C.M.R. 10, 144, ch. 119, 2

Current through 2024-51, December 18, 2024

Chapter 2 - LICENSING APPLICATION PROCEDURES

2.A. Requirements

2.A.1. No home health care agency may provide home health care services without receiving a license from the Department authorizing such services or operation.

2.A.2. The applicant shall comply with all applicable Maine Statutes and rules and regulations.

2.A.3. No home health care agency shall accept any remuneration for delivering home health care services without having first secured a license authorizing its operation in accordance with these regulations.

2.A.4. Any person, organization or corporation seeking home health licensure shall make an appointment for a preliminary conference at the Division of Licensing and Certification at least forty-five (45) days prior to the initial survey.

2.A.5. The following are exempt from the provisions of this chapter in accordance with 22 MRSA §2147:

a. Hospice organizations; volunteer services. Hospice organizations in which services are provided substantially by volunteers;

b. Families, friends and neighbors,

c. Sole practitioners. Sole practitioners otherwise licensed by the State;

d. Physicians. Services provided directly by physicians;

e. Elderly nutrition programs;

f. Chore services;

g. Pharmacy or medical supply company. Any pharmacy or medical supply company which furnishes no home health services to persons in their homes except supplies;

h. Persons or agencies contracting or arranging home health services. Anyone contracting or arranging for home health services provided by home health care providers licensed or excluded under this chapter,

i. Departments. Departments of State Government;

j. Facilities licensed pursuant to Chapter 405. Hospitals, nursing care facilities, skilled nursing facilities, or other facilities licensed pursuant to Chapter 405 when the services are provided either to clients residing in those facilities or to six (6) or fewer clients at any one time in their homes under a plan of care approved by the Department or its designee when it is documented in the patient's record that the licensed home health care agency or agencies serving the patient's area:

1. Have indicated that they are unable to provide those services; or

2. Agree that the plan of care is an acceptable plan.

The plan of care must meet standards for staff qualifications and supervision consistent with the standards required of licensed home health care providers;

k. Licensed Boarding Care Facilities. Boarding care facilities licensed pursuant to Chapters 1663 and 1665 when the services are provided to clients residing in those facilities;

l. Municipal Entities. Municipal departments or agencies or other municipal entities in their provision of nontherapeutic preventive and promotional health educational services where persons providing those services are employed by the municipality.

2.A.6. The following are exempt from the provisions of this chapter in accordance with Title 22 MRSA Section2142, Sub-section 3:

Federally qualified health center or a rural health clinic as defined in 42 United States Code, Section 1395X Sub-section (aa) (1993) that is delivering case management services or health education in a client's place of residence.

2.B. Application Procedure

2.B.1. Film of Application

Any person, partnership, association or corporation desiring a license to engage in home health care services shall, prior to the commencement of such operation, file an application with the Department. Applications submitted on behalf of a corporation or association shall be made by any two officers thereof or by its administrator. All applicants shall comply with the rules and regulations adopted pursuant to Title 22 MRSA §2141et seq.

2.B.2. Contents of Application

Each application shall contain:

a. The name by which the Home Health Care Services Provider is to be legally known and the name under which it shall be doing business;

b. A description of all facilities utilized by the Home Health Care Services Provider. This will include the address(es), telephone number(s) and name of owner(s) of all buildings utilized by the home health care agency. All branches and sub units must be identified by address(es), telephone number(s), and identifying names;

c. A listing of specific home health care services provided by the agency,

d. For proprietary corporations: the full name and address of each person, firm or corporation having (directly or indirectly) an ownership interest of 5% or more in the agency,

e. For business entities with one owner or business partnerships: the full name and address of each partner,

f. For not-for-profit organizations: the full name and address of the President of the Board of Directors or appropriate municipal government representative;

g. The name, home address, home telephone number and office telephone number of the individual designated by the applicant as the administrator of the Home Health Care Services Provider,

h. The name of the Director of Nursing;

i. The number of full time equivalent staff

2.B.3. Suitability of Applicant

In acting upon any application for license or relicensure, the Department shall determine the suitability of the applicant to operate the home health care services facility.

a. A determination of suitability shall require the applicant to demonstrate their willingness and ability to operate and manage the facility with compliance with these regulations and all relevant laws. In making this determination, the Department shall consider each of the following factors to the extent they are relevant to the proposed agency, ownership interest, and/or equipment:

1. Record and reputation for lawful conduct in business and personal affairs (including, but not limited to, a criminal conviction).

