Haw. Code R. § 11-97.1-6 - Policies and procedures and standards
(a) A satisfactory
statement of policy of the home health agency, including the scope of services,
the conditions under which they are offered, and the geographic coverage, shall
be available to the department upon request.
(b) Services provided by the home health
agency shall be available to any qualified patient in a home setting in the
geographic area of the home health agency regardless of race, color, or
national origin. Contracts with other agencies to provide services shall be
approved by authorized persons of agencies involved,
(c) The basic services of nursing shall be
provided by the home health agency.
(d) Policies governing medical services shall
be provided through a governing body or designated persons functioning as a
governing body.
(e) Policies
governing nursing and other therapeutic services shall be provided through the
governing body or an advisory committee which shall include a minimum of at
least a practicing physician or APRN or physician's assistant, and a registered
nurse, a representative of other professional services such as dietary,
occupational therapy, physical therapy, social work, or speech therapy, and
community members who are aware of the needs of the community. The policies
recommended by such committee shall meet current and acceptable professional
practices. Minutes shall be kept of all meetings.
(f) Nursing and other therapeutic service
policies shall be established and include but not be limited to:
(1) Nursing and other therapeutic services
provided shall be in accordance with the physician's or APRN's or physician's
assistant's written order and plan of treatment.
(2) The nurses, therapists, social workers,
aide, or staff members rendering services shall meet qualifications prescribed
in the definitions of this chapter.
(3) A home health agency provides nursing
services, and at least one other therapeutic service such as physical therapy,
occupational therapy, or speech therapy consistent with the definition of home
health services.
(4) When a home
health agency does not provide all the nursing or therapeutic services
specified above. it shall include in its written policies which govern such
services, a plan for identifying, utilizing and cooperating with other
resources and facilities including community social agencies for the purpose of
providing such services to patients. The home health agency may arrange for the
services which it does not provide by written agreements with other licensed
home health agencies or by contracts with health professionals who shall meet
the requirements of this chapter.
(g) Medical records.
(1) A clinical record for each patient shall
be maintained based on standards acceptable to the department;
(2) All staff responsible for specific
professional aspects of care to a patient shall record in the patient's record
information about the services rendered.
(h) Establishment and review plan of
treatment.
(1) A home health agency shall
establish policies and procedures for assuring that care services to be
provided are specified under the plan of treatment ordered, established, and
regularly signed by the physician or APRN or physician assistant responsible
for the care of the patient.
(2)
The plan of treatment ordered by the physician or APRN or physician assistant
shall be signed by the physician or APRN or physician assistant responsible for
the patient and incorporated into the patient's medical record.
(3) The total plan shall be reviewed by the
attending physician or APRN or physician assistant, in consultation with the
agency's professional personnel at such intervals as the severity of the
patient's condition may require, but not less than once every two
months.
(4) The professional staff
shall bring to the attention of the patient's physician or APRN or physician
assistant changes in the patient's condition which may indicate the need for
altering the treatment plan or for the termination of service or
services.
(5) Only the attending
physician or APRN or physician assistant shall terminate services. Upon
termination of services, the physician or APRN or physician assistant shall
prepare or approve a written discharge summary which includes reasons for
termination of services, the patient's medical condition upon discharge and a
summary of the course of the patient's illness.
(6) All orders shall be signed by the
physician or APRN or physician assistant.
(7) When verbal orders are received by the
professional nurse or other professional disciplines they shall be signed by
the physician or APRN or physician assistant within a reasonable period of
time.
(i) Home health
agency shall provide:
(1) Written job
descriptions which specify the qualifications and experience of each category
of health personnel and the type of activity each category of health personnel
may perform;
(2) Written personnel
policies to each staff member; and
(3) A plan for a pre-employment and periodic
medical examination, tuberculosis testing and/or chest x-ray and other
appropriate tests and immunizations for all home health agency
personnel
(j) Home
health agency shall provide for all personnel rendering service to patients, a
planned program of orientation to the agency's policies and objectives and a
continuous in service education program.
(k) Maintenance of records and reports.
(1) Clinical records, service reports, fiscal
reports, job descriptions, personnel reports, personnel policies and rosters,
cost accounting data, committee reports, statements of policies, and such other
records and reports as may be required shall be kept on file in the agency's
office.
(2) When a home health
agency is a subdivision of a parent agency or organization, the fiscal
accounting system shall be maintained in such a method to permit the costs of
the home health agency to be easily identifiable.
(3) Home health agency shall keep
confidential all medical, nursing, paramedical, therapeutical, personnel, and
financial information relating to each patient and make such available only to
authorized persons.
(l)
A home health agency shall develop, implement, evaluate, and maintain an
effective, ongoing, agency-wide, data-driven quality assessment and performance
improvement program that reflects the complexity of its organization and
services, involves all services including those services provided under
contract or arrangement, focuses on indicators related to improved outcomes,
and shall maintain documentary evidence of its quality assessment and
performance improvement program.
(m) A home health agency shall follow
accepted standards of practice, including the use of standard precautions, to
prevent the transmission of infections and communicable diseases.
(n) A home health agency shall provide a
periodic evaluation of employee performance.
(o) The director may approve a modification
of standards for a home health agency when exceptional circumstances warrant
such modification.
Notes
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No prior version found.