Current through Register Vol. 48, No. 12, March 22, 2024
a)
Entities applying for licensure as a home medical equipment and services
provider shall file an application with the Department, on forms provided by
the Department. The application shall include the following:
1) The name, location (including street,
city, state (no post office box)) and telephone number of the
applicant;
2) Certification of
insurance from the insurer showing $1,000,000 of commercial general liability
insurance, including but not limited to coverage for products liability and
professional liability;
3) All
trade or business names used by the applicant;
4) A list of categories of services
provided;
5) Medicare
Identification Number (if applicable);
6) Name of the person in charge of the day to
day operation of the business;
7)
The type of ownership or operation (i.e., partnership, limited liability
company, corporation or sole proprietorship). If a corporation, a copy of the
articles of incorporation;
8) The
name of the owner and/or operator of the entity, including:
A) The name of the person, if a
person;
B) The name of each partner
and the name of the partnership, if a partnership;
C) The name and title of each corporate
officer and director, the corporate names, the name of the state where
incorporated and the name of the parent company, if any, if a
corporation;
D) The full name of
the sole proprietor and the name of the business entity, if a sole
proprietorship; or
E) The full name
and title of each member with 5% or more ownership and each manager of a
limited liability company and the name of the state where organized and a copy
of the articles of organization and the name of any parent company, if
any;
9) The fee set
forth in Section
1253.70 of this
Part;
10) Certification, signed by
an authorized representative of the entity, indicating that the business:
A) maintains a physical facility and a
medical equipment inventory;
B)
maintains records of education, training and experience and annual continuing
education for personnel engaged in the delivery, maintenance, repair, cleaning,
inventory control and financial management of home medical equipment and
services;
C) maintains records on
all patients to whom it provides home medical equipment and services that
include any training, education and other information pertinent to the use and
maintenance of equipment or the services provided. Patients' records shall
include, but not be limited to, name of patient and address, type of service
provided, payer requirements and other pertinent information for the service
level or specific product provided. The provider shall have adequate security
measures to maintain confidential records;
D) establishes and maintains equipment
management and personnel policies such as, but not limited to, security
operation, tracking and maintenance of equipment, customer service
complaints;
E) complies with State
and federal laws applicable to the type of services provided; and
F) provides access to emergency services 24
hours a day, 7 days a week for life sustaining home medical equipment and
services.
b)
A separate license is required for each facility and only one license will be
issued per address where business is conducted.
c) When the address or name of a facility is
changed, the licensee shall be required to notify the Department, obtain a
corrected license and pay the required fee set forth in Section
1253.70.
d) Changes in person in
charge of day to day operation shall be submitted to the Department, on forms
provided by the Department, within 30 days after such change.
e) An applicant may be required to appear
before the Board to further evaluate the entity's qualifications for
licensure.