Source: https://law.lis.virginia.gov/admincodeexpand/title12/agency5/chapter381/
Timestamp: 2020-07-10 04:39:49
Document Index: 41979919

Matched Legal Cases: ['§ 32', '§ 32', '§ 32', '§ 8', '§ 54', '§ 54']

"Administrator" means a person designated in writing by the governing body as having the necessary authority for the day-to-day management of the organization. The administrator must be an employee of the organization. The administrator, the director of nursing, or other clinical director may be the same individual if that individual is dually qualified.
"Home care organization" or "HCO" means a public or private entity providing an organized program of home health, pharmaceutical or personal care services, according to § 32.1-162.1 of the Code of Virginia in the residence of a client or individual to maintain the client's health and safety in his home. A home care organization does not include any family members, relatives or friends providing caregiving services to persons who need assistance to remain independent and in their own homes.
"Home health agency" means a public or private agency or organization, or part of an agency or organization, that meets the requirements for participation in Medicare under 42 CFR 440.70 (d), by providing skilled nursing services and at least one other therapeutic service, for example, physical, speech, or occupational therapy; medical social services; or home health aide services, and also meets the capitalization requirements under 42 CFR 489.28.
"Skilled services" means the provision of the home health services listed in 12VAC5-381-300.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008; Volume 31, Issue 10, eff. February 12, 2015.
C. The commissioner may issue a license to a home care organization authorizing the licensee to provide services at one or more branch offices serving portions of the total geographic area served by the licensee, provided each branch office operates under the supervision and administrative control of the licensee. The address of each branch office at which services are provided by the licensee shall be included on any license issued to the licensee.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008; Volume 29, Issue 8, eff. January 17, 2013; Volume 31, Issue 10, eff. February 12, 2015.
In addition, this chapter is not applicable to those providers of only homemaker, chore or companion services as defined in 12VAC5-381-10.
B. A licensed organization requesting exemption must file a written request and pay the required fee stated in 12VAC5-381-70 D.
C. The home care organization shall be notified in writing if the exemption from licensure has been granted. The basis for the exemption approval will be stated and the organization will be advised to contact the OLC to request licensure should it no longer meet the requirement for exemption.
D. Exempted organizations are subject to complaint investigations in keeping with state law.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
A. The OLC provides prelicensure consultation and technical assistance regarding the licensure process. The purpose of such consultation is to explain the regulation and the survey process. Prelicensure consultations are arranged after a completed initial application is on file with the OLC.
B. Licensure applications are obtained from the OLC. The OLC shall consider an application complete when all requested information and the appropriate fee, stated in 12VAC5-381-70, is submitted. If the OLC finds the application incomplete, the applicant will be notified in writing.
C. The activities and services of each applicant and licensee shall be subject to an inspection by the OLC to determine if the organization is in compliance with the provisions of this chapter and state law.
D. A completed application for initial licensure must be submitted at least 60 days prior to the organization's planned opening date to allow the OLC time to process the application. An incomplete application shall become inactive six months after it is received by the OLC. Applicants must then reapply for licensure with a completed application and application fee. An application for a license may be withdrawn at any time.
E. Licenses are renewed annually. The OLC shall make renewal applications available at least 60 days prior to the expiration date of the current license.
F. It is the home care organization's responsibility to complete and return a renewal application to assure timely processing. Should a current license expire before a new license is issued, the current license shall remain in effect provided a complete and accurate application was filed on time.
12VAC5-381-50. Compliance appropriate for all types of HCOs.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006.
A. It is the responsibility of the organization's governing body to maintain a current and accurate license. Licenses that are misplaced or lost must be replaced.
B. An organization shall give written notification 30 working days in advance of any proposed changes that may require the reissuance of a license. Notices shall be sent to the attention of the director of the OLC.
C. The OLC will evaluate written information about any planned changes in operation that affect the terms of the license or the continuing eligibility for a license. A licensing representative may inspect the organization during the process of evaluating a proposed change.
D. The organization will be notified in writing whether a new application is needed.
A. The OLC shall collect a fee of $500 for each initial and renewal license application. Fees shall accompany the licensure application and are not refundable.
