Ohio Admin. Code 173-3-06.5 - Older Americans Act: personal care
(A) Definition for this rule: "Personal care"
means a case-managed service comprised of
activities to help a consumer achieve optimal functioning with ADLs and IADLs.
(1) "Personal care" includes the following
activities:
(a) Assisting the consumer with
ADLs, IADLs, household management, personal affairs, and self-administration of
medications.
(b) Homemaker
activities listed in rule
173-3-06.4 of the Administrative
Code, if the activities are specified in the consumer's activities plan and are
incidental to the activities provided, or are essential to the health and
safety of the consumer, rather than the consumer's family. The homemaker
activities include routine meal-related activities, routine household
activities, and routine transportation activities.
(c) The activities described in paragraphs
(A)(1)(a) to (A)(1)(b) of this rule when they assist the consumer as respite to
the consumer's caregiver or are essential to the health and safety of the
consumer as respite to the consumer's caregiver.
(2) "Personal care" does not include the
following activities:
(a) Activities provided
outside of the home except for routine transportation activities listed in
paragraph (A)(1)(b) of this rule.
(b) Activities within the scope of home
maintenance and chores.
(c)
Activities available through third-party insurers, community supports, Ohio
medicaid state plan, or a medicaid waiver program.
(d) Activities to administer or set-up
medications.
(B) Requirements for every AAA-provider
agreement for personal care paid, in whole or in part, with Older Americans Act
funds:
(1) General requirements: The
AAA-provider agreement is subject to rule
173-3-06 of the Administrative
Code.
(2) Licensure: The provider
is subject to the requirement under Chapter 3740. of the Revised Code and
Chapter 3701-60 of the Administrative Code for the provider to hold a current,
valid license to provide skilled home health services or nonmedical home health
services.
(3) Availability: The
provider shall maintain the following:
(a)
Adequate staffing levels to provide personal care at least five days per
week.
(b) A back-up plan for
providing personal care when the provider has no PCA available.
(c) The availability of a PCA supervisor
during all hours when PCAs are scheduled to work.
(4) PCAs:
(a) Initial qualifications: The provider may
allow a person to serve as a PCA only if the person meets at least one of the
following qualifications and if the provider meets the verification
requirements under paragraph (B)(4)(d) of this rule:
(i) STNA: The person successfully completed a
nurse aide training and competency evaluation program approved by Ohio
department of health (ODH) under section
3721.31 of the Revised
Code.
(ii) Medicare: The person met
the qualifications to be a medicare- certified home health aide according to
one of the following sets of standards:
(iii) Previous experience: The person has at
least one year of supervised employment experience as a home health aide or
nurse aide and has successfully completed competency evaluation covering the
topics listed under paragraph (B)(4)(a)(v)(b) of this rule.
(iv) Vocational programs: The person
successfully completed the COALA home health training program or another
vocational school program that included at least sixty
thirty hours of
training and competency evaluation covering the topics listed under paragraph
(B)(4)(a)(v)(b) of this rule.
(v)
Other programs: The person successfully completed a training and competency
evaluation program with the following characteristics:
(a) The training lasted at least
sixty
thirty
hours.
(b) All the following
subjects were included in the program's training and its competency evaluation:
(v)(iv) Basic elements of
bodily functioning and changes in body function that should be reported to a
PCA supervisor.
(vii)(vi) Recognition of
emergencies, and knowledge of emergency procedures.
(viii)(vii) Physical,
emotional, and developmental needs of consumers, including the need for privacy
and respect for consumers and their property.
(ix)(viii) Techniques in
personal hygiene and grooming that include bed, tub, shower, and partial bath
techniques; shampoo in sink, tub, or bed; nail and skin care; oral hygiene;
toileting and elimination; safe transfer and ambulation; normal range of motion
and positioning; and adequate nutrition and fluid intake.
(i) Communications skills, including the
ability to read, write, and make brief and accurate reports (oral, written, or
electronic).