2. Financial ability and fiscal responsibility (such as a history of withholding taxes, a good credit rating from an appropriate agency and/or financial institution, capability of obtaining financing for working capital and repairs required by these rules).

3. Management and supervisory experience, including the capacity to manage the financial operations and staff of the agency for which the license is sought.

4. Experience in the field of health care, social services or areas related to the provision of home health services.

5. Conduct which demonstrates an understanding of, and compliance with, clients' rights.

6. Information which relates to the ability in complying with all applicable laws and regulations.

7. Any information reasonably related to the ability to provide safe services at the level of care for which the license is sought.

2.C. Fees

2.C.1. Each application under this chapter shall be accompanied by an annual fee of $300.00.

2.C.2. All licenses shall be renewed annually upon payment of the appropriate fee and demonstration of continued compliance with these rules and regulations.

2.C.3. No fee shall be refunded.

2.D. Additional Information

2.D.1. Copy of the Lease

When a building(s) is/are leased to the person(s) to operate as a Home Health Care Services Provider, a copy of the lease shall be filed with the application for a license This lease agreement shall clearly demonstrate which party is to be held responsible for the maintenance and upkeep of the property. The Department shall be notified within seventy-two (72) hours if there are any changes in the lease agreement that may in any way affect the responsibility for maintenance and upkeep of the property.

2.D.2. Home Health Care Services Providers Operated by Same Management on Different Premises

Sub units of licensed Home Health Care Services Providers will require separate licenses. Home Health Care Services Providers operated by the same management on different grounds shall be required to have in effect a separate license for each sub unit.

2.D.3. Physician Ownership

The Division of Licensing and Certification will investigate whether the physician ordering the need for home health care services has a financial interest or ownership in an agency. A current listing of physicians associated with financial interests or ownership must be submitted to the Division of Licensing and Certification. See Chapter 7.A..5.

2.D.4. Change in Ownership of Home, Health Care Services Provider

a. No license shall be assigned or transferred.

Effective July 1, 2004 At least thirty (30) days advance written notice shall be given to the Division of Licensing and Certification, Bureau of Medical Services, prior to the transfer of ownership of any home health care agency.

b. At least thirty (30) days advance written notice shall be give to the Division of Program Analysis and Development, Office of Health Planning and Development, and the Division of Licensing and Certification, Bureau of Medical Services, prior to the transfer of ownership of any home health care agency.

c. Each application for a license from a new owner shall be accompanied by a statement from the previous owner or his duly authorized representative concerning the change of ownership. In lieu of this statement, a copy of the deed or other validating document shall be submitted. In addition, an application fee, calculated in accordance with Section 2.C of this chapter, shall be submitted to the Department. When the ownership of a Home Health Care Services Provider changes, upon receipt of a completed application and fee, the Department may issue a provisional license for a period not to exceed ninety (90) days. The new owner's application must demonstrate that the agency will continue to comply with the requirements for licensure.

2.E. Certificate of Compliance with Fire Codes

Fire safety inspections are not required for home health care services licensure.

2.F. Compliance with All Local, State and Federal Regulations

2.F.1. The Home Health Care Services Provider and its staff must operate and furnish services in compliance with all applicable federal, state and local laws and regulations.

