Current through Register Vol. 49, No. 9, September, 2024
SECTION 1.
PREFACE
These rules have been prepared for the purpose of establishing
a criterion for minimum standards for the licensure of private care agencies
providing Medicaid Personal Care in Arkansas. By necessity they are of a
regulatory nature but are considered to be practical minimal design and
operational standards for these agencies. These standards are not static and
are subject to periodic revisions in the future as new knowledge and changes in
home care become apparent. However, it is expected that agencies will exceed
these minimum requirements and that they will not be dependent upon future
revisions in these standards as a necessary prerequisite for improved services.
Each private care agency has a strong moral responsibility for providing
optimum home care and services for the clients it serves.
SECTION 2.
AUTHORITY
The following Rules for Private Care Agencies in Arkansas are
duly adopted and promulgated by the Arkansas State Board of Health pursuant to
the authority expressly conferred by the laws of the State of Arkansas in Ark.
Code Ann.§
20-10-2301 et seq.
SECTION 3.
PURPOSE
These rules are established to ensure high quality care and
services for clients in their homes.
SECTION 4.
DEFINITIONS
The following words and terms, when used in these sections,
shall have the stated meanings, unless the context clearly indicates
otherwise.
A) Administrator - A person
who is an agency employee and is a physician, registered nurse, or an
individual with at least one year of supervisory or administrative experience
in home health care or in related health provider programs.
B) Aide Service Plan - written assignments
developed and supervised by a qualified supervisor for the tasks to be
completed by the aide.
C) Client -
Eligible recipient of Medicaid Services.
D) Client Note -A dated, written or
electronic and signed notation by agency personnel of a contact with a client
including a description of services provided, and any changes in circumstances
that impact the client's services or welfare.
E) Client Record - An accurate account of
services provided for each client and maintained by the agency.
F) Contractor -An entity or individual
providing services for the agency who does not meet the definition of
employee.
G) Department- The
Arkansas Department of Health, Health Facility Services.
H) Employee -Any individual for whom the
agency is required to issue a form W-2.
I) Health - The condition of being sound in
body, mind and spirit, especially freedom from physical disease or
pain.
J) Health Assessment-A
determination of a patient's physical and mental status performed by medical
professionals.
K) Personal Care
Services -assistance in activities of daily living, hygiene, or
grooming.
L) Personal Care Aide - A
person who provides personal care/personal services for a client in their place
of residence.
M) Place of Business
-Any office of a private care agency that maintains client records or directs
services.
N) Private Care Agency- a
provider that is, certified by the Division of Aging, Adult, and Behavioral
Health Services of the Department of Human Services as a provider of home- and
community-based health services and that:
1)
furnishes in-home staffing services for personal and attendant care services;
and
2) retains liability insurance
of not less than one million dollars ($1,000,000.00) to cover its employees and
independent contractors while its employees and independent contractors are
engaged in providing personal and attendant care services.
O) Quality of Services -competent care which
are supported and directed in a planned pattern to achieve well-being, dignity
and comfort, and self-management.
P) Residence - A place where a person
resides, including a home, nursing home, residential care facility or
convalescent home for the disabled or aged.
Q) Supervision -Authoritative procedural
guidance by a qualified person, acting within his or her applicable scope of
practice, to a function or activity.
R) Supervisor - A licensed nurse or one who
has completed two years of full-time study at an accredited institution of
higher education. An individual who has a high school diploma or GED may
substitute one (1) year of full time employment in a supervisory capacity in a
healthcare facility or community-based agency for one (1 year at an institution
of higher education.
S) Telenursing
- the use of [distance) technology to deliver nursing care and conduct nursing
practice.
T) Visit-A face to face
meeting in the client's residence or by the use of information
Technology.
SECTION 5.
AGENCY LOCATION
A private care agency shall maintain:
A) a licensed fully operational primary
office physically located within the State of Arkansas; and
B) a sufficient number of licensed regional
offices to adequately service the administrative needs of the agency and the
clients.