(ii) Observation,
reporting, and retaining records of a consumer's status and activities provided
to the consumer.
(iii) Reading and
recording a consumer's temperature, pulse, and respiration.
(iv) Basic infection control,
including hand washing and the disposal of bodily waste.
(b) Orientation: Before
allowing PCAs or other employees to meet consumers in person, the provider
shall ensure that the PCAs or other employees successfully completed
orientation that, at a minimum, addressed the following topics:
(i) The provider's expectations of
employees.
(ii) Person-centered
care.
(iii) The provider's ethical
standards.
(iv) An overview of the
provider's personnel policies.
(v)
The organization and lines of communication of the provider's agency.
(vi) Incident reporting.
(vii) Emergency procedures.
(viii)
Standard
precautions for infection control, including hand washing and the disposal of
bodily waste.
(c)
Additional training: The provider shall ensure that each PCA successfully
completes additional training and competency evaluation if the PCA is expected
to perform activities for which the PCA did not receive training or undergo
competency evaluation under paragraph (B)(4)(a) of this rule.
(d) In-service training: The provider shall
retain records to show that each PCA successfully completes
eight
six
hours of ODA-approved in-service training every
twelve months. Agency- and program-specific orientation do not count toward the
eight
six
hours. If the PCA is also a homemaker aide (aide) according to rule
173-3-06.4 of the Administrative
Code, the provider may consider eight
six hours of successfully-completed in- service
training as an aide to count for the eight
six hours required by this paragraph.
(e)
Training
sources:
Acceptable training, orientation, and
competency evaluation.
(i) An
organization other than the provider may provide the orientation and training
required in paragraphs (B)(4)(b) to (B)(4)(d) of this rule. Any training
successfully through https://mylearning.dodd.ohio.gov/
or https://collinslearnng.com/home-health-care/
is approved.
(ii) The portion of
training that is not competency evaluation may occur online.
(iii) The portion of competency evaluation
that involves return demonstration only qualifies as competency evaluation
under paragraph (B)(4)(a) of this rule if it is conducted in person.
(f) Verification of compliance
with PCA qualifications and requirements:
(i) The provider shall either retain copies
of certificates of completion earned by each PCA after the PCA meets
qualifications/requirements under paragraph (B)(4) of this rule for
successfully completing any training and competency evaluation program,
orientation, additional training, and in-service training under paragraph
(B)(4) of this rule or record the following information for each PCA, and
retain it, if it does not appear on the PCA's certificate of completion (or if
the PCA did not receive a certificate of completion): name of the school or
training organization, name of the course, training dates, and training hours
successfully completed.
(ii) If a
person meets the initial qualifications to be a PCA under paragraph (B)(4)(a)
of this rule by successfully completing a nurse aide training and competency
evaluation program described in paragraph (B)(4)(a)(i) of this rule, the
provider shall retain a copy of the search results from ODH's nurse aide
registry (https://nurseaideregistry.odh.ohio.gov/Public/PublicNurseAideSearch)
to verify the registry listed the person as "active," "in good standing," or
"expired."
(iii) If a person meets
the initial qualifications to be a PCA under paragraph (B)(4)(a) of this rule
only by the previous employment experience described in paragraph
(B)(4)(a)(iii) of this rule, the provider shall also retain records to verify
the person's name, the former employer's name and contact information, the
former supervisor's name, the date the person began working for the former
employer, and the date the person stopped working for the former
employer.
(5)
PCA supervisors, PCA trainers, and PCA testers:
(a) Qualifications: The provider may allow
only an RN (or LPN
under the direction of an RN) to be a PCA
supervisor, PCA trainer, or PCA tester.
(b) PCA supervisor visits:
(i) Initial: The PCA supervisor shall visit
each consumer in person at the consumer's home to define the expected
activities of the PCA and develop a written or electronic activity plan with
the consumer either before allowing a PCA to provide an episode of service to
the consumer or during the PCA's initial episode of service to the consumer.
