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c. Equipment shall include an adequate supply of:
(1: Wet and dry mops (improvised mops shall be prohibited)
(4) Cleaning supplies
tary manner and stored in suitable storage areas. Such equipment shall not be stored in lavatories, bath
rooms or halls or on stairs.
i. Dusters and cleaning cloths shall be laundered daily. B. ACCOMMODATIONS AND EQUIPMENT FOR RESIDENTS
1. Floor Area
For licenses in existence on the effective date of these regulations,
tween beds. 2. Floor area
For all new licenses issued after the effective date of these regulations,
tween beds. 3. Quota Increase
Any increase in quota granted after the effective date of the se regulations must provide in the room or rooms
b. 70 square feet of floor area per adult bed, with at least 3 feet between beds. in multi-bed rooms. 4. Window Area
For new licenses issued after the effective date of these regulations, the minimum window are a shall be at
least one-eighth of the floor area. 5. Rooms for Residents
a. All rooms used for residents shall be outside room s.
cannot be used if it blocks an egress. d. Each home with eighteen or more residents in which residents do not have a private room shall have a
suitable room which can be used for serious illness pending the transfer of the resident. e. Provision shall be made for the immediate removal of a body from a multi-bed room in the event of death. 6. Equipment a. Beds of household height shall be used and spaced three feet apart. Beds shall be arranged so as to
avoid drafts, heat from radiators and other discomforts. Cots and folding beds are not permitted. b. Each resident shall be provided with: (1) A comfortable bed, bed spring and mattress, which shall be maintained in a sanitary condition and
kept in good repair. The mattress shall be protected by a cover and pad. (2) An adequate number of bed pillows of good quality for each resident, maintained in a sanitary co..
dition and in good repair. (3) An adequate supply of bed linen, bed blankets, bedspreads, towels and washcloths of good quality
for each resident, maintained in a sanitary manner and kept in good condition. (4) A bedside table adequate for individual needs, maintained in a sanitary condition and kept in good
repair. . (5) A comfortable chair suited to individual needs, maintained in a sanitary manner and kept in good re
(6) Footstools according to residents' needs, maintained in a sanitary manner and kept in good repair.
manner and kept in good repair.
dentures, maintained in a sanitary manner. (11) An individual soap dish and bar of soap. (12) Individual sputum receptacles of a sanitary type shall be provided when needed and maintained in a
sanitary manner. (13) Sufficient bedpans, urinals, hand wash basins, bath basins and emesis basins for emergency use when
residents are ill with short-term illnesses, such as colds or grippe. This equipment shall be maintained in a sanitary manner and kept in good condition. It shall be stored in such a manner that it can
not be interchanged between residents. (14) A portable screen or other suitable facility when needed to insure resident privacy. (15) A signal system or a hand bell shall be provided for each resident at the bedside. Bathrooms and
sitting rooms shall have a signal system or hand bell for emergency use by residents. c. A standard scale for weighing residents shall be provided. d. All stairways used by boarders shall be well lighted, and provided with hand rails on both sides. e. Grip bars properly placed shall be in all bathrooms used by residents. f. An a dequate number of wastebaskets of a sanitary type shall be provided in each resident's room and sitting
room and main tained in a sanitary manner.
a. Residents' towels and washcloths, when not in use.
C. MEDICAL SUPERVISION 1. Each resident or his guardian or the agency responsible for his care shall on admission designate the name
and address of a physician registered to practice medicine in Massachusetts to be responsible for his medi
cal supervision, including periodic checkups. 2. Each resident on admission shall have a physical examination, including blood pressure, and these findings,
with the routine to be carried out, shall be recorded and signed by a physician registered to practice medicine
in Massachusetts. 3. No person requiring narsing care shall be admitted to a rest home. 4. No person who develops a need for nursing care shall be cared for in a rest home. Arrangements shall be
made for the transfer of such individuals to a suitable facility. (Exception: Care for temporary short-term
illness, such as cold or grippe.) 5. No resident shall be transferred or discharged from the home without a dated, recorded, signed statenent of
his or her physical condition made by the attending physician at the time of transfer or discharge. 6. All medical and psychiatric consultations shall be dated, recorded and signed by the examining physician at
the time of examination. 7. No medication or therapeutic diet shall be given to a resident except on the written order of a physician
registered to practice medicine in Massachusetts. D. SUPERVISION AND CARE OF MEDICATIONS 1. A medicine cabinet or closet of a type approved by the Department shall be provided for the proper storage of
all residents' drugs. 2. The medicine cabinet or closet shall be located in an area that is inaccessible to residents or visitors. 3. me cabinet shall be well lighted, shall have running water easily accessible, and shall be pro
vided with a suitable lock and kept locked at all times.
