sections 61-31-1 through 61-31-25 NMSA 1978.
V. “Speech
language pathologist or audiologist” is an individual who is eligible for a
certificate of clinical competence in speech-language pathology or audiology
granted by the American speech-language hearing association or another
comparable body or who meets the educational requirements for certification and
is in the process of accumulating the supervised experience required for
certification.
W. “U/L
approved” means approved for safety by the national underwriters
laboratory.
X. “Training
and habilitation services” means the training and services which are
provided to a client intended to aid the intellectual, sensorimotor, and
emotional development of that client.
Y. “Variance”
means an act on the part of the licensing authority to refrain from pressing or
enforcing compliance with a portion or portions of these regulations for an
unspecified period of time where the granting of a variance will not create a
danger to the health, safety, or welfare of clients or staff of a facility, and
is at the sole discretion of the licensing authority.
Z. “Waive/waiver”
means to refrain from pressing or enforcing compliance with a portion or
portions of these regulations for a limited period of time provided the health,
safety, or welfare of the clients and staff are not in danger. Waivers are issued at the sole discretion of
the licensing authority.
[8.371.2.7
NMAC - N, 7/1/2024}
8.371.2.8 STANDARD OF COMPLIANCE: The degree of compliance
required throughout these regulations is designated by the use of the words
“shall” or “must” or “may”. “Shall” or “must”
means mandatory. “May” means permissive. The use of the words “adequate”, “proper”,
and other similar words means the degree of compliance that is generally
accepted throughout the professional field by those who provide ICF/MR services
to the public in facilities governed by these regulations.
[8.371.2.8
NMAC - N, 7/1/2024}
8.371.2.9 ICF/MR FACILITY AND SCOPE OF SERVICES PROVIDED: The ICF/MR provides
active treatment in the least restrictive setting and includes all needed
services for mentally retarded individuals or persons with related conditions
whose mental or physical condition require services on a regular basis that are
above the level of a residential or room and board setting and can only be
provided in a facility which is equipped and staffed to provide the appropriate
services.
[8.371.2.9
NMAC - N, 7/1/2024}
8.371.2.10 [RESERVED]
8.371.2.11 INITIAL LICENSURE PROCEDURES: The following procedures
must be followed by the applicant for initial licensure of an ICF/MR facility.
A. Initial phase: These regulations should be thoroughly
understood by the applicant and used as a reference for design of a new
building or renovation or addition to an existing building for licensure as an
ICF/MR facility pursuant to these regulations.
Prior to starting construction, renovations, or additions to an existing
building the applicant of the proposed facility shall:
(1) advise the licensing
authority of intention to open a ICF/MR facility pursuant to these regulations;
(2) submit a complete set of
construction documents (blueprints) for the total building;
(3) blueprints will be
reviewed by the licensing authority for compliance with current licensing
regulations, building and fire codes;
(4) if blue prints or plans
are approved the licensing authority will advise the applicant that
construction may begin.
B. Construction phase: During the construction of a new building or
renovations or additions to an existing building, the applicant must coordinate
with the licensing authority and submit any changes to the blueprints or plans
for approval before making such changes.
C. Licensing phase: Prior to completion of construction,
renovation or addition to an existing building the applicant will submit to the
licensing authority the following:
(1) Application form:
(a) will be provided by the licensing
authority;
(b) all information requested on the
application must be provided;
(c) will be printed or typed;
(d) will be dated and signed;
(e) will be notarized.
(2) Fees:
All applications for licensure must be accompanied by the required fee.
(a) Fees must be in the form of a
certified check, money order, personal or business check made payable to the
state of New Mexico.
(b) Fees are non-refundable.
(3) Zoning and building approval:
(a) All initial applications must be
accompanied with written zoning approval from the appropriate authority (city,
county, or municipality).
(b) All initial applications must be
accompanied with written building approval (certificate of occupancy) from the
appropriate authority (city, county, or municipality).
(4) Fire authority approval: All initial applications must be accompanied
with written approval of the fire authority having jurisdiction.
(5) New Mexico environment department
approval: All initial applications must
be accompanied by written approval of the environmental improvement division
for the following:
(a) private water supply, if applicable;
(b) private waste or sewage disposal, if
applicable;
(c) kitchen approval.
(d) Exception: Facilities utilizing the kitchen as a
training site for clients to develop personal skills in meal planning and
preparation may be exempt from this requirement if the New Mexico environment
department waives the requirement and a letter of exemption is on file in the
facility.
(6) Copy of appropriate drug permit
issued by the state board of pharmacy.
(7) Initial survey: Upon receipt of a properly completed
application with all supporting documentation as outlined above an initial
survey of the proposed facility shall be scheduled by the licensing authority.
(8) Issuance of license: Upon completion of the initial survey and
determination that the facility is in compliance with these regulations the
licensing authority shall issue a license.
[8.371.2.11
NMAC - N, 7/1/2024}
8.371.2.12 LICENSES:
A. Annual license: An annual license is issued
for a one year period to an ICF/MR facility which has met all requirements of these
regulations.
B. Temporary license: The
licensing authority may, at its sole discretion, issue a temporary license
prior to the initial survey or when the licensing authority finds partial
compliance with these regulations.
(1) A temporary license shall
cover a period of time, not to exceed 120 days, during which the facility must
correct all specified deficiencies.
(2) In accordance with Subsection
D of Section 24-1-5 NMSA 1978, no more than two consecutive temporary licenses
shall be issued.
C. Amended license: A licensee must apply to
the licensing authority for an amended license when there is a change of
administrator/director, or when there is a change of name for the facility
(1) Application must be on a
form provided by the licensing authority.
(2) Application must be
accompanied by the required fee for amended license.
(3) Application must be
submitted within 10 working days of the change.
[8.371.2.12
NMAC - N, 7/1/2024}
8.371.2.13 LICENSE RENEWAL:
A. Licensee must submit a renewal
application on forms provided by the licensing authority, along with the
required fee at least 30 days prior to expiration of the current license.
B. Upon receipt of renewal application
and required fee prior to expiration of current license the licensing authority
will issue a new license effective the day following the date of expiration of
the current license if the facility is in substantial compliance with these
regulations.
C. If a licensee fails to submit a
renewal application with the required fee and the current license expires the
facility shall cease operations until it obtains a new license through the
initial licensure procedures. Subsection
A of Section 24-1-5 NMSA 1978 as amended, provides that no health facility
shall be operated without a license.
[8.371.2.13
NMAC - N, 7/1/2024}
8.371.2.14 POSTING OF LICENSE:
The facility's license must be posted in a conspicuous place
on the licensed premises in an area visible to the public.
[8.371.2.14
NMAC - N, 7/1/2024}
8.371.2.15 NON-TRANSFERABLE RESTRICTION ON LICENSE: A license shall not be
transferred by assignment or otherwise to other persons or locations. The license shall be void and must be
returned to the licensing authority when any one of the following situations
occur:
A. ownership of the facility changes;
B. the facility changes location;
C. licensee of the facility changes;
D. The facility discontinues operation.
E. A facility wishing to continue
operation as a licensed ICF/MR facility under circumstances found in Subsections
A through D above must submit an application for initial licensure in
accordance with Section 11 of these regulations at least 30 days prior to the
anticipated change.
[8.371.2.15
NMAC - N, 7/1/2024}
8.371.2.16 AUTOMATIC EXPIRATION OF LICENSE: A license will
automatically expire at midnight on the day indicated on the license as the
expiration date, unless sooner renewed suspended or revoked or:
A. on the day a facility discontinues
operation;
B. on the day a facility is sold,
leased, or otherwise changes ownership or licensee;
C. on the day a facility changes
location.
[8.371.2.16
NMAC - N, 7/1/2024}
8.371.2.17 SUSPENSION OF LICENSE WITHOUT PRIOR HEARING: In accordance with Subsection
H of Section 24-1-5 NMSA 1978, if immediate action is required to protect human
health and safety, the licensing authority may suspend a license pending a
hearing, provided such hearing is held within five working days of the
suspension, unless waived by the licensee.
[8.371.2.17
NMAC - N, 7/1/2024}
8.371.2.18 GROUNDS FOR REVOCATION OR SUSPENSION OF LICENSE, DENIAL
OF INITIAL OR RENEWAL APPLICATION FOR LICENSE, OR IMPOSITION OF INTERMEDIATE
SANCTIONS OR CIVIL MONETARY PENALTIES: A
license may be revoked or suspended, an initial or renewal application may be
denied, or intermediate sanctions or civil monetary penalties may be imposed
after notice and opportunity for a hearing, for any of the following reasons:
A. failure to comply with any material
provision of these regulations;
B. failure to allow survey by
authorized representatives of the licensing authority;
C. any person active in the operation
of a facility licensed pursuant to these regulations shall not be under the
influence of alcohol or narcotics or convicted of a felony;
D. misrepresentation or falsification
of any information on application forms or other documents provided to the
licensing authority;
E. discovery of repeat violations of
these regulations during surveys;
F. failure to provide the required care
and services as outlined by these regulations for the clients receiving care at
the facility.
[8.371.2.18
NMAC - N, 7/1/2024}
8.371.2.19 HEARING PROCEDURES:
A. Hearing procedures for adverse
action taken by the licensing authority against a facility license as outlined
in Section 17 and 18 above will be held in accordance with adjudicatory hearings,
New Mexico health care authority, 8.370.2 NMAC.
B. A copy of the above regulations may
be requested at any time by contacting the licensing authority.
[8.371.2.19
NMAC - N, 7/1/2024}
8.371.2.20 CURRENTLY LICENSED FACILITIES: Any facility currently
licensed on the date these regulations are promulgated and which provides the
services prescribed under these regulations, but which fails to meet all
building requirements may continue to be licensed as an ICF/MR.
