Section 29-5102. ADMINISTRATION AND STAFFING

 

5102.1Each Provider shall have a current organizational chart that clearly describes the organizational structure, staff responsibilities and lines of authority.

 

5102.2Each Provider shall provide to all staff and subcontractors a current policy manual which sets forth all of its policies and procedures.

 

5102.3Each policy manual shall include, but not be limited to, the following information:

 

(a)A description of the services to be provided;

 

(b)Procedures for patient care;

 

(c)The reimbursement methodology or fee schedules;

 

(d)Operational schedules;

 

(e)Quality assurance standards;

 

(f)A statement of patient rights and responsibilities;

 

(g)Financial and record-keeping requirements;

 

(h)Procedures for emergency care;

 

(i)A description of staff and personnel policies, which shall be reviewed by designated Provider staff annually, revised as necessary and dated at time of review;

 

(j)A description of each staff position and procedures for employee hiring, evaluations, grievances and in-service training; and

 

(k)An up-to-date listing of professional staff licensure and registration information.

 

5102.4Each Provider shall be staffed with individuals who are qualified to perform the following functions:

 

(a)Verify and document each patient's Medicaid eligibility;

 

(b)Provide quality services in accordance with the plan of care, including the proper assignment and supervision of home health aides; and

 

(c)Coordinate the provision of services provided by the home health aides with other home health services, as appropriate.

 

5102.5Each Provider shall employ a registered nurse who is responsible for the following:

 

(a)Performing the initial evaluation of the patient and regularly reevaluating the patient's needs;

 

(b)Monitoring the quality of the services on a regular basis;

 

(c)Supervising the home health aide, in accordance with the requirements set forth in § 5102.7 through § 5102.09;

 

(d)Developing and reviewing the plan of care and preparing clinical and progress notes;

 

(e)Coordinating services and informing the physician and others involved in patient care of changes in the patient's condition and needs;

 

(f)Gathering information regarding the patient's condition and the need for continued care; and

 

(g)Counseling the patient and the family regarding meeting nursing and related needs.

 

5102.6The registered nurse shall visit each patient within 48 hours of initiating services to monitor the quality of services provided.

 

5102.7If the patient is receiving skilled nursing care, a registered nurse shall be responsible for the supervision of the home health aide and shall make an on-site visit to the patient no less frequently than every 2 weeks to ensure that the aide is properly caring for the patient.

 

5102.8If the patient is receiving physical therapy, occupational therapy, or speech-language pathology services, supervision may be provided by the physical therapist, occupational therapist, speech pathologist or registered nurse, who shall make an on-site visit to the patient no less frequently than every 2 weeks to ensure that the aide is properly caring for the patient.

 

5102.9The registered nurse may provide an additional supervisory visit to each patient if the situation warrants an additional visit, such as the assignment of a new aide or change in the patient's health status.

 

5102.10Each Provider shall discontinue services when such services are no longer required or have been determined inadequate to meet a patient's needs.

 

5102.11Each Provider shall notify MAA and the patient or patient's representative, in writing, no less than seven (7) calendar days prior to discharge or referral. The seven (7) day written notice shall not be required, and oral notice may be given, if the discharge or referral is the result of:

 

(a)A medical emergency;

 

(b)A physician's order to admit the patient to an inpatient facility;

 

(c)A determination by the home care agency that the discharge or referral is necessary to protect the health, safety or welfare of agency staff; or

 

(d)A determination by a physician that the condition that necessitated the provision of services no longer exists.

 

5102.12If the patient seeks to change providers, the Provider shall assist the patient in selecting a new provider and cannot abandon the patient until the transfer has been successfully completed.

 

5102.13Each Provider shall immediately terminate the services of a home health aide and instruct the aide to discontinue all services to the patient, in any case where the Provider believes that the patient's physical or mental well-being is endangered by the care or lack of care, provided by the aide or that the patient's property is at risk.

 

5102.14Each Provider shall conduct a performance evaluation of each home health aide after the first three (3) months of employment and annually thereafter.

 

5102.15Each Provider shall develop contingency staffing plans to provide coverage for each patient in the event the assigned home health aide cannot provide the services or is terminated.

 

source

Final Rulemaking published at 50 DCR 3957 (May 23, 2003).