Policies and Procedures

A qualified caregiver may be delegated to perform nursing care services beyond their usual and customary roles under the direction and supervision of licensed nurses under WAC 246-840-930 and RCW 18.79.260. A caregiver may be a NAC, HCA-C, NAR or Exempt LTCW and must have completed the Nurse Delegation Certification and have current credentials to be eligible to provide delegated care tasks.

Caregivers are prohibited from performing any licensed nurse functions that are specifically defined in the Board of Nursing Rules and those that require nursing assessment or diagnosis, establishment of a plan or care or teaching, that exercises nursing judgement, or procedures requiring specialized nursing knowledge, skills or techniques (eg. Sterile procedures, central line care, or any care for unstable conditions.)

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The Registered Nurse Delegator (RND) will be familiar with specific facility policies, procedures and available supplies and staffing as well as rules and regulations governing delegation and nursing care.

RND will assess the nursing care needs and services that may be delegated for the client. If a task cannot be delegated RND will make arrangements for outside services to provide care.

Decisions concerning delegation will be determined in accordance with the provisions outlined in the WAC for Nurse Delegation on ALTSA webpage resources.

RND will monitor the caregiver for competence in the performance of specific task being considered for delegation and provide additional training as needed to safely perform task. Certifications will be completed at a minimum of every 90 days or as needed for changes in client condition or caregiver status.

RND will monitor the condition of the client, update the plan of care and modify delegated tasks as needed to meet the needs of the client. Changes in care, to include medication changes and orders, will be communicated to the caregiver and further education and instruction will be provided as necessary. Caregivers will report any changes in client condition or medications to Nurse Delegator within 24 hours, and the RND will respond within a 24 hour business time period.

RND will document the delegation, supervision, corrective action and initiate rescinding of delegation if needed in the Nurse Delegation Binder located in the residence. RND may also provide direct nursing services, assessments and training related to Skin Observation Protocol. All Delegation records are required to remain on site for 7 years.

 

 

 

Notice of Privacy Practices and HIPAA

When it comes to your health information, you have certain rights. This notice describes how medical information about you may be used and disclosed and how you can obtain access to the information. Please review it carefully.

 

Your Rights:

Get an electronic or paper copy of your medical record

 

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.

 

• We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost based fee for this.

 

Ask us to correct your medical record

 

• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.

 

• We may say “no” to your request, but we will tell you why in writing within 60 days.

 

Request confidential communications

 

• You can ask us to contact you using a specific method (for example home or office phone) or to send mail to a different address.

 

• We will say “yes” to all reasonable requests.

 

Ask us to limit use or share

 

• You can ask us not to use or share certain health information for treatment, payment, or our operations.

 

• We are not required to agree to your request, and we may say “no” if it affects your care.

 

• If you pay for a service or health care item out of pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.

 

• We will say “yes” unless a law requires us to share that information.

 

Get a list of those with whom we’ve shared information

 

• You can ask for a list accounting of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.

 

• We will include all of the disclosures except for those about treatment, health care operations and certain other disclosures (such as any you asked us to make). We will provide one accounting a year free of charge, but will charge a reasonable, cost based fee if you request another within a 12 month period.

 

Get a copy of this privacy notice

 

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive this notice electronically. We will provide you with a paper copy promptly.

 

Choose someone to act for you

 

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

 

• We will make sure the person has this authority and can act for you before we take any action.

 

File a complaint if you feel your rights are violated

 

• You can contact us to file a complaint if you feel we have violated rights by contacting us.

 

• You can file a complaint with the U.S. Department of Health and Human Services Office using one of the following methods. We will not retaliate against you for filing a complaint.

 

• Sending a letter to: 200 Independence Avenue SW Washington, D.C. 20201

 

• Calling: 1-877-696-6775

 

• Visiting: www.hhs.gov/ocr/privacy/hipaa.complaints

 

 

We are required by law to maintain the privacy and security of your protected health information.

 

• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

 

• We must follow the duties and privacy practices described in this notice and provide a copy to you.

 

• We will not use or share your information other than as described in this notice unless you give us permission in writing. If you give us permission to, you may change your mind at any time. Let us know in writing if you change your mind. For additional information please visit:

 

• www.hhs.gov/ocr.privacy/hipaa/understanding/consumers/noticepp.html

 

 

 

Changes to the Terms of This Notice

 

• We can change the terms of this notice, and the changes will apply to all of the information we have about you.  The new notice will be available upon request, in our office, and on our website.

 

This Notice of Privacy Practices applies to the following organizations.

2 Nurses Contracting, LLC

Anita Brighton RN, COS-C, RND

Warren Brighton RN

Revised 07/22/2022