A. Variance may be granted for those
building requirements the facility cannot meet provided the variances granted
will not create a hazard to the health, safety and welfare of the clients and
staff, and;
B. The building requirements for which
variances are granted cannot be corrected without an unreasonable expense to
the facility, and
C. Variances granted will be recorded
and made a permanent part of the facility file.
D. Facilities currently licensed for
more than four clients may not increase their capacity.
[8.371.2.20
NMAC - N, 7/1/2024}
8.371.2.21 NEW FACILITY: A
new facility may be opened in an existing building or a newly constructed
building.
A. If opened in an existing building a
variance may be granted for those building requirements the facility cannot
meet under the same criteria outlined in Subsections A, B and C of 8.371.2.20
NMAC, if not in conflict with existing building and fire codes. This is at the sole discretion of the
licensing authority.
B. A new facility opened in a newly
constructed building must meet all requirements of these regulations.
C. A new facility may not be licensed
for more than four clients. Exception: ICF/MR facilities may be licensed for a
maximum capacity of six clients based upon a written plan that must be
submitted to the licensing authority prior to the facility's licensure. Approval of the plan is in the discretion of
the licensing authority. The plan must
demonstrate the following:
(1) The anticipated facility
service benefits to the client population.
(2) How the facility's
services will promote, independence, active treatment and community supports.
(3) How the facility's
services will address the needs and protections of the proposed clients.
[8.371.2.21
NMAC - N, 7/1/2024}
8.371.2.22 FACILITY SURVEYS:
A. Application for licensure, whether
initial or renewal shall constitute permission for entry into and survey of a
facility by authorized licensing authority representatives at reasonable times
during the pendency of the application and, if licensed, during the licensure
period.
B. Surveys may be announced or
unannounced at the sole discretion of the licensing authority.
C. Upon receipt of a notice of
deficiency from the licensing authority the licensee or their representative
will be required to submit a plan of correction to the licensing authority
within 10 working days stating how the facility intends to correct each
violation noted and the expected date of completion.
D. The licensing authority may at its
sole discretion accept the plan of correction as written or require
modifications of the plan by the licensee.
E. The licensing authority may impose
intermediate supervisory and management requirements, including the
administrative costs therefore, and civil monetary penalties pursuant to
Section 24-1-5.2 NMSA 1978.
[8.371.2.22
NMAC - N, 7/1/2024}
8.371.2.23 REPORTING OF INCIDENTS:
All facilities licensed pursuant to these regulations must
report to the licensing authority any serious incident or unusual occurrence
which has, or could threaten the health, safety, and welfare of the clients or
staff, such as but not limited to:
A. fire, flood, or other natural
disaster which creates structural damages to the facility or poses health
hazards;
B. any serious outbreak of contagious
diseases dangerous to the public health;
C. any serious human errors by staff
members of the facility which has resulted in the death, serious illness, or
physical impairment of a client.
D. in accordance with the 'Resident
Abuse and Neglect Act”, NMSA 1978, any incident of abuse, neglect or
exploitation of a client, patient, or resident of a health facility must be
reported to the health care authority and adult protective services.
E. any
incidents of abuse, neglect, exploitation, death or other reportable incidents
must be reported in accordance with health care authority incident management
policies.
[8.371.2.23
NMAC - N, 7/1/2024}
8.371.2.24 QUALITY ASSURANCE:
All facilities licensed pursuant to these regulations must
have an on-going, comprehensive self-assessment of the services provided by the
facility. The assessment must include
the total operation of the facility.
A. To be considered comprehensive the
assessment for quality assurance must include, but is not limited to the
following:
(1) condition of clients and
services rendered;
(2) completeness of client
records;
(3) organization of the
facility;
(4) administration;
(5) staff utilization and
training;
(6) policies and procedures.
B. Where problems (or potential
problems) are identified the facility must act as soon as possible to avoid any
risks to clients by taking corrective steps such as, but not limited to, the
following:
(1) changes in policies and
procedures;
(2) staffing and assignment
changes;
(3) additional educational
training for the staff;
(4) changes in equipment or
physical plant;
(5) deletion or addition of
services.
C. The governing body of the facility
shall ensure that the effectiveness of the quality assurance program is
evaluated by professional and administrative staff at least once a year. If the evaluation is not done all at once, no
more than a year must lapse between evaluation of the same parts.
D. Documentation of the quality
assurance program must be maintained by the facility.
[8.371.2.25
NMAC - N, 7/1/2024}
8.371.2.25 CLIENT RECORDS: The
facility must develop and maintain a record keeping system that includes a
separate record for each client which documents the client's health care,
active treatment, social information, and protection of the client's rights. As a minimum the client's record must
contain:
A. Personal information:
(1) full name;
(2) date of birth;
(3) social security number;
(4) height;
(5) weight;
(6) color of hair;
(7) color of eyes;
(8) identifying marks and
recent photograph;
(9) full name of parents and
their dates of birth;
(10) language(s)
spoken and understood and language used in the natural home;
(11) information
relevant to religious preference;
(12) legal
documentation relevant to commitment or guardianship status;
(13) name,
address, and telephone number of next-of-kin, other person or agency to contact
in case of an emergency.
B. Medical information:
(1) reports of previous
histories, evaluations or observations;
(2) age at onset of
disability;
(3) name, address and
telephone number of physician or health facility providing medical care;
(4) medication history,
including present medication dosage and schedule;
(5) reports of all
treatments, etc.
C. Individual habilitation plan: Each client must have an individual
habilitation plan which specifies goals and objectives.
D. Admission agreement.
[8.371.2.26
NMAC - N, 7/1/2024}
8.371.2.26 REPORTS AND RECORDS REQUIRED TO BE ON FILE IN THE
FACILITY: Each
facility licensed pursuant to these regulations must keep the following reports
and records on file and make them available for review upon request of the
licensing authority.
A. a copy of the latest fire inspection
report by the fire authority having jurisdiction;
B. a copy of the last survey conducted
by the licensing authority and variances granted;
C. record of fire and emergency evacuation
drills conducted by the facility;
D. licensing regulations: a copy of these regulations: Requirements for Intermediate Care Facilities
for the Mentally Retarded, New Mexico health care authority, 8.371.2 NMAC;
E. health certificates of staff;
F. a copy of the current license,
registration or certificate, of each staff member for which a license,
registration, or certification is required by the state of New Mexico;
G. valid drug permit as required by the
state board of pharmacy;
H. latest inspection by the state board
of pharmacy;
I. New Mexico environment department
approval of private water system, if applicable;
J. New Mexico environment department
approval of private waste or sewage disposal, if applicable;
K. New Mexico environment department
approval of the kitchen. NOTE: An approval of kitchen is not required if
preparing meals is part of the training program of the clients of the facility
and the facility has a letter of exemption on file from the New Mexico
environment department;
L. documentation of
fire equipment and fire systems inspections;
M. reports of client abuse and incidents
involving clients.
[8.371.2.26
NMAC - N, 7/1/2024}
8.371.2.27 CLIENT RIGHTS: Any
facility licensed pursuant to these regulations must support, protect, and
enhance the rights of clients as listed below:
A. Information: Each client or legal
guardian must be fully informed before or at time of admission, of their rights
and responsibilities and of all rules governing clients conduct.
(1) If a facility amends its
policies on client rights and responsibilities and its rules governing conduct
the clients must be immediately informed.
(2) Each client and or legal
guardian must acknowledge, in writing, that they have been informed of these
rights.
(3) Each client and or legal
guardian must be fully informed, in writing, of all services available in the
facility and of the charges for these services.
If charges change the client must be immediately informed.
B. Medical condition and treatment: Each
client must be fully informed by a physician of their health and medical
condition unless the physician decides that informing the client is medically
contraindicated.
(1) Each client must be given
the opportunity to participate in planning their total care and medical
treatment.
(2) Each client must be
given the opportunity to refuse treatment.
(3) Each client must give
informed, written consent before participating in experimental research.
C. Transfer and discharge: Each
client must be transferred or discharged only for:
(1) medical reasons;
(2) their welfare or that of
the other residents;
(3) non-payment for services
rendered;
(4) the client requests to be
discharged;
(5) the client no longer
requires an active treatment program.
D. Exercising rights: Each
client must be encouraged and assisted to exercise their rights as a client of
the facility and as a citizen and allowed to submit complaints or
recommendations concerning the policies and services of the facility.
E. Financial affairs: Each
client must be allowed to possess and use money in normal ways or be learning
to do so.
F. Freedom from abuse and restraints: Each
client must be free from mental and physical abuse and free from chemical and
physical restraints unless necessary as part of their treatment plan.
G. Privacy: Each client must be treated with
consideration, respect, and full recognition of their dignity and
individuality.
(1) Each client must be given
privacy during treatment and care of personal needs.
(2) Each client's record,
including information in an automatic data bank (computer), must be treated
confidentially.
(3) Each client must give
written consent before the facility may release information from their record
to someone not otherwise authorized by law to receive it.
(4) A married client must be
given privacy during visits by their spouse.
If husband and wife are both clients in the facility they must be
permitted to share a room.
H. Work: No client shall be required to perform
services for the facility for which they are not paid.
I. Freedom of association and
correspondence: Each client must be allowed to:
(1) communicate, associate,
and meet privately with individuals of their choice, unless this infringes on
the rights of another client;
(2) send and receive personal
mail unopened.
J. Activities: Each client must be allowed
to participate in social, religious, and community group activities, unless the
interdisciplinary team determines that these activities are contraindicated for
a client. Any such determination must be
documented in the client's records.