During a state of emergency declared by the governor or a federal public health
emergency, the PCA supervisor may conduct the visit by telephone, video
conference, or in person at the consumer's home.
(ii) Subsequent: The PCA supervisor shall
visit the consumer in person at the consumer's home at least once every sixty
days after the PCA's initial episode of service with the consumer to evaluate
compliance with the activities plan, the consumer's satisfaction, and the PCA's
performance. The PCA supervisor may conduct subsequent visits with or without
the presence of the PCA being evaluated. During a state of emergency declared
by the governor or a federal public health emergency, the PCA supervisor may
conduct subsequent visits by telephone or video conference, unless an emergency
requires visiting the consumer in person at the consumer's home.
(iii) Verification: In the consumer's record,
the PCA supervisor shall retain a record of the initial visit and each
subsequent visit that includes the date of the
visit; whether the visit occurred by telephone, video conference, or in person
at the consumer's home; the PCA supervisor's name and signature; the consumer's
name; and a unique identifier of the consumer or the consumer's caregiver.
During a state of emergency declared by the governor or a federal public health
emergency, the provider may verify that the PCA supervisor provided the initial
or subsequent visit without collecting a unique identifier of the consumer or
the consumer's caregiver.
either of the
following:
(a)
For an in-person visit, the date of the visit, an indication
that the visit occurred in person at the consumer's home, the PCA supervisor's
name, the PCA supervisor's unique identifier, the consumer's name, and a unique
identifier of the consumer or the consumer's caregiver. During a state of
emergency declared by the governor or a federal public health emergency, the
provider may verify that the PCA supervisor provided the initial or subsequent
visit without collecting a unique identifier of the consumer or the consumer's
caregiver.
(b)
For a visit by telephone or video conference, the date
of the visit, an indication of whether the visit was provided by telephone or
video conference, the PCA supervisor's name, the consumer's name, and evidence
that a visit occurred by telephone or video conference (e.g., a record
automatically generated by telehealth software, a record showing that the PCA
supervisor's phone called the consumer's phone, or clinical notes from the PCA
supervisor).
(6) Provider's policies:
(a) The provider shall develop, implement,
comply with, and maintain written or electronic policies on all the following
topics:
(iv)(iii) Incident
reporting.
(v)(iv) Obtaining the
consumer's written or electronic permission before releasing information
concerning the consumer to anyone.
(vi)(v) The required
content, handling, storage, and retention of consumer records.
(vii)(vi)
The provider's ethical standards.
(viii)(vii) Assistance
with self-administration of medication.
(i) Job descriptions.
(ii) Qualifications to provide personal care.
(iii) Performance
appraisals.
(b) The provider shall make its policies
available to all employees and provide to ODA or the AAA upon
request.
(7) Service
verification:
(a) The provider is subject to
section 121.36 of the Revised
Code.
(b) The following are the
mandatory reporting items for each episode of service that a provider retains
to comply with the requirements under paragraph (B)(9) of rule
173-3-06 of the Administrative
Code:
(i) Consumer's name.
(ii) Service date.
(iii) PCA's arrival time.
(iv) PCA's departure time.
(v) Description of the activities
provided.
(vi) Service
units.
(vii) Name of each PCA in
contact with the consumer.
(viii)
The unique identifier of each PCA in contact with the consumer to attest to
providing the service.
(ix) The
unique identifier of the consumer or the consumer's caregiver to attest to
receiving the service.
(c) During a state of emergency declared by
the governor or a federal public health emergency, the provider may verify each
episode of service provided without collecting the unique identifier of the
consumer or the consumer's caregiver.
(C) Unit of service: A unit of personal care
is one hour of personal care. Providers may report partial hours to two decimal
places (e.g., "0.25 hours").
