Conn. Agencies Regs. § 19-13-D89 - Quality assurance program
(a) An agency shall
have a written quality assurance program which shall include but not be limited
to:
(1) Program evaluation:
(2) Patient record review.
(b) The governing authority, or a
committee appointed by the governing authority and the patient care advisory
committee shall conduct the program evaluation which shall include, but not be
limited to:
(1) The extent to which the
agency's objectives, policies and resources are adequate to maintain programs
and services appropriate to community, patient and family needs;
(2) The extent to which the agency's
administrative practices and patterns for delivery of services achieve
efficient and effective community, patient and family services in a five (5)
year cycle.
(c) At least
quarterly, the professional members of the patient care advisory committee
shall review a random sample of active and closed patient records. Each record
review shall be documented on a record review form and shall include, but not
be limited to verification, that:
(1) Agency
policies are followed in the provision of services to patients and
families;
(2) Homemaker-home health
aide services are utilized appropriately in relation to agency resources and
patient or family resources;
(3)
Services are provided only to patients whose level of care needs can be safely
met by a homemaker-home health aide;
(4) Provision of care is coordinated within
the agency and with other agencies involved in the care of the patient or
family.
(5) Referral of the patient
to a home health care agency when the patient's status and care needs are no
longer limited to supportive services.
(d) An agency's sampling methodology shall be
defined in its quality assurance program policies and procedures. The sample of
patient records reviewed each quarter shall be according to the following
ratios:
(1) Eighty (80) or less cases; eight
(8) records;
(2) Eighty-one (81) or
more cases; ten percent (10%) of caseload for the quarter to maximum of
twenty-five (25) records.
(e) An annual written report of the agency's
quality assurance program shall summarize all findings and recommendations
resulting from the quality assurance activities. This report and documentation
of all actions or implementations on the findings or recommendations included
in the report shall be available to the commissioner .
Notes
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