SECTION 6.
APPLICATION FOR LICENSE
A) Annual
license applications shall be on forms prescribed by the Department and shall
be effective on a calendar year basis with an expiration date of December
31.
B) Each agency shall receive a
license for Medicaid Personal Care.
C) The agency shall notify Health Facility
Services of any of the following:
1) Change of
name;
2) Change of
location;
3) Agency
closing;
4) Change in contact
information, including correspondence address, telephone number, email; FAX;
and
5) Change of
ownership.;
D) Agency
closure. If a licensed agency closes, it shall:
1) Notify Health Facility Services in writing
of:
(a) the effective date;
(b) plans for transfer of current clients and
records; and
2) Return
original license to Health Facility Services.
SECTION 7.
INSPECTIONS
A) A review and/or inspection shall be
conducted before the license is issued.
B) Once the initial inspection is conducted
and the agency becomes licensed, periodic inspections shall be conducted no
less than every three (3) years.
C)
If the inspection is conducted in order to determine compliance with standards,
the agency shall come into compliance within 60 days. If the agency fails to
comply, the Director may propose actions to suspend or revoke the license in
accordance with the section relating to License Denial, Suspension, or
Revocation.
SECTION 8.
DENIAL, SUSPENSION, REVOCATION OF LICENSE
A) A private care agency license may be
denied, suspended, or revoked for one or more of the following reasons:
1) Violation of the provisions of the statute
or any of the standards in these rules;
2) Misstatement of a material fact on any
documents required to be submitted to Health Facility Services or requirements
to be maintained by the agency pursuant to these rules;
3) Commission by the agency or its personnel
of a false, misleading, or deceptive act or practice;
4) Materially altering any license issued by
the Department.
5) An intentional
or negligent act by the agency or its employees which materially affects the
health and safety of a client.
B) If the Director of Health Facility
Services of the Department proposes to deny, suspend, or revoke a license, the
Director shall notify the agency of the reasons for the proposed action and
offer the agency an opportunity for a hearing. The agency may request a hearing
within 30 days after the date the agency receives notice. The request shall be
in writing and submitted to the Director, Health Facility Services, Arkansas
Department of Health, 5800 West Tenth, Suite 400, Little Rock, Arkansas, 72204.
A hearing shall be conducted pursuant to the Administrative Procedures Act. If
the agency does not request a hearing in writing after receiving notice of the
proposed action, the agency is deemed to have waived the opportunity for a
hearing and the proposed action shall be taken.
C) Health Facility Services may suspend or
revoke a license to be effective immediately when the health and safety of
clients are threatened. Health Facility Services shall notify the agency of the
emergency action and shall notify the agency of the date of a hearing, which
shall be within seven days of the effective date of the suspension or
revocation. The hearing shall be conducted pursuant to the Administrative
Procedures Act.
SECTION
9.
TRAINING
A)
Training provided to agency employees shall be approved by Health Facility
Services with the Arkansas Department of Health and:
1) Include all items listed in the attached
TABLE 1;
2) Be supervised by a
registered nurse;
3) Be minimum of
40 hours to include:
(a) classroom;
and
(b) clinical instruction
related to the home setting;
4) Have written:
(a) course objectives;
(b) expected outcomes; and
(c) method(s) of evaluation.
B) Unless the agency
has been properly authorized by the Department of Higher Education to operate a
School, training shall be limited to agency employees.
SECTION 10.
GENERAL REQUIREMENTS
A) Policies and Procedures The agency shall
have written policies including:
1)
Organizational
(a) A description of the
structure showing ownership and line of authority down to the client service
level;
(b) The services
offered;
(c) Hours of operation;
and
(d) Criteria for client
acceptance and termination.
2) Orientation of all personnel to the
policies and objectives of the agency.
3) Procedures for all tasks.
4) Infection control program;
(a) which has as its goal the prevention and
control of infections and communicable diseases.
