ARTICLE 44:80
RESIDENTIAL HOSPICE FACILITIES
Chapter
44:80:01 Rules of general applicability.
44:80:02 Physical environment.
44:80:03 Fire protection.
44:80:04 Management and administration.
44:80:05 Care and services.
44:80:06 Dietetic services.
44:80:07 Medication control.
44:80:08 Resident record services.
44:80:09 Residents' and families rights.
44:80:10 Construction standards.
CHAPTER 44:80:01
RULES OF GENERAL APPLICABILITY
Section
44:80:01:01 Definitions.
44:80:01:02 Posting of license.
44:80:01:03 Name of hospice.
44:80:01:04 Bed capacity.
44:80:01:05 Restrictions on acceptance of residents.
44:80:01:06 Joint occupancy.
44:80:01:07 Reports.
44:80:01:08 Plans of correction.
44:80:01:09 Modifications.
44:80:01:10 Scope of article.
44:80:01:01. Definitions. Terms defined in SDCL 34-12-1.1 have the same meaning in this article. In addition, terms used in this article mean:
(1) "Abuse," an intentional act toward an individual indicating that one or more of the following has occurred:
(a) A criminal conviction against a person for mistreatment toward an individual; or
(b) In the absence of a criminal conviction, substantial evidence that one or more of the following has occurred resulting in harm, pain, fear, or mental anguish:
(i) Misappropriation of a patient's or resident's property or funds;
(ii) An attempt to commit a crime against a patient or resident;
(iii) Physical harm or injury against a patient or resident; or
(iv) Using profanity, making a gesture, or engaging in any other act made to or directed at a patient or resident;
(2) "Agency," the Medicare certified hospice agency which provides or coordinates palliative and supportive care to hospice residents within the facility;
(3) "Activities of daily living," the tasks of transferring, moving about, dressing, grooming, toileting, bathing, and eating performed routinely by a person to maintain physical functioning and personal care;
(4) "Adequate staff," a sufficient number of qualified personnel to perform the duties required to meet the performance criteria established by this article;
(5) "Administrator," a person appointed by the owner or governing body of a facility who is responsible for the daily overall management of the facility, who may maintain an office on the premises of the facility, and appoints a qualified person to represent the administrator during the administrator's absence;
(6) "Client advocate," an agency responsible for the protection and advocacy of residents and residents, including the department, the state ombudsman, and the protection and advocacy network;
(7) "Custodial care," is care and related services that helps a hospice resident with the resident's activities of daily living, and may also include preparation of special diets, medication administration, or other activities that do not require constant attention of medical personnel;
(8) "Department," the South Dakota Department of Health;
(9) "Dietitian," a person who is registered with the Academy of Nutrition and Dietetics and holds a current license to practice in South Dakota pursuant to SDCL chapter 36-10B;
(10) "Distinct part," an identifiable unit, such as an entire ward or contiguous wards, wing, floor, or building, which is licensed at a specific level. It consists of all beds and related facilities in the unit;
(11) "Emergency care," professional health services immediately necessary to preserve life or stabilize health due to the sudden, severe, and unforeseen onset of illness or accidental bodily injury;
(12) "Exploitation," the wrongful taking or exercising of control over property of a person with intent to defraud that person;
(13) "Facility," the place of business licensed by the department as a residential hospice that provides custodial care to hospice residents;
(14) "Governing body," is an individual, partnership, or an organized body of persons that is ultimately responsible for the quality of care in an residential hospice facility, maintaining the financial viability of the facility, and formulating institutional policies and procedures, or bylaws governing the operation of the facility;
(15) "Healthcare worker," any paid person working in a healthcare setting;
(16) "Hospice services," a coordinated interdisciplinary program of health care that provides or coordinates palliative and supportive care to meet the needs of a terminally ill resident and the resident's family. The needs arise out of physical, psychological, spiritual, social, and economic stresses experienced during the final stages of illness and dying and that includes formal bereavement programs as an essential component;
(17) "Instrumental activities of daily living," tasks performed routinely by a person, utilizing physical and social environmental features, to manage life situations, including meal preparation, self-administration of medications, telephone use, housekeeping, laundry, handling finances, shopping, and use of transportation;
(18) "Legend drug," any drug that requires the label bearing the statement "Caution: Federal law prohibits dispensing without prescription";
(19) "Licensed health professional," a physician; physician's assistant; nurse practitioner; physical, speech, or occupational therapist; physical or occupational therapy assistant; nurse; nursing facility administrator; dietitian; pharmacist; respiratory therapist; or social worker who holds a current license to practice in South Dakota;
(20) "Misappropriation of resident or patient property," the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a patient's or resident's belongings or money without the patient's or resident's consent;
(21) "Neglect," harm to a person's health or welfare, without reasonable justification, caused by the conduct of someone responsible for the person's health or welfare, including offensive behavior made to or directed at a patient or resident, and the failure to provide timely, consistent, and safe services, treatment, or care necessary to avoid physical harm, mental anguish, or mental illness to the person;
(22) "Nurse," a registered nurse or a licensed practical nurse who holds a current license to practice in South Dakota pursuant to SDCL chapter 36-9;
(23) "Nurse practitioner," a person who practices the specialty nurse practitioner as authorized pursuant to SDCL chapter 36-9A;
(24) "Nursing personnel," staff which includes registered nurses, licensed practical nurses, nurse aides, restorative aides, and unlicensed assistive personnel;
(25) "Pharmacist," a person registered to practice pharmacy pursuant to SDCL chapter 36-11;
(26) "Physician," a person who is licensed or approved to practice medicine pursuant to SDCL chapter 36-4;
(27) "Practitioner," one of the following:
(a) A physician or surgeon licensed or approved to practice medicine pursuant to SDCL chapter 36-4;
(b) A pharmacist licensed pursuant to SDCL chapter 36-11; or
(c) A nurse practitioner licensed pursuant to SDCL chapter 36-9A;
(28) "Protection and advocacy network," agencies responsible for the protection and advocacy of individuals with developmental disabilities or mental illness, established under the Developmental Disabilities Assistance and Bill of Rights Act of 2000, Pub. L. No. 106-402 (October 30, 2000), codified at 42 U.S.C. § 15041 to 15045, and the Protection and Advocacy for Persons with Mental Illness Act of 2000, Pub. L. No. 106-310 (October 17, 2000), codified at 42 U.S.C. §§ 10801 to 10851, inclusive;
(29) "Qualified personnel," persons with the specific education or training to provide the health service for which they are employed;
(30) "Regular diet," a nutritionally adequate diet using food items and written recipes that can be prepared and correctly served by a staff person;
(31) "Resident," a terminally ill individual that is receiving custodial care on a twenty-four hour per day basis and receives services as a resident under the direction of a Medicare hospice provider certified by the Centers for Medicare and Medicaid Services;
(32) "Respite care," care permitted within the scope of a facility license, with a limited stay no greater than 30 days for any one resident;
(33) "Self-administration of medications," the removal of the correct dosage from the pharmaceutical container and self-injecting, self-ingesting, or self-applying the medication with no assistance or with assistance from qualified personnel of the facility for the correct dosage or frequency;
(34) "Social worker," a person who is licensed pursuant to SDCL chapter 36-26;
(35) "Terminal illness," a medical prognosis that the individual's life expectancy is six months or less if the illness runs its normal course;
(36) "Therapeutic diet," any diet other than a regular diet, excluding low sodium diets, that is ordered by a physician as part of the treatment for a disease or clinical condition to increase, decrease, or to eliminate certain substances in the diet, and to alter food consistency;
(37) "Transfer or discharge," the movement of a resident to a bed outside the distinct part or outside the facility;
(38) "Treatment," a medical aid provided for the purposes of palliating symptoms, improving functional level, or maintaining or restoring health; and
(39) "Unlicensed assistive personnel," a person who is not licensed as a nurse under SDCL chapter 36-9 but who is trained to assist a licensed nurse in the provision of nursing care to a resident or resident as delegated by the nurse and authorized by chapter 20:48:04.01.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13, 34-12-32.
44:80:01:02. Posting of License. The most current license issued by the department shall be posted on the premises of the facility in a place conspicuous to the public. Each facility address shall show a current license. The license certificate remains the property of the department.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-7.
Law Implemented: SDCL 34-12-7.
44:80:01:03. Name of hospice. Each facility shall be designated by a pertinent and distinctive name that shall be used in applying for a license. The name may not be changed without first notifying the department in writing. No facility may be given a name or advertise in a way that implies services rendered are in excess of the classification for which it is licensed or which would indicate an ownership other than actual.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-7.
Law Implemented: SDCL 34-12-7.
44:80:01:04. Bed capacity. The department shall establish the bed capacity of each facility pursuant to the physical plant and space provisions of this article. The resident census shall not exceed the bed capacity for which the facility is licensed. A request by the facility for an adjustment in bed capacity because of change of purpose or construction shall be approved by the department before any changes are made.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-7.
Law Implemented: SDCL 34-12-7.
