Current through 2024-38, September 18, 2024
3.A. Refusal to Issue a License
The Department shall refuse to issue a license to the
applicant if it finds that any or all of the following conditions exist:
3.A.1. The Department finds that the
information submitted in the application is incorrect or incomplete,
3.A.2. The applicant does not meet all
requirements of these laws and regulations;
3.A.3. The applicant has violated applicable
laws and rules and regulations and the Department finds that these practices of
the agency are detrimental to the welfare of persons to whom home health care
services are provided.
3.B. Right of Entry and Inspection
3.B.1. Any duly designated employee of the
Department shall have the right to enter upon and into the premises of any Home
Health Care Services Provider who has applied for a license or who is licensed
pursuant to these rules and regulations. These employees can inspect relevant
agency documents to determine whether the agency is in compliance with these
rules and regulations. The right of entry and inspection shall extend to any
premises and documents of providers whom the Department has reason to believe
are providing home health care services without a license. Such entries or
inspections shall be made with permission of the owner or person in charge
unless a warrant is first obtained from the District Court authorizing that
entry or inspection (
22 MRSA
§2148) . Surveyors, with the permission
of the patient/client, may also make patient/client home visits at their
discretion.
3.B.2. The Department
and any duly designated representative thereof shall have the right to enter
upon and into the premises of any facility licensed pursuant to these rules and
regulations at any time, without threat of injury, verbal abuse or harassment
and in the spirit of mutual cooperation, in order to determine the state of
compliance with the provisions of rules and regulations in force pursuant
thereto. Such right of entry and inspection shall extend to any premises which
the Department has reason to believe are being operated or maintained as a home
health care services agency without a license, but no such entry or inspection
of any premises shall be made without the permission of the owner or person in
charge thereof, unless a warrant is first obtained from the court of
jurisdiction authorizing the same. Any application for a license made pursuant
to these rules and regulations shall constitute permission for, and complete
acquiescence in, any entry or inspection of the premises for which the license
is sought in order to facilitate, verification of the information submitted on
or in connection with such application. (Title 22, § 2148). Application
for licensure, whether initial or renewal, shall constitute permission for
entry into, and survey of, a home health care services provider by authorized
licensing authority representatives at reasonable times during pendency of the
application and, if licensed, during the licensure period.
3.B.3. Surveys may be announced or
unannounced at the sole discretion of the licensing authority. All complaint
investigations will be unannounced.
3.B.4. Upon receipt of a notice of deficiency
from the licensing authority, the licensee or his/her representative will be
required to submit a written plan of correction to the licensing authority
within ten (10) working days of the date of the statement of deficiencies
stating how the agency intends to correct each violation noted and the expected
date of completion.
3.B.5. The
licensing authority may, at its sole discretion, accept the plan of correction
as written or request modification of the plan by the licensee.
3.B.6. Regardless of the term of the license,
the Department shall monitor for continued compliance with applicable laws and
rules on at least a biennial basis.
3.B.7. Licensing Survey Frequency
The Department shall survey the Home Health Care Services
Provider on at least a biennial basis, except that State licensing surveys need
not be performed during a year when a Medicare certification survey is
performed.
State licensure surveys will be performed on at least an
annual basis If any of the following conditions exist:
a. Change of ownership since the previous
licensure or Medicare certification survey; or
b. Complaint survey with deficiency citations
since the last licensure or Medicare certification survey, or
c. Conditional State license issued at the
last regular licensure survey; or
d. Failure to meet any of the Medicare
Conditions of Participation within the past twenty-four (24)
months.
3.B.8. Complaints
a. Any person may file a complaint with the
administrator or any member of the home health care services staff.
b. A procedure must be established for the
review, within two business days, of each complaint received, by the
administrator and/or any designated member of the staff. A report of findings
and action taken shall. be prepared and submitted to the Quality Assurance
Committee or other appropriate committee, and be available for review upon
request of the Department.
