Chapter 3 - LOSS OF, RENEWAL, PROVISIONAL AND CONDITIONAL LICENSES

3.A. Refusal to Issue a License

The Department shall refuse to issue a license to the applicant if it finds that any or all of the following conditions exist:

3.A.1. The Department finds that the information submitted in the application is incorrect or incomplete,

3.A.2. The applicant does not meet all requirements of these laws and regulations;

3.A.3. The applicant has violated applicable laws and rules and regulations and the Department finds that these practices of the agency are detrimental to the welfare of persons to whom home health care services are provided.

3.B. Right of Entry and Inspection

3.B.1. Any duly designated employee of the Department shall have the right to enter upon and into the premises of any Home Health Care Services Provider who has applied for a license or who is licensed pursuant to these rules and regulations. These employees can inspect relevant agency documents to determine whether the agency is in compliance with these rules and regulations. The right of entry and inspection shall extend to any premises and documents of providers whom the Department has reason to believe are providing home health care services without a license. Such entries or inspections shall be made with permission of the owner or person in charge unless a warrant is first obtained from the District Court authorizing that entry or inspection ( 22 MRSA §2148 ). Surveyors, with the permission of the patient/client, may also make patient/client home visits at their discretion.

3.B.2. The Department and any duly designated representative thereof shall have the right to enter upon and into the premises of any facility licensed pursuant to these rules and regulations at any time, without threat of injury, verbal abuse or harassment and in the spirit of mutual cooperation, in order to determine the state of compliance with the provisions of rules and regulations in force pursuant thereto. Such right of entry and inspection shall extend to any premises which the Department has reason to believe are being operated or maintained as a home health care services agency without a license, but no such entry or inspection of any premises shall be made without the permission of the owner or person in charge thereof, unless a warrant is first obtained from the court of jurisdiction authorizing the same. Any application for a license made pursuant to these rules and regulations shall constitute permission for, and complete acquiescence in, any entry or inspection of the premises for which the license is sought in order to facilitate, verification of the information submitted on or in connection with such application. (Title 22, § 2148 ). Application for licensure, whether initial or renewal, shall constitute permission for entry into, and survey of, a home health care services provider by authorized licensing authority representatives at reasonable times during pendency of the application and, if licensed, during the licensure period.

3.B.3. Surveys may be announced or unannounced at the sole discretion of the licensing authority. All complaint investigations will be unannounced.

3.B.4. Upon receipt of a notice of deficiency from the licensing authority, the licensee or his/her representative will be required to submit a written plan of correction to the licensing authority within ten (10) working days of the date of the statement of deficiencies stating how the agency intends to correct each violation noted and the expected date of completion.

3.B.5. The licensing authority may, at its sole discretion, accept the plan of correction as written or request modification of the plan by the licensee.

3.B.6. Regardless of the term of the license, the Department shall monitor for continued compliance with applicable laws and rules on at least a biennial basis.

3.B.7. Licensing Survey Frequency

The Department shall survey the Home Health Care Services Provider on at least a biennial basis, except that State licensing surveys need not be performed during a year when a Medicare certification survey is performed.

State licensure surveys will be performed on at least an annual basis If any of the following conditions exist:

a. Change of ownership since the previous licensure or Medicare certification survey; or

b. Complaint survey with deficiency citations since the last licensure or Medicare certification survey, or

c. Conditional State license issued at the last regular licensure survey; or

d. Failure to meet any of the Medicare Conditions of Participation within the past twenty-four (24) months.

3.B.8. Complaints

a. Any person may file a complaint with the administrator or any member of the home health care services staff.

b. A procedure must be established for the review, within two business days, of each complaint received, by the administrator and/or any designated member of the staff. A report of findings and action taken shall. be prepared and submitted to the Quality Assurance Committee or other appropriate committee, and be available for review upon request of the Department.

3.B.9. Reporting of Abuse, Neglect or Misappropriation of Client and/or Client's Property

a. The Home Health Care Services Provider must ensure that all staff are knowledgeable of the Adult Protective Services Act and that all alleged violations involving mistreatment, neglect and abuse, including injuries of unknown source and/or misappropriation of client/patient property, are reported immediately, through established procedures, to the administrator of the home health care services provider and to other officials in accordance with the State law (Title 22, § 3470et seq.).

b. The Home Health Care Services Provider must have evidence that all alleged employee violations are thoroughly investigated in a timely manner. Policies must address administrative procedures to be implemented to prevent further potential abuse while the investigation is in progress.

c. The results of all investigations conducted in house must be reported to the administrator or his/her designated representative and to other officials in accordance with State law. If the alleged violation is verified, appropriate corrective action must be taken. All reports must be made available to the Department upon request.

d. Results of investigations must be reported to the Department if the allegations involve a certified nursing assistant.

