| (a) In addition to the standards in Subchapter C of
this chapter (relating to Minimum Standards for All Home and Community
Support Services Agencies), an agency providing licensed home health
services must also meet the standards of this section.
(b) The agency must accept a client for home health
services based on a reasonable expectation that the client's medical,
nursing, and social needs can be met adequately in the client's residence.
An agency has made a reasonable expectation that it can meet a client's
needs if, at the time of the agency's acceptance of the client, the
client and the agency have agreed as to what needs the agency would
meet; for instance, the agency and the client could agree that some
needs would be met but not necessarily all needs.
(1) The agency must start providing licensed home health
services to a client within a reasonable time after acceptance of
the client and according to the agency's policy. The initiation of
licensed home health services must be based on the client's health
service needs.
(2) An initial health assessment must be performed
in the client's residence by the appropriate health care professional
prior to or at the time that licensed home health services are initially
provided to the client. The assessment must determine whether the
agency can provide the necessary services.
(A) If a practitioner has not ordered skilled care
for a client, then the appropriate health care professional must prepare
a care plan. The care plan must be developed after consultation with
the client and the client's family and must include services to be
rendered, the frequency of visits or hours of service, identified
problems, method of intervention, and projected date of resolution.
The care plan must be reviewed and updated by all appropriate staff
members involved in client care at least annually, or more often as
necessary to meet the needs of the client.
(B) If a practitioner orders skilled treatment, then
the appropriate health care professional must prepare a plan of care.
The plan of care must be signed and approved by a practitioner in
a timely manner. The plan of care must be developed in conjunction
with agency staff and must cover all pertinent diagnoses, including
mental status, types of services and equipment required, frequency
of visits at the time of admission, prognoses, functional limitations,
activities permitted, nutritional requirements, medications and treatments,
any safety measures to protect against injury, and any other appropriate
items. The appropriate health care personnel must perform services
as specified in the plan of care. The plan of care must be revised
as necessary, but it must be reviewed and updated at least every six
months.
(c) Agency staff must provide at least one home health
service.
(d) All services must be provided and supervised by
qualified personnel. The appropriate licensed health care professional
must be available to supervise as needed, when services are provided.
If medical social service is provided, the social worker must be licensed
in the State of Texas to provide social work services.
(e) All staff providing services, delegation, and supervision
must be employed by or be under contract with the agency.
(f) An agency is not required to employ home health
aides. If an agency employs home health aides, the agency must comply
with §558.701 of this chapter (relating to Home Health Aides).
(g) Unlicensed personnel employed by an agency to provide
licensed home health services must:
(1) have demonstrated competency in the task assigned
when competency cannot be determined through education and experience;
and
(2) be at least 18 years of age or, if under 18 years
of age, be a high school graduate or enrolled in a vocational education
program.
|
| Source Note: The provisions of this §558.401 adopted to be effective February 1, 2002, 26 TexReg 9159; amended to be effective April 1, 2004, 29 TexReg 2383; transferred effective May 1, 2019, as published in the April 12, 2019 issue of the Texas Register, 44 TexReg 1893; amended to be effective April 25, 2021, 46 TexReg 2427 |
