Current through 2024-38, September 18, 2024
2.A.
Requirements
2.A.1. No home health care
agency may provide home health care services without receiving a license from
the Department authorizing such services or operation.
2.A.2. The applicant shall comply with all
applicable Maine Statutes and rules and regulations.
2.A.3. No home health care agency shall
accept any remuneration for delivering home health care services without having
first secured a license authorizing its operation in accordance with these
regulations.
2.A.4. Any person,
organization or corporation seeking home health licensure shall make an
appointment for a preliminary conference at the Division of Licensing and
Certification at least forty-five (45) days prior to the initial
survey.
2.A.5. The following are
exempt from the provisions of this chapter in accordance with
22 MRSA
§2147:
a. Hospice organizations; volunteer services.
Hospice organizations in which services are provided substantially by
volunteers;
b. Families, friends
and neighbors,
c. Sole
practitioners. Sole practitioners otherwise licensed by the State;
d. Physicians. Services provided directly by
physicians;
e. Elderly nutrition
programs;
f. Chore
services;
g. Pharmacy or medical
supply company. Any pharmacy or medical supply company which furnishes no home
health services to persons in their homes except supplies;
h. Persons or agencies contracting or
arranging home health services. Anyone contracting or arranging for home health
services provided by home health care providers licensed or excluded under this
chapter,
i. Departments. Departments
of State Government;
j. Facilities
licensed pursuant to Chapter 405. Hospitals, nursing care facilities, skilled
nursing facilities, or other facilities licensed pursuant to Chapter 405 when
the services are provided either to clients residing in those facilities or to
six (6) or fewer clients at any one time in their homes under a plan of care
approved by the Department or its designee when it is documented in the
patient's record that the licensed home health care agency or agencies serving
the patient's area:
1. Have indicated that
they are unable to provide those services; or
2. Agree that the plan of care is an
acceptable plan.
The plan of care must meet standards for staff qualifications
and supervision consistent with the standards required of licensed home health
care providers;
k. Licensed Boarding Care Facilities.
Boarding care facilities licensed pursuant to Chapters 1663 and 1665 when the
services are provided to clients residing in those facilities;
l. Municipal Entities. Municipal departments
or agencies or other municipal entities in their provision of nontherapeutic
preventive and promotional health educational services where persons providing
those services are employed by the municipality.
2.A.6. The following are exempt from the
provisions of this chapter in accordance with Title
22 MRSA
Section2142, Sub-section 3:
Federally qualified health center or a rural health clinic as
defined in 42 United States Code, Section 1395X Sub-section (aa) (1993) that is
delivering case management services or health education in a client's place of
residence.
2.B.
Application Procedure
2.B.1. Film of
Application
Any person, partnership, association or corporation desiring
a license to engage in home health care services shall, prior to the
commencement of such operation, file an application with the Department.
Applications submitted on behalf of a corporation or association shall be made
by any two officers thereof or by its administrator. All applicants shall
comply with the rules and regulations adopted pursuant to Title
22 MRSA
§2141
et
seq.
2.B.2.
Contents of Application
Each application shall contain:
a. The name by which the Home Health Care
Services Provider is to be legally known and the name under which it shall be
doing business;
b. A description of
all facilities utilized by the Home Health Care Services Provider. This will
include the address(es), telephone number(s) and name of owner(s) of all
buildings utilized by the home health care agency. All branches and sub units
must be identified by address(es), telephone number(s), and identifying
names;
c. A listing of specific home
health care services provided by the agency,
d. For proprietary corporations: the full
name and address of each person, firm or corporation having (directly or
indirectly) an ownership interest of 5% or more in the agency,
e. For business entities with one owner or
business partnerships: the full name and address of each partner,
f. For not-for-profit organizations: the full
name and address of the President of the Board of Directors or appropriate
municipal government representative;
g. The name, home address, home telephone
number and office telephone number of the individual designated by the
applicant as the administrator of the Home Health Care Services
Provider,
h. The name of the
Director of Nursing;
i. The number
of full time equivalent staff
2.B.3. Suitability of Applicant
In acting upon any application for license or relicensure,
the Department shall determine the suitability of the applicant to operate the
home health care services facility.
a.