44:80:01:05. Restrictions on acceptance of residents. A facility shall accept residents in accordance with the following restrictions:
(1) The facility shall ensure hospice services are provided to residents by a Medicare hospice agency certified by the Centers for Medicare and Medicaid Services;
(2) A resident accepted for care by a residential hospice shall be housed within the facility covered by the license;
(3) A licensed residential hospice may not accept or retain a resident who requires care in excess of the classification for which it is licensed;
(4) Personnel essential to maintaining adequate staff may not leave a licensed hospice during the persons tour of duty in the hospice to provide services to a person who is not a resident of the hospice with the exception of providing emergency care on premises contiguous to the hospice's property; and
(5) A licensed hospice facility may only admit and retain a resident certified by a physician as terminally ill.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-7, 34-12-13(5).
Law Implemented: SDCL 34-12-7, 34-12-13(5).
44:80:01:06. Joint occupancy. The use of a portion of a building for a purpose other than that covered by the license may be approved by the department only if it can be shown that joint occupancy is not detrimental to the welfare of the residents. The area shall be open to inspection by the department.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:80:01:07. Reports. Each facility shall fax, email, or mail to the department the pertinent data necessary to comply with the requirements of all applicable administrative rules and statutes.
Any incident or event where there is reasonable cause to suspect abuse or neglect of any patient by any person shall be reported within 24 hours of becoming informed of the alleged incident or event. The facility shall report each incident or event orally or in writing to the state's attorney of the county in which the facility is located, to the Department of Social Services, or to a law enforcement officer. The facility shall report each incident or event to the department within 24 hours, and conduct a subsequent internal investigation and provide a written report of the results to the department within five working days after the event.
Each facility shall report to the department within 48 hours of the event any death resulting from other than natural causes originating on facility property such as accidents or suicide. The facility shall conduct a subsequent internal investigation and provide a written report of the results to the department within five working days after the event.
Each facility shall report a missing patient to the department within 48 hours. The facility shall conduct a subsequent internal investigation and provide a written report of the results to the department within five working days after the event.
Each facility shall also report to the department as soon as possible any fire with damage or where injury or death occurs; any partial or complete evacuation of the facility resulting from natural disaster; or any loss of utilities, such as electricity, natural gas, telephone, emergency generator, fire alarm, sprinklers, and other critical equipment necessary for operation of the facility for more than 24 hours.
Each facility shall notify the department of any anticipated closure or discontinuation of service at least 30 days in advance of the effective date.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:01:08. Plans of correction. Within 10 days of the receipt of the statement of deficiencies, each facility shall submit to the department a written plan of correction for the citation of noncompliance with licensure requirements. The plan of correction shall be signed, dated, and on forms provided by the department. The department may reject the plan of correction if there is no evidence the plan will cause the hospice to attain or maintain compliance with SDCL chapter 34-12 and this article.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
44:80:01:09. Modifications. A modification to the staffing requirements provided in § 44:80:03:02 may be approved by the department for a licensed residential hospice which is physically combined and jointly operated. The health and safety of the resident in either facility shall may be jeopardized. A modification specified by this section shall be requested in writing by the residential hospice.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5) and (14).
Law Implemented: SDCL 34-12-13(5) and (14).
44:80:01:10. Scope of article. Nothing in article 44:80 limits or expands the rights of any healthcare worker to provide services within the scope of the professional's license, certification, or registration, as provided by South Dakota law.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
CHAPTER 44:80:02
PHYSICAL ENVIRONMENT
Section
44:80:02:01 Sanitation.
44:80:02:02 Pets.
44:80:02:03 Cleaning methods and facilities.
44:80:02:04 Chemicals used to sanitize or disinfect.
44:80:02:05 Housekeeping cleaning methods and equipment.
44:80:02:06 Food service.
44:80:02:07 Handwashing facilities.
44:80:02:08 Linen.
44:80:02:09 Infection control.
44:80:02:10 Water supply.
44:80:02:11 Ventilation.
44:80:02:12 Lighting.
44:80:02:13 Refuse and waste disposal.
44:80:02:14 Insect and rodent control.
44:80:02:15 Occupant protection.
44:80:02:16 Area requirements for currently licensed resident rooms.
44:80:02:17 Location.
44:80:02:18 Heating and cooling.
44:80:02:19 Other hazardous conditions.
44:80:02:01. Sanitation. The facility shall be designed, constructed, maintained, and operated to minimize the sources and transmission of infectious diseases to clients, personnel, visitors, and the community at large.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:80:02:02. Pets. No pet kept in or visiting a facility may negatively affect the well-being of a resident.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
Cross-Reference: Physically disabled, blind or deaf person's right to be accompanied by guide dog without extra charge, SDCL 20-13-23.2.
44:80:02:03. Cleaning methods and facilities. The facility shall have supplies, equipment, work areas, and complete written procedures for cleaning, sanitizing, or disinfecting all work areas, equipment, utensils, and medical devices used for resident' care. Common use equipment shall be disinfected after each use. Facilities shall have a separate space for clean and soiled linens. All parts of the hospice shall be kept clean, neat, and free of visible soil, litter, and rubbish.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(2).
Law Implemented: SDCL 34-12-13(2).
44:80:02:04. Chemicals used to sanitize or disinfect. The label of chemicals used to sanitize or disinfected shall indicate registration with the Environmental Protection Agency as effective, safe, and approved for their intended use.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(2).
Law Implemented: SDCL 34-12-13(2).
44:80:02:05. Housekeeping cleaning methods and equipment. The facility shall establish written housekeeping procedures for the cleaning of all areas in the facility and copies made available to all housekeeping personnel. All parts of the facility shall be kept clean, neat, and free of visible soil, litter, and rubbish. Equipment and supplies shall be provided for cleaning of all surfaces. Such equipment shall be maintained in a safe, sanitary condition. Hazardous cleaning solutions, chemicals, poisons, and substances shall be labeled, stored in a safe place, and kept in an enclosed section separate from other cleaning materials. Cleaning of areas designed for resident use shall be performed by dustless methods that minimize the spread of pathogenic organisms in the facility's atmosphere. Each vacuum used in hospice shall be equipped to provide effective discharge air filtration of particles larger than 0.3 microns. Cleaning shall include all environmental surfaces within the residential hospice that are subject to contamination from dust, direct splash, or pathogenic organisms except medical equipment, supplies, or devices that are the responsibility of other services or departments of the hospice.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(2).
Law Implemented: SDCL 34-12-13(2).
44:80:02:06. Food service. If an in-house food service is provided, the hospice shall meet the safety and sanitation procedures for food service in §§ 44:02:07:01, 44:02:07:02, and 44:02:07:04 to 44:02:07:95, inclusive, the Food Service Code. In addition, a mechanical dishwasher shall be provided. The hospice shall have the space, equipment, supplies, and mechanical systems for efficient, safe, and sanitary food preparation. If the hospice food service is contracted out, the contractor shall be a licensed food service establishment that is inspected by a local, state, or federal authority. The facility shall ensure that food is prepared and served in a manner that is safe and palatable. Hot food shall be held at or above 135 degrees Fahrenheit (57.2 degrees Centigrade) and served promptly after being removed from the temperature holding device. Cold foods shall be held at or below 41 degrees Fahrenheit (five degrees centigrade) and served promptly after being removed from the holding device.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3), (5) and (8).
Law Implemented: SDCL 34-12-13(3), (5) and (8).
Note: Article 44:02, Lodging and Food Service, Administrative Rules of South Dakota, contains the Food Service Code and may be obtained from Legislative Mail, 1320 East Sioux Avenue, Pierre, South Dakota 57501, telephone (605) 773-4935, for $4.14.
44:80:02:07. Handwashing facilities. Handwashing facilities consisting of hot and cold running water dispensed through a mixing faucet controlled with blade handles or other hands-free controls, a towel dispenser with single-service towels or a hand-drying device, and hand cleanser shall be located at dietary areas, utility rooms, staff stations, laundry, and all toilet rooms not directly connected to resident rooms. A handwashing facility shall be provided in each resident room. If existing faucets and controls are replaced or changed, they shall be replaced with mixing faucets controlled with blade handles or other hands-free controls.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (4).
Law Implemented: SDCL 34-12-13(1) and (4).
Cross-Reference: Plumbing fixtures, § 44:80:10:21.
44:80:02:08. Linen. The supply of bed linen and towels shall equal three times the licensed capacity. The facility shall have written procedures for the storage and handling of soiled and clean linens. The facility shall contract with a commercial laundry service or the laundry service of another licensed health care facility for all common use linens if laundry services are not provided on the premises. The facility shall process laundry following the laundry equipment and cleaning agent recommendations. A facility providing laundry services shall have adequate space and equipment for the safe and effective operation of the laundry service. Closed containers shall be used during transport and the arrangement of equipment and the handling of linens shall prevent soiled linens from contacting the processed clean linens. Air flow in the linen processing shall be from clean processing areas toward the soiled holding and sorting area. Clean linens shall be covered during transport to storage areas.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (4).
Law Implemented: SDCL 34-12-13(1) and (4).
44:80:02:09. Infection control. The infection prevention and control program shall utilize the concept of standard precautions. Bloodborne pathogen control shall be maintained according to the requirements contained in 29 C.F.R. 1910.1030, July 1, 2006. The facility shall designate an employee to be responsible for the implementation of the infection control program including surveillance and reporting activities. There shall be written procedures that govern the use of aseptic techniques and procedures in all areas of the facility. Each hospice shall develop policies and procedures for the handling and storage of potentially hazardous substances. The hospice shall provide orientation and continuing education to all personnel on the on the cause, effect, transmission, prevention, and elimination of infections. Each hospice shall develop a written policy for evaluation and reporting of any employee with a reportable infectious disease.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), 34-22-9(8).
