Text: SF02073 Text: SF02075 Text: SF02000 - SF02099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 135C.49 NURSING ADMINISTRATOR –
1 2 REQUIRED – PENALTIES.
1 3 1. As used in this section, unless the context otherwise
1 4 requires:
1 5 a. "Health administrator" means an individual employed by
1 6 or under contract with a health care facility to manage
1 7 resources, employees, and capital of the health care facility.
1 8 b. "Nurse administrator" means a registered nurse employed
1 9 by or under contract with a health care facility to perform
1 10 the day-to-day management of nursing services.
1 11 c. "Nursing services" means direct and other patient care
1 12 provided by a registered nurse including but not limited to
1 13 all of the following:
1 14 (1) Ongoing patient assessments, including the
1 15 documentation of the performance and findings of the
1 16 assessment in the patient's medical record.
1 17 (2) The planning, supervision, implementation, and
1 18 evaluation of nursing services provided to each patient.
1 19 (3) The assessment, planning, implementation, and
1 20 evaluation of patient education, including ongoing discharge
1 21 teaching of each patient.
1 22 (4) The planning and delivery of patient care in all of
1 23 its aspects including assessment, nursing diagnosis, planning,
1 24 intervention, evaluation, and, as appropriate, patient
1 25 advocacy.
1 26 (5) Other tasks as may be delegated, assigned, or
1 27 supervised by registered nurses as permitted pursuant to
1 28 chapter 152.
1 29 2. a. A health care facility that receives reimbursement
1 30 through the federal Medicare or medical assistance program
1 31 that employs or contracts with nurses shall provide a minimum
1 32 of one nurse administrator to review and oversee nursing
1 33 services.
1 34 b. The duties of the nurse administrator shall include but
1 35 are not limited to development and review of patient care
2 1 systems, nurse staffing and assessment, and analysis of
2 2 patient outcomes.
2 3 c. The nurse administrator may manage financial and
2 4 personnel resources to provide adequate nurse staffing.
2 5 3. A health administrator who is not a licensed registered
2 6 nurse or a licensed physician shall not act as a nurse
2 7 administrator.
2 8 4. The director shall issue a written citation to a health
2 9 care facility in accordance with section 135C.40, and the
2 10 health care facility shall be subject to the citation
2 11 procedures and penalties of this chapter, if the director
2 12 determines any of the following, based on the findings of an
2 13 inspection or investigation of a health care facility:
2 14 a. That a health administrator is acting as a nurse
2 15 administrator, or that a health administrator is negligent in
2 16 a manner that results in harm to a resident of a nursing
2 17 facility.
2 18 b. That a nurse administrator is responsible for deficient
2 19 nursing services or nurse staffing or that a nurse
2 20 administrator is negligent in a manner that results in harm to
2 21 a patient of a nursing facility.
2 22 5. The director shall consider all of the following as
2 23 mitigating factors in determining if a health administrator is
2 24 acting as a nurse administrator in violation of this section,
2 25 if a nurse administrator is responsible for deficient nursing
2 26 services or nurse staffing, or if either a health
2 27 administrator or a nurse administrator is negligent in a
2 28 manner that results in harm to a resident of a nursing
2 29 facility:
2 30 a. Whether the actions of the health administrator or
2 31 nurse administrator were in accordance with and followed the
2 32 terms of a physician order, medical order, staffing plan, or
2 33 valid patient classification system. It shall not be
2 34 considered a mitigating factor if the health administrator or
2 35 nurse administrator is responsible for the issuance of an
3 1 erroneous medical or nursing order, or the creation or use of
3 2 a deficient staffing plan or patient classification system and
3 3 did not take reasonable measures to correct the defect.
3 4 b. The comparative responsibility between the health
3 5 administrator or nurse administrator and the requirements
3 6 placed on those members of the staff who are employees,
3 7 including but not limited to the adequacy of the facility's
3 8 compliance with related regulatory standards, laws, and
3 9 regulations; policies and procedures; training, including
3 10 individual employees' participation in staff training;
3 11 employee supervision; staffing levels; and consideration of
3 12 the scope of responsibilities of the health administrator,
3 13 nurse administrator, and other staff.
3 14 c. Whether the health administrator or nurse administrator
3 15 followed professional standards in exercising professional
3 16 judgment.
3 17 d. Whether the health administrator properly delegated or
3 18 granted authority to the nurse administrator to utilize
3 19 funding and develop budgets which when implemented would
3 20 provide adequate staffing.
3 21 6. A health care facility that employs or contracts with a
3 22 health administrator or a nurse administrator who violates
3 23 this section is subject to the civil penalties established
3 24 pursuant to sections 135C.36 and 135C.44.
3 25 EXPLANATION
3 26 This bill requires each licensed health care facility or
3 27 health care facility that employs or contracts with nurses to
3 28 provide a minimum of one nurse administrator to review and
3 29 oversee nursing services. The bill prohibits a health
3 30 administrator who is not a licensed nurse or physician from
3 31 acting as the nurse administrator. The bill provides that if
3 32 the director of the department of inspections and appeals
3 33 determines, based on the findings of an inspection or
3 34 investigation of a health care facility, that a health
3 35 administrator is acting as a nurse administrator, or that a
4 1 health administrator is negligent in a manner that results in
4 2 harm to a resident of a nursing facility, or that a nurse
4 3 administrator is responsible for deficient nursing services or
4 4 nurse staffing, or that a nurse administrator is negligent in
4 5 a manner that results in harm to a patient of a nursing
4 6 facility, the director is to issue a written citation to the
4 7 health care facility and the health care facility is subject
4 8 to the citation procedures and penalties established for
4 9 violations by health care facilities. The bill provides for
4 10 mitigating circumstances to be considered by the director in
4 11 determining if a violation has been committed.
4 12 LSB 5489XS 79
4 13 pf/cls/14
Text: SF02073 Text: SF02075 Text: SF02000 - SF02099 Text: SF Index Bills and Amendments: General Index Bill History: General Index
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