K. Personal possessions: Each client must be allowed to retain and use
their personal possessions and clothing as space permits.
[8.371.2.27
NMAC - N, 7/1/2024}
8.371.2.28 PHILOSOPHY, OBJECTIVES AND GOALS: Each facility licensed
pursuant to these regulations must have a written outline of the philosophy,
objectives, and goals it is striving to achieve that includes, at least:
A. the facility's role in the state
comprehensive program for the mentally retarded;
B. the facility's goals for its clients
to include but not limited to: an
integrated active treatment program, homelike living environments and consumer
protections;
C. the facility's concept of its
relationship to the parents or legal guardians of its residents;
D. the facility's outline of the above
must be available for distribution to staff, consumer representatives, and the
interested public;
E. the facility's promotion of informed
decision making by the consumer;
F. the facilities policies on utilization
of community supports and how clients will be involved in the community.
[8.371.2.28
NMAC - N, 7/1/2024}
8.371.2.29 POLICIES AND PROCEDURES:
Each facility licensed pursuant to these regulations must
have written policies and procedures covering the following areas:
A. client's civil rights;
B. delegation of client's civil rights;
C. handling of client funds;
D. admission criteria and evaluations;
E. personnel policies;
F. prohibitions against mistreatment,
neglect or abuse of clients by employees or other persons;
G. staff training and evaluations;
H. control and discipline of clients,
including behavior management;
I. use of physical and chemical
restraints;
J. quality assurance;
K. procurement, handling, storage,
safeguarding and accountability of medications;
L. maintenance of buildings, grounds
and equipment;
M. transfer of client to hospital or
other facility;
N. release of client medical records;
O. fire and disaster.
[8.371.2.29
NMAC - N, 7/1/2024}
8.371.2.30 STAFF RECORDS: There
must be maintained on file in the facility or in a central office if there are
multi-facilities run by the same organization in the same city or town, a
record for each staff member which contains at least, but is not limited to,
the following:
A. Personal information:
(1) name;
(2) address and telephone
number;
(3) position for which
employed;
(4) person to contact in case
of emergency.
B. a clearance letter from the health
care authority caregivers criminal history screening program stating criminal
records check has been conducted with negative results;
C. documentation of training to include
transportation and wheelchair safety training.
D. health certificate as outlined in
Section 68 of these regulations.
[8.371.2.30
NMAC - N, 7/1/2024}
8.371.2.31 FACILITY RULES:
A. Each facility licensed pursuant to
these regulations must have facility rules which must include, but is not
limited to, the following:
(1) the use of tobacco or alcohol;
(2) visitors and visiting
hours;
(3) use of the telephone;
(4) hours and volume for
viewing and listening to television, radio, and phonographs;
(5) use and safekeeping of
personal property.
B. Facility rules shall be posted in a
conspicuous place in the facility.
[8.371.2.31
NMAC - N, 7/1/2024}
8.371.2.32 ADMISSION AGREEMENT:
Prior to admission to a facility, the licensee or authorized
representative and the client or client's parent/s or guardian shall sign a
written admission agreement. The
facility shall keep the original agreement in the client's record and a copy
must be provided to the client or client/s parent/s or guardian. A standard form may be developed and used. The admission agreement must meet the
criteria stated below:
A. The services that will be provided
by the facility and the charges for such services must be explained in full.
B. The method of payment for the
services must be clearly stated.
C. Terms for termination of the
admission agreement either on part of the facility or the client or parent/s or
guardian must be clearly outlined.
D. A new admission agreement must be
made whenever any term of the agreement is changed by either the facility or
the client or the parent/s or guardian of the client.
[8.371.2.32
NMAC - N, 7/1/2024}
8.371.2.33 AGREEMENTS WITH OUTSIDE RESOURCES: If the ICF/MR does not
employ a qualified professional to furnish a required service, it must have in
effect a written agreement with a qualified professional outside the ICF/MR to
furnish the required service. The
agreement must:
A. contain the responsibilities,
functions, objectives, and other items agreed to by the ICF/MR and the
qualified professional;
B. be signed by the administrator or their
representative and by the qualified professional;
C. the facility must assure that
outside providers meet all appropriate state and federal requirements, and the
quality of services meet the needs of the individual.
[8.371.2.33
NMAC - N, 7/1/2024}
8.371.2.34 STAFF CLIENT COMMUNICATIONS: The facility must provide
for effective staff and resident participation and communication in the
following manner:
A. The facility must establish
appropriate standing committees such as human rights, and other committees as
appropriate to the facility.
B. The committees must meet regularly
and include direct-care staff whenever appropriate.
C. Reports of staff meetings and
standing and ad hoc committee meetings must include recommendations and their
implementation, and be filed in the facility.
[10/11/1990;
Recompiled 10/31/2001]
8.371.2.35 COMMUNICATIONS WITH THE CLIENTS, PARENTS/GUARDIANS: The facility must have an
active program of communication with the client's and their families, that
includes:
A. keeping client's families or legal guardians
informed of resident activities that may be of interest to them and of
significant changes in the client's condition;
B. answering communications from
client's relatives promptly and appropriately;
C. allowing close relatives and
guardians to visit at any reasonable hour, without prior notice, unless the
client's needs limit visits;
D. allowing parents to visit any part
of the facility that provides services to clients;
E. encouraging frequent and informal
visits home by the clients;
F. having rules that make it easy to
arrange visits home;
G. the facility must insure that
individuals allowed to visit the facility under Subsection C of 8.371.2.35 NMAC
above do not infringe on the privacy and rights of other clients.
[8.371.2.35
NMAC - N, 7/1/2024}
8.371.2.36 RESEARCH STATEMENT:
If the facility conducts research, it must establish
protocols based on standards of conduct currently endorsed by professional and
federal standards.
[8.371.2.36
NMAC - N, 7/1/2024}
8.371.2.37 BUILDING(S), GROUNDS, AND SAFETY REQUIREMENTS:
A. Those programs which are located in
a building which is licensed as a long term care facility or hospital must meet
all the building requirements for that type facility as outlined in the
following regulations:
(1) Requirements for General
and Special Hospitals, New Mexico health care authority, 8.370.12 NMAC.
(2) Requirements for Long
Term Care Facilities, New Mexico health care authority, 8.370.16 NMAC.
(3) Copies of these
regulations may be requested from the licensing authority.
B. Capacity
of building(s): All building
requirements contained in these regulations are based on a maximum capacity of
15 clients. All facilities requesting
licensure for more than 15 clients will have additional requirements according
to the applicable building and fire codes.
Due to the complexities of the building and fire codes these additional
requirements will be outlined by the appropriate building and fire authorities,
and by the licensing authority through plan review and on site surveys during
the licensing process. Maximum capacity
for any facility licensed after the effective date of revisions to these
regulations is four clients. Exception: ICF/MR facilities may be licensed for a
maximum capacity of six clients based upon a written plan that must be approved
by the licensing authority prior to the facility's licensure. The plan must demonstrate the following:
(1) the anticipated facility
service benefits to the client population;
(2) how the facility's
services will promote, independence, active treatment and community supports;
(3) how the facility's
services will address the needs and protections of the proposed clients.
C. Number of stories: All
building requirements contained in these regulations are based on buildings of
one story,which do not house clients above or below ground level. Buildings which are multi-storied or house
clients below ground level shall have additional requirements which vary due to
the complexities of the building and fire codes. These additional requirements will be
outlined by the appropriate building and fire authorities and by the licensing
authority through plan review and on-site surveys during the licensing process.
D. Additional requirements: A
facility applying for licensure pursuant to these regulations may have
additional requirements not contained herein.
The complexity of building and fire codes and requirements of city,
county, or municipal governments may require these additional requirements. Any additional requirement will be outlined
by the appropriate building and fire authorities, and by the licensing
authority through plan review, consultation and on-site surveys during the
licensing process.
E. Access to the handicapped: All
facilities licensed pursuant to these regulations must be accessible to and
usable by handicapped employees, visitors and clients.
F. Prohibition on mobile homes: Trailers and mobile homes must not be used as
any part of a facility in which services and care are given to clients.
G. Extent of a facility: All
buildings on the premises providing client care and services shall be
considered part of the facility and must meet all requirements of these
regulations.
H. Individual living units may not be
located within 150 feet of each other.
[8.371.2.37
NMAC - N, 7/1/2024}
8.371.2.38 MAINTENANCE OF BUILDING(S), GROUNDS, AND EQUIPMENT: Facilities licensed
pursuant to these regulations must keep the building(s), grounds, and equipment
in good repair and presentable at all times such as, but not limited to the
following:
A. All electrical, signaling,
mechanical, water supply, heating, fire protection, and sewage disposal systems
must be maintained in a safe and functioning condition to include regular
inspections of these systems.
B. All client care equipment must be
maintained in a safe and operable condition at all times.
C. All furniture and furnishings must
be kept clean and in good repair. Furnishings
or decorations of an explosive or highly flammable character must not be used.
D. The grounds of the facility must be
maintained in a safe, sanitary and presentable condition at all times.
[8.371.2.38
NMAC - N, 7/1/2024}
8.371.2.39 HOUSEKEEPING:
A. The facility must be kept free from
offensive odors, accumulations of dirt, rubbish, dust and safety hazards.
B. Client rooms must be cleaned and
tidied daily.
C. Floors and walls must be constructed
of a finish that can be easily cleaned. Floor
polish shall provide a slip-resistant finish.
D. Bathrooms and lavatories must be
cleaned as often as necessary to maintain a clean and sanitary condition.
E. Deodorizers must not be used to mask
odors caused by the unsanitary conditions or poor housekeeping practices.
