Current through Register Vol. 30, No. 38, September 20, 2024
A. An
administrator shall ensure that an individual admitted to the home health
agency has an order from a physician, registered nurse practitioner, or
podiatrist for home health services.
B. An administrator shall ensure that the
home health services director provides direction for home health services
provided by or through the home health agency.
C. A home health services director shall
ensure that nursing services are provided by a registered nurse or practical
nurse, according to policies and procedures.
D. A home health services director shall
ensure that a registered nurse:
1. Unless a
patient's physician or registered nurse practitioner orders only speech
therapy, occupational therapy, or physical therapy for the patient, within 48
hours after the patient begins receiving home health services provided by or
through the home health agency, conducts an initial assessment of the patient
to determine:
a. The needs of the
patient;
b. Resources available to
address the patient's needs;
c. The
patient's home and family environment;
d. Goals for patient care;
e. Medications used by the patient, including
non-compliance, drug interactions, side effects, and contraindications;
and
f. Medical supplies or
equipment needed by the patient;
2. Reviews a patient's health care directives
at the time of the initial assessment;
3. Implements a patient's care plan,
developed as specified in R9-10-1207;
4. Coordinates patient care with other
individuals providing home health services or other services to the
patient;
5. Immediately informs the
patient's physician or registered nurse practitioner of a change in a patient's
condition that requires medical services; and
6. At least every 60 calendar days until a
patient is discharged:
a. Reassesses the
patient based on the patient's care plan, needs, and medical condition;
and
b. Summarizes the patient's
condition and needs for the patient's physician, registered nurse practitioner,
or podiatrist, as applicable.
E. A home health services director shall
ensure that:
1. A patient's condition and the
services provided to the patient are documented in the patient's medical record
after each patient contact; and
2.
Verbal orders from a patient's physician, registered nurse practitioner, or
podiatrist, as applicable, are:
a. Except as
specified in subsection (F)(2)(d), received by a registered nurse and
documented by the registered nurse in the patient's medical record;
and
b. Authenticated by the
patient's physician, registered nurse practitioner, or podiatrist, as
applicable, with a signature, within 30 calendar days.
F. A home health services director
shall ensure that:
1. A registered nurse:
a. Except as specified in subsection
(F)(2)(b)(i) and (ii):
i. Assigns tasks in
writing to a home health aide who is providing home health services to a
patient; and
ii. Verifies the
competency of the home health aide in performing assigned tasks;
b. Except as specified in
subsection (F)(2)(b)(iii), provides direction for the home health aide services
provided to a patient; and
c.
Except as specified in subsection (F)(2)(e)(ii), meets with a patient who is
receiving home health aide services to assess the home health services provided
by the home health aide:
i. At least every
two weeks when the patient is also receiving nursing services or therapy
services, and
ii. At least every 60
calendar days when the patient is only receiving home health aide
services;
2.
When a patient's physician or registered nurse practitioner orders speech
therapy, occupational therapy, or physical therapy for the patient, an
individual specified in R9-10-1203(C)(6)(a), (c), or (d), as applicable:
a. Provides the applicable therapy service to
the patient according to the patient's care plan;
b. If a home health aide is assigned to
assist the patient in performing activities related to the therapy service:
i. Assigns tasks in writing to the home
health aide who is assisting the patient;
ii. Verifies the competency of the home
health aide in performing assigned tasks; and
iii. Provides direction to the home health
aide in performing the assigned tasks related to the therapy service;
c. Coordinates the provision of
the therapy service to the patient with the registered nurse providing
direction for other home health services for the patient;
d. Documents in the patient's medical record
any orders by the patient's physician or registered nurse practitioner received
concerning the therapy service; and
e. If the only home health services ordered
for the patient are speech therapy, occupational therapy, or physical therapy:
i. Within 48 hours after the patient begins
receiving home health services provided by or through the home health agency,
conducts an initial assessment of the patient as specified in subsections
(D)(1)(a) through (f); and
ii.
Meets with a patient who is receiving home health services from a home health
aide every two weeks to assess the home health services provided by the home
health aide; and
3. A home health aide:
a. Is only assigned to provide services the
home health aide can competently perform; and
b. Only performs tasks assigned to the home
health aide in writing by a registered nurse or as specified in subsection
(F)(2)(b)(i).