3.B.10. The Home Health Care Services Provider must develop and implement written policy and procedures that prohibit abuse, neglect or misappropriation of client's property.

3.C. Renewal of License

3.C.1. The Department will send the Home Health Care Services Provider a renewal application at least fifty (50) days prior to the expiration of the license. This application shall be completed and submitted to the Department at least twenty (20) days prior to the expiration of the license. The Department shall review this renewal application to ensure that it is consistent with these rules and regulations.

3.C.2. Based upon its review, Department staff will inform the Home Health Care Services Provider of its decision to:

a. Renew the license for a period of one year;

b. Grant the Home Health Care Services Provider a conditional license, or

c. Refuse to issue the applicant a new license.

3.D. Provisional License

3.D.1. A provisional license shall be issued by the Department to an applicant who:

a. Has not previously been licensed as a Home Health Care Services Provider or is licensed but has not operated during the term of that license;

b. Complies with all applicable laws and rules, except those which can be complied with only once clients are served by the applicant; and

c. Demonstrates the ability to comply with all applicable laws and rules by the end of the provisional license. Department staff will make a site monitoring visit to the home health cam services agency to accumulate the information necessary to make this determination.

3.E. Conditional License

3.E.1. The Department may issue a conditional license when an agency fails to comply with applicable laws and rules, and in the judgment of the Commissioner, the best interest of the public would be served by issuing a conditional license.

3.E.2. The decision to grant a conditional license can be made by the Commissioner at the time of application for an initial license, at the expiration of a full or provisional license or during the term of a full license.

3.E.3. The conditional license shall specify when and what corrections shall be made during the term of the conditional license.

3.F. Suspension or Revocation of License

3.F.1. The Department may recommend suspension or revocation of any license issued pursuant to 22 MRSA §2141 et seq., for violation of applicable laws and rules committing, permitting, aiding or abetting any illegal practices in the operation of the provider or conduct or practices detrimental to the welfare of persons to whom home health care services are provided.

3.F.2. When the Department believes that a license should be suspended or revoked, it shall file a complaint with the Administrative Court in accordance with Title 4 MRSA §1153 or the Maine Administrative Procedure Act, Title 5 MRSA §10051 et seq.

3.F.3. Upon suspension or revocation of a license, the license shall be immediately surrendered to the Department.

3.G. Emergency Revocation, Suspension or Refusal to Renew License

Whenever the Department determines that the health or physical safety of a person is in immediate jeopardy, and action in accordance with 5 MRSA §9051 - 9064 or 5 M RSA § 10051 would fail to respond to a known risk, the Department may revoke, suspend or refuse to renew a home health care services license, provided that the revocation, suspension or refusal to renew shall not continue for more than 30 days.

3.H. Receivership

Pursuant to 22 MRSA, Section7931 et seq. the Department may petition the Superior Court to appoint a receiver to operate a home health care service in the following circumstances:

1. When the home health care service intends to close, but has not arranged at least thirty (30) days prior to closure for the orderly transfer of its patients/clients;

2. When an emergency exists in a home health care service which threatens the health, security or welfare of its patients/clients;

3. When the home health care services is in substantial or habitual violation of the standards of health, safety or patient/client care established under State or Federal regulations to the detriment of the welfare of the patient/client.

3.I. Appeals

Any person aggrieved by the Department's decision to take any of the following actions may request an administrative hearing as provided by the Maine Administrative Procedure Act, Title 5 MRSA §9051 et seq.

3.I.1. Issue a conditional license,

3.I.2. Amend or modify a license;

3.I.3. Refusal to issue, or renew a full license; or

3.I.4. Refusal to issue a provisional license.

3.J. Public Notice

If an annual license is revoked, suspended or not renewed, the Department will advise the public of such action. This public notice will be in the form of a paid legal notice in the local newspaper(s), published within fifteen (15) days following the suspension or revocation of the license.

Notes