Law Implemented: SDCL 34-12-13(1).
44:80:02:10. Water supply. The facility's water supply shall be obtained from a public water system or, in its absence, from a supply approved by the Department of Agriculture and Natural Resources. Private water supplies shall have a water sample bacteriologically tested at least monthly. The volume of water shall be sufficient for the needs of the hospice, including fire fighting requirements. The hot water system shall be capable of supplying the work and resident areas with water at the required temperatures. Maximum hot water temperatures at plumbing fixtures used by residents may not exceed 125 degrees Fahrenheit (52 degrees centigrade). The minimum temperature of hot water for resident use shall be at least 100 degrees Fahrenheit (38 degrees centigrade).
Each water supply system shall maintain one part per million free residual chlorine at remote point-of-use fixtures in the facility or may use another bacteriological control method such as increasing water temperature range from 122 degrees to 125 degrees Fahrenheit (50-52 degrees centigrade), that has been demonstrated to be equivalent in control of Legionella. The facility shall document water temperatures to verify the hot water temperature is being maintained within the acceptable range. The chlorine testing shall be done daily using photocell and light source DPD (N, N, Diethyl-p-phenylenediamine) test kits, and the test results logged. If testing demonstrates that consistent chlorine levels are maintained, the frequency of testing may be reduced to a level necessary to demonstrate compliance.
Source: 42 SDR 51, effective October 13, 2015; SL 2021, ch 1, §§ 8, 19, effective April 19, 2021.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
Cross-References: Standards adopted for plumbing -- Conformity to National Code, SDCL 36-25-15; Scope and objectives of plumbing standards and rules, SDCL 36-25-15.1.
44:80:02:11. Ventilation. Electrically powered exhaust ventilation shall be provided in all soiled areas, wet areas, toilet rooms, and storage rooms. Clean storage rooms may also be ventilated by supplying and returning air from the building's air-handling system.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:80:02:12. Lighting. Spaces occupied by people, machinery, and equipment within buildings and their approaches and parking lots shall have artificial lighting at a level for general safety. Each resident bedroom shall have general lighting and night lighting. Each required exit shall be equipped with continuous emergency lighting.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:80:02:13. Refuse and waste disposal. Garbage, refuse, and waste shall be handled and disposed of in a safe and sanitary manner. Final disposal of all refuse and waste shall comply with articles 74:27 and 74:28. Putrescible garbage shall be removed at a frequency to contain or prevent odors, insects, and vermin.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:80:02:14. Insect and rodent control. The facility shall take safe and effective measures to protect against the entrance into the facility and the breeding or presence on the premises of rodents, flies, roaches, and other vermin.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:80:02:15. Occupant protection. Each facility shall be constructed, arranged, equipped, maintained, and operated to avoid injury or danger to the occupants. The extent and complexity of occupant protection precautions is determined by the services offered and the physical needs of the residents admitted to the facility. The hospice shall take at least the following precautions:
(1) Develop and implement a written and scheduled preventive maintenance program;
(2) Provide securely constructed and conveniently located grab bars in all toilet rooms and bathing areas used by residents;
(3) Provide a call system for each resident bed and in all toilet rooms and bathing facilities routinely used by residents. The call system shall be capable of being easily activated by the resident and shall register at a staff station, work area, or to a advice carried by care staff. A wireless call system may be used;
(4) Ground fault circuit interrupters shall be provided in wet areas and for outlets within six feet of sinks;
(5) A portable space heater, portable halogen lamp, household-type electric blanket, or household-type heating pad may not be used in a facility;
(6) Any light fixture located over a resident bed, in any bathing or treatment area, in a clean supply storage room, in any laundry clean linen storage area, or in any medication set-up area shall be equipped with a lens cover or a shatterproof lamp;
(7) Any clothes dryer shall have a galvanized metal vent pipe for exhaust; and
(8) The storage and transfilling of oxygen cylinders or containers shall meet the requirements of the NFPA 99 Standard for Health Care Occupancies, 2012 Edition.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
Reference: NFPA 99 Health Care Facilities, 2012 edition, National Fire Protection Association. Copies may be obtained from the National Fire Protection Association, P.O. Box 9101, Quincy, MA 02269-9101. Phone: 1-800-344-3555. Cost: $66.50.
44:80:02:16. Area requirements for currently licensed resident rooms. Each currently licensed resident room shall have at least 120 square feet (8.83 square meters) of floor space per bed, exclusive of closets and wardrobes. Each resident shall have for individual use in the assigned room a bed, a bedside stand, and a chair appropriate to the needs and comfort of the resident. Each hospice shall have 10 square feet (0.93 square meters) of general storage for each bed. A total of 40 square feet (3.72 square meters) of dining and lounge area for each resident shall be provided in a facility. Each hospice shall be constructed, equipped, and operated to maintain the comfort, privacy and dignity of all residents.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
Cross-Reference: Area requirements for new construction or renovations, § 44:80:10:08(2).
44:80:02:17. Location. The location of a facility shall promote the health, treatment, comfort, safety, and well-being of persons accepted and retained for care. Facilities shall be served by good, passable roads. Easy accessibility for employees, visitors, and fire-fighting services shall be maintained.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).
44:80:02:18. Heating and cooling. The temperature in any occupied space in the facility shall be maintained between 68 and 80 degrees Fahrenheit during waking hours and not lower than 64 degrees Fahrenheit during sleeping hours. Individual resident’s space may be maintained outside the required range when desired by the occupant.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
44:80:02:19. Other hazardous conditions. A facility may be directed to remove or correct other hazardous conditions not covered in this chapter if the department considers the conditions to have a potential to cause injury or illness to the residents or staff.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).
CHAPTER 44:80:03
FIRE PROTECTION
Section
44:80:03:01 Fire safety code requirements.
44:80:03:02 General fire safety.
44:80:03:03 Staffing exception.
44:80:03:04 Fire extinguisher equipment.
44:80:03:05 Fire alarm systems.
44:80:03:06 Detached structures.
44:80:03:01. Fire safety code requirements. Each hospice shall meet applicable fire safety standards in NFPA 101 Life Safety Code, 2000 edition.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
Reference: NFPA 101 Life Safety Code, 2000 edition, National Fire Protection Association. Copies may be obtained from the National Fire Protection Association, P.O. Box 9101, Quincy, Massachusetts 02269-9101. Phone: 1-800-344-3555. Cost: $ 93.00.
44:80:03:02. General fire safety. Each facility shall be constructed, arranged, equipped, maintained, and operated to avoid undue danger to the lives and safety of its occupants from fire, smoke, fumes, or resulting panic during the period of time reasonably necessary for escape from the structure in case of fire or other emergency. The fire alarm system shall be sounded each month. At least two staff members shall be on duty at all times unless approved for a staffing exception. In a multilevel hospice, at least one staff member shall be on duty on each floor containing occupied beds.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
Cross-Reference: Fire safety code requirements, § 44:80:03:01.
44:80:03:03. Staffing exception. A staffing exception may be approved for residential hospice facilities if the following are met:
(1) The bed capacity is six beds or less;
(2) The building is equipped with an automatic sprinkler system as defined in § 9.7, Automatic Sprinklers and Other Extinguishing Equipment, of NFPA 101 Life Safety Code, 2012 edition.
(3) The building is equipped with an automatic fire alarm dialer as defined in § 9.6.4 Emergency Forces Notification, of NFPA 101 Life Safety Code, 2012 edition to summon the local fire department; and
(4) The building is equipped with a staff call system.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
References: NFPA 101 Life Safety Code, 2012 edition, National Fire Protection Association. Copies may be obtained from the National Fire Protection Association, P.O. Box 9101, Quincy, MA 02269-9101. Phone: 1-800-344-3555. Cost: $93.00.
44:80:03:04. Fire extinguisher equipment. Fire extinguisher equipment shall be installed and maintained by the following minimum standards:
(1) Portable fire extinguishers shall have a minimum rating of 2-A:10-B:C;
(2) Fire extinguisher equipment shall be inspected monthly and maintained yearly; and
(3) Approved fire extinguisher cabinets shall be provided throughout the building with one cabinet for each 3,000 square feet (278.7 square meters) of floor space or fraction thereof. The fire resistance rating of corridor walls shall be maintained at recessed fire extinguisher cabinets. The glazing in doors of fire extinguisher cabinets shall be safety glazing material. Fire extinguisher cabinets shall be identified with a sign mounted perpendicular to the wall surface above the cabinet or with sign mounted on the sides of cabinet that are visible from the corridor.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:03:05. Fire alarm systems. A manually operated, electrically supervised fire alarm system shall be installed in each facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:03:06. Detached structures. A detached structure or auxiliary building used for combustible storage or vehicle parking built adjacent to, but not directly attached to, a hospice shall either be separated from the facility by a minimum distance of 20 feet, equipped with an automatic sprinkler protection, or provided with two-hour fire rated separation.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
CHAPTER 44:80:04
MANAGEMENT AND ADMINISTRATION
Section
44:80:04:01 Governing body.
44:80:04:02 Administrator.
44:80:04:03 Personnel.
44:80:04:04 Personnel training.
44:80:04:05 Employee health program.
44:80:04:06 Tuberculin screening requirements.
44:80:04:07 Admissions of residents.
44:80:04:08 Care policies.
