Current through Register Vol. 50, No. 9, September 20, 2024
A.
Admission Criteria. The HHA shall follow written policies in making decisions
regarding the acceptance of patients for care. Decisions shall be based upon
medical and social information provided by the patient's attending authorized
healthcare provider, and the patient and/or the family as well as the agency
resources available to meet the needs of potential patients. The HHA shall
accept patients for care without regard to age, color, creed, sex, national
origin or handicap. Patients shall be admitted to an agency based on the
following written criteria:
1. the ability of
the agency and its resources to provide services on a timely basis and
available within 24 hours unless specified otherwise by authorized healthcare
provider's orders and in accordance with the needs of the patients;
2. the willingness of the patient and
caregiver to participate in the POC;
3. the patient's medical, nursing or social
needs can be adequately met in his/her residence; and
4. all other criteria required by any
applicable payor source(s).
B. Admission Procedure. Patients are to be
admitted only upon the order of the patient's authorized healthcare provider.
The patient shall have the right to choose an authorized healthcare provider
and an HHA without interference. Admission procedures are as follows:
1. an initial visit shall be made by an RN or
an appropriate therapist who shall perform the assessment and instruct the
patient regarding home care services. This visit shall be made available to an
individual in need within 24 hours of referral unless otherwise ordered by an
authorized healthcare provider;
2.
an initial POC shall be completed by an RN or an appropriate therapist and
incorporated into the patient's clinical record within seven days from the
start of care; and
3. documentation
shall be obtained at admission and retained in the clinical record including:
a. the referral for home care and/or
authorized healthcare provider's order to assess patient;
b. a history;
c. a physical assessment;
d. a functional assessment, including a
listing of all ADL's;
e. current
problems, needs, and strengths;
f.
prescribed and over-the-counter medications currently used by the
patient;
g. services needed,
including frequency and duration expected;
h. defined expected outcomes, including
estimated date of resolution;
i.
ability, availability, and willingness of potential care-givers;
j. barriers to the provision of
care;
k. orientation, which
includes:
i. advanced directives;
ii. agency services;
iii. patient's rights and responsibilities,
including the telephone number for the home health hotline;
iv. agency contact procedures; and
v. conflict resolution;
l. freedom of choice statement signed by
patient or patient representative; and
m. other pertinent information.
C. Plan of Care. The POC
for each patient shall be individualized to address the patient's problems,
goals, and required services.
1. The POC,
telephone and/or verbal orders shall be signed by the authorized healthcare
provider within a timely manner, not to exceed 60 days; such orders may be
accepted by an RN, a qualified therapist or a licensed practical nurse as
authorized by state and federal laws and regulations.
a. - b. Repealed.
2. Agency staff shall administer services and
treatments only as ordered by the authorized healthcare provider.
3. A POC for continuation of services shall
be completed by an RN or an appropriate therapist and incorporated into the
patient's clinical record within seven days from the date of the development of
the POC.
D. Review of the
Plan of Care. The total POC shall be reviewed by the patient's attending
authorized healthcare provider in consultation with the agency's professional
personnel at such intervals as required by the severity of the patient's
illness, but at least once every two months.
E. Drugs and Biologicals. The agency shall
institute procedures that protect the patient from medication errors. Agency
policy and procedures shall be established to ensure that agency staff has
adequate information regarding the drugs and treatments ordered for the
patient.
1. Agency staff shall only administer
drugs and treatments as ordered by the authorized healthcare
provider.
2. Only medications
dispensed, compounded or mixed by a licensed pharmacist and properly labeled
with the drug name, dosage, frequency of administration and the name of the
prescribing authorized healthcare provider shall be administered.
3. The agency shall provide verbal and
written instruction to patient and family as indicated.
F. Coordination of Services. Patient care
goals and interventions shall be coordinated in conjunction with providers,
patients and/or caregivers to ensure appropriate continuity of care from
admission through discharge.
1. All agencies
shall provide for nursing services at least eight hours a day, five days a week
and be available on emergency basis 24 hours a day, seven days a week. Agencies
shall maintain an on-call schedule for RNs.
2. The agency shall maintain a system of
communication and integration of services, whether provided directly or under
arrangement, that ensures identification of patient needs and barriers to care,
the ongoing coordination of all disciplines providing care, and contact with
the authorized healthcare provider regarding relevant medical issues.
G. Discharge Policy and Procedures
1. The patient may be discharged from an
agency when any of the following occur:
a. the
patient care goals of home care have been attained or are no longer
attainable;
b. a caregiver has been
prepared and is capable of assuming responsibility for care;
c. the patient moves from the geographic
service area served by the agency;
d. the patient and/or caregiver refuses or
discontinues care;
e. the patient
and/or caregiver refuses to cooperate in attaining the objectives of home
care;
f. conditions in the home are
no longer safe for the patient or agency personnel. The agency shall make every
effort to satisfactorily resolve problems before discharging the patient and,
if the home is unsafe, make referrals to appropriate protective
agencies;
g. the patient's
authorized healthcare provider fails to renew orders for the patient;
h. the patient, family, or third-party payor
refuses to meet financial obligations to agency;
i. the patient no longer meets the criteria
for services established by the payor source;
j. the agency is closing out a particular
service or any of its services;
k.
30 days advance written notice has been provided to the patient, or responsible
party, when applicable and appropriate; and
l. death of the patient.
2. The agency shall have discharge procedures
that include, but are not limited to:
a.
notification of the patient's authorized healthcare provider;
b. documentation of discharge planning in the
patient's record;
c. documentation
of a discharge summary in the patient's record; and
d. forwarding of the discharge summary to the
authorized healthcare provider.
3. The following procedures shall be followed
in the event of the death of a patient in the home:
a. ...
b. the HHA parent office shall be
notified;
c. the HHA personnel in
attendance shall offer whatever assistance they can to the family and others
present in the home; and
d.
progress notes shall be completed in detail and shall include observations of
the patient, any treatment provided, individuals notified, and time of death,
if established by the authorized healthcare provider.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and
R.S.
40:2116.31 et
seq.