2.F.2. The applicant shall submit a letter from the appropriate municipal official(s) that demonstrates compliance with all local ordinances relative to zoning and building codes and a certificate of occupancy, if appropriate, which includes electrical and life safety code compliance.

2.F.3. The applicant will submit proof of a Clinical Laboratory number (if appropriate) under the Clinical Laboratory Improvement Amendments of 1988.

2.F.4. The applicant will submit proof of a Department of Environmental Protection number (if appropriate).

2.G. Posting of License

The license granted by the Department shall be conspicuously posted in an area where business is conducted/coordinated for the home health care services.

2.H. Waiver Provisions

2.H.1. The Department may upon written request waive or modify any provision contained herein which is not mandated by Maine Statutes. The applicant or licensee shall provide clear and convincing evidence that the alternative method will comply with the intent of the regulation for which a waiver is sought. Requests for a waiver shall be made on forms approved by the Department, and shall include:

a. A statement of the regulation for which a waiver is requested;

b. An explanation of the reasons why the provisions cannot be met and a waiver is being requested; and

c. A description of the alternative method proposed for meeting the intent of the provision sought to be waived. Waivers, when approved, shall be time limited. Prior to the expiration of the approval, if the waiver continues to be necessary, an extension of time may be granted by the Department on receipt of a new application.

2.H.2. Home Health Care Services Providers regulated by the State Government or the Federal Government may apply for consideration of a waiver to be granted by the Commissioner of the Department of Health and Human Services. Home Health Care Services Providers that are regulated by the State Government or the Federal Government that may apply for than waiver include:

a. Alcohol and substance abuse treatment agencies possessing a current license authorized by Title 22 MRSA §7801 - 7815.

b. Pre-school coordination sites which are regulated by the Department of Education.

c. Public schools and private educational agencies winch are regulated by the Department of Education.

d. Mental health services providers which are licensed and regulated by the Department of Behavioral and Developmental Services as authorized by Title 34B MRSA § 3606.

2.H.3. These providers will be eligible for the waiver solely for those home health care services for which they are regulated by a Bureau of the Department of Health and Human Services or another Department within State Government.

2.H.4. The Commissioner of the Department of Health and Human Services may grant a full, provisional, or conditional license to those entities otherwise regulated by the State Government or the Federal Government, if he/she determines that those providers meet the purpose and intent of this chapter This shall be determined through submission of information in accordance with the waiver forms described in Chapter 2.I.1. of these regulations.

2.I. Changes in Licensed Home Health Care Services

Each Home Health Care Services Provider will notify the Bureau of Medical Services in writing of any changes in:

2.I.1. Ownership;

2.I.2. Scope and nature of services provided,

2.I.3. Relocation or change of business address and telephone;

2.I.4. Administrator,

2.I.5. Addition/deletion of a branch or sub unit, or

2.I.6. Deeming.

2.J. Types of Licenses Issued

The Department will issue the following types of licenses to Home Health Care Services Providers:

2.J.1. Full License-effective for the period of twelve (12) months to an applicant who complies with all applicable laws and rules.

2.J.2. Provisional License- effective for a minimum of three (3) months and not to exceed twelve (12) months, to an applicant who:

a. Has not previously operated 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 term

2.J.3. Conditional License-effective for a specific period not to exceed one (1) year to an applicant who has not fully complied with all applicable laws and rules, and in the judgment of the Commissioner, the best interest of the public would be so served by issuing a conditional license. The conditional license shall specify when and what corrections shall be made during the term of the conditional license.

2.K. Specifications of License

Each license issued by the Department shall identify:

2.K.1. The name of the Home Health Care Services Provider,

2.K.2. The name of the administrator,

2.K.3. The geographical location of each unit or subunits, if so designated;

2.K.4. The type of home health care services provided;

2.K.5. Any waiver(s) that have been granted;

2.K.6. The period of licensure and date of licensure expiration; and

2.K.7. The date issued, and type of license.

C.M.R. 10, 144, ch. 119, 2