A. All financial records, including resident funds, shall be kept according to generally accepted accounting principles (GAAP).

B. Each nursing facility shall maintain, per facility, noneroding general liability insurance coverage in a minimum amount of $1 million per occurrence, and professional liability coverage in an amount at least equal to the recovery limit set forth in § 8.01-581.15 of the Code of Virginia per patient occurrence, to compensate residents or individuals for injuries and losses resulting from the negligent acts of the nursing facility.

1. Failure to maintain minimum insurance limits comply with the insurance coverages required under this section shall result in revocation of the nursing facility's license.

2. Each nursing facility shall provide at licensure renewal or have available to the board proof of the insurance coverages as required by this subsection.

3. When an existing owner of a licensed nursing home or certified nursing facility sells or transfers ownership and the general liability and the professional liability insurance coverages are claims-made policies, then the purchaser shall purchase an extended reporting endorsement of two years after the date of sale, or purchase general liability and professional liability insurance coverage with coverage dates that begin two years prior to the date the existing owner's general liability and professional liability policies end. The seller may provide the purchaser with a certificate of insurance evidencing coverage under an extended reporting endorsement consistent with the requirements of this section. The purchaser shall provide evidence of compliance with this section to the Virginia Department of Health. Failure to comply with the insurance coverages required under this section shall result in revocation of the facility's license.

C. Nursing facilities choosing to handle resident funds shall:

1. Comply with § 32.1-138 A 7 of the Code of Virginia regarding resident funds;

2. Purchase a surety bond or otherwise provide assurance for the security of all personal funds deposited with the nursing facility; and

3. Provide for separate accounting for resident funds.

D. In the event the nursing facility is sold, the nursing facility shall provide written verification that all resident funds have been transferred and shall obtain a signed receipt from the new owner. Upon receipt, the new owner shall provide an accounting of resident funds.

E. Each nursing facility shall be required to provide a full refund of any unexpended patient funds on deposit with the nursing facility following the discharge or death of a patient, other than entrance related fees, within 30 days of a written request for such funds by the discharged patient or, in the case of the death of a patient, the person administering the patient's estate in accordance with the Virginia Small Estate Act (§ 64.2-600 et seq. of the Code of Virginia).

A. A written emergency preparedness plan shall be developed, reviewed, and implemented when needed. The plan shall address responses to natural disasters, as well as fire or other emergency which disrupts the normal course of operations. The plan shall address provisions for relocating residents and also address staff responsibilities for:

1. Alerting emergency personnel and sounding alarms;

2. Implementing evacuation procedures including the evacuation of residents with special needs;

3. Using, maintaining and operating emergency equipment;

4. Accessing resident emergency medical information; and

5. Utilizing community support services.

B. All staff shall participate in periodic emergency preparedness training.

C. Staff shall have documented knowledge of, and be prepared to implement, the emergency preparedness plan in the event of an emergency.

D. At least one telephone shall be available in each area to which residents are admitted and additional telephones or extensions as are necessary to ensure availability in case of need.

E. In the event of a disaster, fire, emergency or any other condition that may jeopardize the health, safety and well-being of residents, the nursing facility shall notify the OLC of the conditions and status of the residents and the physical plant as soon as possible.

F. The nursing facility shall have a policy on smoking.

G. Each nursing facility and certified nursing facility shall have and maintain an automated external defibrillator, as defined in § 32.1-111.1, and have staff trained to use such automated external defibrillator.

A. The nursing facility shall conduct an initial and periodic assessment of each resident's needs. The assessment shall accurately describe the resident's capability to perform daily life functions and significant impairments in functional capacity. This comprehensive assessment shall include, but is not limited to:

1. Medically defined conditions and prior medical history;

2. Medical status;

3. Physical and mental functional status;

4. Sensory and physical impairments;

5. Nutritional status and requirements;

6. Special treatments or procedures;

7. Psychosocial status;

8. Discharge potential;

9. Dental condition;

10. Activities potential;

11. Rehabilitative potential;

12. Cognitive status;

13. Drug therapy; and

14. Any known advance directives.

B. The nursing facility shall conduct a complete assessment:

1. No later than 14 days after the date of admission;

2. Promptly after a significant change in the resident's physical or mental condition; and

3. In all cases, at least once every 12 months366 days.

C. The nursing facility shall review each resident's assessment at least once every three months92 days and shall update the plan of care as indicated.

D. Each assessment shall be coordinated by a registered nurse who signs, dates and certifies completion of the assessment.

E. Each assessment shall be conducted or coordinated with the participation of health professionals. Each person completing a portion of the assessment shall sign and date that portion of the assessment.

F. The nursing facility shall use the results of the assessment to develop, review, and revise the resident's comprehensive plan of care.

G. A comprehensive plan of care shall be developed for each resident. The plan shall include measurable objectives and timetables to meet the resident's medical, nursing, nutritional, and psychosocial needs identified in the comprehensive assessment. The plan shall also describe the services that are to be furnished to maintain or improve the resident's physical, mental, and psychosocial status.

H. The comprehensive plan of care shall be developed within seven days of completion of the comprehensive assessment. Upon request, a copy or summary of such comprehensive plan of care, as defined by the facility's established policy, shall be delivered to the resident and the resident's family or legal representative within seven days of completion.

I. The comprehensive plan of care shall be prepared by a multidisciplinary team. The multidisciplinary team shall include a registered nurse, the attending physician, to the extent practicable, and other staff in disciplines as determined by the resident's needs. The resident, the resident's family or legal representative shall also be provided a meaningful opportunity to participate in the care planning.

J. If any required visits to a resident by a physician do not take place in accordance with the federal physician visit schedule described in 42 C.F.R. § 483.30(c), any nursing home licensed under this chapter shall send notice to the resident, the resident's family or legal representative, and the Virginia Department of Health.