A determination of suitability shall require the applicant to demonstrate their
willingness and ability to operate and manage the facility with compliance with
these regulations and all relevant laws. In making this determination, the
Department shall consider each of the following factors to the extent they are
relevant to the proposed agency, ownership interest, and/or equipment:
1. Record and reputation for lawful conduct
in business and personal affairs (including, but not limited to, a criminal
conviction).
2. Financial ability
and fiscal responsibility (such as a history of withholding taxes, a good
credit rating from an appropriate agency and/or financial institution,
capability of obtaining financing for working capital and repairs required by
these rules).
3. Management and
supervisory experience, including the capacity to manage the financial
operations and staff of the agency for which the license is sought.
4. Experience in the field of health care,
social services or areas related to the provision of home health
services.
5. Conduct which
demonstrates an understanding of, and compliance with, clients'
rights.
6. Information which relates
to the ability in complying with all applicable laws and regulations.
7. Any information reasonably related to the
ability to provide safe services at the level of care for which the license is
sought.
2.C. Fees
2.C.1. Each application under this chapter
shall be accompanied by an annual fee of $300.00.
2.C.2. All licenses shall be renewed annually
upon payment of the appropriate fee and demonstration of continued compliance
with these rules and regulations.
2.C.3. No fee shall be
refunded.
2.D. Additional
Information
2.D.1. Copy of the Lease
When a building(s) is/are leased to the person(s) to operate
as a Home Health Care Services Provider, a copy of the lease shall be filed
with the application for a license This lease agreement shall clearly
demonstrate which party is to be held responsible for the maintenance and
upkeep of the property. The Department shall be notified within seventy-two
(72) hours if there are any changes in the lease agreement that may in any way
affect the responsibility for maintenance and upkeep of the
property.
2.D.2. Home Health
Care Services Providers Operated by Same Management on Different Premises
Sub units of licensed Home Health Care Services Providers
will require separate licenses. Home Health Care Services Providers operated by
the same management on different grounds shall be required to have in effect a
separate license for each sub unit.
2.D.3. Physician Ownership
The Division of Licensing and Certification will investigate
whether the physician ordering the need for home health care services has a
financial interest or ownership in an agency. A current listing of physicians
associated with financial interests or ownership must be submitted to the
Division of Licensing and Certification. See Chapter 7.A..5.
2.D.4. Change in Ownership of Home, Health
Care Services Provider
a. No license shall be
assigned or transferred.
Effective July 1, 2004 At least thirty (30) days advance
written notice shall be given to the Division of Licensing and Certification,
Bureau of Medical Services, prior to the transfer of ownership of any home
health care agency.
b. At
least thirty (30) days advance written notice shall be give to the Division of
Program Analysis and Development, Office of Health Planning and Development,
and the Division of Licensing and Certification, Bureau of Medical Services,
prior to the transfer of ownership of any home health care agency.
c. Each application for a license from a new
owner shall be accompanied by a statement from the previous owner or his duly
authorized representative concerning the change of ownership. In lieu of this
statement, a copy of the deed or other validating document shall be submitted.
In addition, an application fee, calculated in accordance with Section 2.C of
this chapter, shall be submitted to the Department. When the ownership of a
Home Health Care Services Provider changes, upon receipt of a completed
application and fee, the Department may issue a provisional license for a
period not to exceed ninety (90) days. The new owner's application must
demonstrate that the agency will continue to comply with the requirements for
licensure.
2.E.
Certificate of Compliance with Fire Codes
Fire safety inspections are not required for home health care
services licensure.
2.F.
Compliance with All Local, State and Federal Regulations
2.F.1. The Home Health Care Services Provider
and its staff must operate and furnish services in compliance with all
applicable federal, state and local laws and regulations.
2.F.2. The applicant shall submit a letter
from the appropriate municipal official(s) that demonstrates compliance with
all local ordinances relative to zoning and building codes and a certificate of
occupancy, if appropriate, which includes electrical and life safety code
compliance.
