§ 131D-4.4 — Adult care home minimum safety requirements; smoking prohibited inside long-term care facilities; penalty

North Carolina § 131D-4.4

• Jurisdiction: North Carolina
• Ch. 131D: Inspection and Licensing of Facilities
• Art. 1: Adult Care Homes

Text

(a) In addition to other requirements established by this Article or by rules adopted pursuant to this Article or other provisions of law, every adult care home shall provide to each resident the care, safety, and services necessary to enable the resident to attain and maintain the highest practicable level of physical, emotional, and social well-being in accordance with:
(1) The resident's individual assessment and plan of care; and
(2) Rules and standards relating to quality of care and safety adopted under this Chapter.
(b) Smoking is prohibited inside long-term care facilities. As used in this section:
(1) "Long-term care facilities" include adult care homes, nursing homes, skilled nursing facilities, facilities licensed under Chapter 122C of the General Statutes, and other licensed facilities that provide long-term care services.
(2) "Smoking" means the use or possession of any lighted cigar, cigarette, pipe, or other lighted smoking product.
(3) "Inside" means a fully enclosed area.
(c) The person who owns, manages, operates, or otherwise controls a long-term care facility where smoking is prohibited under this section shall:
(1) Conspicuously post signs clearly stating that smoking is prohibited inside the facility. The signs may include the international "No Smoking" symbol, which consists of a pictorial representation of a burning cigarette enclosed in a red circle with a red bar across it.
(2) Direct any person who is smoking inside the facility to extinguish the lighted smoking product.
(3) Provide written notice to individuals upon admittance that smoking is prohibited inside the facility and obtain the signature of the individual or the individual's representative acknowledging receipt of the notice.
(d) The Department may impose an administrative penalty not to exceed two hundred dollars ($200.00) for each violation on any person who owns, manages, operates, or otherwise controls the long-term care facility and fails to comply with subsection (c) of this section. A violation of this section constitutes a civil offense only and is not a crime. (1999-334, s. 1.1; 2007-459, s. 1.)
§ 131D-4.4A. Adult care home infection prevention requirements.
(a) As used in this section, "adult care home staff" means any employee of an adult care home.
(b) In order to prevent transmission of infectious diseases, each adult care home shall do all of the following:
(1) Implement written infection prevention and control policies and procedures that are based on accepted national standards consistent with the federal Centers for Disease Control and Prevention guidelines on infection control, which shall be maintained in the facility and accessible to adult care home staff working at the facility. The policies and procedures shall address at least all of the following:
a. Proper disposal of single-use equipment used to puncture skin, mucous membranes, and other tissues, and proper disinfection of reusable resident care items that are used for multiple residents.
b. Sanitation of rooms and equipment, including cleaning procedures, agents, and schedules.
c. Accessibility of infection control devices and supplies.
d. Blood and bodily fluid precautions.
e. Procedures to be followed when adult care home staff is exposed to blood or other body fluids of another person in a manner that poses a significant risk of transmission of HIV, hepatitis B, hepatitis C, or other bloodborne pathogens.
f. Procedures to prohibit adult care home staff with exudative lesions or weeping dermatitis from engaging in direct resident care that involves the potential for contact between the resident, equipment, or devices and the lesion or dermatitis until the condition resolves.
g. Standard and transmission-based precautions, including the following:
1. Respiratory hygiene and cough etiquette.
2. Environmental cleaning and disinfection.
3. Reprocessing and disinfection of reusable resident devices.
4. Hand hygiene.
5. Accessibility and proper use of personal protective equipment.
6. Types of transmission-based precautions and when each type is indicated, including contact precautions, droplet precautions, and airborne precautions.
h. In accordance with the public health laws of North Carolina, when and how to report to the local health department a suspected or confirmed, reportable communicable disease case or condition, or a communicable disease outbreak.
i. Procedures for ensuring that residents, representatives of residents, and adult care home staff are informed of the following without disclosing any personally identifiable information of the facility's residents or staff:
1. The existence of a communicable disease outbreak within 24 hours following confirmation of the outbreak by the local health department.
2. When the communicable disease outbreak has resolved.
3. Any changes to facility operations during the communicable disease outbreak, such as visitation policy changes.
j. Measures the facility should consider for specific types of communicable disease outbreaks in order to prevent the spread of illness, such as:
1. Isolating infected residents.
2. Limiting or stopping group activities and communal dining.
3. Limiting or restricting outside visitation to the facility.
4. Screening staff, residents, and visitors for signs of illness.
5. Using source control as tolerated by the residents.
k. Strategies for addressing potential staffing issues and ensuring adequate staffing is available to meet the needs of the residents during a communicable disease outbreak.
(2) Require and monitor compliance with the facility's infection prevention and control policies and procedures.
(3) Update the infection prevention and control policies and procedures as necessary to maintain consistency with accepted national standards in infection prevention and control.
(4) Designate one on-site staff member for each noncontiguous facility who is knowledgeable about the federal Centers for Disease Control and Prevention guidelines on infection control to direct the facility's infection control activities and ensure that all adult care home staff is trained in the facility's written infection prevention and control policies and procedures developed pursuant to subdivision (b)(1) of this section within 30 days after hire and annually thereafter. Any nonsupervisory staff member designated to direct the facility's infection control activities shall complete the infection control course developed by the Department pursuant to G.S. 131D-4.5C.
(5) When a communicable disease outbreak has been identified at a facility or there is an emerging infectious disease threat, the facility shall ensure implementation of the facility's infection control and prevention policies and procedures developed pursuant to subdivision (b)(1) of this section; provided, however, that if guidance or directives specific to a communicable disease outbreak or emerging infectious disease threat have been issued in writing by the Department or local health department, the Department's or local health department's specific guidance or directives shall be implemented by the facility. (2011-99, s. 3; 2021-180, s. 9E.7(a); 2021-189, s. 3.2(a).)
§ 131D-4.4B. Guidelines for reporting suspected communicable disease outbreaks.
The Department shall develop guidelines prescribing the manner in which an adult care home is to report a suspected communicable disease outbreak within the facility to the local health department. (2011-99, s. 3.)