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Laws pertaining to LTC, etc.

Posted

Specializes in Sub-Acute. Has 5 years experience.

So I've been a nurse for 4 years in two different states. 

There are random things that I want to investigate or research, mostly related to policy/procedure.  Not that which pertain to my facility, but in general. 

Anyone know a good resource to look stuff like this up?

For example I had a resident try to elope.  She is her own person, I wanted to find out if I'm even legally allowed to force her to stay.  I ended up redirecting, but I hate not having a definitive go to place for this stuff.  I also wanted to look up what the law says about discharging someone who is homeless, (long story).  I like to have facts and whatnot when people ask me questions, rather than just dictate what I"m told our policy is. 

At the end of the day I'm more concerned with what is legal/ethical than what my specific policy is. 

I'd also like to just know what the law/BON says about specific things regardless of facility policy so that I have a baseline, if that makes sense. 

I just got off a double so If I don't make any sense, forgive me. 

If you are in a Skilled Nursing Facility, here is a link to the Title 42, Code of Federal Regs:

https://www.ecfr.gov/cgi-bin/text-idx?SID=f64b6edcc2b2ee52bf5de8e19a340569&mc=true&node=sp42.5.483.b&rgn=div6

CMS (Centers for Medicare/Medicaid) also has the State Operating Manual, which helps explain the Federal regulations:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf

Your state should also have regs that you should be able to find via your Dept of Public Health or similar agency. 

You should have access to your facility's  policies and follow those.  Those policies should comply with government regulations.  You may not find answers to your specific scenarios in the government regs, and should be following facility policy and Dr's orders.

kbrn2002, ADN, RN

Specializes in Geriatrics, Dialysis. Has 19 years experience.

Agree with the above poster.  While every state does have federal rules and regulations that must be followed after that the various state's laws vary so wildly it's pretty impossible to provide the answers you are looking for. Your best resources to start with are the facilities policies and procedures since they won't be written in contradiction to state/federal laws.

I can tell you where I live when a resident attempts to elope and redirection isn't effective the local police become involved for their safety as no, we can't legally or for that matter morally physically prevent them from leaving.

As for discharging a homeless person that's a sticky situation there. I know my former workplace had a policy in place where a resident could not be discharged unless they had a safe place to discharge to.  As a result we had a few so called short term rehab residents that essentially became long term simply because they had nowhere else to go. They were functional enough to not qualify for placement in an assisted living but not functional enough to really live independently and had financial barriers that made finding them appropriate housing impossible.