1. (1) For an intermediate care facility, the licensee:

   1. (a) may employ a licensed practical nurse to act as the health services supervisor instead of a director of nursing if a registered nurse consultant meets regularly with the health services supervisor;
   2. (b) shall ensure nursing staff are present on the premises 24 hours a day to meet the needs of each resident;
   3. (c) shall provide 24-hour licensed nursing services;
   4. (d) shall provide at least one registered nurse either by direct employ or by contract to provide direction to nursing services; and

   5. (e) shall provide at least:

      1. (i) dietary services;
      2. (ii) medical supervision;
      3. (iii) recreational therapy; and
      4. (iv) social services.

2. (2) The licensee shall provide the following service as required in the resident's care plan:

   1. (a) occupational therapy;
   2. (c) physical therapy;
   3. (d) respiratory therapy;
   4. (e) speech therapy; and
   5. (f) any other therapy as ordered by the licensed practitioner.

3. (3) For a skilled level of nursing care facility, the licensee shall:

   1. (a) designate a registered nurse to serve as the director of nursing on a full-time basis;
   2. (b) employ a registered nurse for at least eight consecutive hours a day, seven days a week;
   3. (c) ensure a licensed charge nurse is present on each shift;
   4. (d) ensure nursing staff are present on the premises 24 hours a day to meet the needs of each resident;
   5. (e) not permit a person to concurrently serve as the director of nursing and as a charge nurse;
   6. (f) provide 24-hour licensed nursing services; and

   7. (g) provide a service to each resident that maintains current capabilities and prevents further deterioration, including:

      1. (i) a dental service;
      2. (ii) a dietary service;
      3. (iii) a pharmacy service;
      4. (iv) medical supervision;
      5. (v) physical therapy;
      6. (vi) recreational therapy; and
      7. (vii) social services.

4. (4) The licensee shall provide the following services as required by the resident's care plan:

   1. (a) occupational therapy;
   2. (b) respiratory therapy; and
   3. (c) speech therapy.

5. (5)(a) The licensee shall ensure that a respite service comply with Subsections R432-150-5(5) through (13).

   1. (b) The licensee may provide a respite service at an hourly rate or daily rate but may not exceed 14 days for any single respite stay.
   2. (c) A respite stay that exceeds 14 days is considered a nursing facility admission and is subject to the requirements of this rule applicable to a non-respite resident.
   3. (d) The licensee shall coordinate the delivery of respite services with the recipient, the case manager, if applicable, and the family member, or primary caretaker.
   4. (e) The licensee shall document and coordinate with each provider agency to ensure uninterrupted service delivery.

6. (6) The licensee shall complete:

   1. (a) a Level 1 pre-admission screening upon the person's admission for respite services;
   2. (b) a record for each person receiving respite services;
   3. (c) a service agreement to serve as the care plan, that identifies the prescribed medications, physician treatment orders, need for assistance with activities of daily living, and diet orders; and
   4. (d) written respite care policies and procedures that are available to staff.

7. (7) The licensee shall ensure respite care policies and procedures address:

   1. (a) behavior management interventions;
   2. (b) handling personal funds;
   3. (c) medication administration;
   4. (d) notification of a responsible person in the case of an emergency;
   5. (e) philosophy of respite services;
   6. (f) post-service summary;
   7. (g) service agreement and admission criteria; and
   8. (h) training and in-service requirement for employees.
8. (8) The licensee shall ensure the individual receiving respite services receives a copy of the resident rights documents upon initiation of the respite services.

9. (9) The licensee shall ensure a respite record contains:

   1. (a) a post-service summary;
   2. (b) any accident and injury report;
   3. (c) an advanced directive, if available;
   4. (d) daily staff notes;
   5. (e) nursing notes;
   6. (f) physician treatment orders;
   7. (g) resident demographic information; and
   8. (h) the service agreement.
10. (10) The licensee shall ensure retention and storage of a respite record complies with Subsection R432-150-25(3).
11. (11) The licensee shall ensure confidentiality and release of information complies with Subsection R432-150-25(4).
12. (12) Hospice care may only be arranged and provided by a licensed hospice agency in accordance with Rule R432-750.
13. (13) A nursing care facility may provide terminal care.

KEY: health care facilities

Date of Last Change: February 18, 2025

Notice of Continuation: January 24, 2022

Authorizing, and Implemented or Interpreted Law: 26B-2-202