44:80:04:09 Discharge planning.
44:80:04:10 Quality assessment.
44:80:04:01. Governing body. Each facility operated by limited liability partnership, a corporation, or political subdivision shall have an organized governing body legally responsible for the overall conduct of the facility. If the facility is operated by an individual or partnership, the individual or partnership shall carry out the functions in this chapter pertaining to the governing body. The governing body shall establish and maintain administration policies, procedures, or bylaws governing the operation of the facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
44:80:04:02. Administrator. The governing body shall designate a qualified administrator to represent the owner or governing body and to be responsible for the daily overall management of the facility. The administrator shall designate a qualified person to represent the administrator during the administrator's absence. The governing body shall notify the department in writing of any change of administrator.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
44:80:04:03. Personnel. The facility shall have a sufficient number of qualified personnel to provide effective and safe care. Staff members on duty shall be awake at all times. Any supervisor shall be 18 years of age or older. Written job descriptions and personnel policies and procedures shall be made available to personnel. The hospice may not knowingly employ any person with a conviction for abusing another person. The hospice shall establish and follow policies regarding special duty or staff members on contract.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
44:80:04:04. Personnel training. The facility shall have a formal orientation program and an ongoing education program for all personnel. Ongoing education programs shall cover the required subjects annually. These programs shall include the following subjects:
(1) Fire prevention and response. The hospice shall conduct fire drills quarterly for each shift to train all staff. Silent or code announcement drills may be conducted;
(2) Emergency procedures and preparedness;
(3) Infection control and prevention;
(4) Accident prevention and safety procedures;
(5) Proper use of restraints;
(6) Resident rights;
(7) Hospice philosophy and death & dying;
(8) Confidentiality of resident information;
(9) Incidents and diseases subject to mandatory reporting and the hospice's reporting mechanisms;
(10) Care of residents with special and unique needs; and
(11) Dining assistance, nutritional risks, and hydration needs of residents.
Any personnel whom the hospice determines will have no contact with residents are exempt from training required by subdivisions (5), (7), (10), and (11) of this section.
Additional personnel education shall be based on hospice identified needs.
Current professional and technical reference books and periodicals shall be made available for personnel.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
44:80:04:05. Employee health program. The facility shall have an employee health program for the protection of the residents. All personnel shall be evaluated by a licensed health professional for freedom from reportable communicable disease which poses a threat to others before assignment to duties or within 14 days after employment including an assessment of previous vaccinations and tuberculin skin tests. The hospice may not allow anyone with a communicable disease, during the period of communicability, to work in a capacity that would allow spread of the disease. Any personnel absent from duty because of a reportable communicable disease which may endanger the health of residents and fellow employees may not return to duty until the person is determined by a physician, physician's designee, physician assistant, nurse practitioner, or clinical nurse specialist to no longer have the disease in a communicable stage.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (5), and (14).
Law Implemented: SDCL 34-12-13(1), (5), and (14).
Cross-Reference: Reportable diseases and conditions, ch 44:20:01.
44:80:04:06. Tuberculin screening requirements. Each facility shall develop criteria to screen healthcare workers for Mycobacterium tuberculosis (TB) based on the guidelines issued by Centers for Disease Control and Prevention. Each facility shall establish policies and procedures for conducting Mycobacterium tuberculosis risk assessment that include the key components of responsibility, surveillance, containment, and education. The frequency of repeat screening shall depend upon annual risk assessments conducted by the facility.
Tuberculin screening requirements for healthcare workers are as follows:
(1) Each new healthcare worker shall receive the two-step method of tuberculin skin test or a TB blood assay test to establish a baseline within 14 days of employment. Any two documented tuberculin skin tests completed within a 12 month period prior to the date of employment can be considered a two-step or one blood assay TB test completed within a 12 month period prior to the date of employment can be considered an adequate baseline test. Skin testing or TB blood assay tests are not necessary if a new employee transfers from one licensed healthcare facility to another licensed healthcare facility within the state if the facility received documentation of the last skin testing completed within the prior 12 months. Skin testing or TB blood assay tests are not necessary if documentation is provided of a previous positive reaction to either test. Any new healthcare worker who has a newly recognized positive reaction to the skin test or TB blood assay test shall have a medical evaluation and a chest X-ray to determine the presence or absence of the active disease;
(2) A new healthcare worker who provides documentation of a positive reaction to the tuberculin skin test or TB blood assay test shall have a medical evaluation and chest X-ray to determine the presence or absence of the active disease; and
(3) Each healthcare worker with a history of a positive reaction to the tuberculin skin test or blood assay shall be evaluated annually by a physician, physician assistant, nurse practitioner, clinical nurse specialist, or a nurse and a record maintained of the presence or absence of symptoms of Mycobacterium tuberculosis. If this evaluation results in suspicion of active tuberculosis, the person shall be referred for further medical evaluation to confirm the presence or absence of tuberculosis.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (5), and (14), 34-22-9.
Law Implemented: SDCL 34-12-13(1), (5), and (14).
Reference: Reference: Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Facilities, 2005. "Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report," December 30, 2005 (RR17).
44:80:04:07. Admissions of residents. The governing body of the facility shall establish and maintain policies, with written evidence to assure the residents admitted to and retained in the hospice are within the licensure classification of the facility. Only residents that can receive hospice care safely and effectively may reside in the facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
44:80:04:08. Care policies. All hospice care and services provided by facility staff shall be under the direction of the Medicare certified hospice agency. Each facility shall establish and maintain policies, procedures, and practices that follow accepted standards of professional practice to govern care, and related medical or other services necessary to meet the residents’ needs. Each facility shall establish and maintain policies and procedures for the management of respite care residents if the facility offers those services.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).
44:80:04:09. Discharge planning. Each facility shall have policies and procedures for discharge planning that is coordinated with the Medicare certified hospice agency.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5) and (14).
Law Implemented: SDCL 34-12-13(5) and (14).
44:80:04:10. Quality assessment. Each facility shall provide for on-going evaluation of the quality of services provided to residents and families.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5) and (14).
Law Implemented: SDCL 34-12-13(5) and (14).
CHAPTER 44:80:05
CARE AND SERVICES
Section
44:80:05:01 Admissions.
44:80:05:02 Organized service.
44:80:05:03 Policies and procedures.
44:80:05:04 Custodial care services.
44:80:05:05 Staffing for hospice facilities.
44:80:05:01. Admissions. Each resident admitted to a facility shall be terminally ill and shall be a patient of a Medicare certified hospice agency.
The facility or the Medicare certified hospice agency may not delegate a task when the delegation is prohibited under state law or by the facility's own policies.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(6).
Law Implemented: SDCL 34-12-13(6).
44:80:05:02. Organized service. The facility shall provide services with a written organizational plan that delineates its custodial care.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13(7).
44:80:05:03. Policies and procedures. The facility shall establish and maintain policies and procedures that provide the staff with methods of meeting its administrative and technical responsibilities in providing custodial care to residents. The policies shall include at least the following:
(1) The noting of care and services provided by facility staff may be part of the Medicare certified hospice agency records;
(2) Providing custodial care for residents under the direction and as delegated by the Medicare certified hospice agency;
(3) Administration and control of medications;
(4) Documentation by personnel;
(5) Infection control; and
(6) Resident safety.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13(7).
44:80:05:04. Custodial care services. Each residential hospice shall offer custodial care and services to terminally ill individuals and supporting services that are arranged with and directed by a Medicare certified hospice agency. An unlicensed employee of a facility may not accept any delegated skilled tasks from any individual pursuant to SDCL chapter 36-9.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13(7).
44:80:05:05. Staffing for hospice facilities. All residential hospice facilities shall maintain a sufficient number of personnel, directly or by contract, to provide custodial care and services offered to all residents. Written staffing patterns shall be developed including instructions for contacting support service personnel. All hospice staff shall have been specifically trained to provide care for the terminally ill.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13(7).
CHAPTER 44:80:06
DIETETIC SERVICES
Section
44:80:06:01 Dietetic services.
44:80:06:02 Food substitutions.
44:80:06:03 Written dietetic policies.
44:80:06:04 Preparation of food.
44:80:06:05 Dietetic services.
44:80:06:06 Nutritional assessments.
44:80:06:07 Required dietary in-service training.
44:80:06:08 Nutrition and hydration assistance program.
44:80:06:01. Dietetic services. The facility shall have an organized dietetic service that meets the nutritional needs of residents and ensures that food is stored, prepared, distributed, and served in a manner that is safe, wholesome, and sanitary in accordance with the provisions of § 44:80:02:06.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).
44:80:06:02. Food substitutions. The hospice shall offer reasonable substitutions of equal nutritional value to patients who refuse or are unable to eat the food served.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).
44:80:06:03. Written dietetic policies. There shall be written policies and procedures that govern all dietetic activities. Policies shall include food handling procedures, length of duration for leftovers, and opened packages of commercially prepared food in accordance with chapter 44:02:07, the Food Service Code. The policies and procedures shall be reviewed yearly and revised as necessary.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5) and (8).
Law Implemented: SDCL 34-12-13(5) and (8).
Reference: Article 44:02, Lodging and Food Service, Administrative Rules of South Dakota, contains the Food Service Code and may be obtained from Legislative Mail, 1320 East Sioux Avenue, Pierre, South Dakota 57501, telephone (605) 773-4935, for $3.30 and Food Code, U.S. Public Health Service, FDA, 1999, and may be obtained from U.S. Department of Commerce Technology Administration National Technical Information Service, 5285 Port Royal Road, Springfield, Virginia 22161, 1-800-553-6847 for $69.00.
