N.H. Admin. Code § He-P 822.15

Current through Register No. 45, November 7, 2024

Section He-P 822.15 - Required Services

(a) The licensee shall have a written contractual agreement for all services provided by arrangement.

(b) Any contractual agreement to provide services shall:

(1) Identify the services to be provided;

(2) Specify the qualifications of the personnel that will be providing the services;

(3) Require that the HCSPA must authorize the services;

(4) Stipulate the HCSPA retains professional responsibility for all services provided; and

(5) Be limited to the types of services allowed under the HCSPA level of services.

(c) The licensee shall provide staff for the following positions:

(1) An administrator to oversee the HCSPA, except as allowed by (e) (1) below; and

(2) A director of client services.

(d) Any new administrator shall possess:

(1) An associate degree from an accredited school and at least 2 years of relevant HCSPA experience;

(2) A bachelor's degree from an accredited school and one year of relevant experience; or

(3) A high school diploma or equivalent and a minimum of 5 years relevant HCSPA experience.

(e) The administrator shall:

(1) Designate, in writing, an alternate administrator who shall assume the responsibilities of the administrator in his or her absence; and

(2) Be permitted to hold more than one position at the HCSPA if:

a. The individual meets the qualifications of all positions; and

b. The duties and responsibilities of the positions can be accomplished by one individual.

(f) Any new director of client services shall have at least a high school diploma and 2 years' experience supervising personnel or providing personal care services.

(g) The director of client services or designee shall:

(1) Be responsible for the overall delivery of client services;

(2) Provide sufficient qualified personnel to meet the needs of the clients; and

(3) Supervise the overall delivery of client services.

(h) At the time of admission, personnel of the HCSPA shall:

(1) Provide, both orally and in writing, to the client, or the client's guardian or agent, if applicable, the HCSPA's:

a. Policy on client rights and responsibilities, including a copy of the Home Care Clients' Bill of Rights, pursuant to RSA 151:21-b;

b. Complaint procedure;

c. List of services that are to be provided by the HCSPA; and

d. List of care and services to be provided by an independent contractor, if appropriate;

(2) Obtain written confirmation acknowledging receipt of the items in (1) above from the client, or the client's guardian or agent, or surrogate decision-maker, if applicable;

(3) Collect and record the following information:

a. Client's name, home address, home telephone number, and date of birth;

b. Name and telephone number of an emergency contact and guardian or agent, if applicable;

c. Name of client's primary care provider and the provider's address and telephone number as applicable;

d. Written and signed consent for the provision of care and services; and

e. Copies of all legal directives such as durable power of attorney, guardianship, or living will, as applicable; and

(4) Obtain documentation of informed consent and consent for release of information.

(i) Each client shall have an assessment conducted by an HCSPA nurse, the director of client services or designee to determine the services required by the client, except as allowed in (j) below:

(1) Prior to initiating services;

(2) At least every 6 months thereafter; and

(3) Whenever there is a significant change in the client's condition.

(j) The assessment required by (i) above shall contain at a minimum the following:

(1) Pertinent diagnoses including mental status, as related by the client or the client's agent, as appropriate;

(2) Any equipment required;

(3) Functional limitations;

(4) Activities that are limited;

(5) Dietary requirements; and

(6) Any safety precautions.

(k) Clients receiving only homemaker services shall not require an assessment or a service plan.

(l) For clients receiving only personal care services, the assessment in (i) above shall be performed initially and every 6 months thereafter by a registered nurse, licensed practical nurse (LPN), the director of client services or designee to determine the services required.

(m) The licensee shall develop a service plan within 3 business days of admission or prior to the initiation of services, if later, that is based on the results of the assessments required by (i) above.

(n) The service plan required by (l) above shall include:

(1) The date of the assessment;

(2) A description of the client's needs;

(3) The services to be provided by HCSPA personnel;

(4) The responsible person(s) or position;

(5) The date of changes to the service plan; and

(6) Documentation that the client and their legal representative, if applicable, were involved in the development of the service plan and any revisions made to the plan.

(o) The licensee shall develop a discharge plan, pursuant to RSA 151:26, with the input of the client or the client's legal representative, if any, including:

(1) Date and reason for discharge;

(2) Discharge instructions and referrals, if applicable;

(3) Discharge or transfer summary; and

(4) An order for discharge, if applicable.

(p) Written notes shall be documented in the client's record at the time of each visit for:

(1) All services provided by the HCSPA and shall include the:

a. Date and time of the service;

b. Description of the service;

c. Progress notes including, as applicable:

1. Observable changes in the client's functional, cognitive, or daily activity abilities; and

2. Changes in the client's behaviors such as eating or sleeping patterns; and

d. Signature and title of the person providing the service;

(2) Any reportable incident involving the client when HCSPA personnel are in the client's home; and

(3) Discharge or transfer documentation, if applicable, that shall include the date and reason for discharge or transfer.

(q) For each client accepted for care and services by the HCSPA, a current and accurate record shall be maintained and include, at a minimum:

(1) The written confirmation required by (h) (2) above;

(2) The identification data required by (h) (3) above;

(3) Consent forms, as applicable;

(4) Consent for release of information, as applicable;

(5) The record of the assessment required by (i) above;

(6) All service plans required by (l) above including documentation that the client or their legal representative participated in the development of the service plan;

(7) All written notes required by (p) above; and

(8) Discharge documentation as required by (p) (3) above.

(r) Client records shall be available to:

(1) The client, the client's guardian, or the client's agent;

(2) HCSPA personnel as required by their job responsibilities and subject to the licensee's policy on confidentiality;

(3) Any individual given written authorization by the client, the client's guardian, client's agent, or the patient's surrogate decision-maker;

(4) Any individual authorized by a court of competent jurisdiction; and

(5) The department or any individual authorized by law.

(s) The licensee shall develop and implement a method for the written release of information in client records that is consistent with federal and state laws.

(t) The HCSPA shall store all paper and electronic backup files of client records in the primary or branch office except when they are being utilized by authorized personnel.

(u) Paper records shall be safeguarded against loss, damage, or unauthorized use by being stored in locked containers, cabinets, rooms, or closets except when they are being used by authorized personnel.

(v) Electronic records shall be maintained as required by He-P 822.14(t) .

(w) Records shall be retained for a minimum of 4 years after discharge and in the case of minors, until one year after reaching age 18, but no less than 4 years after discharge.

(x) The HCSPA shall arrange for storage of, and access to, client records as required by (u) and (v) above in the event that the HCSPA ceases operation.

N.H. Admin. Code § He-P 822.15

#9522, eff 7-25-09

Amended by Volume XXXIX Number 02, Filed January 10, 2019, Proposed by #12702, Effective 1/3/2019, Expires 1/3/2029.