(1) The home health agency must organize,
manage and administer its home health services to attain and maintain the
highest practicable functional capacity for each patient regarding medical,
nursing and rehabilitative needs as indicated by the plan of care.
(2) The home health agency shall ensure a
framework for addressing issues related to care at the end of life.
(3) The home health agency shall provide a
process that assesses pain in all patients. There shall be an appropriate and
effective pain management program.
(4) The agency develops and maintains
administrative control of any branch office.
(5) The organizational structure, home health
services provided, administrative control and lines of authority for the
delegation of responsibility down to the patient care level shall be clearly
set forth in writing and shall be readily identifiable. Administrative and
supervisory functions shall not be delegated to another agency. All home health
services not provided directly by the licensed agency shall be monitored and
controlled by that agency.
governing body (or designated persons so functioning) must: assume full legal
authority and responsibility for the management and provision of all home
health services; fiscal operations; quality assessment and performance
improvement programs. The governing body shall appoint a qualified
administrator who is responsible for the day-to-day operation of the
organization and is responsible for designating people to carry out these
(7) The administrator
shall organize and direct the organization's ongoing functions; the
professional personnel and the staff; employ qualified personnel and ensure
adequate staff education and evaluation for all personnel involved in direct
patient care; ensure the accuracy of public information materials and
activities; and implement an effective budgeting and accounting system. A
person with sufficient experience and training shall be authorized in writing
to assume temporary duty during the administrator's short-term
(8) An agency shall have a
duly qualified administrator accessible during normal operating hours. Any
change of administrators shall be reported to the Department within fifteen
(9) An administrator
shall serve no more than one (1) licensed home care organization unless that
home care organization provides other categories of home care organization
services under the same ownership and at the same location.
(10) The agency shall maintain an office with
a working telephone and be staffed during normal business hours.
(11) When licensure is applicable for a
particular position of employment, a copy of the current license or the number
and renewal number of the employee's current license must be maintained in the
employee's personnel file. Each personnel file shall contain accurate
information as to the education, training, experience and personnel background
of the employee. Proof of adequate medical screenings to exclude communicable
disease shall be maintained in the file of each employee.
(12) Personnel practices shall be supported
by written personnel policies. Personnel records shall include at a minimum:
job descriptions, verification of references and credentials, and performance
evaluations. Personnel records must be kept current.
(13) An ongoing educational program shall be
planned and conducted for the development and improvement of skills of all the
organization's personnel engaged in delivery of home health services. Each
employee shall receive appropriate orientation to the organization, its
policies, the employee's position, and the employee's duties. Records shall be
maintained which indicate the subject of and attendance at such staff
personnel, under hourly or per visit contracts, are utilized by the agency,
there shall be a written contract between such personnel and the organization
(a) That patients are
accepted for care only by the agency;
(b) Which home health services are to be
(c) That it is necessary
to conform to all applicable organization policies including personnel
responsibility for participating in developing plans of care;
(e) The manner in which home health services
will be controlled, coordinated and evaluated by the agency;
(f) The procedures for submitting clinical
and progress notes, scheduling visits and periodic patient evaluations;
(g) The procedures for
determining charges and reimbursement.
(15) Whenever the rules of this chapter
require that a licensee develop a written policy, plan, procedure, technique or
system concerning a subject, the licensee shall develop the required policy,
maintain it and adhere to its provisions. An agency which violates a required
policy also violates the rule establishing the requirement.
(16) Policies and procedures shall be
consistent with professionally recognized standards of practice.
(17) All agencies shall adopt appropriate
policies regarding the testing of patients and staff for human immunodeficiency
virus (HIV) and any other identified causative agent of acquired immune
agency utilizing students shall establish policies and procedures for their
(19) No agency shall
retaliate against or, in any manner, discriminate against any person because of
a complaint made in good faith and without malice to the Board, the Department,
the Department of Human Services Adult Protective Services or the Comptroller
of the State Treasury. An agency shall neither retaliate nor discriminate
because of information lawfully provided to these authorities, because of a
person's cooperation with them or because a person is subpoenaed to testify at
a hearing involving one of these authorities.
All health care facilities licensed
pursuant to T.C.A. §§
, et seq. shall post the
following in the main public entrance:
Contact information including statewide toll-free number of the division of
adult protective services, and the number for the local district attorney's
(b) A statement that a
person of advanced age who may be the victim of abuse, neglect, or exploitation
may seek assistance or file a complaint with the division concerning abuse,
neglect and exploitation; and
statement that any person, regardless of age, who may be the victim of domestic
violence may call the nationwide domestic violence hotline, with that number
printed in boldface type, for immediate assistance and posted on a sign no
smaller than eight and one-half inches (8½") in width and eleven inches
(11") in height.
Postings of (a) and (b) shall be on a sign no smaller than
eleven inches (11") in width and seventeen inches (17") in height.
(21) "No smoking" signs
or the international "No Smoking" symbol, consisting of a pictorial
representation of a burning cigarette enclosed in a red circle with a red bar
across it, shall be clearly and conspicuously posted at every
(22) The facility shall
develop a concise statement of its charity care policies and shall post such
statement in a place accessible to the public.