Section R9-10-1210. Home Health Services

A.      An administrator shall ensure that an individual admitted to the home health agency has an order from a physician, regis- tered nurse practitioner, or podiatrist for home health services.

B.       An administrator shall ensure that the home health services director provides direction for home health services provided by or through the home health agency.

C.      A home health services director shall ensure that nursing ser- vices are provided by a registered nurse or practical nurse, according to policies and procedures.

D.      A home health services director shall ensure that a registered nurse:

1.        Unless a patient’s physician or registered nurse practi- tioner orders only speech therapy, occupational therapy, or physical therapy for the patient, within 48 hours after the patient begins receiving home health services pro- vided by or through the home health agency, conducts an initial assessment of the patient to determine:

a.         The needs of the patient;

b.        Resources available to address the patient’s needs;

c.         The patient’s home and family environment;

d.        Goals for patient care;

e.         Medications used by the patient, including non-com- pliance, drug interactions, side effects, and contrain- dications; and

f.         Medical supplies or equipment needed by the patient;

2.        Reviews a patient’s health care directives at the time of the initial assessment;

3.        Implements a patient’s care plan, developed as specified in R9-10-1207;

4.        Coordinates patient care with other individuals providing home health services or other services to the patient;

5.        Immediately informs the patient’s physician or registered nurse practitioner of a change in a patient's condition that requires medical services; and

6.        At least every 60 calendar days until a patient is dis- charged:

a.         Reassesses the patient based on the patient’s care plan, needs, and medical condition; and

b.        Summarizes the patient’s condition and needs for the patient’s physician, registered nurse practitioner, or podiatrist, as applicable.

E.       A home health services director shall ensure that:

1.        A patient’s condition and the services provided to the patient are documented in the patient’s medical record after each patient contact; and

2.        Verbal orders from a patient’s physician, registered nurse practitioner, or podiatrist, as applicable, are:

a.         Except as specified in subsection (F)(2)(d), received by a registered nurse and documented by the regis- tered nurse in the patient’s medical record; and

b.        Authenticated by the patient’s physician, registered nurse practitioner, or podiatrist, as applicable, with a signature, within 30 calendar days.

F.       A home health services director shall ensure that:

1.        A registered nurse:

a.         Except as specified in subsection (F)(2)(b)(i) and (ii):

i.         Assigns tasks in writing to a home health aide who is providing home health services to a patient; and

ii.        Verifies the competency of  the home  health aide in performing assigned tasks;

b.        Except as specified in subsection (F)(2)(b)(iii), pro- vides direction for the home health aide services provided to a patient; and

c.         Except as specified in subsection (F)(2)(e)(ii), meets with a patient who is receiving home health aide ser- vices to assess the home health services provided by the home health aide:

i.         At least every two weeks when the patient is also receiving nursing services or therapy ser- vices, and

ii.        At least every 60 calendar days when the patient is only receiving home health aide ser- vices;

2.        When a patient’s physician or registered nurse practi- tioner orders speech therapy, occupational therapy, or physical therapy for the patient, an individual specified in R9-10-1203(C)(6)(a), (c), or (d), as applicable:

a.         Provides the applicable therapy service to the patient according to the patient’s care plan;

b.        If a home health aide is assigned to assist the patient in performing activities related to the therapy ser- vice:

i.         Assigns tasks in writing to the home health aide who is assisting the patient;

ii.        Verifies the competency  of  the home health aide in performing assigned tasks; and

iii.      Provides direction to the home health aide in performing the assigned tasks related to the therapy service;

c.         Coordinates the provision of the therapy service to the patient with the registered nurse providing direc- tion for other home health services for the patient;

d.        Documents in the patient’s medical record any orders by the patient’s physician or registered nurse practitioner received concerning the therapy service; and

e.         If the only home health services ordered for the patient are speech therapy, occupational therapy, or physical therapy:

i.         Within 48 hours after the patient begins receiv- ing home health services provided by or through the home health agency, conducts an initial assessment of the patient as specified in subsections (D)(1)(a) through (f); and

ii.        Meets with a patient who is receiving home health services from a home health aide every two weeks to assess the home health services provided by the home health aide; and

3.        A home health aide:

a.         Is only assigned to provide services the home health aide can competently perform; and

b.        Only performs tasks assigned to the home health aide in writing by a registered nurse or as specified in subsection (F)(2)(b)(i).

Historical Note

Section made by exempt rulemaking at 19 A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, pursuant to Laws 2013, Ch. 10, § 13; effective July 1, 2014 (Supp. 14-2).