F. Storage areas must be kept free from
accumulation of refuse, discarded furniture, old newspapers, and the like.
G. Combustibles such as cleaning rags
and compounds must be kept in closed metal containers in areas providing
adequate ventilation and away from client rooms.
H. Poisonous or flammable substances
must not be stored in residential areas, food preparation areas, or food
storage areas.
[8.371.2.39
NMAC - N, 7/1/2024}
8.371.2.40 HEATING, VENTILATION AND AIR CONDITIONING:
A. Heating, air-conditioning, piping, boilers,
and ventilation equipment must be furnished, installed and maintained to meet
all requirements of current state and local mechanical, electrical, and
construction codes. All facilities must
have documentation that fuel-fire heating systems have been checked, tested and
maintained annually by qualified personnel.
B. The heating method used by the
facility must provide a minimum temperature of 70 degrees farenheit in all
rooms used by the clients.
C. An ample supply of outside air for
proper combustion must be provided in all spaces where fueled fired boilers or
heaters are located.
D. All gas fired heating equipment must
be provided with a one hundred percent automatic cutoff control valve in event
of pilot failure.
E. Each building where gas is used must
have an outside gas shutoff valve. The
facility must have a tool readily available which will operate the shut-off
valve. All personnel employed by the
facility must be instructed as to location of the shut-off valve and tool and
must know how to shut off the gas supply in case of fire or gas leakage.
F. No open-face gas or electric heater
nor unprotected single shell gas or electric heating device shall be used for
heating the facility. Portable heating
units shall not be used for heating the facility.
G. All boiler, furnace or heater rooms
shall be protected from other parts of the building by construction having a
fire resistance rating of not less than one-hour. Doors to these rooms shall be 1-3/4” solid
core.
H. A facility must be adequately
ventilated at all times to provide fresh air and the control of unpleasant
odors by either mechanical or natural means.
I. All gas burning heating and cooking
equipment must be connected to an approved venting system to take the products
of combustion directly to the outside air.
J. All openings to the outer air used
for ventilation must be screened with screening material of not less than 16
meshes per lineal inch.
K. Screen doors must be equipped with
self-closing devices.
L. A facility must be provided with a
system for maintaining residents comfort during periods of hot weather.
[8.371.2.40
NMAC - N, 7/1/2024}
8.371.2.41 WATER HEATERS:
A. All fuel fired water heaters shall
be separated from other parts of the facility by partitions having a fire
resistive rating of one hour. Doors to
enclosure must be one and three quarter inches solid core.
B. All water heaters must be equipped
with a pressure relief valve (pop-off valve).
C. Water heaters must not be located in
sleeping rooms or rooms opening into sleeping rooms.
[8.371.2.41
NMAC - N, 7/1/2024}
8.371.2.42 WATER:
A. A facility must be provided with an
adequate supply of water which is of a safe and sanitary quality suitable for
domestic use.
B. If the water supply is not obtained
from an approved public system, the private water system must be inspected,
tested, and approved by the New Mexico environment department prior to
licensure. It is the facility's
responsibility to insure that subsequent periodic testing or inspection of such
private water systems be made at intervals prescribed by the New Mexico
environment department.
C. Hot and cold running water under
pressure must be distributed to all food preparation areas, lavatories,
washrooms, and laundries. The hot water
temperature in all rooms accessible to clients must be maintained at a maximum
of 110 degrees farenheit.
[8.371.2.42
NMAC - N, 7/1/2024}
8.371.2.43 SEWAGE AND WASTE DISPOSAL:
A. All sewage and liquid wastes must be
disposed of into a municipal sewage system where such facilities are available.
B. Where a municipal sewage system is
not available, the system used must be inspected and approved by the
environmental health authority.
C. Where municipal or community garbage
collection and disposal service are not available the method of collection and
disposal of garbage used by the facility must be inspected and approved by the
New Mexico environment department.
D. All garbage and refuse receptacles
must be durable, have tight fitting lids, must be insect and rodent proof,
washable, leak proof, and constructed of material which will not absorb liquids. Receptacles must be kept clean.
[8.371.2.43
NMAC - N, 7/1/2024}
8.371.2.44 LIGHTING AND LIGHTING FIXTURES:
A. All areas of the facility including storerooms,
stairways, hallways, and entrances must be lighted sufficiently to make all
parts of the area clearly visible.
B. Exits, exit-access ways, and other
areas used at night by clients and staff must be illuminated.
C. Lighting fixtures must be selected
and located with the comfort and convenience of the clients in minds.
D. Lamps and lighting fixtures must be
shaded to prevent glare to the eyes of clients and staff, and shielded from
accidental breakage or shattering.
E. A facility must be provided with
emergency lighting which will activate automatically upon disruption of
electrical services.
[8.371.2.44
NMAC - N, 7/1/2024}
8.371.2.45 ELEMENTS OF FACILITY ELECTRICAL SYSTEM:
A. Electrical installations and
electrical equipment must comply with all current state and local codes.
B. All fuse and breaker boxes must be
labeled to indicate the area of the facility to which each fuse or circuit
breaker provides services.
C. The main electrical service line
must have a readily available disconnect switch. All staff personnel of the facility must know
the location of the electrical disconnect switch in each building to which such
staff are regularly assigned.
D. The use of jumpers or devices to
bypass circuit breakers or fuses is prohibited.
E. Electrical cords and appliances must
be U/L approved.
(1) Electrical cords shall be replaced as
soon as they show wear.
(2) Under no circumstances shall
extension cords be used as a general wiring method.
(3) Extension cords must be plugged into
an electrical outlet within the room where used and may not be connected in one
room and extended to some other room.
(4) Extension cords must not be used in
series.
F. The use of multiple sockets in
electrical outlets is strictly prohibited.
[8.371.2.45
NMAC - N, 7/1/2024}
8.371.2.46 WINDOWS:
A. Each resident sleeping room and
activity room must have window area of at least one-tenth the floor area with a
minimum of at least 10 square feet.
B. Each sleeping room must provide at
least one window for egress or rescue with a minimum net clear opening of five
point seven square feet. The minimum net
clear opening for height dimension shall be 24 inches. The minimum net clear opening width dimension
shall be 20 inches.
C. Egress and rescue windows shall have
a finished sill height of not more than 44 inches above the floor. Exception: If a sleeping room has a door directly to the
outside, egress/rescue window is not required.
[8.371.2.46
NMAC - N, 7/1/2024}
8.371.2.47 EXITS:
A. Each building must have at least two
approved exits.
B. Each exit will be clearly marked
with signs having letters at least six inches high whose principal strokes are
at least three fourths of an inch wide. Exit
signs shall be visible at all times.
C. Exits must be clear of obstructions
at all times.
D. Exits, exit paths, or means of
egress shall not pass through hazardous areas, storerooms, closets, bedrooms,
or spaces subject to locking.
[8.371.2.47
NMAC - N, 7/1/2024}
8.371.2.48 CORRIDORS:
A. Corridors in a facility must have a
minimum width of 36 inches. Corridors in
newly constructed facilities shall have a minimum width of 44 inches.
B. Corridors shall have a clear ceiling
height of not less than seven feet measured to the lowest projection from the
ceiling.
C. Corridors shall be maintained clear
and free of obstructions at all times.
[8.371.2.48 NMAC - N, 7/1/2024}
8.371.2.49 MINIMUM ROOM DIMENSIONS:
A. All
habitable rooms in a facility shall have a ceiling height of not less than seven
feet six inches. Kitchens, halls,
bathrooms and toilet compartments will have a ceiling height of not less than
seven feet.
B. All habitable rooms other than a
kitchen shall be not less than seven feet in any dimension.
C. Any room with sloped ceiling is
subject to review and approval or disapproval by the licensing authority, based
upon Uniform Building Code computation of minimum area.
[8.371.2.49
NMAC - N, 7/1/2024}
8.371.2.50 DOORS:
A. All client sleeping room doors must
be at least one and three quarter inches bonded solid core with a minimum width
of 30 inches.
B. All exit doors must have a minimum
width of 36 inches.
C. All doors to toilet and bathing
facilities must have a minimum width of 24 inches.
D. Locks on doors to toilets,
if used, shall be of such type that the lock can be released from the outside.
E. Exit doors leading to the outside of
the facility with a capacity of 10 or more clients must open outward. Exit doors may be provided with a night
latch, dead bolt, or security chain, provided such devices are openable from
the inside without the use of a key, tool, or any special knowledge and are
mounted at a height not to exceed 48 inches above the finished floor.
F. If locks are not readily openable by
all occupants within the building, then the locks must:
(1) unlock upon activation of the fire
detection or sprinkler system;
(2) unlock upon loss of power in the
facility. The facility must have written
approval from the fire authorities having jurisdiction prior to installing such
locking devices.
[8.371.2.50
NMAC - N, 7/1/2024}
8.371.2.51 CLIENT ROOMS:
A. Each client room must be an outside
room.
B. There must be no through traffic in
client rooms.
C. Client rooms must communicate
directly with other areas of the facility.
D. Client rooms must be private or
semi-private.
E. Private rooms must have at least 100
square feet of floor area. Closet and
locker area shall not be counted as part of the available floor space.
F. Semi-private rooms must have at
least 80 square feet of floor area for each bed. Closet and locker area shall not be counted
as part of the available floor space.
G. Client rooms will have beds spaced
at least three feet apart.
[8.371.2.51
NMAC - N, 7/1/2024}
8.371.2.52 TOILET AND BATHING FACILITIES:
A. Toilets and sinks for residents in a
facility must be provided in a ratio of at least one toilet and one sink for
every eight clients.
