(a) Definitions. As used in this subsection:
(1) “Attending physician” means the physician attending the patient at the time of
treatment;
(2) “By-Laws” means a set of rules adopted by the facility for governing its operation;
(3) “Certified Nurse’s Aide” means a nurse’s aide issued a certificate – from January 1,
1982 through January 31, 1990 – of satisfactory completion of a training program which
has been approved by the department;
(4) “Commissioner” means the Commissioner of the Connecticut Department of Public
Health;
(5) “Curriculum” means the plan of classroom and clinical instructions for training and
skills assessment leading to registration as a nurse’s aide, which has been approved by the
commissioner;
(6) “Department” means the Connecticut Department of Public Health;
(7) “Facility” means a chronic and convalescent nursing home and/or a rest home with
nursing supervision;
(8) “Feeding assistant” means an individual who has successfully completed a state
approved training program and who is paid or under contract with a facility to orally feed
patients who do not have complicated feeding problems as provided in section 19-13-D8t
(l)(9)(D) of the Regulations of Connecticut State Agencies, but does not include an
individual who is a licensed practical nurse, registered nurse or other health professional
otherwise licensed or certified by the department, or volunteers who provide such services
without monetary compensation or a family member assisting a relative;
(9) “Full time” means a time period of not less than 32 hours, established as a full working
week by a facility;
(10) “Job description” means a written list developed for each position in the facility,
containing the qualifications, duties, responsibilities, and accountability required of all
employees in that position;
(11) “Licensed nursing personnel” means registered nurses or licensed practical nurses
licensed in Connecticut;
(12) “Nurse’s aide” means an individual providing nursing or nursing-related services to
residents in a chronic and convalescent nursing home or rest home with nursing supervision,
but does not include an individual who is a health professional otherwise licensed or certified
by the Department of Public Health, or who volunteers to provide such services without
monetary compensation;
(13) “Patient care plan” means an overall, interdisciplinary written plan documenting an
evaluation of the individual patient’s needs, short and long term goals, and care and
treatment;
(14) “Personal physician” means the physician indicated on the patient’s medical record
as being responsible for the medical care of that patient;
(15) “Reportable Event” means a happening, occurrence, situation or circumstance which
was unusual or inconsistent with the policies and practices of the facility;
(16) “Supervision” means the direction, inspection, and on-site observation of the
functions and activities of others in the performance of their duties and responsibilities;
(17) “Therapeutic recreation” means individual and group activities designed to improve
the physical and mental health and condition of each patient.
(b) Licensure procedure.
(1) Commission on hospitals and health care. A facility shall not be constructed, expanded
or licensed to operate except upon application for, receipt of, and compliance with all
limitations and conditions required by the commission on hospitals and health care in
accordance with Connecticut General Statutes, sections 19-73l through 19-73n inclusive.
(2) Application for licensure.
(A) No person shall operate a facility without a license issued by the department in
accordance with the Connecticut General Statutes, sections 19-576 through 19-586
inclusive.
(B) Application for the grant or renewal of a license to operate a facility shall be made in
writing on forms provided by the department; shall be signed by the person seeking authority
to operate the facility; shall be notarized; and shall include the following information if
applicable:
(i) Application for Owner’s Certificate of Compliance, as required by subsection (v) (1)
of these regulations;
(ii) Names and titles of professional and nurse’s aide staff;
(iii) Upon initial appointment only, signed acknowledgement of duties for the
administrator, medical director, and director of nurses;
(iv) Patient capacity;
(v) Total number of employees, by category;
(vi) Services provided;
(vii) Evidence of financial capacity;
(viii) Certificates of malpractice and public liability insurance;
(ix) Local Fire Marshal’s annual certificate.
(3) Issuance and renewal of license.
(A) Upon determination by the department that a facility is in compliance with the statutes
and regulations pertaining to its licensure, the department shall issue a license or renewal
of license to operate the facility for a period not to exceed one year.
(i) Each building which is not physically connected to a licensed facility shall be treated
as a distinct facility for purposes of licensure;
(ii) A facility which contains more than one level of care within a single building shall
be treated as a single facility for purposes of licensure;
(B) A license shall be issued in the name of the person who signs the application for the
license for a specific facility. The license shall not be transferable to any other person or
facility.
