Compilation of Rules and Regulations of the State of Georgia
Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH
Chapter 111-8 - HEALTHCARE FACILITY REGULATION
Subject 111-8-65 - RULES AND REGULATIONS FOR PRIVATE HOME CARE PROVIDERS
Rule 111-8-65-.09 - Administration and Organization
Universal Citation: GA Rules and Regs r 111-8-65-.09
Current through Rules and Regulations filed through March 20, 2024
(1) Services Description. A provider shall establish and implement written policies and procedures that define the scope of private home care services it offers and the types of clients it serves. No provider shall provide services that are prohibited by these rules, the applicable legal authority, or other laws.
(2) Service Agreements. No provider shall offer to provide a client any private home care services that it cannot reasonably expect to deliver in accordance with these rules.
(a) A provider shall establish and implement
policies and procedures for service agreements. All services provided to a
client shall be based on a written service agreement entered into with the
client or the client's responsible party, if applicable. The service agreement
must include the following:
1. Date that
provider makes initial contact with client for services;
2. Date of referral, i.e. the date on which
the provider received a specific request to deliver private home care services
to a particular client;
3.
Description of services needed as stated by client or responsible party, if
applicable;
4. Description of
services to be provided and expected frequency and duration of
services;
5. Charges for such
services, and mechanisms for billing and payment of such charges;
6. Acknowledgment of receipt of a copy of
client's rights and responsibilities as outlined at rule .12;
7. A telephone number of the provider that a
client can call for information, questions, or complaints about services
supplied by the provider;
8. The
telephone number of the state licensing authority, i.e. the department, to call
for information or questions about the provider concerning a violation of
licensing requirements that was not resolved to the client's satisfaction by
complaining to the provider;
9.
Authorization from client or responsible party, if applicable, for access to
client's personal funds when home management services are to be provided and
when those services include assistance with bill paying or any activities, such
as shopping, that involve access to or use of such funds; similarly approved
authorization for use of client's motor vehicle when services to be provided
include transport and escort services and when the client's personal vehicle
will be used;
10. Signatures for
the provider's representative and the client or responsible party, if
applicable, and date signed; if a client or responsible party refuses to sign
the agreement, such refusal shall be noted on the agreement with an explanation
from the provider's representative.
(b) For new clients, such initial service
agreements shall be completed not later than the second visit to the client's
residence to provide services if the second visit occurs on a different day
from the first visit or not later than seven calendar days after services are
initially provided in the residence, whichever is earlier.
1. If the provider is unable to complete the
service agreement for good cause, the provider will document such reason(s) in
the client's file.
2. Subsequent
revisions to the initial service agreement may be handled by the provider
noting in the client's record the specific changes in service (e.g. addition or
deletion of service, changes in frequency, or duration, or charge for services,
etc.) that will occur and that the change was discussed with and agreed to by
the client and/or responsible party, as appropriate, who signed the initial
agreement prior to the change in services occurring.
(c) A client has the right to cancel any
service agreement at any time and shall only be charged for services actually
rendered prior to the time that the provider is notified of the cancellation.
The provider may assess a reasonable charge for travel and staff time if notice
of the cancellation of the service agreement is not provided in time to cancel
the service prior to the provider's staff member arriving at the client's house
to perform the service.
(3) Administrator. The governing body shall appoint an administrator who shall have full authority and responsibility for the operation of the private home care provider.
(a) Any administrator employed after the
effective date of these rules must meet the following minimum qualifications:
1. Never have been shown by credible evidence
(e.g. a court or jury, a department investigation, or other reliable evidence)
to have abused, neglected, sexually assaulted, exploited, or deprived any
person or to have subjected any person to serious injury as a result of
intentional or grossly negligent misconduct as evidenced by an oral or written
statement to this effect obtained at the time of application;
2. Participate in the orientation and
training required by these rules;
3. Not have made any material false
statements concerning qualifications requirements either to the department or
the provider.
(4) Record keeping.
(a) Client Records. A provider shall maintain
a separate file containing all written records pertaining to the services
provided for each client that it serves and the file shall contain the
following:
1. Identifying information
including name, address, telephone number, and responsible party, if
any;
2. Current service agreement
as described at rule .09(2);
3.