(b) Work restrictions for employees shall be
according to CDC Recommendations;
(c) Measures for prevention of communicable
disease outbreaks, especially Mycobacterium tuberculosis (TB). All plans for
the prevention of transmission of TB shall conform to the most current CDC
guidelines for preventing the transmission of Mycobacterium Tuberculosis in
Health Care Facilities.
5) Personnel records shall be maintained for
each employee and/or contracted individual. A current personnel record shall
include:
(a) job description, signed by
employee;
(b) qualifications,
education, and/or training;
(c)
application for employment;
(d)
verification of licenses, certifications, and work history;
(e) evidence of orientation and competency
for the topics listed in TABLE 1; and
(f) criminal history determination of
eligibility for employment.
6) An agency wide Quality Assurance and
Improvement Program that includes all services for the purpose of monitoring
the safety and effectiveness of services and quality of care. The program will
include:
(a) client satisfaction
surveys;
(b) supervision of
services;
(c) results of
inspections, surveys and audits from outside entities; and
(d) performance improvement projects as
applicable.
7)
Complaints and incidents. Each agency shall keep a record of complaints
received. Documentation shall include:
(a) the
names of involved individuals
(b)
the relationship to the client;
(c)
the nature of the complaint;
(d)
date of incident; and
(e) the
action taken to resolve the complaint (including referrals to other
entities).
B)
Governing Board.
1) A Private Care Agency
shall have an organized Governing Board, consisting of at least one member,
which may be the owner, who shall be legally responsible for maintaining
quality client services and establishing policies for the agency, shall be
legally responsible for the conduct of the agency, and shall establish a
mechanism to:
(a) Adopt and periodically
review written bylaws or an acceptable equivalent;
(b) Approve written policies and procedures
related to safe, adequate services and operation of the agency;
(c) Appoint an administrator and approve a
plan for an alternate in the absence of the administrator; and
(d) Oversee the management and fiscal affairs
of the agency, including approving the agency's annual budget.
C) Administrator
Responsibilities. The Administrator shall:
1)
Manage the agency's daily ongoing functions;
2) Ensure all persons providing services on
behalf of the agency are qualified and receive ongoing education;
3) Ensure the accuracy of public information
materials and activities;
4)
Implement and monitor budgeting and accounting systems
5) Implement quality assurance and infection
control programs; and
6) Conduct
annual review of the changes to the policies and procedures.
D) Client Rights.
1) The agency shall provide each client or
representative with a copy of the Bill of Rights affirming the client's right
to:
(a) Be informed of the services offered by
the agency and those being provided to the client;
(b) Participate in the development of the
plan of care and to be informed of the dates and approximate time of
service;
(c) Receive an explanation
of any responsibilities the client may have in the care process;
(d) Be informed of the name of agency and how
to contact that agency during all hours of operation;
(e) Be informed of the process for submitting
and addressing complaints to the agency and be notified of the State Home
Health Hotline number.
(f) Be
informed orally and in writing of any charges which insurance might not cover
and for which the client would be responsible;
(g) Courteous and respectful treatment,
privacy and freedom from abuse and discrimination;
(h) Confidential management of client records
and information;
(i) Access
information in the client record upon request
(j) Receive prior notice and an explanation
for the reasons of termination, referral, transfer, discontinuance or change of
service; and
(k) Control access to
the client's home.
2)
The agency shall provide each client and family with a written list of
responsibilities affirming the client's responsibility to:
(a) Assist in developing and maintaining a
safe environment;
(b) Treat all
agency staff with courtesy and respect;
(c) Participate in the development and update
of services; and
(d) Adhere to the
plan of care or services as developed by the agency and to assist in the care
as necessary.
E) Records and Documentation
1) The private care agency shall maintain
records of all services provided to clients which are orderly, intact, legibly
written and available and retrievable either in the agency or by electronic
means and suitable for photocopying or printing.
2) Records shall be stored in a manner which:
(a) Prevents loss or manipulation of
information;
(b) Protects the
record from damage; and
(c)
Prevents access by unauthorized persons.
