NAC449.2726. Residents having diabetes.

     1. A person who has diabetes must not be admitted to a residential facility or be permitted to remain as a resident of a residential facility unless:

     (a) The resident’s glucose testing is performed by:

          (1) The resident himself or herself without assistance; or

          (2) A medical laboratory licensed pursuant to chapter 652 of NRS; and

     (b) The resident’s medication is administered:

          (1) By the resident himself or herself without assistance;

          (2) By a medical professional, or licensed practical nurse, who is:

               (I) Not employed by the residential facility;

               (II) Acting within his or her authorized scope of practice and in accordance with all applicable statutes and regulations; and

               (III) Trained to administer the medication; or

          (3) If the conditions set forth in subsection 2 are satisfied, with the assistance of a caregiver employed by the residential facility.

     2. A caregiver employed by a residential facility may assist a resident in the administration of the medication prescribed to the resident for his or her diabetes if:

     (a) The resident’s physical and mental condition is stable and is following a predictable course.

     (b) The amount of the medication prescribed to the resident for his or her diabetes is at a maintenance level and does not require a daily assessment.

     (c) A written plan of care by a physician or registered nurse has been established that:

          (1) Addresses possession and assistance in the administration of the medication for the resident’s diabetes; and

          (2) Includes a plan, which has been prepared under the supervision of a registered nurse or licensed pharmacist, for emergency intervention if an adverse condition results.

     (d) The medication prescribed to the resident for his or her diabetes is not administered by injection or intravenously.

     (e) The caregiver has successfully completed training and examination approved by the Division regarding the administration of such medication.

     3. The caregivers employed by a residential facility with a resident who has diabetes shall ensure that:

     (a) Sufficient amounts of medicines, equipment to perform tests, syringes, needles and other supplies are maintained and stored in a secure place in the facility;

     (b) Syringes and needles are disposed of appropriately in a sharps container which is stored in a safe place; and

     (c) The caregivers responsible for the resident have received instruction in the recognition of the symptoms of hypoglycemia and hyperglycemia by a medical professional who has been trained in the recognition of those symptoms.

     4. The caregivers employed by a residential facility with a resident who has diabetes and requires a special diet shall provide variations in the types of meals served and make available food substitutions in order to allow the resident to consume meals as prescribed by the resident’s physician. The substitutions must conform with the recommendations for food exchanges contained in the Exchange Lists For Meal Planning, published by the American Diabetes Association, Incorporated, and the American Dietetic Association, which is hereby adopted by reference. A copy of the publication may be obtained from the American Diabetes Association, Incorporated, Order Fulfillment Department, P.O. Box 930850, Atlanta, Georgia 31193-0850, at a cost of $2.50.

     (Added to NAC by Bd. of Health by R003-97, eff. 10-30-97; A by R073-03, 1-22-2004)