2.F.3. The applicant
will submit proof of a Clinical Laboratory number (if appropriate) under the
Clinical Laboratory Improvement Amendments of 1988.
2.F.4. The applicant will submit proof of a
Department of Environmental Protection number (if
appropriate).
2.G.
Posting of License
The license granted by the Department shall be conspicuously
posted in an area where business is conducted/coordinated for the home health
care services.
2.H. Waiver
Provisions
2.H.1. The Department may upon
written request waive or modify any provision contained herein which is not
mandated by Maine Statutes. The applicant or licensee shall provide clear and
convincing evidence that the alternative method will comply with the intent of
the regulation for which a waiver is sought. Requests for a waiver shall be
made on forms approved by the Department, and shall include:
a. A statement of the regulation for which a
waiver is requested;
b. An
explanation of the reasons why the provisions cannot be met and a waiver is
being requested; and
c. A
description of the alternative method proposed for meeting the intent of the
provision sought to be waived. Waivers, when approved, shall be time limited.
Prior to the expiration of the approval, if the waiver continues to be
necessary, an extension of time may be granted by the Department on receipt of
a new application.
2.H.2.
Home Health Care Services Providers regulated by the State Government or the
Federal Government may apply for consideration of a waiver to be granted by the
Commissioner of the Department of Health and Human Services. Home Health Care
Services Providers that are regulated by the State Government or the Federal
Government that may apply for than waiver include:
a. Alcohol and substance abuse treatment
agencies possessing a current license authorized by Title
22 MRSA
§7801 - 7815.
b. Pre-school coordination sites which are
regulated by the Department of Education.
c. Public schools and private educational
agencies winch are regulated by the Department of Education.
d. Mental health services providers which are
licensed and regulated by the Department of Behavioral and Developmental
Services as authorized by Title 34B MRSA § 3606.
2.H.3. These providers will be eligible for
the waiver solely for those home health care services for which they are
regulated by a Bureau of the Department of Health and Human Services or another
Department within State Government.
2.H.4. The Commissioner of the Department of
Health and Human Services may grant a full, provisional, or conditional license
to those entities otherwise regulated by the State Government or the Federal
Government, if he/she determines that those providers meet the purpose and
intent of this chapter This shall be determined through submission of
information in accordance with the waiver forms described in Chapter 2.I.1. of
these regulations.
2.I.
Changes in Licensed Home Health Care Services
Each Home Health Care Services Provider will notify the
Bureau of Medical Services in writing of any changes in:
2.I.1. Ownership;
2.I.2. Scope and nature of services
provided,
2.I.3. Relocation or
change of business address and telephone;
2.I.4. Administrator,
2.I.5. Addition/deletion of a branch or sub
unit, or
2.I.6.
Deeming.
2.J. Types of
Licenses Issued
The Department will issue the following types of licenses to
Home Health Care Services Providers:
2.J.1. Full License-effective for the period
of twelve (12) months to an applicant who complies with all applicable laws and
rules.
2.J.2. Provisional License-
effective for a minimum of three (3) months and not to exceed twelve (12)
months, to an applicant who:
a. Has not
previously operated as a Home Health Care Services Provider or is licensed but
has not operated during the term of that license;
b. Complies with all applicable laws and
rules, except those which can be complied with only once clients are served by
the applicant; and
c. Demonstrates
the ability to comply with all applicable laws and rules by the end of the
provisional license term
2.J.3. Conditional License-effective for a
specific period not to exceed one (1) year to an applicant who has not fully
complied with all applicable laws and rules, and in the judgment of the
Commissioner, the best interest of the public would be so served by issuing a
conditional license. The conditional license shall specify when and what
corrections shall be made during the term of the conditional
license.
2.K.
Specifications of License
Each license issued by the Department shall identify:
2.K.1. The name of the Home Health Care
Services Provider,
2.K.2. The name
of the administrator,
2.K.3. The
geographical location of each unit or subunits, if so designated;
2.K.4. The type of home health care services
provided;
2.K.5. Any waiver(s) that
have been granted;
2.K.6. The period
of licensure and date of licensure expiration; and
2.K.7. The date issued, and type of
license.