B. If a facility has a capacity greater
than five and provides service to both male and female clients, separate
facilities must be provided for each sex in the same ratio as stated above.
C. Showers or tubs must be provided for
the clients use in the same ratio as stated in Subsections A and B above. At least one tub and one shower must be
provided to allow for residents bathing preference.
D. The combination type tub and shower
is permitted.
E. Toilets, tubs, and showers must be
provided with grab bars.
F. If a facility has live-in staff, a
separate toilet, hand washing, and bathing facilities for staff must be
provided.
G. Tubs and showers must have a slip
resistant surface.
H. Toilet, hand washing, and bathing
facilities must be readily available to the clients. No passage through a client room by another
client to reach a toilet, bath, or hand washing facility is permitted.
I. All facilities must have at least
one toilet and bathing facility which meets requirements for handicapped.
J. Toilet paper and soap must be
provided in each toilet room.
K. The use of a common towel is
prohibited.
[8.371.2.52
NMAC - N, 7/1/2024}
8.371.2.53 FIRE SAFETY COMPLIANCE:
All current applicable requirements of state and local codes
for fire prevention and safety must be met by the facility.
[8.371.2.53
NMAC - N, 7/1/2024}
8.371.2.54 FIRE CLEARANCE AND INSPECTIONS:
A. Written documentation from the state
fire marshall’s office or fire prevention authority having jurisdiction
evidencing a facility's compliance with applicable fire prevention codes shall
be submitted to the licensing authority prior to issuance of a initial license.
B. Each facility shall request, from
the local fire prevention authorities, an annual fire inspection. If the policy of the local fire department
does not provide for annual inspection of the facility, the facility will
document the date the request was made and to whom. If the local fire prevention authorities do
make annual inspections, a copy of the latest inspection must be kept on file
in the facility.
[8.371.2.54
NMAC - N, 7/1/2024}
8.371.2.55 FIRE ALARMS, SMOKE DETECTORS AND OTHER FIRE EQUIPMENT:
A. The facility shall be equipped with
an approved, manually operated alarm system or other continuously sounding
alarm approved in writing by the fire authority having jurisdiction.
B. Approved smoke detectors powered by
house electrical service shall be installed to provide, when activated, an
alarm which is audible in all sleeping areas.
Smoke detectors must be installed in corridors at no more than 30 foot
spacing. Areas of assembly, such as the
dining and living room, must be provided with smoke detectors. All smoke detectors must be connected to the
electrical system of the facility and have battery back-up.
C. Heat detectors shall be installed in
all enclosed kitchens and also powered by the facility electrical service.
D. Fire extinguishers, as approved by
the state fire marshall or fire prevention authority having jurisdiction, must
be located in the facility. Facilities
must, as a minimum, have two 2A10BC fire extinguishers, one located in the
kitchen or food preparation area, and one centrally located in the facility. All fire extinguishers shall be inspected
yearly and recharged as needed. All fire
extinguishers must be tagged noting the date of inspection.
E. Fire extinguishers, alarm systems,
automatic detection equipment, and other fire fighting equipment must be
properly maintained and inspected as recommended by the manufacturer, state
fire marshall, or fire authority having jurisdiction. Documentation of these inspections must be
maintained on file in the facility.
[8.371.2.55
NMAC - N, 7/1/2024}
8.371.2.56 STAFF AND CLIENT FIRE AND SAFETY TRAINING:
A. All staff personnel of the facility
must know the location of and be instructed in proper use of fire fighting
equipment and other procedures to be observed in case of fire or other
emergencies. The facility should request
the local fire prevention authority to give periodic instructions in the use of
fire prevention and techniques of evacuation.
B. Facility staff must be instructed as
part of their duties to constantly strive to detect and eliminate potential
safety hazards, such as loose handrails, frayed electrical cords, blocked exits
or exit ways, and any other condition which could cause burns, falls, or other
personal injury to the clients or staff.
C. Each new client must, upon being
accepted into the facility, be given an orientation tour of the facility to
include, but not be limited to, the location of the exits, fire extinguishers,
and telephones, and shall be instructed in action to be taken in case of fire
or other emergency.
D. Fire drills and evacuation drills: The facility must conduct at least one fire
drill each month.
(1) Fire drills must be held
at different times of the day.
(2) The fire alarm system or
detector system in the facility shall be used in the conduct of fire drills.
(3) In the conduct of fire
drills, emphasis must be placed upon orderly evacuation under proper discipline
rather than upon speed.
(4) A record of fire drills
held must be maintained on file in the facility. Such record must show date and time of the
drill, number of personnel participating in the drill, any problem noted during
the drill and the evacuation time in total minutes.
(5) The local fire department
should be requested to supervise and participate in fire drills.
[8.371.2.56
NMAC - N, 7/1/2024}
8.371.2.57 PROVISIONS FOR EMERGENCY CALLS:
A. An easily accessible telephone for
summoning help in case of emergency must be available in each facility. A pay telephone will not fulfill this
requirement.
B. A list of emergency numbers,
including, but not limited to, fire department, police department, ambulance
services, and poison control center, shall be posted by each telephone in the
facility.
[8.371.2.57
NMAC - N, 7/1/2024}
8.371.2.58 SMOKING:
A. Smoking by clients and staff must
only be done in supervised areas designated by the facility and approved by the
state fire marshall or local fire prevention authorities. Smoking must not be allowed in a kitchen or
food preparation area.
B. All designated smoking areas must be
provided with suitable ashtrays.
[8.371.2.58
NMAC - N, 7/1/2024}
8.371.2.59 ACCESS REQUIREMENTS FOR THE HANDICAPPED IN NEW
FACILITIES: Accessibility
to the handicapped must be provided in all facilities in accordance with ANSI
standards and shall include the following:
A. main entry into
the facility must be ground level or ramped to allow wheelchair access;
B. building must
allow access to main living area and dining area;
C. access to at least
one bedroom is provided which requires a door clearance of 34 inches;
D. access to at least
one toilet and bathing facility is required which requires a minimum door
clearance of 34 inches, 36 inches is recommended. Toilet and bathing area must also provide a 60
inch diameter clear space (turning radius for a wheelchair);
E. if ramps are
provided to the building, slope must be at least 12 inches horizontal run for
each one inch of vertical rise;
F. ramps leading to
doorway must have a five foot by five foot level area at the doorway;
G. ramps exceeding a
six inch rise shall be provided with handrails;
H. Requirements
contained herein are minimum and additional handicap requirements may apply
depending on size and complexity of the facility.
[8.371.2.59
NMAC - N, 7/1/2024}
8.371.2.60 GOVERNING BODY:
A. Each facility licensed pursuant to
these regulations must have a governing body that:
(1) exercises general
direction over the affairs of the facility.
(2) establishes policies
concerning the operation of the facility and the welfare of the individuals it
serves.
(3) establishes
qualifications for the administrator in the following areas:
(a) education;
(b) experience;
(c) personal factors;
(d) skills;
(4) appoints the
administrator.
B. The governing body may consist of
one individual or a group.
[8.371.2.60
NMAC - N, 7/1/2024}
8.371.2.61 ADMINISTRATOR: Each
facility licensed pursuant to these regulations must have an administrator
appointed by the governing body who acts for the governing body in the overall
management of the facility.
[8.371.2.61
NMAC - N, 7/1/2024}
8.371.2.62 QUALIFIED MENTAL RETARDATION PROFESSIONAL: Each facility licensed
pursuant to these regulations must have a qualified mental retardation
professional. A qualified mental
retardation professional is a person who has specialized training or one year
of experience in treating or working with the mentally retarded and is one of
the following:
A. a psychologist with a masters degree
from an accredited program;
B. a licensed doctor of medicine or
osteopathy;
C. an educator with a degree in
education from an accredited program;
D. a social worker with a bachelors
degree in:
(1) social work from an
accredited program; or
(2) a field other than social
work and at least three years of social work experience under the supervision
of a qualified social worker.
E. a physical or occupational therapist
who meets all criteria of the state or federal government as a physical or
occupational therapist.
F. a speech pathologist or audiologist
who meets all criteria of the state or federal government as a speech
pathologist or audiologist.
G. a registered nurse licensed in the
state of New Mexico.
H. a therapeutic recreation specialist
who:
(1) is a graduate of an
accredited program; or
(2) meets all criteria of the
state or federal government as a therapeutic recreation specialist;
I. a rehabilitation counselor who is
certified by the committee on rehabilitation counselor certification.
J. a human services professional who
has at least a bachelor's degree in a human services field (including but not
limited to sociology, special education, rehabilitation counseling, or
psychology).
[8.371.2.62
NMAC - N, 7/1/2024}
8.371.2.63 INTERDISCIPLINARY TEAM:
Each facility licensed pursuant to these regulations must
have an interdisciplinary team assigned to each client.
A. Each interdisciplinary team shall be
composed of staff members including direct care staff and individuals including
the client's family or guardian who are involved or interested in meeting the
client's active treatment needs.
B. Interdisciplinary teams must:
(1) evaluate each client's
needs;
(2) plan an individualized
habilitation program to meet each client's identified needs;
(3) quarterly review each
client's responses to their program and revise the program accordingly.
[8.371.2.63
NMAC - N, 7/1/2024}
8.371.2.64 SUPPORT STAFF: Each
facility licensed pursuant to these regulations must have either adequate staff
not involved in direct care to clients or contractual services to perform the
following functions:
A. administration;
B. fiscal;
C. clerical;
D. housekeeping and maintenance.
[8.371.2.64
NMAC - N, 7/1/2024}
8.371.2.65 DIRECT CARE STAFF:
Direct care staff must make care and development of the
clients, their primary responsibility, this includes training of each client in
the activities of daily living and in the development of self-help and social
skills.