Notes
Promulgated Under: 119.03
Statutory Authority: 121.07, 121.36, 173.01, 173.02, 173.392; 42 U.S.C. 3025; 45 C.F.R. 1321.9
Rule Amplifies: 121.36, 173.39, 173.392; 42 U.S.C. 3025, 3030d; 45 C.F.R. 1321.9, 1321.73
Prior Effective Dates: 02/23/2009, 02/14/2010, 01/01/2014, 05/08/2020, 06/11/2020 (Emer.), 12/31/2020, 01/29/2022, 01/01/2023
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
(A) Definition for this rule: "Personal care" means a case-managed service comprised of activities to help a consumer achieve optimal functioning with ADLs and IADLs.
(1) "Personal care" includes the following activities:
(a) Assisting the consumer with ADLs, IADLs, household management, personal affairs, and self-administration of medications.
(b) Homemaker activities listed in rule 173-3-06.4 of the Administrative Code, if the activities are specified in the consumer's activities plan and are incidental to the activities provided, or are essential to the health and safety of the consumer, rather than the consumer's family. The homemaker activities include routine meal-related activities, routine household activities, and routine transportation activities.
(c) The activities described in paragraphs (A)(1)(a) to (A)(1)(b) of this rule when they assist the consumer as respite to the consumer's caregiver or are essential to the health and safety of the consumer as respite to the consumer's caregiver.
(2) "Personal care" does not include the following activities:
(a) Activities provided outside of the home except for routine transportation activities listed in paragraph (A)(1)(b) of this rule.
(b) Activities within the scope of home maintenance and chores.
(c) Activities available through third-party insurers, community supports, Ohio medicaid state plan, or a medicaid waiver program.
(d) Activities to administer or set-up medications.
(B) Requirements for every AAA-provider agreement for personal care paid, in whole or in part, with Older Americans Act funds:
(1) General requirements: The AAA-provider agreement is subject to rule 173-3-06 of the Administrative Code.
(2) Licensure: The provider is subject to the requirement under Chapter 3740. of the Revised Code and Chapter 3701-60 of the Administrative Code for the provider to hold a current, valid license to provide skilled home health services or nonmedical home health services.
(3) Availability: The provider shall maintain the following:
(a) Adequate staffing levels to provide personal care at least five days per week.
(b) A back-up plan for providing personal care when the provider has no PCA available.
(c) The availability of a PCA supervisor during all hours when PCAs are scheduled to work.
(4) PCAs:
(a) Initial qualifications: The provider may allow a person to serve as a PCA only if the person meets at least one of the following qualifications and if the provider meets the verification requirements under paragraph (B)(4)(d) of this rule:
(i) STNA: The person successfully completed a nurse aide training and competency evaluation program approved by Ohio department of health (ODH) under section 3721.31 of the Revised Code.
(ii) Medicare: The person met the qualifications to be a medicare- certified home health aide according to one of the following sets of standards:
(iii) Previous experience: The person has at least one year of supervised employment experience as a home health aide or nurse aide and has successfully completed competency evaluation covering the topics listed under paragraph (B)(4)(a)(v)(b) of this rule.
(iv) Vocational programs: The person successfully completed the COALA home health training program or another vocational school program that included at least sixty thirty hours of training and competency evaluation covering the topics listed under paragraph (B)(4)(a)(v)(b) of this rule.
(v) Other programs: The person successfully completed a training and competency evaluation program with the following characteristics:
(a) The training lasted at least sixty thirty hours.
(b) All the following subjects were included in the program's training and its competency evaluation: (v)(iv) Basic elements of bodily functioning and changes in body function that should be reported to a PCA supervisor. (vii)(vi) Recognition of emergencies, and knowledge of emergency procedures. (viii)(vii) Physical, emotional, and developmental needs of consumers, including the need for privacy and respect for consumers and their property. (ix)(viii) Techniques in personal hygiene and grooming that include bed, tub, shower, and partial bath techniques; shampoo in sink, tub, or bed; nail and skin care; oral hygiene; toileting and elimination; safe transfer and ambulation; normal range of motion and positioning; and adequate nutrition and fluid intake.
(i) Communications skills, including the ability to read, write, and make brief and accurate reports (oral, written, or electronic).
