Current through Register No. 40, October 3, 2024
(a) Contract
agencies shall maintain a service record for all individuals receiving one or
more Title III services except as provided in (h) below.
(b) The service record shall contain:
(1) The individual's name, address, and
telephone number;
(2) A notation
that the individual meets the eligibility requirements for services as
described in He-E 502.05;
(3) An annual notation of the decision to
recertify or terminate services as described in
He-E
502.08;
(4) Notation of the following:
a. The name of the Title III service(s) being
provided and the type of service activities, based on the service description
contained in this rule;
b. The
dates of service provision and the number of service units provided;
c. Identification of the individual's
communication access needs, including type and modality, and the name of the
communication access provider or type of device utilized, if applicable;
and
d. Any other information or
correspondence deemed relevant to service provision; and
(5) The service authorization as described in
He-E
502.14(a), if applicable.
(c) The following services shall
require additional documentation in the service record:
(1) Adult in-home care services;
(2) Home health aide services;
(3) Homemaker services;
(4) Nursing services; and
(5) Nutrition services: home delivered
meals.
(d) The
additional documentation specified in (c) above shall include:
(1) A copy of the notice of decision for the
provision of service(s) as described in
He-E
502.07, as applicable;
(2) The name and telephone number of a person
who may be contacted in an emergency;
(3) The name, address, and telephone number
of the individual's primary caregiver, if applicable;
(4) The name and telephone number of the
individual's licensed practitioner, if applicable;
(5) Documentation of changes in the
individual's health or other circumstances affecting service
provision;
(6) A copy of any
termination notification(s) to the individual and BEAS as described in
He-E
502.09, if applicable, or a notation that the
individual voluntarily terminated services;
(7) The person-centered plan as described in
He-E
502.17;
(8) The dates upon which service(s) will
begin and end;
(9) The planned
frequency of the service(s);
(10)
The total number of service units that will be provided on each date of
service, if appropriate; and
(11)
Copies of all executed legal directives provided to the contract agency, such
as guardianship orders for health care under RSA 464-A, a durable power of
attorney or a living will, or any advanced directives under RSA
137-J.
(e) Contract
agencies providing adult day program services shall be required to comply with
all documentation requirements as described in He-P 818, in addition to the
requirements outlined in
He-E
502.15(b).
(f) Service records shall be kept
confidential in accordance with
He-E
502.03 and all applicable federal and state laws and
regulations.
(g) Service records
shall be retained for a period of 4 years after services have ended or have
been terminated.
(h) No service
record shall be required for individuals receiving only group educational or
walk-in services, or telephone services as described in
He-E
502.25 Legal Services.
(See Revision Note at part heading for He-E 502) #10530,
eff 2-28-14