B. An additional late fee of $50 shall be collected for an organization's failure to file a renewal application by the date specified.
C. A processing fee of $250 shall be collected for each reissuance or replacement of a license and shall accompany the written request for reissuance or replacement.
D. A one time processing fee of $75 for exemption from licensure shall accompany the written exemption request.
A. An OLC representative shall make periodic unannounced on-site inspections of each home care organization as necessary but not less often than biennially. The organization shall be responsible for correcting any deficiencies found during any on-site inspection. Compliance with all standards will be determined by the OLC according to applicable law.
B. The home care organization shall make available to the OLC's representative any necessary records and shall allow access to interview the agents, employees, contractors, and any person under the organization's control, direction or supervision.
C. After the on-site inspection, the OLC's representative shall discuss the findings of the inspection with the administrator or his designee.
D. The administrator shall submit, within 15 working days of receipt of the inspection report, an acceptable plan for correcting any deficiencies found. The plan of correction shall contain:
E. The administrator will be notified whenever any item in the plan of correction is determined to be unacceptable.
G. Completion of corrective actions shall not exceed 45 working days from the last day of the inspection.
12VAC5-381-90. Home visits.
A. As part of any inspection, an OLC representative may conduct home visits.
B. The home care organization shall be responsible for arranging in-home visits with clients, family members, and caregivers for the OLC representative.
C. The organization shall explain clearly to the client, family or caretaker that the permission for the representative's home visit is voluntary and that consent to the home visit will not affect the client's care or other health benefits.
E. The administrator will be notified in writing whenever any item in the plan of correction is determined to be unacceptable.
A. Section 32.1-162.9:1 of the Code of Virginia requires home care providers, as defined in § 32.1-162.7 of the Code of Virginia, to obtain a criminal record report on applicants for compensated employment from the Virginia Department of State Police. Section 32.1-162.9:1 of the Code of Virginia also requires that all applicants for employment in home care organizations provide a sworn disclosure statement regarding their criminal history.
3. A statement verifying that the criminal record report has been obtained within 30 days of employment, is on file at the temporary staffing agency, and does not contain any barrier crimes listed in § 32.1-162.9:1 of the Code of Virginia.
E. No employee shall be permitted to work in a position that involves direct contact with a patient until an original criminal record report has been received by the home care organization or temporary staffing agency, unless such person works under the direct supervision of another employee for whom a background check has been completed in accordance with subsection B of this section.
I. Any applicant denied employment because of convictions appearing on his criminal record report shall be provided a copy of the report by the hiring organization.
J. All criminal record reports shall be confidential and maintained in locked files accessible only to the administrator or designee.
K. Further dissemination of the criminal record report and sworn disclosure statement information is prohibited other than to the commissioner's representative or a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006; amended, Virginia Register Volume 31, Issue 10, eff. February 12, 2015.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006; Errata, 22:4 VA.R. 659 October 31, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-381-130. Revocation or suspension of a license.
12VAC5-381-140. Return of a license.
C. If the organization is no longer operational, or the license has been suspended or revoked, the license shall be returned to the OLC within five working days. The licensee shall notify its clients and the OLC where all home care records will be located.
B. The organization must comply with:
C. The organization shall submit or make available reports and information necessary to establish compliance with this chapter and applicable law.
E. The organization shall notify the OLC 30 days in advance of changes affecting the organization, including the:
1. Service area;
2. Mailing address of the organization;
3. Ownership;
4. Services provided;
5. Operator;
6. Administrator;
7. Organization name; and
8. Closure of the organization.
G. Service providers or community affiliates under contract with the organization must comply with the organization's policies and this chapter.
K. The organization must have a prepared plan for emergency operations in case of inclement weather or natural disaster to include contacting and providing essential care to clients, coordinating with community agencies to assist as needed, and maintaining a current list of clients who would require specialized assistance.
12VAC5-381-160. Governing body.
A. The organization shall have a governing body that is legally responsible for the management, operation and fiscal affairs of the organization. The governing body of a hospital that operates a home care organization shall include in its internal organization structure an identified unit of home care services.
