Current
through Register Vol. 43, No. 12, March 20, 2024
(a) Each home health agency shall provide
home health services, HCBS, and supportive care services to a patient or client
only when the home health agency reasonably expects that the patient's medical,
rehabilitation, and social needs or the client's needs can be met adequately by
the home health agency in the patient's or client's place of
residence.
(b) Each home health
agency shall be limited to the home health services, HCBS, and supportive care
services specified by the home health agency's initial application or renewal
application.
(c)
(1) Each licensee issued a license that
indicated on the licensee's initial application or renewal application that the
licensee intends to provide home health services shall provide the following
for each patient:
(A) An order from the
patient's physician, nurse practitioner, clinical nurse specialist, or
physician assistant;
(B) an
assessment of the patient by a registered nurse or physical therapist if only
physical therapy will be provided;
(C) a plan of care for the patient developed
by the registered nurse or physical therapist based upon the patient's
needs;
(D) training of appropriate
staff to deliver the plan of care in accordance with the home health agency
regulations in this article of the department's regulations;
(E) written policies and procedures regarding
the provision of skilled care services and, if offered, separate written
policies for supportive care services or HCBS;
(F) a written plan of care for each patient
that is reviewed at least every 60 days by a registered nurse or physical
therapist as required by the home health agency regulations in this article of
the department's regulations;
(G) a
clinical record for each patient that includes progress notes for the
patient;
(H) a policy indicating
who can administer medications;
(I)
policies and procedures indicating that all personnel providing services to the
same patient shall maintain communication with the registered nurse or physical
therapist employed by the home health agency to ensure that all home health
services support the plan of care;
(J) a registered nurse, who shall be
available or on-call to the staff to serve patients during all hours that home
health services are provided;
(K) a
visit by a physician, a registered nurse, or a qualified health professional to
each patient's home every two weeks to supervise home health services if
nursing or therapy services, or both, are being provided to the patient. This
visit may be made less often if only personal care is provided to a patient and
documented in the clinical record. If only personal care is provided, a
supervisory visit shall be made at least every 60 days; and
(L) written instructions for the home health
services to be provided to each patient prepared by a qualified health
professional.
(2) Each
licensee issued a license that indicated on the licensee's initial application
or renewal application that the licensee intends to provide HCBS shall provide
the following for each patient:
(A) The plan
of care;
(B) training of
appropriate staff to deliver the plan of care in accordance with HCBS
guidelines and home health agency regulations in this article of the
department's regulations;
(C)
written policies and procedures regarding the provision of HCBS and, if
offered, separate written policies and procedures for supportive care
services;
(D) documentation of the
HCBS provided to the patient, which shall become part of the clinical
record;
(E) policies and procedures
indicating who can provide medication administration;
(F) policies and procedures indicating that
all personnel providing HCBS to the same patient shall maintain communication
to ensure that all HCBS support the plan of care;
(G) a registered nurse, who shall be
available or on-call to the staff to serve patients during all hours that
personal care is provided; and
(H)
a physician, registered nurse, or other qualified health professional, who
shall visit the patient's home every 60 days if personal care is
provided.
(3) Each
licensee issued a license that indicated on the licensee's initial application
or renewal application that the licensee intends to provide supportive care
services shall provide the following for each client:
(A) Written policies and procedures that
indicate admission criteria for the client consistent with supportive care
services, as defined in
K.S.A.
65-5101 and amendments thereto, and the
requirements of this regulation;
(B) written policies and procedures
describing the appropriate scope of practice for the supportive care worker
consistent with supportive care services, as defined in
K.S.A.
65-5101 and amendments thereto, and the
requirements of this regulation;
(C) an assessment of the client by a manager
used to develop a plan of care for the client based upon the client's
needs;
(D) training of managers and
supportive care workers to deliver the plan of care in accordance with the home
health agency regulations in this article of the department's regulations,
including competency in the following:
(i)
Communication skills, with special focus on communicating with clients with
hearing deficits, dementia, or other special needs;
(ii) observation, reporting, and
documentation of client status and documenting supportive care services
provided to the client;
(iii) basic
infection control procedures;
(iv)
basic elements of body functioning and changes in body function and when to
report changes in bodily functions to the manager;
(v) maintenance of a clean, safe, and healthy
environment;
(vi) recognizing
emergencies and knowledge of home health agency emergency procedures;
(vii) recognizing physical, emotional, and
developmental needs of the clients served by the home health agency;
(viii) working with clients, including
respect of the client and the client's privacy and property; and
(ix) appropriate and safe techniques in
personal hygiene and grooming;
(E) written policies and procedures regarding
the provision of supportive care services;
(F) a plan of care for the client, which
shall be reviewed by the manager at least every 60 days;
(G) progress notes for the client, which
shall be kept as part of the client record;
(H) policies and procedures indicating that
medications shall not be set up by supportive care workers or allow supportive
care workers to provide medication administration;
(I) policies and procedures indicating that
all personnel providing supportive care services to the same client shall
maintain communication with the manager to ensure that all supportive care
services promote the plan of care;
(J) a manager, who shall be on-call to assist
staff providing supportive care services for clients; and
(K) a visit by the manager to each client
every three months to provide supervision to each supportive care
worker.
(d)
Each licensee shall maintain the following documents, which shall be available
to a department surveyor upon request:
(1) The
documents maintained by each home health agency providing home health services
or HCBS shall include the following:
(A) A
clinical record for each patient; and
(B) personnel records for each employee that
include all training received, qualifications, performance evaluations, and
evidence of a background check clearance.
(2) The documents maintained by each home
health agency providing supportive care services shall include the following:
(A) A client record for each client;
and
(B) personnel records for each
employee that include all training received, qualifications, performance
evaluations, and evidence of a background check clearance.
(e) Each licensee shall maintain a
copy of each policy and the policies and procedures required by this article of
the department's regulations.