(ii) Observation, reporting, and retaining records of a consumer's status and activities provided to the consumer.
(iii) Reading and recording a consumer's temperature, pulse, and respiration.
(iv) Basic infection control, including hand washing and the disposal of bodily waste.
(b) Orientation: Before allowing PCAs or other employees to meet consumers in person, the provider shall ensure that the PCAs or other employees successfully completed orientation that, at a minimum, addressed the following topics:
(i) The provider's expectations of employees.
(ii) Person-centered care.
(iii) The provider's ethical standards.
(iv) An overview of the provider's personnel policies.
(v) The organization and lines of communication of the provider's agency.
(vi) Incident reporting.
(vii) Emergency procedures.
(viii) Standard precautions for infection control, including hand washing and the disposal of bodily waste.
(c) Additional training: The provider shall ensure that each PCA successfully completes additional training and competency evaluation if the PCA is expected to perform activities for which the PCA did not receive training or undergo competency evaluation under paragraph (B)(4)(a) of this rule.
(d) In-service training: The provider shall retain records to show that each PCA successfully completes eight six hours of ODA-approved in-service training every twelve months. Agency- and program-specific orientation do not count toward the eight six hours. If the PCA is also a homemaker aide (aide) according to rule 173-3-06.4 of the Administrative Code, the provider may consider eight six hours of successfully-completed in- service training as an aide to count for the eight six hours required by this paragraph.
(e) Training sources: Acceptable training, orientation, and competency evaluation.
(i) An organization other than the provider may provide the orientation and training required in paragraphs (B)(4)(b) to (B)(4)(d) of this rule. Any training successfully through https://mylearning.dodd.ohio.gov/ or https://collinslearnng.com/home-health-care/ is approved.
(ii) The portion of training that is not competency evaluation may occur online.
(iii) The portion of competency evaluation that involves return demonstration only qualifies as competency evaluation under paragraph (B)(4)(a) of this rule if it is conducted in person.
(f) Verification of compliance with PCA qualifications and requirements:
(i) The provider shall either retain copies of certificates of completion earned by each PCA after the PCA meets qualifications/requirements under paragraph (B)(4) of this rule for successfully completing any training and competency evaluation program, orientation, additional training, and in-service training under paragraph (B)(4) of this rule or record the following information for each PCA, and retain it, if it does not appear on the PCA's certificate of completion (or if the PCA did not receive a certificate of completion): name of the school or training organization, name of the course, training dates, and training hours successfully completed.
(ii) If a person meets the initial qualifications to be a PCA under paragraph (B)(4)(a) of this rule by successfully completing a nurse aide training and competency evaluation program described in paragraph (B)(4)(a)(i) of this rule, the provider shall retain a copy of the search results from ODH's nurse aide registry (https://nurseaideregistry.odh.ohio.gov/Public/PublicNurseAideSearch) to verify the registry listed the person as "active," "in good standing," or "expired."
(iii) If a person meets the initial qualifications to be a PCA under paragraph (B)(4)(a) of this rule only by the previous employment experience described in paragraph (B)(4)(a)(iii) of this rule, the provider shall also retain records to verify the person's name, the former employer's name and contact information, the former supervisor's name, the date the person began working for the former employer, and the date the person stopped working for the former employer.
(5) PCA supervisors, PCA trainers, and PCA testers:
(a) Qualifications: The provider may allow only an RN (or LPN under the direction of an RN) to be a PCA supervisor, PCA trainer, or PCA tester.
(b) PCA supervisor visits:
(i) Initial: The PCA supervisor shall visit each consumer in person at the consumer's home to define the expected activities of the PCA and develop a written or electronic activity plan with the consumer either before allowing a PCA to provide an episode of service to the consumer or during the PCA's initial episode of service to the consumer. During a state of emergency declared by the governor or a federal public health emergency, the PCA supervisor may conduct the visit by telephone, video conference, or in person at the consumer's home.