Current service plan as described at rule .11;
4. Clinical and/or progress notes if the
client is receiving nursing services that have been signed and dated by the
staff providing the direct care;
5.
Documentation of personal care tasks and companion or sitter tasks actually
performed for the client;
6.
Documentation of findings of home supervisory visits by the supervisor unless
entered in service plan;
7. Any
material reports from or about the client that relate to the care being
provided to the client including items such as progress notes and problems
reported by employees of the provider, communications with personal physicians
or other health care providers, communications with family members or
responsible parties, or similar items;
8. The names, addresses, and telephone
numbers of the client's personal physicians, if any; and
9. Date and source of referral.
(b) Retention and Confidentiality
of Client Records. Written policies and procedures shall be established and
implemented for the maintenance and security of client records specifying who
shall supervise the maintenance of records, who shall have custody of records,
to whom records may be released and for what purposes and how long the records
will be retained.
1. At a minimum, all client
records shall be retained for five years from the date of last service
provided. The provider shall maintain the confidentiality of client
records.
2. Employees of the
provider shall not disclose or knowingly permit the disclosure of any
information in a client record except to appropriate provider staff, the
client, responsible party (if applicable), the client's physician or other
health care provider, the department, other individuals authorized by the
client in writing or by subpoena.
(c) Personnel Records. A provider shall
maintain separate written records for each employee and the records shall
include the following:
1. Identifying
information such as name, address, telephone number, and emergency contact
person(s);
2. A five year
employment history or a complete employment history if the person has not been
employed five years;
3. Records of
qualifications;
4. Documentation of
a satisfactory TB screening test upon employment and annually
thereafter;
5. Date of
employment;
6. The person's job
description or statements of the person's duties and
responsibilities;
7. Documentation
of orientation and training required by these rules;
8. Documentation of at least an annual
performance evaluation;
9.
Documentation of bonding if the employee performs home management services
which permit unlimited access to the client's personal funds. (If bonding is
provided through a universal coverage bond, evidence of bonding need not be
maintained separately in each personnel folder.)
(d) Reports of Complaints and Incidents. The
provider shall maintain files of all documentation of complaints submitted
pursuant to rule .12(2). A provider shall also maintain on file for a minimum
of five years all incident reports or reports of unusual occurrences (e.g.
falls, accidents, significant medication errors, etc.) that affect the health,
safety, and welfare of its clients. Documentation required to be maintained
shall include what actions, if any, the provider took to resolve clients'
complaints and to address any incident reports or unusual occurrences required
to be retained.
(5) Staffing. The provider shall have sufficient numbers of qualified staff as required by these rules to provide the services specified in the service agreements with its clients. In the event that the provider becomes aware that it is unable to deliver the specified services to the client because of an unexpected staff shortage, the provider shall advise the client and refer the client to another provider if the client so desires.
(a) All staff employed by a provider shall
have included in their personnel records or files maintained by the particular
provider a written evaluation that was performed within one year before or
after the effective date of these rules. The written evaluation must reflect
that the employee's performance of required job tasks was observed personally
by a supervisor either by demonstration or observation and such performance was
determined to be competent for all job tasks required to be performed. All
staff hired after the effective date of these rules must meet the following
minimum qualifications:
1. Never have been
shown by credible evidence (e.g. a court or jury, a department investigation,
or other reliable evidence) to have abused, neglected, sexually assaulted,
exploited, or deprived any person or to have subjected any person to serious
injury as a result of intentional or grossly negligent misconduct as evidenced
by an oral or written statement to this effect obtained at the time of
application;
2. Participate in the
orientation and training required by these rules;
3. Not have made any material false
statements concerning qualifications requirements either to the department or
the provider.
(b)
Nursing Personnel. Any persons employed by the provider to provide nursing
services shall be licensed in Georgia in accordance with professional licensing
laws and associated rules. Such persons may also provide any other types of
private home care services offered by the provider.