44:80:06:04. Preparation of food. Food shall be wholesome and prepared by methods that conserve nutritive value, flavor, and appearance and shall be attractively served at the temperature applicable to the particular food in a form to meet the individual resident's needs.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).
44:80:06:05. Dietetic services. A person who is responsible to the administrator shall direct the dietetic services. At least one person shall successfully complete and possess a current certificate from a ServSafe Food Protection Program offered by various retailers or the Certified Food Protection Professional's Sanitation Course offered by the Dietary Managers Association, or successfully completed equivalent training as determined by the department. Individuals seeking ServSafe recertification are only required to take the national examination. The person shall monitor the dietetic service to ensure that the nutritional and therapeutic dietary needs for each resident are met. A dietitian, nutritionist, or registered nurse shall approve each menu, assess the nutritional status of each resident with problems identified in the assessment, and review and revise dietetic policies and procedures during scheduled visits.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).
44:80:06:06. Nutritional assessments. A dietitian, nutritionist, or registered nurse shall ensure a nutritional assessment is completed on each new resident upon admission; any resident having a significant change in diet, eating ability, or nutritional status.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).
44:80:06:07. Required dietary in-service training. A dietitian, nutritionist, or registered nurse shall provide ongoing in-service training for all dietary and food-handling employees. Topics shall include: food safety, handwashing, food handling and preparation techniques, food-borne illnesses, serving and distribution procedures, leftover food handling policies, time and temperature controls for food preparation and service, nutrition and hydration, and sanitation requirements.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).
44:80:06:08. Nutrition and hydration assistance program. A facility may develop a program to train nutrition and hydration assistants.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).
CHAPTER 44:80:07
MEDICATION CONTROL
Section
44:80:07:01 Policies and procedures.
44:80:07:02 Orders for medication required.
44:80:07:03 Storage and labeling of medications and drugs.
44:80:07:04 Control and accountability of medications and drugs.
44:80:07:05 Documentation of drug disposal.
44:80:07:06 Medication administration.
44:80:07:07 Medication records.
44:80:07:01. Policies and procedures. Each facility shall establish and practice methods and procedures for medication control that include the following:
(1) A requirement that each resident's Medicare certified hospice agency provide instructions for the administration of medication, the recording of medication administration by facility staff, medications or drugs kept on the person or in the room of the resident; and release of medications;
(2) Provisions for proper storage of prescribed medications so that the medications are inaccessible to residents or visitors with requirements for:
(a) Separate storage of poisons, topical medications, and oral medications; and
(b) A medication prescribed for one resident not to be administered to any other resident;
(3) The facility shall have policies and procedures for the self-administration of medications. Self-administration to be accomplished with the supervision of a designated employee and approval of the resident's Medicare certified hospice agency;
(4) The return of medicines to the residents Medicare certified hospice agency that are discontinued because of the discharge or death of the resident, because the drug is outdated, or because the prescription is no longer appropriate to the care of the resident.
Methods and written policies and procedures shall be established to include the manner of issuance, proper storage, control, accountability, and administration of medications or drugs in accordance with pharmaceutical and nursing practices as well as professional standards.
The facility shall use records to ensure the receipt and disposition for all controlled drugs in sufficient detail to enable an accurate reconciliation. The facility, with the assistance of the Medicare certified hospice agency, shall ensure the drug records are in order and that an account of all controlled drugs is maintained and periodically reconciled. The facility shall have policies and procedure for the periodic reconciliation of all controlled substances. The policies and procedure shall minimize the time between the actual loss or diversion and the time of detection and follow-up to determine the extent of the loss.
If a loss or diversion of controlled substances is identified the facility shall notify the Medicare certified hospice agency to evaluate the residents potentially affected. If the systems have not been effective in preventing the loss or diversion of controlled substances, the facility shall review and revise related controls and procedures as necessary.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.
44:80:07:02. Orders for medication required. All orders for medications or drugs administered to residents shall be the responsibility of resident's Medicare certified hospice agency.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13(9).
44:80:07:03. Storage and labeling of medications and drugs. All drugs or medications shall be stored in a well illuminated, locked storage area that is well ventilated, maintained at a temperature appropriate for drug storage, and inaccessible to residents or visitors at all times. Medications suitable for storage at room temperature shall be maintained between 59 and 86 degrees Fahrenheit (15 and 30 degrees centigrade). Medications that require refrigeration shall be maintained between 36 and 46 degrees Fahrenheit (two and eight degrees centigrade). Poisons and medications prescribed for external use shall be stored separately from internal medications, locked and made inaccessible to residents.
The medications or drugs of each resident for whom medications are administered shall be stored in the containers in which they were originally received and may not be transferred to another container unless otherwise allowed by this section. A nurse may move mediations into a medication reminder box or similar device. Special modification of this requirement may be made if single dose packaging is used. The facility that administers and stores medications shall ensure each prescription drug container, including manufacturer's complimentary samples, shall be labeled with the resident’s name, physician, physician assistant, or nurse practitioner's name, drug name and strength, directions for use, and prescription date.
Containers with contents that will not be used within 30 days of issue or with contents that expire in less than 30 days of issue shall bear an expiration date. If a single dose system is used, the drug name and strength, expiration date, and a control number shall be on the unit dose packet.
A facility may not procure or stock, including in bulk form any legend or nonlegend medications.
Any container with a worn, illegible, or missing label shall be destroyed. Licensed pharmacists are responsible for the labeling, relabeling, or altering of labels on medication containers.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13(9).
44:80:07:04. Control and accountability of medications and drugs. Medications brought from home may be used once approved by the Medicare certified hospice agency and ordered by the residents attending physician and, if prior to administration, is identified as the prescribed drug. Medications prescribed for one resident may not be administered to another. Residents may not keep medications on their person or in their room without approval from the resident's Medicare certified hospice agency allowing self-administration. Written authorization by the resident's physician shall be secured for the release of any medication to a resident upon discharge, transfer, or temporary leave from the facility. The release of medication shall be documented in the resident's medical or care record provided by the Medicare certified hospice agency, indicating quantity, drug name, and strength. The facility shall maintain records provided by the Medicare certified hospice agency that account for all medications and drugs from their receipt through administration or destruction.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13(9).
44:80:07:05. Documentation of drug disposal. Legend drugs not controlled under SDCL chapter 34-20B shall be destroyed or disposed of by the Medicare certified hospice agency nurse and another witness. Destruction or disposal of medications controlled under SDCL chapter 34-20B shall be witnessed by two persons, both of whom are a nurse or pharmacist, as designated by facility policy. Methods of destruction or disposal may include:
(1) Disposal by using a professional waste hauler to take the medications to a permitted medical waste facility or by facility disposal at a permitted municipal solid waste landfill. Prior to disposal all medications shall be removed from original containers and made unpalatable by the addition of adulterants and alteration of solid dosage forms by dissolving or combination into a solid mass;
(2) Return to the dispensing pharmacy for destruction or dispose according to federal and state regulations;
(3) Return to an authorized reverse distributor company licensed by the South Dakota Board of Pharmacy; or
(4) Release to resident upon discharge after authorization by the resident's prescribing practitioner.
Medications controlled under SDCL chapter 34-20B shall not be returned to the dispensing pharmacy or to an authorized reverse distributor company. Documentation of destruction or disposal of medications shall be included in the resident's record. The documentation shall include the method of disposition; the medication name, strength, prescription number, quantity, and date of disposition; and the name of any person who witnessed the destruction or disposal.
Medications, excluding those controlled under SDCL chapter 34-20B, contained in unit dose packaging meeting the requirements of § 20:51:13:02.01 may be returned to the dispensing pharmacy for credit and re-dispensing.
Any medication held for disposal shall be physically separated from the medications being used in the facility, locked with access limited, in an area with a system to reconcile, audit, or monitor them to prevent diversion.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13(9).
44:80:07:06. Medication administration. Each medication administered by facility staff shall be recorded in the resident's medical record and signed by the person responsible. Medication errors and drug reactions shall be reported to the resident's Medicare certified hospice provider and an entry made in the resident’s medical record. Abbreviations and chemical symbols may be carried out only if the facility has a standard list of abbreviations and symbols provided by the Medicare certified hospice agency. All medications shall be administered to residents by personnel acting under delegation of a licensed nurse, or individual licensed to administer medications.
A person may not administer medications that have been prepared by another person, other than a pharmacist.
Medication administration shall comply with §§ 44:80:08:02 to 44:80:08:05, inclusive, and with the requirements for training in §§ 20:48:04.01:14 and 20:48:04.01:15 and for supervision in § 20:48:04.01:02. A nurse shall provide an orientation to the unlicensed assistive personnel who will administer medications. The orientation shall be specific to the facility and relevant to the residents receiving administered medications. A registered nurse shall provide medication administration training annually pursuant to § 20:48:04:01 to any unlicensed assistive personnel employed by the facility who will be administering medications.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13(9).
44:80:07:07. Medication records. Medication administration records provided by the Medicare certified hospice agency shall be used and regularly checked by the Medicare certified hospice agency.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13(9).
CHAPTER 44:80:08
RESIDENT RECORD SERVICES
Section
44:80:08:01 Medical or care record.
