DAR File No. 41959

Health, Family Health and Preparedness, Licensing

Rule R432-650

End Stage Renal Disease Facility Rules

Notice of Proposed Rule

(Amendment)

DAR File No.: 41959
Filed: 07/31/2017 08:27:46 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this rule amendment is to add requirements for staff to be certified in Cardiopulmonary Resuscitation (CPR) Certification, define which CPR Certification courses can be utilized to obtain CPR Certification, and to amend incorrect references and wording. The Health Facility Committee reviewed and approved these rule amendments on 05/10/2017.

Summary of the rule or change:

The rule amendment adds requirements for staff to be certified in CPR Certification, defines which courses can be utilized to certify staff in CPR. This amendment also corrects many outdated references and corrects errors.

Statutory or constitutional authorization for this rule:

• Title 26, Chapter 21

Anticipated cost or savings to:

the state budget:

After conducting a thorough analysis, it was determined that this proposed rule will not result in a fiscal impact to the state budget because this amendment simply updates references and clarifies the rule requirements.

local governments:

After conducting a thorough analysis, it was determined that this proposed rule will not result in a fiscal impact to the local government budget because this amendment simply updates references and clarifies the rule requirements.

small businesses:

After conducting a thorough analysis, it was determined that this proposed rule will not result in a fiscal impact to the small businesses budget because this amendment simply updates references and clarifies the rule requirements.

persons other than small businesses, businesses, or local governmental entities:

After conducting a thorough analysis, it was determined that this proposed rule will not result in a fiscal impact to businesses, individuals, local governments, and persons that are not small businesses because this amendment simply updates references and clarifies the rule requirements.

Compliance costs for affected persons:

After conducting a thorough analysis, it was determined that this proposed rule will not result in a fiscal impact to affected persons because this amendment simply updates references and clarifies the rule requirements.

Comments by the department head on the fiscal impact the rule may have on businesses:

There will be no fiscal impact on business.

Joseph Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Family Health and Preparedness, Licensing
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-273-2804, by FAX at 801-274-0658, or by Internet E-mail at jhoffman@utah.gov
• Carmen Richins at the above address, by phone at 801-273-2802, by FAX at 801-274-0658, or by Internet E-mail at carmenrichins@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

09/14/2017

This rule may become effective on:

09/21/2017

Authorized by:

Joseph Miner, Executive Director

R432. Health, Family Health and Preparedness, Licensing.

R432-650. End Stage Renal Disease Facility Rules.

R432-650-3. Definitions.

(1) The definitions in R432-1-3 apply to this rule.

(2) In addition:

(a) Certification in Cardiopulmonary Resuscitation (CPR) refers to certification issued after completion of a course that is consistent with the most current version of the American Heart Association Guidelines for Health Care Provider CPR.

(b) "Interdisciplinary[professional] team" means a team of qualified professionals who are responsible for conducting the patient assessment and developing the patient care plan[creating the Patient Long Term Care Program and Patient Care Plan]. The [qualifications]requirements are described in 42CFR [405.2137(a) and (b), 2008]494.80, 10-1-14 edition, which is adopted and incorporated by reference.

 

R432-650-4. Licensure.

License Required. See R432-2[and R432-3].

 

R432-650-5. Patient Care Services.

Each ESRD facility must comply with the conditions of participation set forth in the Code of Federal Regulations, Title 42, Part 4[05]94,[Subpart U., 2008,] which is adopted and incorporated by reference.

 

R432-650-7. Required Staffing.

(1) Each patient shall be under the continuing supervision of a physician. A physician shall be available in medical emergency situations through a current telephone call roster readily accessible to the nursing staff.

(2) Physician assistants and advanced practice registered nurses may provide services in ESRD facilities in association with the supervising or consulting nephrologist, and in accordance with state law.

(3) Each ESRD facility shall provide sufficient qualified clinical staff to meet patient care needs. A minimum of two clinical staff personnel, one a registered nurse for supervision of patient clinical care, shall be on duty whenever patients are receiving dialysis services.

(a) A registered nurse may not supervise the clinical care of more than 10 patients if arranged in an open setting, or 12 patients if arranged in three pods of four patients.

(b) A registered nurse may not supervise patient clinical care, or provide unsupervised patient clinical care until the nurse has completed training and demonstrated competency as determined by facility policy.

(c) Dialysis technicians and licensed practical nurses may not be assigned patient clinical care for more than four patients at a time.

(d) Dialysis technicians and licensed practical nurses must complete training and demonstrate competency according to facility policy prior to providing patient care.

(4) Each ESRD facility must orient all employees to specific job requirements and facility policies. The facility shall document initial and on-going employee orientation and training. Patient clinical care staff orientation and training shall include at least the following topics:

(a) patient rights and responsibilities;

(b) kidney disease processes;

(c) hemodialysis process;

(d) hemodialysis complications;

(e) dialysis access and management;

(f) psycho-social implications of dialysis on patient care;

(g) nutritional requirements;

(h) universal precautions;

(i) use of the medical emergency kit;

(j) use and function of facility equipment;

(k) emergency procedures;

(l) AAMI water treatment standards; and

(m) dialyzer re-use procedures, if offered.

(5) A registered nurse may delegate the following patient care activities to licensed practical nurses or dialysis technicians:

(a) cannulation of peripheral vascular access;

(b) administration of intradermal lidocaine, intravenous heparin and intravenous normal saline; and

(c) initiation, monitoring and discontinuation of the dialysis process.

(6) Each ESRD facility must ensure that all personnel are licensed, certified or registered as required by the Utah Department of Commerce.

(7) Each ESRD facility must ensure that on all shifts, staff are available who are CPR certified, trained in emergency procedures and basic first aid.

 

R432-650-15. Penalties.

Any person who violates any provision of this rule may be subject to the penalties enumerated in 26-21-11 and R432-3-[6]7 and be punished for violation of a class A misdemeanor as provided in 26-21-16.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: [March 28, 2012]2017

Notice of Continuation: September 15, 2016

Authorizing, and Implemented or Interpreted Law: 26-21-5; 26-21-16