A. The facility management must insure
that the direct care staff are not diverted from their primary responsibilities
by housekeeping or clerical duties or other activities not related to client
care.
B. Members of the direct care staff
from all shifts must participate in appropriate activities relating to the care
and development of the client including at least, referral, planning,
initiation, coordination, implementation, follow-through, monitoring and
evaluation.
[8.371.2.65
NMAC - N, 7/1/2024}
8.371.2.66 STAFF EVALUATION AND DEVELOPMENT: A facility licensed
pursuant to these regulations must have a written plan for the orientation,
on-going staff development, supervision, and evaluation of all staff members.
A. The facility must have a staff
training program appropriate to the size and nature of the facility that
includes:
(1) orientation for each new
employee to acquaint them with the philosophy, organization, program, practices
and goals of the facility;
(2) orientation for each new
employee on the facility's emergency and safety procedures;
(3) orientation for each new
employee on the policies and procedures of the facility.
B. The facility must have continuing in-service
training for all employees to update and improve their skills.
C. The facility must have supervisory
and management training for each employee who is in, or a candidate for, a
supervisory position.
D. Each facility must have someone
designated to be responsible for staff development and training.
E. Any employee or agent of a facility
or agency who is responsible for assisting a client in boarding or alighting
from a motor vehicle must complete a state-approved training program in
passenger transportation assistance before assisting any client.
F. Any employee or agent of a facility
or agency who drives a motor vehicle provided by the facility or agency for use
in the transportation of clients must complete:
(1) a state approved training
program in passenger assistance, and
(2) a state approved training
program in the operation of a motor vehicle to transport clients of a regulated
facility or agency.
G. Each facility and agency shall
establish and enforce written policies (including training) and procedures for
employees who provide assistance to clients with boarding or alighting from
motor vehicles.
H. Each facility and agency shall
establish and enforce written policies (including training) and procedures for
employees who operate motor vehicles to transport clients.
[8.371.2.66
NMAC - N, 7/1/2024}
8.371.2.67 ORGANIZATION CHART:
The facility must have an organization chart that shows the
following:
A. the major operating programs of the
facility;
B. the staff divisions of the facility;
C. the administrative personnel in
charge of the programs and divisions;
D. the lines of authority,
responsibility and communication for administrative personnel.
[8.371.2.67
NMAC - N, 7/1/2024}
8.371.2.68 HEALTH REQUIREMENTS FOR STAFF:
A. Prior to employment all staff must
obtain a health certificate stating that they are free from tuberculosis.
B. Health certificate means a completed
New Mexico health care authority, public health division form 015, “health
certificate” signed by a physician licensed in New Mexico or a public health
nurse in one of the public health division health offices who is acting for the
state tuberculosis control officer.
[8.371.2.68
NMAC - N, 7/1/2024}
8.371.2.69 STAFF/CLIENT RATIOS:
For each facility regardless of organization or design must
have, as a minimum, overall staff/client ratios (allowing for a five day work
week plus holiday, vacation and sick time) as shown below:
A. Those facilities serving children
under the age of six years, severely and profoundly retarded, severely
physically handicapped, or client's who are aggressive, assaultive, or security
risks, or who manifest severely hyperactive or psychotic-like behavior, the
overall ratio is one staff member to three point two (3.2) clients.
B. Those facilities serving moderately
retarded clients requiring habit training, the overall ratio is one staff
member to four clients.
C. Those facilities
serving clients in vocational training programs and adults who work in
sheltered employment situation, the overall ratio is one staff member to six
point four (6.4) clients.
[8.371.2.69
NMAC - N, 7/1/2024}
8.371.2.70 CRIMINAL RECORDS CHECK AS CONDITION OF EMPLOYMENT:
A. All staff of a facility providing
services must apply for a nationwide criminal records check and employment
history in compliance with New Mexico regulations governing criminal records
check.
B. Copies of the above cited
regulations will be provided by the health care authority, caregivers criminal
history screening program.
C. Fingerprint cards, instructions, and
employment history forms will be provided by the health care authority,
caregivers criminal history screening program.
[8.371.2.70
NMAC - N, 7/1/2024}
8.371.2.71 ACTIVE TREATMENT SERVICES: Each client must receive
a continuous active treatment program, which includes aggressive, consistent
implementation of a program of specialized and generic training, treatment,
health services, and related services as described in these regulations, that
is directed toward:
A. the acquisition of the behaviors
necessary for the client to function with as much self determination and
independence as possible;
B. the prevention of deceleration of
regression or loss of current optimal functional status;
C. clients who are admitted by the
facility must be in need of receiving active treatment services;
D. active treatment does not include
services to maintain generally independent clients who are able to function
with little supervision or in the absence of a continuous active treatment
plan.
[8.371.2.71
NMAC - N, 7/1/2024}
8.371.2.72 CLIENT ACTIVITIES:
Every facility licensed pursuant to these regulations must
develop an activity schedule for each client that:
A. The amount of daily active treatment
a person receives should be based on the individual needs of that person and
planned and provided for by the facility in both formal and informal settings
directed at achieving needed and possible independence. To the extent possible, the active treatment
schedule should allow for the flexible participation of the individual in a
broad range of options, rather than a fixed routine.
B. Allows free time for individual or
group activities using appropriate materials.
C. Includes planned outdoor periods all
year round.
D. Each client's activity schedule must
be available to direct care staff and be carried out daily.
E. The facility must insure that a
multiple-handicapped or non-ambulatory client:
(1) spends a major portion of
the waking day out of bed;
(2) spends a portion of the
waking day out of their bedroom area;
(3) has planned daily
activity and exercise periods;
(4) moves around by various
methods and devices whenever possible.
[8.371.2.72
NMAC - N, 7/1/2024}
8.371.2.73 PERSONAL POSSESSIONS:
The facility must allow the clients to have personal
possessions such as toys, books, pictures, games, radios, arts and crafts
materials, religious articles, toiletries, jewelry, and letters.
[8.371.2.73
NMAC - N, 7/1/2024}
8.371.2.74 CONTROL AND DISCIPLINE OF CLIENTS: The facility must have
written policies and procedures for the control and discipline of clients that
are available in each living unit and to parents and guardians.
A. If appropriate, clients must
participate in formulating these policies and procedures.
B. The facility must not allow:
(1) corporal punishment of a
client;
(2) a client to discipline
another client unless it is done as part of an organized self-government
program conducted in accordance with written policy;
(3) a client to be placed
alone in a locked room.
[8.371.2.74
NMAC - N, 7/1/2024}
8.371.2.75 PHYSICAL RESTRAINT OF CLIENTS: Except as provided for
behavior modification programs, the facility may allow the use of physical
restraint on a client only if absolutely necessary to protect the client from
injuring himself or others.
A. The facility may not use physical
restraint:
(1) as punishment;
(2) for the convenience of
the staff;
(3) as a substitute for
activities or treatment.
B. The facility must have written
policies that specify:
(1) how and when physical
restraints may be used;
(2) the staff members who
must authorize its use;
(3) the method for monitoring
and controlling its use.
C. An order for physical restraint may
not be in effect longer than 12 hours.
D. Appropriately trained staff must
check a client placed in a physical restraint at least every 30 minutes and
keep a record of these checks.
E. A client who is in a physical
restraint must be given an opportunity for motion and exercise for a period of
not less than 10 minutes during each two hours of restraint.
[8.371.2.75
NMAC - N, 7/1/2024}
8.371.2.76 MECHANICAL DEVICES USED FOR PHYSICAL RESTRAINT: Mechanical devices used
for physical restraint must be designed and used in a way that causes the
client no physical injury and the least possible physical discomfort.
A. A totally enclosed crib or a barred
enclosure is a physical restraint.
B. Mechanical supports used to achieve
proper body position and balance are not physical restraints. However, mechanical supports must be designed
and applied:
(1) under the supervision of
a qualified professional;
(2) in accordance with
principles of good body alignment, concern for circulation, and allowance for change
of position.
[8.371.2.76
NMAC - N, 7/1/2024}
8.371.2.77 CHEMICAL RESTRAINT OF CLIENTS: The facility shall not
use chemical restraints in the following manner:
A. excessively;
B. as punishment;
C. for the convenience of the staff;
D. as a substitute for activities or
treatment;
E. in quantities that interfere with a
client habilitation program.
[8.371.2.77
NMAC - N, 7/1/2024}
8.371.2.78 BEHAVIOR MODIFICATION PROGRAMS:
A. “Aversive stimuli”: things or events that a client finds unpleasant
or painful that are used to immediately discourage undesired behavior may be
used by the facility as a means of behavior modification.
B. “Time out”: a procedure designed to improve a client's
behavior by removing positive reinforcement when their behavior is undesirable
may be used by the facility as a means of behavior modification.
C. Behavior modification programs
involving the use of aversive stimuli or time out must be:
(1) reviewed and approved by
the facility's human rights committee and the qualified mental retardation
professional;
(2) conducted only with the
consent of the affected client's parents or legal guardian;
(3) described in written
plans that are kept on file in the facility;
(4) a physical restraint used
as a time-out device shall be applied only during behavior modification
exercises and only in the presence of the trainer.
(5) time-out devices and
aversive stimuli may not be used for longer than one hour for time-out purposes
involving removal from a situation, and then only during the behavior
modification program and only under the supervision of the trainer.
[8.371.2.78
NMAC - N, 7/1/2024}
8.371.2.79 GROUPING AND ORGANIZATION OF LIVING UNITS:
A. A facility licensed pursuant to
these regulations may not house clients of grossly different ages,
developmental levels, and social needs in close physical or social proximity
unless the housing is planned to promote the growth and development of all those
housed together.
