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Advance Directives
A verbal or written instruction plan in advance of incapacitating illness or
injury, which ensures that the resident's wishes about treatment will be
followed. This includes but is not limited to a health care proxy, a
do-not-resuscitate (DNR) order recorded in the resident's medical record and
a living will.
Basic Services
Those services included in the daily rate. At the time of admission, a
written copy of the following basic services must be made available to all
residents:
- the daily, weekly or monthly rate;
- board, including therapeutic or modified diets, as prescribed by a doctor;
- lodging -- a clean, healthful, sheltered environment, properly outfitted;
- 24-hour-per-day nursing care;
- the use of all equipment, medical supplies and modalities used in the care
of nursing home residents, including but not limited to catheters,
hypodermic syringes and needles, irrigation outfits, dressings and pads,
etc.;
- fresh bed linen, as required, changed at least twice weekly, including
sufficient quantities of necessary bed linen or appropriate substitutes
changed as often as required for incontinent residents;
- hospital gowns or pajamas as required by the clinical condition of the
resident, unless the resident, family member or designated representative
elects to furnish them, and laundry services for these and other launderable
personal clothing items;
- general household medicine cabinet supplies, including but not limited to
nonprescription medications, materials for routine skin care, dental
hygiene, care of hair, etc., except when specific items are medically
indicated and prescribed for exceptional use for a specific resident;
- assistance and/or supervision, when required, with activities of daily
living, including but not limited to toileting, bathing, feeding and
assistance with getting from place to place;
- services, in the daily performance of their assigned duties, by members of
the nursing home staff assigned to resident care;
- use of customarily stocked equipment, including but not limited to
crutches, walkers, wheelchairs or other supportive equipment, including
training in their use when necessary, unless such items are prescribed by a
doctor for regular and sole use by a specific resident;
- activities program, including but not limited to a planned schedule of
recreational, motivational, social and other activities together with the
necessary materials and supplies to make the resident's life more
meaningful; - social services as needed;
- physical therapy, occupational therapy, speech pathology services,
audiology services and dental services, on either a staff or
fee-for-services basis, as prescribed by a doctor, administered by or under
the direct supervision of a licensed and currently registered physical
therapist, occupational therapist, speech pathologist, qualified audiologist
or registered dentist.
Designated Representative
The individual or individuals designated to receive information and to
assist and/or act on behalf of a particular resident to the extent permitted
by State law. The representation occurs by a court of law if sought; by the
resident if he or she has the capacity to make such a designation; or by
family members and others who have an interest in the well-being of the
resident. The name of the designated representative must be noted in the
residents clinical record at the facility.
The designated representative:
(1) receives any written and verbal information required to be provided to
the resident if the resident lacks the capacity to understand or make use of
the information, and receives any information required to be provided to
both the resident and the designated representative;
(2) participates (to the extent authorized by State law) in decisions and
choices regarding the care, treatment and well-being of the resident if such
resident lacks the capacity to make decisions and choices. These decisions
are not the same as those made by a health care agent unless the same person
has been appointed both the designated representative and the health care
agent.
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