(C) Each license shall specify the maximum licensed bed capacity for each level of care,
and shall list on its face the names of the administrator, medical director, and director of
nurses, and notations as to waivers of any provision of this code. No facility shall have more
patients than the number of beds for which it is licensed.
(4) Notice to public. The license shall be posted in a conspicuous place in the lobby by
reception room of the facility.
(5) Change in status. Change of ownership, level of care, number of beds or location shall
require a new license to be issued. The licensee shall notify the department in writing no
later than 90 days prior to any such proposed change.
(6) Change in personnel. The licensee shall notify the department immediately, to be
confirmed in writing within five days, of both the resignation or removal and the subsequent
appointment of the facility’s administrator, medical director, or director of nurses.
(7) Failure to grant the department access to the facility or to the facility’s records shall
be grounds for denial or revocation of the facility’s license.
(8) Surrender of license. The facility shall directly notify each patient concerned, the next
of kin and/or guardian, the patient’s personal physician, and any third party payors
concerned at least 30 days prior to the voluntary surrender of the facility’s license or
surrender of license upon the department’s order of revocation, refusal to renew or
suspension of license. In such cases, the license shall be surrendered to the department
within seven days of the termination of operation.
(c) Waiver.
(1) The commissioner or his/her designee, in accordance with the general purpose and
intent of these regulations, may waive provisions of these regulations if the commissioner
determines that such waiver would not endanger the life, safety or health of any patient.
The commissioner shall have the power to impose conditions which assure the health, safety
and welfare of patients upon the grant of such waiver, or to revoke such waiver upon a
finding that the health, safety, or welfare of any patient has been jeopardized.
(2) Any facility requesting a waiver shall apply in writing to the department. Such
application shall include:
(A) The specific regulations for which the waiver is requested;
(B) Reasons for requesting a waiver, including a statement of the type and degree of
hardship that would result to the facility upon enforcement of the regulations;
(C) The specific relief requested; and
(D) Any documentation which supports the application for waiver.
(3) In consideration of any application for waiver, the commissioner or his/her designee
may consider the following:
(A) The level of care provided;
(B) The maximum patient capacity;
(C) The impact of a waiver on care provided;
(D) Alternative policies or procedures proposed.
(4) The Department reserves the right to request additional information before processing
an application for waiver.
(5) Any hearing which may be held in conjunction with an application for waiver shall
be held in conformance with Chapter 54 of the Connecticut General Statutes and department
regulations.
(d) General Conditions.
(1) Patient admission.
(A) Patients shall be admitted to the facility only after a physician certifies the following:
(i) That a patient admitted to a chronic and convalescent nursing home has uncontrolled
and/or unstable and/or chronic conditions requiring continuous skilled nursing services
and/or nursing supervision or has chronic conditions requiring substantial assistance with
personal care, on a daily basis;
(ii) That a patient admitted to a rest home with nursing supervision has controlled and/or
stable chronic conditions which require minimal skilled nursing services, nursing
supervision, or assistance with personal care on a daily basis.
(B) Nothing in subparagraph (A) above shall require the transfer of any patient admitted
to the facility prior to October 1, 1981.
(C) No patient shall be admitted to a facility without compliance with the above
requirements except in the event of an emergency, in which case the facility shall notify the
Department within 72 hours after such admission.
(2) Visiting hours shall be as liberal as is consistent with good patient care, but shall in
no event be less than eight hours per day.
(3) Patient Identification.
(A) Each chronic and convalescent nursing home shall ensure that all patients wear, at
all times, identification bracelets or some other form of visible identification.
(B) A method for identification of all patients at all times shall be established by rest
homes with nursing supervision.
(4) All areas used by patients shall have temperatures of not less than 75°F. All other
occupied areas shall have temperatures of not less than 70°F.
(5) When a patient ceases to breathe and has no detectable pulse or blood pressure, the
patient shall be screened from view of other patients. Upon pronouncement of death in
accordance with Section 7-62b of the Connecticut General Statutes or Sections 7-62-1
through 7-62-3 of the Regulations of Connecticut State Agencies, the body shall be moved
promptly to the facility’s holding room, as required by subsection (v) (13) (B) of these
regulations