(c) Personal Care Assistant (PCA). The
provider may have PCAs perform personal care tasks for clients. Such persons
may also perform companion or sitter tasks for clients, but shall not provide
nursing services unless qualified as stated in rule .09(5)(b) above.
1. Any PCA hired after the effective date of
these rules shall have the following training and/or experience:
(i) successful completion of a nurse aide
training and competency evaluation program pursuant to the requirements of 42
CFR Part 483, Subpart D, as revised or recodified, if applicable; or
(ii) successful completion of a competency
examination for nurse aides recognized by the department; or
(iii) successful completion of a health care
or personal care credentialing program recognized and approved by the
department; or
(iv) successful
completion or progress in the completion of a 40 hour training program provided
by a private home care provider, which addresses at least the following areas:
(I) Ambulation and transfer of clients,
including positioning;
(II)
Assistance with bathing, toileting, grooming, shaving, dental care, dressing,
and eating;
(III) Basic first aide
and CPR;
(IV) Caring for clients
with special conditions and needs so long as the services are within the scope
of the tasks authorized to be performed by demonstration;
(V) Home management;
(VI) Home safety and sanitation;
(VII) Infection control in the
home;
(VIII) Medically related
activities to include the taking of vital signs; and
(IX) Proper nutrition.
2. A training program described in
rule .09(5)(c)1. (iv) must be conducted under the direction of a licensed
registered professional nurse, or a health care professional with commensurate
education and experience. Twenty hours of the program must be completed by the
employee prior to serving clients and the additional twenty hours must be
completed within six months of the date the training initially began. No PCA
shall be assigned to perform a task for which training has not been completed
and competency has not been determined. No PCA shall be assigned to care for a
client with special conditions unless the PCA has received training and has
demonstrated competency in performing such services related to such special
conditions.
(d)
Companions or Sitters. The provider may have companions or sitters perform
companion or sitter tasks for clients.
1. Such
persons may not provide other private home care services to clients unless
qualified as stated in rules .09(5)(b)and(c).
2. Any companion or sitter hired after the
effective date of these rules must meet the following minimal requirements:
(i) Be able to read and write, follow verbal
and written instructions, and complete written reports and documents;
(ii) Successfully complete training or
demonstrate understanding and practical competency in the following areas:
understanding the needs and characteristics of elderly, handicapped, or
convalescing individuals; meal preparation and serving; transportation and
escort services; housekeeping to include sanitation; home safety; handling
medical emergencies in the home; and infection control.
(6) Staff Training. Prior to working with clients, all employees hired or used on or after the effective date of these rules and who provide services to clients shall be oriented in accordance with these rules and shall thereafter receive additional training in accordance with these rules.
(a)
Orientation shall include instruction in:
1.
The provider's written policies and procedures regarding its scope of services
and the types of clients it serves (rule .09(1) and clients rights and
responsibilities and complaints (rule .12), as well as other policies that are
relevant to the employee's range of duties and responsibilities;
2. The employee's assigned duties and
responsibilities;
3. Reporting
client progress and problems to supervisory personnel and procedures for
handling medical emergencies or other incidents that affect the delivery of
services in accordance with the client's services plan;
4. The employee's obligation to report known
exposure to tuberculosis and hepatitis to the employer.
(b) Additional training consisting of a
minimum of eight clock hours of training or instruction shall be provided
annually for each employee after the first year of employment. Employees hired
prior to the effective date of these rules are also required to receive eight
clock hours of training or instruction annually beginning with the effective
date of these rules. Such training or instruction shall be in subjects that
relate to the employee's assigned duties and responsibilities.
(7) Contracted Services. If a provider arranges with independent contractors, individuals, or agents for them to provide any authorized private home care services on behalf of the provider in any way, such arrangements shall be set forth in writing detailing the services to be provided. The provider must assure that the independent contractor, individual, or agent supplying the services follow the provisions of these rules and are qualified to provide the services. The services must be supervised, as outlined in rule .10(2) (Supervision of Services), by a supervisor of the licensed provider.
O.C.G.A. §§ 31-2-5, 31-2-7 and 31-7-300et seq.
Disclaimer: These regulations may not be the most recent version. Georgia may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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