B. The facility may not segregate
clients on the basis of their physical handicaps. It must integrate residents who are mobile,
non-ambulatory, deaf, blind, epileptic, and so forth with others of comparable
social and intellectual development.
C. Individual living units may not be
located within 150 feet of each other.
[8.371.2.79
NMAC - N, 7/1/2024}
8.371.2.80 RECREATION SERVICES:
The facility must coordinate recreational services with other
services and programs provided to each client in order to:
A. make the fullest possible use of the
facility's resources;
B. maximize benefits to the clients;
C. design and construct or modify
recreation areas and facilities so that all residents, regardless of their
disabilities have access to them;
D. provide recreation equipment and supplies
in a quantity and variety that is sufficient to carry out the stated objectives
of the activities programs.
[8.371.2.80
NMAC - N, 7/1/2024}
8.371.2.81 RESIDENT CLOTHING:
The facility must insure that each client:
A. has enough neat, clean, suitable and
seasonable clothing;
B. has their own clothing marked with their
name when necessary;
C. is dressed daily in their own
clothing unless this is contraindicated in written medical orders;
D. is trained and encouraged as
appropriate to:
(1) select their daily
clothing;
(2) dress themselves;
(3) change their clothes to
suit their activities;
(4) has storage space for
their clothing that is accessible to them even if they are in a wheelchair.
[8.371.2.81
NMAC - N, 7/1/2024}
8.371.2.82 CLIENT ROOMS: The
facility must provide each client with:
A. a separate bed of proper size and
height for the convenience of the client;
B. bedding appropriate to the weather
and climate;
C. a clean comfortable mattress;
D. appropriate furniture, such as a
chest of drawers, a table or desk, and an individual closet with clothes racks
and shelves accessible to the client.
[8.371.2.82
NMAC - N, 7/1/2024}
8.371.2.83 STORAGE SPACE IN LIVING UNITS: Each facility licensed
pursuant to these regulations must provide:
A. space for equipment for daily
out-of-bed activity for all clients who are not yet mobile, except those who
have a short-term illness or those few clients for whom out-of-bed activity is
a threat to life;
B. suitable storage space, accessible
to the client for personal possessions, such as toys and prosthetic equipment;
C. adequate clean linen and dirty linen
storage areas.
[8.371.2.83
NMAC - N, 7/1/2024}
8.371.2.84 HEALTH, HYGIENE, GROOMING AND TOILET TRAINING:
A. Each client must be trained to be as
independent as possible in health, hygiene and grooming practices, including
bathing, brushing teeth, shampooing, combing and brushing hair, shaving and
caring for toenails and fingernails.
B. Each client who does not eliminate
appropriately and independently must be in a regular, systematic toilet
training program and a record must be kept of their progress in the program.
C. A client who is incontinent must be
bathed or cleaned immediately upon voiding or soiling, unless specifically
contraindicated by the training program and all soiled items must be changed.
D. The facility must
establish procedures for:
(1) weighing each client
monthly, unless the special needs of the client require more frequent weighing;
(2) measuring the height of
each client every three months until the client reaches the age of maximum
growth;
(3) maintaining weight and
height records for each client;
(4) insuring that each client
maintains a normal weight.
E. At least every three days a physician
must review orders prescribing bed rest or prohibiting a client from being
outdoors.
F. The facility must furnish, maintain
in good repair, and encourage the use of dentures, eyeglasses, hearing aids,
braces, and other aids prescribed for a client by an appropriate specialist.
[8.371.2.84
NMAC - N, 7/1/2024}
8.371.2.85 DENTAL SERVICES:
A. Diagnostic services:
(1) The facility must provide
each client with comprehensive diagnostic dental services that include a
complete extraoral and intraoral examination using all diagnostic aids
necessary to properly evaluate the client's oral condition, not later than one
month after a client's admission to the facility unless they received the
examination within six months before admission.
(2) The facility must review
the results of the examination and enter them in the client's record.
B. Treatment: The facility must provide each client with
comprehensive dental treatment that includes:
(1) provision for emergency
dental treatment on a 24 hour a day basis by a qualified dentist;
(2) a system that assures
that each client is re-examined as needed but at least once a year.
C. Education and training: The
facility must provide education and training in the maintenance of oral health
that includes:
(1) a dental hygiene program
that informs clients and all staff on nutrition and diet control measures, and
clients and living unit staff on proper oral hygiene methods;
(2) instruction of parents or
guardians in the maintenance of proper oral hygiene in appropriate instances,
for example when the client leaves the facility.
[8.371.2.85
NMAC - N, 7/1/2024}
8.371.2.86 PREVENTIVE HEALTH SERVICES: The facility must have
preventive health services for clients that include:
A. means for the prompt detection and
referral of health problems through adequate medical surveillance, periodic
inspection and regular medical examinations;
B. annual physical examinations that
include:
(1) examination of vision and
hearing;
(2) routine screening
laboratory examinations as determined necessary by the physician and special
studies when needed.
C. immunizations using as a guide the
recommendations of the public health service advisory committee on immunization
practices and of the committee on the control of infectious diseases of the
American academy of pediatrics;
D. Tuberculosis control in accordance
with New Mexico state law;
E. Reporting of communicable diseases
and infections in accordance with New Mexico state law.
[8.371.2.86
NMAC - N, 7/1/2024}
8.371.2.87 MEDICAL SERVICES:
The facility must:
A. provide medical services through
direct contact between physicians and clients and through contact between
physicians and individuals working with the clients;
B. provide health services including
treatment, medications, diet, and any other health service prescribed or
planned for the client 24 hours a day;
C. have available
electroencephalographic services as needed;
D. have enough space, facilities and
equipment to fulfill the medical needs of the clients;
E. provide evidence that hospital and
laboratory services are used in accordance with professional standards.;
F. goals and evaluations: physicians must participate, when
appropriate, in:
(1) the continuing
interdisciplinary evaluation of individual clients for the purposes of
beginning, monitoring, and following-up on individualized habilitation
programs;
(2) the development for each
client of a detailed written statement of:
(a) case management goals for
physical and mental health, education and functional and social competence;
(b) a management plan
detailing the various habilitation or rehabilitation services to achieve those
goals with clear designation of responsibility for implementation.
(3) the facility must review
and update the statement of treatment goals and management plans as needed but
at least annually to insure:
(a) continuing
appropriateness of the goals;
(b) consistency of management
methods with the goals;
(c) the achievement of
progress toward the goals.
[8.371.2.87
NMAC - N, 7/1/2024}
8.371.2.88 PSYCHOLOGICAL SERVICES:
The facility must:
A. provide psychological services
through personal contact between psychologists and clients and through contact
between psychologists and individuals involved with the clients;
B. have available enough qualified
staff and support personnel to furnish the following psychological services
based on need:
(1) administration and
supervision of psychological services;
(2) staff training.
C. a qualified psychologist must:
(1) participate, when
appropriate, in the continuing interdisciplinary evaluation of each individual
client for the purpose of beginning, monitoring and following-up on the clients
individualized habilitation program.
(2) report and disseminate
evaluation results in a manner that:
(a) promptly provides
information useful to staff working directly with the clients;
(b) maintains accepted
standards of confidentiality.
(3) participate, when
appropriate, in the development of written detailed, specific and
individualized habilitation program that:
(a) provide for periodic
review, follow-up and updating;
(b) are designated to
maximize each client's development and acquisition of perceptual skills,
sensorimotor skills, self-help skills, communication skills, social
skills,self-direction, emotional stability, and effective use of time,
including leisure time.
[8.371.2.88
NMAC - N, 7/1/2024}
8.371.2.89 PHYSICAL AND OCCUPATIONAL THERAPY SERVICES: The facility must provide
physical and occupational therapy services through direct contact between
therapist and individuals involved with the clients.
A. Physical and occupational therapy
staff must provide treatment training programs that are designed to:
(1) preserve and improve
abilities for independent function, such as range of motion, strength,
tolerance, coordination and activities of daily living;
(2) prevent, insofar as
possible, irreducible or progressive disabilities through means such as the use
of orthotic and prosthetic appliances, assistive and adaptive devices,
positioning, behavior adaptations and sensory stimulation.
B. The therapist must:
(1) work closely with the
client's primary physician and with other medical specialists;
(2) record regularly and
evaluate periodically the treatment training progress;
(3) use the treatment
training progress as the basis for continuation or change in the client's
program.
C. The facility must have evaluation
results, treatment objectives, plans and procedures, and continuing
observations of treatment progress, which must be:
(1) recorded accurately,
summarized, and communicated to all relevant parties;
(2) used in evaluating
progress;
(3) included in the client's
record kept in the living unit.
[8.371.2.89
NMAC - N, 7/1/2024}
8.371.2.90 NURSING SERVICES:
The facility must provide clients with nursing services, in
accordance with their needs, that include, as appropriate, the following:
A. Registered nurse participation:
(1) The pre-admission
evaluation study and plan.
(2) The evaluation study,
program design, and placement of the client at the time of admission.
(3) The periodic
re-evaluation of the type, extend and quality of services and programming.
B. Training in habits of personal
hygiene, family life and sex education that includes, but is not limited to,
family planning and venereal disease counseling.
C. Control of communicable diseases and
infections through:
(1) Identification and
assessment.
(2) Reporting to medical
authorities.
(3) Implementation of
appropriate protective and preventive measures.
(4) Development of a written
nursing services plan for each client as part of the total habilitation program.
(5) Modification of the
nursing plan in terms of the client's daily needs, at least annually for adults
and more frequently for children in accordance with developmental changes.