3) Records shall be retained for a minimum of
five years after discharge of the client or two years after the age of
majority.
4) Each record shall
include:
(a) Initial assessment performed by a
qualified supervisor;
(b) Plan of
care which shall detail the services;
(c) Aide service plan;
(d) Physician or licensed practitioner
orders, if any;
(e) Records of
supervisory visits;
(f) Date and
time service providers are in the home; and
(g) Tasks completed.
5) Client notes are to be written the day the
service is rendered and incorporated into the record no less than every 14
days.
6) Provisions shall be made
for the records in the event an agency ceases operation.
F) A written notice of the felony status
under A.C.A §
5-13-202 of attacking a healthcare worker shall be posted in
all public entrances and patient waiting area of the healthcare facility
utilizing the digital poster available on the Arkansas Department of Health
website.
G) A healthcare provider
shall not mislead any patient regarding the healthcare provider's licensure
status.
SECTION 11.
SERVICES
A) All Services
1) The agency shall:
(a) Perform an initial evaluation visit and
determine;
(i) the needs and condition of the
client;
(ii) the services to be
provided; and
(iii) the personnel
to provide the services.
(b) Develop the Aide Service Plan which
shall;
(i) outline the services;
(ii) determine scope and frequency of
visits;
(iii) assign appropriate
delegation of services consistent with the Arkansas State Board of Nursing;
and
(iv) determine supervision
scope and frequency. Frequency shall be at least annually.
B) Personal Care
Services shall be rendered by a person who has completed an approved 40-hour
aide training course that meets the requirements set forth in Section 9 and:
1) Delegate through the use of an Aide
Service Plan;
2) Each aide shall
receive a copy of the Aide Service Plan;
3) A copy of the Aide Service Plan will be
accessible in the home;
4) The Aide
Service Plan shall be individualized and specific;
5) Aides shall receive a minimum of 12 hours
of in-service training per 12 months. The inservices provided shall address
areas that directly relate to the client care aspect of the aide's
job.
6) The agency is responsible
for evaluating the competency of any Personal Care aide. At a minimum, the aide
shall be observed by a registered nurse performing the skills required to care
for a client according to Table 1. There shall be documentation by the agency
to show evidence of this evaluation.
C) Services Provided by Contractors
A contracted entity or contracted individual conforms to all
applicable agency policies including those described in Section 10.A.
SECTION 12.
SEVERABILITY
If any provision of these Rules, or the application thereof to
any person or circumstances is held invalid, such provisions or applications of
these Rules that can give effect without the invalid provisions or applications
will be enforced, and to this end the provisions hereto are declared to be
severable.
TABLE 1
Aide training for employees course and clinical work topics
shall include, but not be limited to:
A) Body Functions;
B) Body Mechanics & Safety
Precautions;
C) Communication
Skills;
D) Health
conditions;
E) Alzheimer's disease
and dementia (4 hours) to include:
1)
Communication Skills;
2) Problem
solving with challenging behaviors;
3) Assistance with daily living;
and
4) explanation of Alzheimer's
disease and other dementia;
F) Emergency recognition and
procedures;
G) Household safety and
fire;
H) Infection
control;
I) Ethical considerations
and state law regarding Nurse delegation;
J) Nutrition;
K) Ambulation;
L) Household services for healthcare to
include basic housekeeping procedures and laundry;
M) Bathing, shampooing, shaving;
N) Personal grooming to include dressing and
undressing;
O) Meal preparation and
clean up;
P) Oral
hygiene;
Q) Normal range of
motion;
R) Toileting;
S) Transfer techniques;
T) Recordkeeping and documentation to include
reporting changes to appropriate supervisor;
U) Role of caregiver in team; and
V) Nail and skin care.
CERTIFICATION
This will certify that the foregoing revisions to the Rules for
Private Care Agencies in Arkansas were adopted by the State Board of Health of
Arkansas at a regular session of said Board held in Little Rock, Arkansas, on
the 26th day of October, 2023.