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2005-2006 Summary of Rule and Statute Changes
Protective Health Services
Long Term Care Service

Chapter 257. Food Service Establishment [New]

The proposed rule replaces Chapter 256, which is being revoked simultaneously with the adoption of this new chapter. The adoption of a new chapter is intended to bring Oklahoma food service rules into conformity with the 2001 edition of the Food Code published by the Food and Drug Administration and the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.

Significant changes and additions to food service requirements in Chapter 257 include but are not limited to the responsibility of the person in charge to report an employee diagnosed with a food borne disease. Requirements to prevent cross contamination through bare hand contact will be addressed.  Raw shell eggs shall be received in refrigeration and maintained at 41 F. Juice packaged in a food establishment shall have a HACCP Plan for processing. Ready-to-eat, potentially hazardous food shall be date marked for food products that have been prepared, held, packaged, re-wrapped or combined with additional ingredients or portions in a licensed facility.  Fruits and vegetables that are cooked for hot holding shall be cooked to a temperature of 135°F.  Changes in equipment requirements state that food establishments must incorporate a visual or audible alarm to signal if the detergent or sanitizer needs to be added to the system.  All food equipment that is certified or classified for sanitation by an American National Standards Institute (ANSI) – Accredited certification program, must comply with the materials for construction and design for commercial equipment.  There shall be a temperature measuring device with a suitable small-diameter probe that is designed and readily accessible to accurately measure the temperature in the foods such as meat patties and fish filets. There will be a procedure for obtaining a variance for nonconforming use of equipment. The owner of a food service establishment may request a variance(s) for equipment and facilities that exist prior to effective date(s) thereof; each variance may be granted only for the term of the existing license, but shall be subject to Department review and may be approved for an additional license year unless revoked by the Department. Any new construction or replacement equipment must conform to existing rules.

Chapter 663. Continuum of Care and Assisted Living [Amended]
      Subchapter 21.  Applying for a license
      310:663-21-2. Deadlines for filing [AMENDED]
      310:663-21-4. Filing fees [AMENDED]

Provides for assisted living license expirations and renewals to be distributed throughout the year, rather than all renewals coming due on July 31 each year. This will enable the Department to significantly reduce average response times to applicants for assisted living licenses.

Chapter 675. Nursing and Specialized Facilities [Amended]
       
Subchapter 3.  Licenses
      310:675-3-5.1. Description of forms [AMENDED]
      310:675-3-8. Notice of change [AMENDED]

Requirements for license application forms are modified to ensure that all persons with ownership, operation, management or supervision of the facility are fully and accurately disclosed as required under the Nursing Home Care Act.  Notice requirements are modified to ensure that changes affecting disclosures submitted for a facility's ownership, operation, management or supervision are timely and accurately reported to the State Health Department

Chapter 675. Nursing and Specialized Facilities [Amended]
      Subchapter 7.  Administration
      310:675-7-9.1  [AMENDED]
      Subchapter 9. Resident Care Services
      310:675-9-1.1 [AMENDED]
      310:675-9-5.1 [AMENDED]
      Subchapter 13. Staff Requirements
      310:675-13-5 [AMENDED]

Establishes standards for assessing and documenting pain experienced by nursing facility residents.  Requires facility policy and procedure manuals to address pain assessment and treatment.  Requirements for nursing care are amended to establish a frequency for pain assessment, and to require record keeping.  Provisions on resident assessments and care plans are amended to specify minimums for individualized pain assessment.  Facility staff training requirements for pain recognition, pain screening and pain management are established.  The amendments implement recommendations adopted on February 17, 2005 by the State Advisory Council on Pain Management, pursuant to Title 63 O.S. Sections 1-1918A and 1-1918B.  The changes were needed to implement a July 1, 2005 requirement for nursing facilities to perform pain assessments.

Chapter 675. Nursing and Specialized Facilities [Amended]
      Subchapter 19.  Feeding Assistants [NEW]
      310:675-19-1 through 310:675-19-8 [NEW]

This Subchapter establishes standards for training and registration of feeding assistants in Oklahoma in accordance with 42 Code of Federal Regulations Parts 483 and 488.  The rule requires a Feeding Assistant Registration Application form.  The intent is to give nursing, specialized nursing, and skilled nursing facilities the option to use paid feeding assistants, allowing them to provide more residents with help in eating and drinking and reduce the incidence of unplanned weight loss and dehydration.

Nursing Home Care Act. Title 63 Section  1-1944 et seq. "Long Term Care Security Act"                                                                                                                                             

Facilities must determine from the local law enforcement authority or the Department of Corrections the registration status of the following individuals who are required to register pursuant to the Sex Offenders Registration Act or the Mary Rippy Violent Crime Offenders Registration Act:
a. an applicant for admission to a long-term care facility,
b. a resident of a long-term care facility, and
c. an employee of a long-term care facility
.

Facilities must notify the department when an individual who is required to register pursuant to the Sex Offenders Registration Act or the Mary Rippy Violent Crime Offenders Registration Act is residing at the facility.

Chapter 677. Nurse Aid Training and Certification                                                                                                                                             

      Subchapter1.General Provisions
      310:677-1-6. Temporary emergency waiver [NEW]

Provides for permanent implementation of rules required by 63 O.S. Supp. 2004 Section 1-1950.3(A)(2)(b). The proposed rule is intended to supercede the emergency rule adopted by the State Board of Health on September 16, 2004 and approved by Governor Henry on October 31, 2004.Implements temporary emergency waivers for nursing facilities, specialized facilities, continuum of care facilities, assisted living centers, adult day care centers, and residential care homes that are unable to meet the nurse aide certification and registration requirements pursuant to 63 O.S. Section 1-1950.3(A). The rules specify requirements relating to eligibility for receipt of the waiver, and the process and conditions for obtaining the waiver.

Chapter 675. Nursing and Specialized Facilities [Amended]
       
Subchapter 13.  Certified medication aides
     310:677-13-1 [AMENDED]
      310:677-13-2 [AMENDED]
      310:677-13-3 [AMENDED]
      310:677-13-4 [AMENDED]
      310:677-13-5 [AMENDED]
      310:677-13-6 [NEW]
      310:677-13-7 [NEW]
      310:677-13-8 [NEW]
      310:677-13-9 [NEW]
      310:677-13-10 [NEW]
      310:677-13-11 [NEW]

The amendments to Subchapter 13 establish competency and practice standards for medication aides, create a list of skills and functions that medication aides may perform, specify certification and re-certification requirements for medication aides, provide criteria and procedures for approval of training programs, and establish procedures for administrative sanctions against certified medication aides.  The amendments establish advanced training and certification requirements for administration of diabetic medications, and for administration of medications via nasogastric and gastrostomy routes, and administration of oral metered dose inhalers and nebulizers.  The phrases "stable diabetes" and "unstable diabetes" are defined.  Requirements for facility policies and procedures on certified medication aides are established.  The amendments affect the administration of medications in nursing facilities, specialized nursing facilities including ICF/MR and Alzheimer's facilities, continuum of care facilities, assisted living centers, adult day care centers, and residential care homes.

Full texts of rules are available at :

Nursing and Specialized Facilities Rules, Chapter 675:

Nursing Home Care Act and Long Term Care Security Act:            

Continuum of Care and Assisted Living Rules Chapter 663:

Nurse Aide Training and Certification Rules Chapter 677:

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