4. There shall be a separate locked compartment within the locked medicine closet for the proper storage of
prescribed narcotics and sedatives. 5. Poisons and medications for external use only shall be kept separate and apart from intemal medications in
a locked compartment. 6. A responsible person shall be in charge of and administer all medications to residents. 7. Custody of the key to the medicine closet shall be assigned to a responsible person at all times. 8. All medications shall be accurately recorded and accounted for at all times. 9. No medication for a specific resident shall be administered to another resident. 10. Medications shall not be stored in residents' 11. Medicines shall not be removed from their original containers. . 12. Prescription labels shall not be defaced. 13. Medications having a specific expiration date shall not be used after date of expiration. 14. Medicines shall be properly refrigerated when required. 15. Following a resident's transfer or discharge, all drugs prescribed for said resident, if not transferred with
the resident, shall be disposed of as follows: a. Narcotics and sedatives shall be destroyed in the home in the presence of the hospital in spector and the
fact duly recorded, dated, timed, signed and witnessed in the Narcotic and Sedative Book (Sec. I - 2c) b. All other drugs shall be disposed of as directed by the hospital inspector. 16. Upon the death of a resident, all drugs prescribed for said resident shall be disposed of as follows: a. Narcotics and sedatives shall be destroyed in the home in the presence of the hospital inspector, and the
fact duly recorded, dated, timed, signed and witnessed in the Narcotic and Sedative Book. b. All other drugs shall be disposed of immediately as directed by the hospital in spector. 17. The medicine cabinet or closet shall be used exclusively for the storage of medications and equipment rem
quired for their administration. This cabinet or closet shall be maintained in a sanitary manner. 18. Rubbing alcohol, when not in use, shall be stored in a locked closet.
E. PERSONNEL 1. There shall be at least one person physically and temperamentally qualified who is responsible for the super4. Occupational Therapy and Rehabilitation
vision and care of the residents at all times. 2. There shall be sufficient and adequate personnel maintained to provide adequate supervision and care of the
residents, and for the satisfactory maintenance of the home at all times. 3. No male individual shall care for female residents. 4. There shall be sufficient personnel maintained for relief and vacation periods.
5. Homes with 18 or more residents shall provide a person for night duty to supervise residents' needs at night. F. SUPERVISION OF CARE INCIDENT TO OLD AGE 1. Health Supervision
a. In the event of illness or accident the resident's physician shall be notified immediately. b. Each resident shall have a complete physical examination at least once a year. Special examinations,
when indicated, shall be arranged for the care of the residents' eyes, ears and teeth. Ey glasses, hearing
aids and dentures shall be provided when indicated by the responsible individuals or agencies. c. Proper arrangements shall be provided for residents reporting to clinics or to a doctor's office. 2. Personal Hygiene
The functions to be supervised by the licensee shall include:
e. The care of feet, hands and nails 3. Clothing
Supervision of residents shall insure the following:
These shall be supervised as prescribed (see Section III). Arrangements shall be made with the Division of the Blind of the Massachusetts Department of Education for provision for occupational therapy and recreational
facilities for residents who are blind or have impaired vision. 5. Care During Temporary Illness
In the event a resident is temporarily ill, the following shall be provided: a. Adequate equipment for care during temporary short-term illness, kept in good repair and maintained in a and other data in chronological order. This record shall be filed in a safe manner and kept in the home for not
sanitary manner. This equipment, when not in use, shall be stored in a manner approved by the Department. b. Tray service if a resident is temporarily ill and unable to go to the dining-room.
