(1) The home care organization providing
professional support services must organize, manage and administer its services
to attain and maintain the highest practicable functional capacity for each
consumer regarding nursing and therapy needs as indicated by the plan of
(2) The agency shall develop
and maintain administrative control of any site code.
(3) The organizational structure,
professional support services provided, administrative control and lines of
authority for the delegation of responsibility down to the consumer care level
shall be clearly set forth in writing and shall be readily identifiable.
Administrative and supervisory functions shall not be delegated to another
(4) A governing body (or
designated person(s) so functioning) must: assume full legal authority and
responsibility for the management and provision of all professional support
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 functions.
(5) 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 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 absence. The designee may be a physician, registered
nurse, or a therapist.
agency shall have a duly qualified administrator accessible during normal
operating hours. Any change of administrators shall be reported to the
Department within fifteen (15) days.
(7) 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.
(8) The agency shall maintain an office with
a working telephone that is staffed or takes voice messages during normal
(9) 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
(10) 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. Agencies employing only one (1) staff member must maintain a personnel
record with verification of current credentials.
(11) An ongoing educational program shall be
planned and conducted for the development and improvement of skills of all the
agency's personnel engaged in delivery of professional support services. Each
employee shall receive appropriate orientation to the agency, 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 development
If personnel, under
hourly or per visit contracts, are utilized by the agency, there shall be a
written contract between such personnel and the agency clearly designating:
(a) That consumers are accepted for care only
by the agency;
professional support services are to be provided;
(c) That it is necessary to conform to all
applicable agency policies including personnel qualifications;
(d) The responsibility for participating in
developing plans of care;
manner in which professional support services will be controlled, coordinated
and evaluated by the agency;
The procedures for submitting clinical and progress notes, scheduling visits
and periodic consumer evaluations; and
(g) The procedures for determining charges
Supervision of unlicensed personnel must occur at a minimum of every thirty
(30) days and must include direct observation of the provision of care, record
review and individual conferences.
(14) 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.
(15) Policies and procedures shall be
consistent with professionally recognized standards of practice.
(16) All agencies shall adopt appropriate
policies regarding the testing of consumers and staff for human
immunodeficiency virus (HIV) and any other identified causative agent of
acquired immune deficiency syndrome.
(17) 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, the state agency financially responsible
for services to consumers, 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
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.
(19) "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
(20) The facility shall
develop a concise statement of its charity care policies and shall post such
statement in a place accessible to the public.