(A) Written policies
and procedures must be available for review and designed to meet all the
following standards. Documentation of all staff training must be kept in each
employee's personnel Hie. All local, state, and federal regulatory agency
policies concerning HME and oxygen must be followed.
(1)
Order Intake: A
home medical equipment (HME) provider shall recognize the importance of order
intake. The provider is responsible for assuring that order intake personnel
are appropriately trained in the following:
(a) Identifying equipment;
(b) Determining patient/caregiver
needs;
(c) Determining referral
sources needs;
(d) Knowing
equipment coverage criteria based on diagnosis;
(e) Responding appropriately during a medical
equipment emergency;
(f)
Explaining service procedures;
(g)
Billing third party; and
(h)
Verifying insurance.
The provider must assure that only trained order intake personnel
receive referrals.
(2)
Selection of Appropriate
Equipment:
(a) When providing
equipment services for a patient, a provider shall consider: physician orders,
equipment needs of the patient, economic situation of the patient and
caregiver, and requirement of any third party payor source.
(b) A provider shall recognize those items
which require special fitting and evaluation. fitting of custom items shall be
performed within a reasonable time frame by specially trained
personnel.
(3)
Delivery and Set-Up/Patient and Caregiver Education:
(a) A provider shall maintain trained
personnel to coordinate order fulfillment and to schedule equipment services
with timely delivery. Documentation of training will be maintained.
(b) A provider shall assure delivery
personnel are appropriately trained to:
(A)
Conduct an environment/equipment compatibility assessment.
(B) Appropriately and safely set up the
equipment.
(C) Instruct patient and
caregivers in the safe operation and client maintenance of the
equipment.
(D) Recognize when
additional education and/or follow-up patient compliance monitoring is
appropriate.
(c) Written
instructions must be provided to the patient/caregiver upon delivery and
documentation of receipt of written instruction must be maintained in the
patient record.
(4)
Services During Use:
(a) A provider shall document that patients
are advised of service hours and emergency service procedures. If equipment
malfunction may threaten the customer's health, access to 24 hour per day, 365
days per year emergency service must be available for equipment maintenance or
replacement.
(b) A provider shall
establish a schedule at the time of the initial delivery for any appropriate
follow-up HME services such as periodic maintenance, supply delivery and other
related activities.
(5)
Retrieval/Disinfection/Maintenance:
(a) A provider shall assure that
state/federal requirements for equipment disinfection are followed including
red-tagging for bio-hazards, maintaining dirty equipment isolation, equipment
cleaning and disinfection areas and procedures, and appropriate staff training
on hazard prevention.
(b) Cleaning
and disinfection solutions must be bactericidal, tuberculocidal, and
viricidal.
(c) CDC Universal
precautions and OSHA regulations concerning equipment handling must be
followed.
(d) Create and implement
a preventative maintenance program based on manufacturers' guidelines which
include appropriate record keeping. Trained staff must be utilized.
(6)
Patient
Record:
(a) A supplier must
maintain a record for each customer when required by state or federal law or
when a physician's order is required.
(b) The patient record must include an intake
form and applicable physician's orders.
(c) Records should be safeguarded from loss
and kept confidential.
(d)
Documentation of proper patient/caregiver instruction must be maintained in the
patient record.
(7)
Patient Rights:
(a)
The patient has the right to considerate and respectful service.
(b) The patient has the right to obtain
service without regard to race, creed, national origin, sex, age, disability,
diagnosis or religious affiliation,
(c) Subject to applicable law, the patient
has the right to confidentiality of all information pertaining to his/her
medical equipment and service. Individuals or organizations not involved in the
patient's care may not have access to the information without the patient's
written consent.
(d) The patient
has the right to a timely response to his/her request for HME
services.
(e) The patient has the
right to select the HME supplier of his/her choice.
(f) The patient has the right to voice
grievances without fear of termination of service or other reprisals.
(g) The patient has the right to expect
reasonable continuity of service.
(h) The patient has the right to an
explanation of charges for equipment and supplies.
(8)
Quality
Assurance:
(a) There is an
ongoing continuous quality improvement program designed to monitor and evaluate
quality of patient care, improvement of patient services, if applicable, and
resolution of identified problems.
(b) Continuous quality improvement activities
are defined in a written plan.
(c)
Issues monitored should be determined by evaluating all complaints or incidents
and items that are high volume, high risk or problem prone.
(9) Liability insurance coverage
for products provided and operations of each licensed entity is required in the
amount of at least $500,000.
(B) Prohibited Practices - The following
practices are prohibited:
(1)
Patient Freedom of Choice:
(a) Participation in any plan, agreement, or
arrangement which eliminates the patient's right to select a provider, licensed
under this act, of their choice shall be considered a violation of this
regulation.
(2)
Bribes Kickbacks and Rebates:
(a) It shall be considered a violation of
this regulation for anyone to knowingly and willfully offer, pay, solicit or
receive any payment in return for referring an individual to another person for
the furnishing, or arranging for the furnishing, of any item or service covered
by this regulation. (10/13/95)