44:80:08:02 Written policies and confidentiality of records.
44:80:08:03 Record content.
44:80:08:04 Retention and storage of medical or care records.
44:80:08:05 Resident index.
44:80:08:06 Disposition of records on closure of facility or transfer of ownership.
44:80:08:01. Medical or care record. Medical or care records are considered the property of the Medicare certified hospice agency and are the responsibility of that agency. The medical or care record shall show the current condition of the resident and necessary information for the facility to provide custodial care and support services to the terminally ill resident.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).
44:80:08:02. Written policies and confidentiality of records. There shall be written policies and procedures to govern the activities of the medical or care record service. They shall include policies and procedures pertaining to the confidentiality and safeguarding of medical records and the entries to be made by various authorized personnel.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).
44:80:08:03. Record content. Each medical or care record provided by the Medicare certified hospice agency shall include necessary information for the facility to provide custodial care and support services to the resident from the time of admission until discharge.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).
44:80:08:04. Retention and storage of medical or care records. The Medicare certified hospice agency shall retain medical or care records once the resident is discharged. A facility shall provide for filing, safe storage, and easy accessibility for active medical or care records provided by the Medicare certified hospice agency during the residents stay. Medical or care records shall be protected against access by unauthorized individuals.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).
Cross-Reference: Disposition of medical or care records on closure of facility or transfer of ownership, § 44:80:08:06.
44:80:08:05. Resident index. The facility shall prepare and maintain a resident index or abstract that include:
(1) Resident name;
(2) Date of birth;
(3) Summary of care dates; and
(4) Medicare certified hospice agency providing hospice services.
The facility shall destroy or turn over to the Medicare certified hospice agency any resident information in a way that maintains confidentiality.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).
44:80:08:06. Disposition of records on closure of facility or transfer of ownership. If a facility ceases operation, the facility shall provide for safe storage and prompt retrieval of any resident indexes specified in § 44:80:08:05. The facility may arrange storage of these records with another health care facility of the same licensure classification or arrange storage of remaining records with a third party vendor who undertakes such a storage activity. At least 30 days before closure, the facility shall notify the department in writing indicating the provisions for the safe preservation of records and their location and publish in a local newspaper the location and disposition arrangements of the records.
If ownership of the facility is transferred, the new owner shall maintain the records as if there was not a change in ownership.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).
CHAPTER 44:80:09
RESIDENTS' AND FAMILIES RIGHTS
Section
44:80:09:01 Residents' rights policies.
44:80:09:02 Facility to inform resident of rights.
44:80:09:03 Facility to provide information on available services.
44:80:09:04 Notification when resident's condition changes.
44:80:09:05 Notification of a change in available services.
44:80:09:06 Choice in planning care.
44:80:09:07 Privacy and confidentiality.
44:80:09:08 Quality of life.
44:80:09:09 Grievances.
44:80:09:10 Availability of survey results.
44:80:09:11 Admission, transfer, and discharge policies.
44:80:09:01. Residents' rights policies. Each facility shall establish policies consistent with the provisions of this chapter to protect and promote the rights of each resident.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:09:02. Facility to inform resident of rights. Prior to or at the time of admission, a facility shall inform the resident, both orally and in writing, of the resident's rights and of the rules governing the resident's conduct and responsibilities while in the facility. The resident shall acknowledge in writing that the resident received the information. During the resident's stay the facility shall notify the resident, both orally and in writing, of any changes to the original information. A resident has the right to receive visitors. A visitor may not cause a disruption to the care and services residents receive or infringement on other residents' rights or place an undue burden on the facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:09:03. Facility to provide information on available services. A facility shall provide the following information in writing to each resident:
(1) A list of services available in the facility and the charges for such services. The facility shall specify which items and services are included in the services for which the resident may not be charged, those other items and services that the facility offers and for which the resident may be charged, and the amount of any such charges;
(2) A description of how a resident may protect personal funds;
(3) A list of names, addresses, and telephone numbers of client advocates;
(4) A description of how to file a complaint with the department concerning abuse, neglect, and misappropriation of resident property;
(5) A description of readmission rights of the resident; and
(6) A description explaining the responsibilities of the resident and family members regarding self-administered medication.
A signed and dated admission agreement between the resident or the resident's legal representative and the facility shall include subdivisions (1) to (6), inclusive, of this section. The resident or resident's legal representative and the facility shall complete the admission agreement before or at the time of admission and before the resident has made a commitment for payment for proposed or actual care.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:09:04. Notification when resident's condition changes. A facility shall immediately inform the resident, consult with the resident's Medicare certified hospice agency and, if known, notify the resident's legal representative or interested family member when any of the following occurs:
(1) An accident involving the resident that results in injury or has the potential for requiring intervention by a physician;
(2) A significant change in the resident's physical, mental, or psychosocial status; or
(3) A decision to transfer or discharge the resident from the facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:09:05. Notification of change in available services. A facility shall promptly notify the resident and, if known, the resident's legal representative, as specified in SDCL 34-12C-3, or interested family member if there has been a change in available services.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:09:06. Choice in planning care. A resident may choose a Medicare certified hospice agency, be fully informed in advance about care and treatment provided by the facility and of any changes in that care or treatment that may affect the resident's well-being, and, unless adjudged incompetent or otherwise found to be incapacitated under the laws of the state, participate in planning care and treatment or changes in care or treatment.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
Cross-References: Right to choose own physician unimpaired by public health programs -- Misdemeanor, SDCL 34-1-20.
Rights of authorized person as incapacitated person, SDCL 34-12C-6.
Liability of health care provider -- Liability of authorized decision maker, SDCL 34-12C-7.
44:80:09:07. Privacy and confidentiality. A facility shall provide for privacy and confidentiality for the resident, including the resident's accommodations, medical treatment, written and telephone communications, personal care, visits, and meetings of family and resident groups. A facility shall permit residents to perform the following:
(1) To send and receive unopened mail;
(2) To access and use a telephone without being overheard;
(3) To visit a spouse or, if both are residents of the same facility, to share a room with the spouse, within the capacity of the facility, upon the consent of both spouses;
(4) Except in an emergency, to have room doors closed and to require knocking before entering the resident's room;
(5) To have only authorized staff present during treatment or activities of personal hygiene;
(6) To retire and rise according to the resident's wishes, as long as the resident does not disturb other residents;
(7) To meet, associate, and communicate with any person of the resident's choice in a private place within the facility;
(8) To participate in social, religious, and community activities that do not interfere with the rights of other residents in the facility; and
(9) To approve or refuse the release of personal and medical records to any individual outside the facility, except if the resident is transferred to another health care facility or if the release of the record is required by law. With the resident's permission, a facility shall allow the state ombudsman or a representative of the ombudsman access to the resident's medical records.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
Cross-Reference: Written policies and confidentiality of records, § 44:80:08:03.
44:80:09:08. Quality of life. A facility shall provide care and an environment that contributes to the resident's quality of life, including:
(1) A safe, clean, comfortable, and homelike environment;
(2) Maintenance or enhancement of the resident's ability to preserve individuality, exercise self-determination, and control everyday physical needs;
(3) Freedom from physical or chemical restraints imposed for purposes of discipline or convenience;
(4) Freedom from verbal, sexual, physical, and mental abuse and from involuntary seclusion, neglect, or exploitation imposed by anyone, and theft of personal property;
(5) Retention and use of personal possessions, including furnishings and clothing, as space permits, unless to do so would infringe upon the rights or health and safety of other residents; and
(6) Support and coordination to assure pain is recognized and addressed appropriately.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
Cross-Reference: Care policies § 44:80:04:05.
44:80:09:09. Grievances. A resident may voice grievances without discrimination or reprisal. A facility shall adopt a grievance process and make the process known to each resident and to the resident's immediate family. The grievance process shall include the facility's efforts to resolve the grievance and documentation of:
(1) The grievance;
(2) The names of the persons involved;
(3) The disposition of the matter; and
(4) The date of disposition.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:09:10. Availability of survey results. Survey results, along with the corresponding Plan of Correction shall be provided to residents and individuals upon request.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
44:80:09:11. Admission, transfer, and discharge policies. A facility shall establish and maintain policies and practices for admission, discharge, and transfer of residents. The facility shall notify each resident at or before the time of admission of these policies and procedures. The policies and practices shall include the following provisions:
(1) The resident may remain in the facility and may not be transferred or discharged unless the resident's needs and welfare cannot be met by the facility, the resident's health has improved sufficiently so the resident no longer needs the services provided by the hospice agency or facility, the safety or health of persons in the facility is endangered by the resident, the resident has failed to pay for allowable billed services as agreed to, or the facility ceases to operate;
(2) The facility shall notify the resident and a family member or client advocate in writing before the transfer or discharge unless a change in the resident's health requires immediate transfer or discharge. The written notice shall specify the reason for and effective date of the transfer or discharge and the location to which the resident will be transferred or discharged;
(3) The conditions under which the resident may request or refuse transfer within the facility; and
(4) A description of how the resident may appeal a decision by the facility to transfer or discharge the resident.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13(14).
CHAPTER 44:80:10
CONSTRUCTION STANDARDS
Section
44:80:10:01 Application of chapter.
44:80:10:02 Administrative space.
44:80:10:03 Storage rooms.
44:80:10:04 Resident dining and lounge area.