1. Admissions to rest homes are restricted to persons who are ambulatory and who are not in need of nursing care. 2. No rest home shall admit a person suffering from a contagious disease, or a person requiring prenatal or mater
nity care. 3. No rest home shall admit or care for persons who are suffering from insanity or abnormal mental conditions,
or persons who are addicted to the use of narcotics or stimulants. 4. Persons released by and under the supervision of the Department of Mental Health are eligible for admission
provided prior approval has been received from the Department of Public Health. 5. No person receiving shock therapy shall be admitted to a rest home. 6. No person shall receive shock therapy in the home.
H. RESIDENT TRANSFER OR DISCHARGE 1. No licensee shall arrange for the transfer of a resident from one home to another or for his or her discharge
without the written permission of the resident, a respasible individu al or relative, or a responsible publicor
private agency. 2. The resident shall be examined by a physician prior to transfer or discharge. The physical findings of this
examination shall be recorded and signed and dated on the resident's record by the examining physician. 3. A record shall be kept of all drugs transferred with a resident at the time of discharge or transfer. This record
c. File cabinets for active and inactive records 2. Required record material for each home shall include: a. A standard type bound Resident Register Book for the recording of admissions, transfers, discharges,
deaths and other required data
f. Record form for listing residents' clothing, personal effects and valuables at time of admission 3. All records shall be permanent, either type written or legibly written with pen and ink (no record shall be written
with pencil). No erasures or ink eradicator shall be used. No pages shall be removed from bound books. 4. A complete and accurate record shall be maintained each resident from the time of admission
the time of discharge. This record shall be kept in an individual folder or file and shall include all pertinent medical shall be respected at all times by all employees.
less than five years following the resident's discharge or death. 5. Resident's record shall include: a. Identification data
Date and time of admission; resident's name, previous address, age, sex, color, race, marital status (married, single, divorced or widowed) and religion; name and address of referring physician or hospital; name and address of attending physician; name, address and telephone number of person or agency responsible for
resident. b. Medical records (1) A statement of the resident's physical condition and diagnosis at the time of admission, transfer or
discharge, dated and signed by the attending physician, shall be incorporated in the resident's record
with in twenty-four hours after admission and prior to transfer or discharge. (2) All doctors' visits and orders for treatments and diet during period of temporary illness shall be dated,
recorded and signed in the Doctor's Order Book by the attending physician. (3) Residents shall be examined at least annually and said physical examination shall be dated, recorded
and signed by the attending physician and in corporated in the resident's record. (4) All medical and psychiatric consultations shall be dated, recorded and signed by the examining phy
sician and incorporated in the resident's rocord. (5) A record shall be kept of all accidents occurring to residents in the home including the date and time of
accident, physical findings and treatment prescribed. This record shall be signed by the attending
physician and incorporated in the resident's record. c. Residents' individual records (1) Admission data
How admitted -- referred by whom and accompanied by whom, date and time (2) Description of resident's condition upon admission, including weight, recorded and signed by admitting
personnel. (3) Date, time, dosage and method of administration of any medications administered during period of
temporary illness. (4) The person administering medications shall record and sign them on the residents' record. (5) All pertinent data relating to residents shall be recorded on the weekly resident's record and signed
by the individual responsible for resident supervision. Weight shall be recorded monthly. (6) A list of the resident's clothing, personal effects and valuables shall be entered at time of admission
on a form, dated and signed by the resident or responsible person and witnessed. A copy of this list
shall be given to the resident or other responsible person.
(a) Date and time of discharge or transfer
(8) An individual narcotic and sedative record shall be maintained for each narcotic or sedative prescribed
for each resident during period of temporary illness. This record shall be kept in the Narcotic and
responsible person in charge. J. RESPONSIBILITIES OF THE LICENSEE 1. To insure humane understanding care of the residents. Their personal and spiritual rights and privileges