Current through Register No. 40, October 3, 2024
(a) The licensee
shall have a written contractual agreement for all services provided by
arrangement.
(b) Any contractual
agreement to provide services shall:
(1)
Identify the services to be provided;
(2) Specify the qualifications of the
personnel that will be providing the services;
(3) Require that the HCSPA must authorize the
services;
(4) Stipulate the HCSPA
retains professional responsibility for all services provided; and
(5) Be limited to the types of services
allowed under the HCSPA level of services.
(c) The licensee shall provide staff for the
following positions:
(1) An administrator to
oversee the HCSPA, except as allowed by (e) (1) below; and
(2) A director of client services.
(d) Any new administrator shall
possess:
(1) An associate degree from an
accredited school and at least 2 years of relevant HCSPA experience;
(2) A bachelor's degree from an accredited
school and one year of relevant experience; or
(3) A high school diploma or equivalent and a
minimum of 5 years relevant HCSPA experience.
(e) The administrator shall:
(1) Designate, in writing, an alternate
administrator who shall assume the responsibilities of the administrator in his
or her absence; and
(2) Be
permitted to hold more than one position at the HCSPA if:
a. The individual meets the qualifications of
all positions; and
b. The duties
and responsibilities of the positions can be accomplished by one
individual.
(f) Any new director of client services shall
have at least a high school diploma and 2 years' experience supervising
personnel or providing personal care services.
(g) The director of client services or
designee shall:
(1) Be responsible for the
overall delivery of client services;
(2) Provide sufficient qualified personnel to
meet the needs of the clients; and
(3) Supervise the overall delivery of client
services.
(h) At the
time of admission, personnel of the HCSPA shall:
(1) Provide, both orally and in writing, to
the client, or the client's guardian or agent, if applicable, the HCSPA's:
a. Policy on client rights and
responsibilities, including a copy of the Home Care Clients' Bill of Rights,
pursuant to
RSA
151:21-b;
b. Complaint procedure;
c. List of services that are to be provided
by the HCSPA; and
d. List of care
and services to be provided by an independent contractor, if
appropriate;
(2) Obtain
written confirmation acknowledging receipt of the items in (1) above from the
client, or the client's guardian or agent, or surrogate decision-maker, if
applicable;
(3) Collect and record
the following information:
a. Client's name,
home address, home telephone number, and date of birth;
b. Name and telephone number of an emergency
contact and guardian or agent, if applicable;
c. Name of client's primary care provider and
the provider's address and telephone number as applicable;
d. Written and signed consent for the
provision of care and services; and
e. Copies of all legal directives such as
durable power of attorney, guardianship, or living will, as applicable;
and
(4) Obtain
documentation of informed consent and consent for release of
information.
(i) Each
client shall have an assessment conducted by an HCSPA nurse, the director of
client services or designee to determine the services required by the client,
except as allowed in (j) below:
(1) Prior to
initiating services;
(2) At least
every 6 months thereafter; and
(3)
Whenever there is a significant change in the client's condition.
(j) The assessment required by (i)
above shall contain at a minimum the following:
(1) Pertinent diagnoses including mental
status, as related by the client or the client's agent, as
appropriate;
(2) Any equipment
required;
(3) Functional
limitations;
(4) Activities that
are limited;
(5) Dietary
requirements; and
(6) Any safety
precautions.
(k) Clients
receiving only homemaker services shall not require an assessment or a service
plan.
(l) For clients receiving
only personal care services, the assessment in (i) above shall be performed
initially and every 6 months thereafter by a registered nurse, licensed
practical nurse (LPN), the director of client services or designee to determine
the services required.
(m) The
licensee shall develop a service plan within 3 business days of admission or
prior to the initiation of services, if later, that is based on the results of
the assessments required by (i) above.
(n) The service plan required by (l) above
shall include:
(1) The date of the
assessment;
(2) A description of
the client's needs;
(3) The
services to be provided by HCSPA personnel;
(4) The responsible person(s) or
position;
(5) The date of changes
to the service plan; and
(6)
Documentation that the client and their legal representative, if applicable,
were involved in the development of the service plan and any revisions made to
the plan.
(o) The
licensee shall develop a discharge plan, pursuant to
RSA
151:26, with the input of the client or the
client's legal representative, if any, including:
(1) Date and reason for discharge;
(2) Discharge instructions and referrals, if
applicable;
(3) Discharge or
transfer summary; and
(4) An order
for discharge, if applicable.
(p) Written notes shall be documented in the
client's record at the time of each visit for:
(1) All services provided by the HCSPA and
shall include the:
a. Date and time of the
service;
b. Description of the
service;
c. Progress notes
including, as applicable:
1. Observable
changes in the client's functional, cognitive, or daily activity abilities;
and
2. Changes in the client's
behaviors such as eating or sleeping patterns; and
d. Signature and title of the person
providing the service;
(2) Any reportable incident involving the
client when HCSPA personnel are in the client's home; and
(3) Discharge or transfer documentation, if
applicable, that shall include the date and reason for discharge or
transfer.
(q) For each
client accepted for care and services by the HCSPA, a current and accurate
record shall be maintained and include, at a minimum:
(1) The written confirmation required by (h)
(2) above;
(2) The identification
data required by (h) (3) above;
(3)
Consent forms, as applicable;
(4)
Consent for release of information, as applicable;
(5) The record of the assessment required by
(i) above;
(6) All service plans
required by (l) above including documentation that the client or their legal
representative participated in the development of the service plan;
(7) All written notes required by (p) above;
and
(8) Discharge documentation as
required by (p) (3) above.
(r) Client records shall be available to:
(1) The client, the client's guardian, or the
client's agent;
(2) HCSPA personnel
as required by their job responsibilities and subject to the licensee's policy
on confidentiality;
(3) Any
individual given written authorization by the client, the client's guardian,
client's agent, or the patient's surrogate decision-maker;
(4) Any individual authorized by a court of
competent jurisdiction; and
(5) The
department or any individual authorized by law.
(s) The licensee shall develop and implement
a method for the written release of information in client records that is
consistent with federal and state laws.
(t) The HCSPA shall store all paper and
electronic backup files of client records in the primary or branch office
except when they are being utilized by authorized personnel.
(u) Paper records shall be safeguarded
against loss, damage, or unauthorized use by being stored in locked containers,
cabinets, rooms, or closets except when they are being used by authorized
personnel.
(v) Electronic records
shall be maintained as required by
He-P
822.14(t) .
(w) Records shall be retained for a minimum
of 4 years after discharge and in the case of minors, until one year after
reaching age 18, but no less than 4 years after discharge.
(x) The HCSPA shall arrange for storage of,
and access to, client records as required by (u) and (v) above in the event
that the HCSPA ceases operation.
#9522, eff
7-25-09