44:80:10:05 Resident rooms.
44:80:10:06 Family room.
44:80:10:07 Service area in care units.
44:80:10:08 Food preparation services and equipment.
44:80:10:09 Laundry.
44:80:10:10 Corridor restrictions.
44:80:10:11 Doors.
44:80:10:12 Floor surface finish.
44:80:10:13 Wall and ceiling finish.
44:80:10:14 Ventilating systems.
44:80:10:15 Plumbing fixtures.
44:80:10:16 Water supply systems.
44:80:10:17 Vacuum breakers.
44:80:10:18 Hot water systems.
44:80:10:19 Drainage systems.
44:80:10:20 Piping requirements.
44:80:10:21 Electrical distribution system.
44:80:10:22 Lighting.
44:80:10:23 Emergency electrical service.
44:80:10:24 Staff call system.
44:80:10:25 Submittal of plans and specifications.
44:80:10:01. Application of chapter. The provisions of this chapter apply to any new facility and to any renovation, addition, or change in space use of currently approved existing facility. Accessible and usable accommodations shall be available to the public, staff, and residents with disabilities.
Each facility shall comply with NFPA 101 Life Safety Code, 2012 edition.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-1-17(4), (5), and 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
Reference: NFPA 101 Life Safety Code, 2012 edition, National Fire Protection Association. Copies may be obtained from the National Fire Protection Association, P.O. Box 9101, Quincy, MA 02269-9101. Phone: 1-800-344-3555. Cost: $93.00.
44:80:10:02. Administrative space. The administrative area shall consist of an office and public toilet room.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:03. Storage rooms. There shall be at least 10 square feet (0.929 square meters) of central storage provided for each bed. General storage shall be concentrated in one area in the facility, but up to 50 percent of the general storage space may be provided on the premises.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:04. Resident dining and lounge area. The total areas set aside for resident dining, lounge, and other central use areas may not be less than 40 square feet (4.18 square meters) for each bed.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:05. Resident rooms. A resident room shall meet the following requirements:
(1) A maximum room capacity is one resident;
(2) A minimum area, exclusive of toilet rooms, closets, lockers, wardrobes, or vestibules, of 150 square feet (13.98 square meters) in each bedroom. Any sleeping room designed as part of a suite of rooms shall have a minimum area of 120 square feet (11.15 square meters). The minimum dimension in sleeping rooms shall not be less than nine feet six inches (2.90 meters);
(3) A window sill not higher than three feet (0.91 meters) above the floor. The floor shall be above grade;
(4) A toilet room shall be attached to the resident room. The toilet room shall include a water closet, handsink, mirror, soap dispenser, towel dispenser, and private individual storage. All new construction of toilet rooms shall be wheelchair accessible;
(5) A handsink shall be provided in the room equipped with a soap dispenser and paper towel dispenser; and
(6) A separate closet space or wardrobe of five square feet (.46 meters).
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:06. Family room. At least one family room must be provided for every two licensed beds. The attached living space for the resident family shall be 150 square feet (13.94 meters) and be equipped with comfortable seating and sleeping accommodations. Provisions shall be made for resident privacy at the adjoining family room.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:07. Service area in care units. Each care unit shall contain following:
(1) Staff station work area with handwashing fixture, charting space, communication and security equipment, supply storage, and locked medication storage, including refrigerated storage and dispensing area;
(2) Staff toilet room convenient to work area. The toilet room shall be accessible and shall contain a handwashing fixture with mirror, soap and towel dispenser, and toilet with at least a side grab bar and toilet paper dispenser;
(3) Clean linen storage or linen cart storage room;
(4) Housekeeping room for supply and equipment storage. A floor receptor or service sink shall be provided and the adjacent wall surfaces shall be impervious to protect from water damage. The space could be arranged as part of a soiled utility room;
(5) Bathing room for residents with whirlpool bath fixture equipped with a resident lift for resident and staff safety or a walk-in shower;
(6) Clean workroom for the storage and assembly of supplies for nursing procedures which contains a work counter and sink;
(7) Soiled workroom with a work counter and handwashing facility, a waste receptacle, soiled linen receptacles, a clinical sink with an exposed water trap seal, siphon jet or blowout action, and a bedpan flushing device;
(8) Nourishment station containing food storage space, refrigerated storage, microwave, self-dispensing ice machine, and a sink;
(9) Equipment storage room for resident care equipment; and
(10) Multipurpose rooms for staff, residents, and residents' families for conferences, reports, education, training sessions, and consultation.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:08. Food preparation services and equipment. The dietary area shall be completely cleanable by conventional methods. The location and design of the dietary area shall enable convenient handling of incoming supplies, preparation of meals, including tray service, and disposal of rubbish and garbage. Equipment and space provided shall include the following:
(1) A dishwasher with a sanitizing cycle;
(2) A dry food storage area with adequate shelving and a functional aisle;
(3) Refrigerated and freezer storage space with sufficient refrigerated storage space located within the food production area for convenient food preparation;
(4) Aisles not less than three feet (0.91 meters) width;
(5) A vegetable preparation area with a two-compartment sink with a garbage disposal;
(6) Food production equipment designed to prepare a complete meal for the total bed complement and for personnel, guests, or other catering services;
(7) Food holding and transportation equipment capable of protecting food from contamination and of maintaining cold or hot food temperatures during the total serving period;
(8) Ventilation equipment sized and designed to effectively remove steam, heat, cooking vapors, and grease from food production areas, dishwashing areas, and serving areas;
(9) Handwashing facilities that are convenient to each work area, consisting of hot and cold running water, towel dispenser with single-service towels or hand drying device and hand cleanser; and
(10) An ice maker with bin or self-dispensing ice maker. A built-in dispensing ice maker in a refrigerator may be used in any facility or resident neighborhood with a capacity of six beds or less. Any ice maker accessible to residents or visitors shall be self-dispensing.
The facility may request in writing modifications to § 44:80:10:09. There shall be appliances that allow for the storing, refrigeration, preparation, cooking, and disposal of food products based on the facilities food service plan.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (2), and (14).
Law Implemented: SDCL 34-12-13(1), (2), and (14).
44:80:10:09. Laundry. Equipment for processing an individual resident’s personal clothing shall be provided. All common use linens and combined residents’ personal clothing must be processed for disinfecting. The laundry shall contain an area for soiled linen holding with adequate storage capacity to be used for sorting, cart storage, janitor's closet with storage for housekeeping supplies and equipment and a floor receptor or service sink convenient to the laundry, storage for laundry supplies, and a lavatory conveniently accessible to soiled, clean, and processing rooms.
The space and equipment layout shall be sized and designed to produce quality linen with a work flow that minimizes potential for cross-contamination of clean linen by soiled linen, contaminated equipment, contaminated air, or splash. The facility may request in writing modifications to § 44:80:10:10.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:10. Corridor restrictions. Drinking fountains, fire extinguisher cabinets, and vending machines shall be located so that they do not project into the required width of exit corridors. Handrails shall be installed with top 34 to 38 inches above the floor on both sides of the corridor and return to the wall at the ends. Handrails shall be installed with the top 34 to 38 inches, inclusive, from the floor.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:80:10:11. Doors. Any door to a resident room toilet or bathroom shall be equipped with hardware which will permit access in any emergency. A pocket or sliding door may not be installed except on a clothes closet or restroom in a resident room. Any hardware on a restroom pocket or sliding door shall provide for ease of operation for a resident with limited mobility. Any door opening onto a corridor, except an elevator door, shall be hinged on the side. An alcove or similar space which generally does not require a doors are excluded from this requirement. No door may swing into the corridor except a closet door. Any cross-corridor door shall be provided with vision panels.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:80:10:12. Floor surface finish. Floors shall be easily cleanable and shall have the wear resistance appropriate for the location involved. Floors in kitchens and related spaces shall be water-resistant. All areas where floors are subject to wetting shall have a nonslip finish. A walking surface that is not flush with an adjacent surface shall be provided with a transition. A change in level up to one eighth inch may be vertical and without edge treatment. Changes in level between one eighth inch and one half inch are to be beveled with a slope no greater than 1:2. A change in level may not exceed one half inch. Gaps in the walking surface may not exceed one half inch wide in the direction of travel.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:80:10:13. Wall and ceiling finish. Walls shall be washable, and in the immediate area of plumbing fixtures the finish shall be protected from water damage. Wall bases in dietary areas shall be free of spaces that can harbor insects. All dietary ceilings shall be washable or easily cleanable.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:80:10:14. Ventilating systems. The ventilating systems shall maintain temperatures, minimum air changes of outdoor air an hour, and minimum total air changes as follows:
(1) For all other occupied areas, the facility shall be able to maintain a minimum temperature of 75 degrees Fahrenheit (23.9 degrees centigrade) at winter design conditions with a minimum of at least two total air changes an hour. All air supply and air exhaust systems shall be mechanically operated. All fans serving exhaust systems shall be located at the discharge end of the system. Each mechanical ventilation systems shall be designed and balanced to provide make-up air and safe pressure relationships between adjacent areas to preclude the spread of infections and assure the health of the occupants. A corridor may not be used to supply air to or exhaust air from any room, except that exhaust air from corridors may be used to ventilate bathrooms, toilet rooms, or janitor's closets opening directly on corridors. Continuous mechanical exhaust ventilation shall be provided in all soiled areas, wet areas, and storage rooms. In unoccupied service areas, ventilation may be reduced or discontinued when the health and comfort of the occupants are not compromised.