(ii) Subsequent: The PCA supervisor shall visit the consumer in person at the consumer's home at least once every sixty days after the PCA's initial episode of service with the consumer to evaluate compliance with the activities plan, the consumer's satisfaction, and the PCA's performance. The PCA supervisor may conduct subsequent visits with or without the presence of the PCA being evaluated. During a state of emergency declared by the governor or a federal public health emergency, the PCA supervisor may conduct subsequent visits by telephone or video conference, unless an emergency requires visiting the consumer in person at the consumer's home.
(iii) Verification: In the consumer's record, the PCA supervisor shall retain a record of the initial visit and each subsequent visit that includes the date of the visit; whether the visit occurred by telephone, video conference, or in person at the consumer's home; the PCA supervisor's name and signature; the consumer's name; and a unique identifier of the consumer or the consumer's caregiver. During a state of emergency declared by the governor or a federal public health emergency, the provider may verify that the PCA supervisor provided the initial or subsequent visit without collecting a unique identifier of the consumer or the consumer's caregiver. either of the following:
(a) For an in-person visit, the date of the visit, an indication that the visit occurred in person at the consumer's home, the PCA supervisor's name, the PCA supervisor's unique identifier, the consumer's name, and a unique identifier of the consumer or the consumer's caregiver. During a state of emergency declared by the governor or a federal public health emergency, the provider may verify that the PCA supervisor provided the initial or subsequent visit without collecting a unique identifier of the consumer or the consumer's caregiver.
(b) For a visit by telephone or video conference, the date of the visit, an indication of whether the visit was provided by telephone or video conference, the PCA supervisor's name, the consumer's name, and evidence that a visit occurred by telephone or video conference (e.g., a record automatically generated by telehealth software, a record showing that the PCA supervisor's phone called the consumer's phone, or clinical notes from the PCA supervisor).
(6) Provider's policies:
(a) The provider shall develop, implement, comply with, and maintain written or electronic policies on all the following topics: (iv)(iii) Incident reporting. (v)(iv) Obtaining the consumer's written or electronic permission before releasing information concerning the consumer to anyone. (vi)(v) The required content, handling, storage, and retention of consumer records. (vii)(vi) The provider's ethical standards. (viii)(vii) Assistance with self-administration of medication.
(i) Job descriptions.
(ii) Qualifications to provide personal care.
(iii) Performance appraisals.
(b) The provider shall make its policies available to all employees and provide to ODA or the AAA upon request.
(7) Service verification:
(a) The provider is subject to section 121.36 of the Revised Code.
(b) The following are the mandatory reporting items for each episode of service that a provider retains to comply with the requirements under paragraph (B)(9) of rule 173-3-06 of the Administrative Code:
(i) Consumer's name.
(ii) Service date.
(iii) PCA's arrival time.
(iv) PCA's departure time.
(v) Description of the activities provided.
(vi) Service units.
(vii) Name of each PCA in contact with the consumer.
(viii) The unique identifier of each PCA in contact with the consumer to attest to providing the service.
(ix) The unique identifier of the consumer or the consumer's caregiver to attest to receiving the service.
(c) During a state of emergency declared by the governor or a federal public health emergency, the provider may verify each episode of service provided without collecting the unique identifier of the consumer or the consumer's caregiver.
(C) Unit of service: A unit of personal care is one hour of personal care. Providers may report partial hours to two decimal places (e.g., "0.25 hours").
Notes
Promulgated Under: 119.03
Statutory Authority: 121.07, 121.36, 173.01, 173.02, 173.392; 42 U.S.C. 3025; 45 C.F.R. 1321.9
Rule Amplifies: 121.36, 173.39, 173.392; 42 U.S.C. 3025, 3030d; 45 C.F.R. 1321.9, 1321.73
Prior Effective Dates: 02/23/2009, 02/14/2010, 01/01/2014, 05/08/2020, 06/11/2020 (Emer.), 12/31/2020, 01/29/2022, 01/01/2023