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CALIFORNIA CODE OF REGULATIONS
TITLE 22. SOCIAL SECURITY
DIVISION 7. HEALTH PLANNING AND FACILITY CONSTRUCTION
CHAPTER 11. ALZHEIMER'S DISEASE INSTITUTE DEMONSTRATION PROJECT
SUBCHAPTER 12. RESIDENTIAL CARE SERVICES
ARTICLE 4. BASIC SERV
Date:
08/31/2009
Document:
22 CCR 97426.9 (2011)
ยง 97426.9. Incidental Medical and Dental Care
(a) A plan for incidental medical and dental care shall be developed by each Unit. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:
(1) The Unit staff shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of patients.
(2) The Unit staff shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available Institute service, medical or dental facility which will meet the patient's need. In providing transportation the Unit staff shall do so through the Institute's transportation program in accordance with the provisions of Section 97321.149.
(3) There shall be arrangements for separation and care of patients whose illness requires separation from others.
(4) When patients require prosthetic devices, vision and hearing aids, the Unit staff shall be familiar with the use of these devices, and shall assist the patients with their utilization as needed.
(5) The Unit staff shall provide for assisting patients with self-administered medications as needed. Unit staff, except those authorized by law, shall not administer injections but may assist patients with self-administration as needed. Assistance with self-administered medications shall be limited to the following:
(A) Medications usually prescribed for self-administration which have been authorized by the patient's physician.
(B) Medications during an illness determined by a physician to be temporary and minor.
(C) Assistance required because of tremor, failing eyesight and similar conditions.
(6) A record of dosages of medications which are centrally stored shall be maintained by the Unit.
(7) There shall be adequate privacy for first aid treatment of minor injuries and for examination by a physician if required.
(8) A complete first aid kit shall be maintained and be readily available in a specific location in the Unit. The kit shall be a general type approved by the American Red Cross, or shall contain at least the following:
(A) A current edition of a first aid manual approved by the American Red Cross, the American Medical Association or a state or federal health agency.
(B) Sterile first aid dressings.
(C) Bandages or roller bandages.
(D) Scissors.
(E) Tweezers.
(F) Thermometers.
(b) Emergency care requirements shall include the following:
(1) The name, address and telephone number of each patient's physician and dentist shall be readily available.
(2) The name, address and telephone number of each emergency agency to be called in the event of an emergency, including but not limited to the fire department, crisis center or paramedical unit or medical resource, shall be posted in a location visible to both staff and patients.
(3) The name and telephone number of an ambulance service shall be readily available.
(4) Unit staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the Red Cross.
(c) The following requirements shall apply to medications which are centrally stored:
(1) Medications shall be centrally stored under the following circumstances:
(A) The preservation of medicines requires refrigeration.
(B) Any medication is determined by the physician to be hazardous if kept in the personal possession of the patient for whom it was prescribed.
(C) Because of physical arrangements and the condition or the habits of other patients in the Unit, the medications are determined by either the program administrator or by the Department to be a safety hazard to others.
(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication.
(3) Each container shall carry all of the information specified in (6)(A) through (E) below plus expiration date and number of refills.
(4) All centrally stored medications shall be labeled and maintained in compliance with state and federal laws. No persons other than the dispensing pharmacist shall alter a prescription label.
(5) Each patient's medication shall be stored in its originally received container. No medications shall be transferred between containers.
(6) The Unit staff shall be responsible for assuring that a record of centrally stored prescription medications for each patient is maintained for at least one year and includes:
(A) The name of the patient for whom prescribed.
(B) The name of the prescribing physician.
(C) The drug name, strength and quantity.
(D) The date filled.
(E) The prescription number and the name of the issuing pharmacy.
(F) Instructions, if any, regarding control and custody of the medication.
(d) Prescription medications which are not taken with the patient upon termination of services or which are otherwise to be disposed of shall be destroyed in the Institute by the Institute administrator and one other adult who is not a patient. Both shall sign a record, to be retained for at least three years, which lists the following:
(1) Name of the patient.
(2) The prescription number and name of the pharmacy.
(3) The drug name, strength and quantity destroyed.
(4) The date of destruction.
(e) In a Unit designated for sixteen (16) patients or more, one or more employees shall be designated as having primary responsibility for assuring that each patient receives needed first aid and needed emergency medical services and for assisting patients as needed with self-administration of medications. The names of the staff employees so responsible and the designated procedures shall be documented and made known to all patients and staff.
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