(2) Each cooking appliances, other than microwave ovens, shall be provided with exhaust ventilation to the exterior of the building to remove cooking odors, heat, and moisture.
(3) Each vehicle parking garage shall be provided with carbon monoxide detection to activate exhaust ventilation of six air changes each hour or to open the garage door if the area of the garage is under 1000 square feet. A sign shall be posted at the front of each parking space advising the driver to shut off the engine.
(4) Each crawl spaces shall be provided with mechanical ventilation at least one half air changes each day or be provided with open perimeter venting as required by the International Building Code.
A ventilation system using a recirculated central air system shall be equipped with a minimum of 30 percent effective filters. These filter efficiencies shall be warranted by the manufacturer and shall be based on the ASHRAE 52.2, 2007 edition, American Society of Heating, Refrigeration, and Air Conditioning Engineers dust spot test method with atmospheric dust. Each filter frame shall be durable and carefully dimensioned and shall provide a tight fit with the enclosing duct work.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).
Reference: ASHRAE 52.(2), 2007 edition, American Society of Heating, Refrigeration, and Air Conditioning Engineers. Copies may be obtained from 1801 Tullie Circle, N.E., Atlanta, GA 30329. Phone: 1-800-527-4723. Cost: $39.
44:80:10:15. Plumbing fixtures. The material used for plumbing fixtures shall be of non-absorptive acid-resistant material. Each lavatory and sink required in resident care areas shall have the water supply spout mounted so that the discharge is a minimum of five inches (0.13 meters) above the rim of the fixture. Handwashing facilities shall be equipped with hands-free controls. A single lever devices may be used. Each clinical sink shall have an integral trap in which the upper portion of a visible trap seal provides a water surface. If blade handles are used, proper clearance shall be maintained for operation. An aerator is not approved for use on faucet spouts. A paper towel dispenser or hand-drying device shall be provided at each lavatory and sink used for handwashing. A mirrors or paper towel dispenser with reflective surface may not be provided at handwashing facility in the clean utility or dietary where grooming could potentially cause contamination.
Each water closet shall be an elongated bowl type and be equipped with an open front seat.
Any shower stall that is not required to be wheelchair transfer or standard roll-in type shall have curb heights not more than six inches above the finished floor. The shower floor elevation and bathroom finished floor elevation shall be level where possible but the difference in elevation cannot exceed three inches.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
44:80:10:16. Water supply systems. Each water supply systems shall supply water to the fixtures and equipment on the upper floors at a minimum pressure of 15 pounds a square inch (1055.9 kilograms a square meter) during maximum demand periods. Each water service main, branch main, riser, and branch to a group of fixtures shall be valved. Stop valves shall be provided at each fixture. Hot, cold, and chilled water piping and waste piping on which condensation may occur shall be insulated. Insulation of cold and chilled water lines shall include an exterior vapor barrier.
Water supply systems in a health care facility must maintain one part per million free residual chlorine at remote point-of-use fixtures in the facility or may use another bacteriological control method (increasing water temperature range from 122 degrees to 125 degrees Fahrenheit [50-52 degrees centigrade] is acceptable) that has been demonstrated to be equivalent in control of Legionella. The facility must document water temperatures to verify the hot water temperature is being maintained within the acceptable range The chlorine testing must be done daily using photocell and light source DPD (N, N, Diethyl-p-phenylenediamine) test kits and the test results logged. When testing demonstrates that consistent chlorine levels are maintained, the frequency of testing may be reduced to a level necessary to demonstrate compliance.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (4), and (14).
Law Implemented: SDCL 34-12-13(1), (4), and (14).
44:80:10:17. Vacuum breakers. An antisiphon device or backflow preventer shall be installed on any hose bib and on any fixture to which hoses or tubing can be attached such as a janitor sink, bedpan flushing attachment, or handheld shower. An antisiphon device or backflow preventer shall be installed on all plumbing and equipment where any possibility exists for contamination of the potable water supply.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (4), and (14).
Law Implemented: SDCL 34-12-13(1), (4), and (14).
44:80:10:18. Hot water systems. The facility shall install a recirculating system to provide hot water to all fixtures. The hot water heating equipment shall have sufficient capacity to supply water at the temperature and amounts to meet the needs of the facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (4), and (14).
Law Implemented: SDCL 34-12-13(1), (4), and (14).
44:80:10:19. Drainage systems. Any piping over a food preparation center, food serving facility, food storage area, and any other critical area shall be kept to a minimum and may not be exposed. Special precautions shall be taken to protect these areas from possible leakage of necessary overhead piping systems. The building sewer shall discharge into a community sewerage system. If such a system is not available, a facility providing sewage treatment which conforms to applicable local and state regulations is required.
Water from roof systems shall be collected and discharged away from the building foundation. Rain gutters with downspouts and splash blocks shall be provided for pitched roof systems. Provisions shall be made to avoid having water accumulated on sidewalks and parking areas around the building.
The building sewer system shall have a cleanout located outside the perimeter of the building foundation.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (4), and (14).
Law Implemented: SDCL 34-12-13(1), (4), and (14).
Cross-Reference: Individual and small on-site wastewater systems, ch 74:53:01.
44:80:10:20. Pipe requirements. Before placing potable water systems in service, the piping system shall be disinfected in accordance with the South Dakota Plumbing Commission standards in article 20:54 and certification shall be available from the installer showing the method used, date, test procedure used to verify chlorine concentrations, and date the system was flushed and placed in service.
Pipe covering, vapor barriers, and adhesives used for applying them shall have a flame spread of not more than 25 and a smoke emission factor of not more than 50 when tested in accordance with the NFPA 101 Life Safety Code, 2012 edition.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
Reference: NFPA 101 Life Safety Code, 2012 edition, National Fire Protection Association. Copies may be obtained from the National Fire Protection Association, P.O. Box 9101, Quincy, Massachusetts 02269-9101. Phone: 1-800-344-3555. Cost: $93.00.
44:80:10:21. Electrical distribution system. All material including equipment, conductors, controls, and signaling devices shall be installed to provide a complete electrical system with the necessary characteristics and capacity to supply the electrical facilities shown in the specifications or indicated on the plans. All materials shall be listed as complying with applicable standards of Underwriters' Laboratories, Inc., or other similarly established standards. Each circuit breaker or fusible switch that provides disconnecting means and overcurrent protection for a conductor connected to switchboard and distribution panel board shall be enclosed or guarded to provide a dead front type of assembly. The main switchboard shall be located in a separate enclosure accessible only to authorized persons. Each lighting and appliance panel board shall be provided for the circuit on each floor. The provisions of this section do not apply to emergency system circuits.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).
44:80:10:22. Lighting. Each resident bedroom shall have general lighting of at least ten footcandles (0.929 lumens per square meter) and night lighting. If task illumination is required, a light with an intensity of at least 30 footcandles (2.80 lumens per square meter) at the work surface shall be provided. At least one luminaire for night lighting shall be switched at the entrance to each resident room. Illumination of at least 100 footcandles (9.29 lumens per square meter) shall be provided at the medication set-up area. Illumination of at least 30 footcandles (2.80 lumens per square meter) shall be provided in each dining area and at any bathing facility.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3), (4) and (14).
Law Implemented: SDCL 34-12-13(3), (4) and (14).
44:80:10:23. Emergency electrical service. A facility shall be equipped with automatic emergency lighting for each exit way, staff work area, medication room, room where main electrical panels are located, and power for the alarm system.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).
44:80:10:24. Staff call system. A staff call system shall be provided for resident use to summon assistance from staff. The system shall be capable of being easily activated by the resident and shall register both visually and audibly at the staff station, work area, or device carried by care staff. The system shall be utilized and maintained in such a manner as to ensure that it is a consistent and effective means for a resident to alert staff of the need for assistance. The call stations convenient for resident use shall be provided at each bed, resident toilet, bathing or shower facility used by the resident. Staff call systems which provide two-way voice communication shall be equipped with an indicating light at each calling station which lights and remains lighted as long as the voice circuit is operating. The call system shall also meet at least one of the following requirements:
(a) The call system utilizes fixed call stations that are convenient for resident use and activated by a pull cord or other approved device. In multicorridor nursing units, additional visible signals shall be installed at corridor intersections;
(b) The call system utilizes wireless devices that are convenient for resident use and activated by a pull cord or other approved device. The wireless system shall actuate a visual and audible signal at the staff station and on pocket paging devices carried by all direct care staff. Wireless devices shall be fully supervised, shall be capable of alarm reset at the source, and transmit low battery alert. Wireless devices shall utilize batteries that are readily available; or
(c) Another type of call system that has been submitted for review and approved by the department.
A call station or device is not required in the resident room of a cognitively impaired resident if a nursing assessment determines the resident would not benefit from the availability. There shall be a method for staff to summon assistance if needed.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(4) and (14).
Law Implemented: SDCL 34-12-13(4) and (14).
44:80:10:25. Submittal of plans and specifications. Plans and specifications for new construction shall be submitted to the department for evaluation of function and fire protection. The department's approval shall be obtained before beginning construction. Modification during construction shall be submitted to the department for review and shall be approved prior to the modification. A written narrative describing the intended use of the proposed construction shall accompany the plans and specifications.
Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).