D. Management of the medication aide
program in accordance with the board of nursing.
[8.371.2.90
NMAC - N, 7/1/2024}
8.371.2.91 SOCIAL SERVICES: The
facility must provide, as part of an inter-disciplinary set of services, social
services to each client directed toward:
A. maximizing the social functioning of
each client;
B. enhancing the coping capacity of
each client's family;
C. asserting and safeguarding the human
and civil rights of the retarded and their families;
D. fostering the human dignity and
personal worth of each client;
E. the development of the discharge
plan;
F. the referral to appropriate
community resources.
[8.371.2.91
NMAC - N, 7/1/2024}
8.371.2.92 LAUNDRY SERVICES:
The facility must manage its laundry services to that it
meets daily clothing and linen needs without delays.
A. Each client must have available a
clean change of clothing whenever necessary.
B. There must be separate handling and
storage of clean and soiled linens.
C. Linens must be laundered and
disinfected prior to re-use by another client.
D. New linens must be laundered before
use.
[8.371.2.92
NMAC - N, 7/1/2024}
8.371.2.93 SPEECH PATHOLOGY AND AUDIOLOGY SERVICES: The facility must provide
speech pathology and audiology services through direct contact between speech
pathologists and audiologist and clients, and working with other personnel,
including but not limited to, teachers and direct care staff. Speech pathology and audiology services must
include:
A. screening and evaluation of clients
with respect to speech and hearing functions;
B. comprehensive audiological
assessment of clients, as indicated by screening results that include tests of
puretone air and bone conduction, speech audiometry and other procedures as
necessary, and the assessment of the use of visual cues;
C. assessment of the use of
amplification;
D. provision for procurement,
maintenance and replacement of hearing aids, as specified by a qualified
audiologist;
E. comprehensive speech and language
evaluation of clients, as indicated by screening results including appraisal of
articulation, voice, rhythm, and language;
F. participation in the continuing
interdisciplinary evaluation of individual clients for purposes of beginning,
monitoring, and following-up on individualized habilitation programs;
G. treatment services as an extension
of the evaluation process that include:
(1) direct counseling with
clients;
(2) consultation with
appropriate staff for speech improvement and speech education activities;
(3) work with appropriate
staff to develop specialized programs for developing each client's
communication skills, in comprehension, including speech, reading, auditory
training, hearing aid utilization and skills in expression, including
improvement in articulation, voice, rhythm, and language.
H. participation in in-service training
programs for direct care and other staff.
[8.371.2.93
NMAC - N, 7/1/2024}
8.371.2.94 PHARMACY SERVICES:
Any facility licensed pursuant to these regulations that
supervises the administration or self-administration of medications for clients
must have a current custodial care facility license issued by the New Mexico
board of pharmacy.
A. The facility must make formal
arrangements for qualified pharmacy services, including provision for emergency
service.
B. Have a current pharmacy manual that:
(1) includes policies and
procedures and defines the functions and responsibilities relating to pharmacy
services;
(2) is revised annually to
keep abreast of current developments in services and management techniques;
(3) have a formulary system
approved by a responsible physician and pharmacist and other appropriate staff. Copies of the facility's formulary system and
of the American Hospital Formulary Service must be located and available in the
facility.
C. Pharmacist:
(1) Pharmacy services must be
provided under the direction of a qualified pharmacist.
(2) The pharmacist must:
(a) when a client is admitted
obtain, if possible, a history of prescription and non-prescription drugs used
and enter this information in the client's record;
(b) receive the original, or
a direct copy, of the physician's drug treatment order;
(c) maintain for each client
an individual record of all prescription and non-prescription medication
dispensed, including quantities and frequency of refills;
(d) participate, as
appropriate, in the continuing interdisciplinary evaluation of individual
clients for the purpose of beginning, monitoring and following up on
individualized habilitation programs;
(e) establish quality
specifications for drug purchases and insure that they are met.
(3) A pharmacist must
regularly review the medication record of each client for potential adverse
reactions, allergies, interactions, contraindications, rationality and
laboratory test modifications and advise the physician of any recommended
changes with reasons and with an alternate drug regimen.
(4) The responsible
pharmacist, physician, nurse and other professional staff must write policies
and procedures that govern the safe administration and handling of all drugs. The following policies and procedures must be
included:
(a) self-administration of
drugs, whether prescribed or not.
(b) the pharmacist or an
individual under the pharmacist’s supervision must compound, package, label and
dispense drugs including samples and investigational drugs. Proper controls and records must be kept of
these processes.
(c) each drug must be
identified up to the point of administration.
(d) whenever possible, the
pharmacist must dispense drugs that require dosage measurements in a form ready
to be administered to the client.
D. Drugs and medications:
(1) A medication must be used
only by the client for whom it is issued.
Only appropriately trained staff may administer drugs.
(2) Any drug that is
discontinued or outdated and any container with a worn, illegible or missing
label must be returned to the pharmacy for proper disposition.
(3) The facility must have:
(a) an automatic stop order
on all drugs;
(b) a drug recall procedure
that can be readily used;
(c) a procedure for reporting
adverse drug reactions to the Food and Drug Administration;
(d) an emergency kit
available to each living unit and appropriate to the needs of its clients.
(4) Medication errors and
drug reactions must be recorded and reported immediately to the practitioner
who ordered the drug.
E. Drug storage:
(1) The facility must store
drugs under proper conditions of sanitation, temperature, light, moisture,
ventilation, segregation and security.
(2) The facility must store
drugs used externally and drugs taken internally on separate shelves or in
separate cabinets.
(3) The facility must keep
medication that is stored in a refrigerator containing other items in a
separate compartment with proper security.
(4) If there is a drug
storeroom separate from the pharmacy, an inventory of receipts and issues of
all drugs from that storeroom must be kept.
(5) The facility must meet
the drug security requirements of federal and state laws that apply to
storerooms, pharmacies and living units.
[8.371.2.94
NMAC - N, 7/1/2024}
8.371.2.95 FOOD AND NUTRITION SERVICES:
A. Dietician: The facility must employ a
qualified dietitian either full-time, part-time, or on a consultant basis. If a qualified dietitian is not employed
full-time, the facility must designate a person to serve as the director of
food service.
B. Food services: The facility's food
services must include:
(1) menu planning;
(2) initiating food orders or
requisitions;
(3) establishing
specifications for food purchases and insuring that the specifications are met;
(4) storing and handling
food;
(5) preparing and serving
food;
(6) maintaining sanitary
standards in compliance with the New Mexico environment department food service
regulations;
(7) orienting, training and
supervising food service personnel.
C. Diet requirements:
(1) The facility must provide
each client with a nourishing well-balanced diet.
(2) Modified diets must be:
(a) prescribed by the
client's interdisciplinary team with a record of the prescription kept on file;
(b) planned, prepared and
served by individuals who have received adequate instruction;
(c) periodically reviewed and
adjusted as needed.
(3) The facility must furnish
a nourishing, well-balanced diet in accordance with the recommended dietary
allowances of the food and nutrition board of the national research council,
national academy of sciences, adjusted for age, sex, activity and disability,
unless otherwise required by medical needs.
(4) A client may not be
denied a nutritionally adequate diet as a form of punishment.
D. Meal service:
(1) The facility must serve
at least three meals daily at regular times comparable to normal mealtimes in
the community with:
(a) not more than 14 hours
between a substantial evening meal and breakfast of the following day;
(b) not less than 10 hours
between breakfast and the evening meal of the same day.
(2) Food must be served:
(a) in appropriate quantity;
(b) at appropriate
temperature;
(c) in a form consistent with
the developmental level of the resident;
(d) with appropriate
utensils;
(e) food served and uneaten
must be discarded.
E. Menus:
(1) Must be written in
advance.
(2) Provide a variety of
foods at each meal.
(3) Be different for the same
days of each week and adjusted for seasonal changes.
(4) Menus must be kept on
file for at least 30 days as served.
F. Food storage:
(1) Dry or staple food items
at least 12 inches above the floor, in a ventilated room not subject to sewage
or waste water back flow or contamination by condensation, leakage, rodents or
vermin.
(2) Perishable foods must be
kept at proper temperatures to conserve nutritive values.
G. Work areas:
(1) The facility must have
effective procedures for cleaning all equipment and work areas.
(2) The facility must be
provided with hand washing facilities to include hot and cold water, soap and
paper towels adjacent to the work areas.
H. Dining areas and service:
(1) The facility must serve
meals for all residents, including the mobile non-ambulatory, in dining rooms
unless otherwise required for health reasons or by decision of the team
responsible for the client's program.
(2) The facility must provide
table service for all clients who can and will eat at a table, including
clients in wheelchairs.
(3) The facility will equip
areas with table, chairs, eating utensils and dishes designed to meet the developmental
needs of each client.
(4) The facility must
supervise and staff dining rooms adequately to direct self-help dining
procedures and to assure that each client receives enough food.
[8.371.2.95
NMAC - N, 7/1/2024}
8.371.2.96 RELATED REGULATIONS AND CODES: ICF/MR facilities subject
to these regulations are also subject to other regulations, codes and standards
as the same may from time to time be amended as follows:
A. Health facility licensure fees and
procedures, New Mexico health care authority, 8.370.3 NMAC.
B. Health facility sanctions and civil
monetary penalties, 8.370.4 NMAC.
C. Adjudicatory hearings, New Mexico health
care authority, 8.370.2 NMAC.
D. Caregivers criminal history
screening requirements, New Mexico health care authority, 8.370.5 NMAC.
[8.371.2.96
NMAC - N, 7/1/2024}
HISTORY
OF 8.371.2 NMAC: [RESERVED]