Current through Register Vol. 51, No. 19, September 20, 2024
A. The
home health agency shall have a duly constituted governing body, or designated
persons so functioning, with full legal authority, responsibility, and
accountability for its operation.
B. Adoption of By-laws.
(1) The governing body shall adopt written
by-laws, in accordance with applicable legal requirements, for the conduct of
business by the home health agency.
(2) These by-laws shall include, at least the
following:
(a) A statement of objectives;
and
(b) An organizational structure
by which agency policies and procedures are implemented.
(3) These by-laws shall be reviewed annually
and revised as necessary.
C. The governing body shall appoint a home
health agency administrator who shall be responsible for the overall management
and fiscal operations of the agency.
D. The governing body shall designate a
"professional advisory group" whose functions shall include, at least:
(1) To regularly review and advise on agency
policies covering professional issues, including:
(a) Scope of services offered;
(b) Criteria for acceptance, discharge and/or
rejection of patients;
(c)
Appropriateness of medical supervision;
(d) Emergency care services to
patients;
(e) Adequacy of system
for maintaining clinical records;
(f) Adequacy of agency's review and
evaluation program; and
(g)
Mechanism for referrals and continuity of care with allied health care
providers;
(2) To
participate in the annual evaluation of the agency's programs.
E. The Professional Advisory Group
shall meet at least three times each calendar year and shall keep documented
minutes.
F. The governing body
shall take appropriate actions on recommendations made by the professional
advisory group. Complete documentation of recommendations made and actions
taken shall be maintained.
G. The
governing body shall assure that all services offered by the home health
agency, whether directly or indirectly, are:
(1) Monitored and supervised by the parent
agency; and
(2) When stipulated by
a physician's order, provided to an individual within 24 hours after the
physician refers the individual to the agency.
H. The home health agency shall establish a
written contractual arrangement for the provision of all services which are not
provided directly by the agency. At a minimum, the written contract shall:
(1) Designate the services which are to be
provided, the setting and the geographical area served (services provided are
to be within the scope and limitations set forth in the plan of treatment and
may not be altered in type, amount, frequency, or duration, except in the case
of adverse reaction, by the individual under contract);
(2) Describe how the contracted personnel are
to be administratively or professionally supervised, or both;
(3) Describe how services will be controlled,
coordinated, and evaluated by the parent agency;
(4) Describe the procedure for submitting
clinical and progress notes, scheduling of visits, and periodic patient
evaluations;
(5) Specify the
charges for specific services provided under contract;
(6) Specify that only the parent agency shall
bill for service and collect the applicable deductible or co-insurance
payments;
(7) Specify the period of
time that the contract shall be in effect and how frequently it shall be
reviewed; the contract shall be reviewed at least annually and renewed when
necessary;
(8) Insure that
personnel and services contracted meet the requirements specified in these
regulations for home health agency personnel and services, including licensure,
personnel qualifications, physical examinations, functions, supervision,
orientation, in-service education, and attendance at case
conferences;
(9) Provide for the
acceptance of patients for home health services only by the parent agency.
Patients may not be admitted for home health service by a contracted individual
without prior review of the case and acceptance of the patient by the home
health agency in accordance with agency policies.