3.B.9. Reporting of Abuse, Neglect or
Misappropriation of Client and/or Client's Property
a. The Home Health Care Services Provider
must ensure that all staff are knowledgeable of the Adult Protective Services
Act and that all alleged violations involving mistreatment, neglect and abuse,
including injuries of unknown source and/or misappropriation of client/patient
property, are reported immediately, through established procedures, to the
administrator of the home health care services provider and to other officials
in accordance with the State law (Title 22, § 3470et
seq.).
b. The Home Health
Care Services Provider must have evidence that all alleged employee violations
are thoroughly investigated in a timely manner. Policies must address
administrative procedures to be implemented to prevent further potential abuse
while the investigation is in progress.
c. The results of all investigations
conducted in house must be reported to the administrator or his/her designated
representative and to other officials in accordance with State law. If the
alleged violation is verified, appropriate corrective action must be taken. All
reports must be made available to the Department upon request.
d. Results of investigations must be reported
to the Department if the allegations involve a certified nursing
assistant.
3.B.10. The
Home Health Care Services Provider must develop and implement written policy
and procedures that prohibit abuse, neglect or misappropriation of client's
property.
3.C. Renewal of
License
3.C.1. The Department will send the
Home Health Care Services Provider a renewal application at least fifty (50)
days prior to the expiration of the license. This application shall be
completed and submitted to the Department at least twenty (20) days prior to
the expiration of the license. The Department shall review this renewal
application to ensure that it is consistent with these rules and
regulations.
3.C.2. Based upon its
review, Department staff will inform the Home Health Care Services Provider of
its decision to:
a. Renew the license for a
period of one year;
b. Grant the
Home Health Care Services Provider a conditional license, or
c. Refuse to issue the applicant a new
license.
3.D.
Provisional License
3.D.1. A provisional
license shall be issued by the Department to an applicant who:
a. Has not previously been licensed 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. Department
staff will make a site monitoring visit to the home health cam services agency
to accumulate the information necessary to make this
determination.
3.E. Conditional License
3.E.1. The Department may issue a conditional
license when an agency fails to comply with applicable laws and rules, and in
the judgment of the Commissioner, the best interest of the public would be
served by issuing a conditional license.
3.E.2. The decision to grant a conditional
license can be made by the Commissioner at the time of application for an
initial license, at the expiration of a full or provisional license or during
the term of a full license.
3.E.3.
The conditional license shall specify when and what corrections shall be made
during the term of the conditional license.
3.F. Suspension or Revocation of License
3.F.1. The Department may recommend
suspension or revocation of any license issued pursuant to
22 MRSA
§2141
et seq., for
violation of applicable laws and rules committing, permitting, aiding or
abetting any illegal practices in the operation of the provider or conduct or
practices detrimental to the welfare of persons to whom home health care
services are provided.
3.F.2. When
the Department believes that a license should be suspended or revoked, it shall
file a complaint with the Administrative Court in accordance with Title
4 MRSA
§1153 or the Maine Administrative
Procedure Act, Title
5 MRSA
§10051
et seq.
3.F.3. Upon suspension or
revocation of a license, the license shall be immediately surrendered to the
Department.
3.G.
Emergency Revocation, Suspension or Refusal to Renew License
Whenever the Department determines that the health or
physical safety of a person is in immediate jeopardy, and action in accordance
with
5 MRSA §9051 -
9064 or
5
M RSA § 10051 would fail to respond to a known risk, the Department may
revoke, suspend or refuse to renew a home health care services license,
provided that the revocation, suspension or refusal to renew shall not continue
for more than 30 days.
3.H.
Receivership
Pursuant to
22 MRSA,
Section7931
et seq. the
Department may petition the Superior Court to appoint a receiver to operate a
home health care service in the following circumstances:
1. When the home health care service intends
to close, but has not arranged at least thirty (30) days prior to closure for
the orderly transfer of its patients/clients;
2. When an emergency exists in a home health
care service which threatens the health, security or welfare of its
patients/clients;
3. When the home
health care services is in substantial or habitual violation of the standards
of health, safety or patient/client care established under State or Federal
regulations to the detriment of the welfare of the
patient/client.
3.I.
Appeals
Any person aggrieved by the Department's decision to take any
of the following actions may request an administrative hearing as provided by
the Maine Administrative Procedure Act, Title
5 MRSA §9051
et seq.
3.I.1. Issue
a conditional license,
3.I.2. Amend
or modify a license;
3.I.3. Refusal
to issue, or renew a full license; or
3.I.4. Refusal to issue a provisional
license.
3.J. Public
Notice
If an annual license is revoked, suspended or not renewed,
the Department will advise the public of such action. This public notice will
be in the form of a paid legal notice in the local newspaper(s), published
within fifteen (15) days following the suspension or revocation of the
license.