B. The governing body shall:
1. Determine which services are to be provided by the organization;
2. Ensure that the organization is staffed and adequately equipped to provide the services it offers to clients, whether provided directly by the organization or through contract;
3. Comply with federal and state laws, regulations and local ordinances governing operations of the organization; and
4. Establish a quality improvement committee.
C. The governing body shall review annually and approve the written policies and procedures of the organization.
D. The governing body shall review annually and approve the recommendations of the quality improvement committee, when appropriate.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006; amended, Virginia Register Volume 26, Issue 26, eff. September 30, 2010.
B. The organization shall document financial resources to operate based on a working budget showing projected revenue and expenses.
D. All financial records shall be audited at least triennially by an independent certified public accountant (CPA) or audited as otherwise provided by law.
I. New employees and contract individuals shall be oriented commensurate with their function or job-specific responsibilities. Orientation shall include:
2. Confidentiality;
3. Client rights;
4. Mandated reporting of abuse, neglect, and exploitation;
7. Infection control practices and measures;
8. Cultural awareness; and
9. Applicable laws, regulations, and other policies and procedures that apply to specific positions, specific duties and responsibilities.
M. All individuals who enter a client's home for or on behalf of the organization shall be readily identifiable by employee nametag, uniform or other visible means.
10. The criminal record check and sworn affidavit.
S. Employee health-related information shall be maintained separately within the employee's personnel file.
1. Malpractice insurance consistent with § 8.01-581.15 of the Code of Virginia;
6. Adequate liability insurance and third-party crime insurance or a blanket fidelity bond.
C. Written procedures to implement the policies shall ensure that each client is:
10. Given at least five days written notice when the organization determines to terminate services.
C. The client or his designee shall be given a copy of the complaint procedures at the time of admission to service. The organization shall provide each client or his designee with the name, mailing address, and telephone number of the:
1. Organization contact person;
12VAC5-381-260. Infection control.
A. The organization shall implement a program to reduce the risk of infection.
B. Infection control activities shall include, but are not limited to:
1. Staff education regarding infection risk-reduction behaviors;
2. Use of universal precautions;
3. Handling, storing, processing and transporting of regulated medical waste according to applicable procedures;
4. Handling, storing, processing and transporting supplies and equipment in a manner that prevents the spread of infections; and
5. Monitoring staff performance in infection control practices.
C. Accumulated waste, including all contaminated sharps, dressings, or similar infectious waste, shall be disposed of in a manner compliant with the OSHA Bloodborne Pathogens standard (29 CFR 1910.1030).
C. Operation of a drop site as a business office shall constitute a separate organization and shall require licensure.
D. Provisions shall be made for the safe storage of the original record and for accurate and legible reproductions of the original.
2. Identification of the primary care physician;
3. Admitting information, including a client history;
4. Information on the composition of the client's household, including individuals to be instructed in assisting the client;
5. An initial assessment of client needs to develop a plan of care or services;
6. A plan of care or service that includes the type and frequency of each service to be delivered either by organization personnel or contract services;
7. Documentation of client rights review; and
8. A discharge or termination of service summary.
9. Documentation and results of all medical tests ordered by the physician or other health care professional and performed by the organization's staff;
10. A medical plan of care including appropriate assessment and pain management;
11. Medication sheets that include the name, dosage, frequency of administration, possible side effects, route of administration, date started, and date changed or discontinued for each medication administered; and
12. Copies of all summary reports sent to the primary care physician.
G. Signed and dated notes on the care or services provided by each individual delivering service shall be written on the day the service is delivered and incorporated in the client record within seven working days.
H. Entries in the client record shall be current, legible, dated and authenticated by the person making the entry. Errors shall be corrected by striking through and initialing.
6. Have satisfactorily completed training using the "Personal Care Aide Training Curriculum," 2003 edition, of the Department of Medical Assistance Services. However, this training is permissible for home attendants of personal care services only.
4. Speech therapy services;
6. Medical social services.
F. There shall be a director of skilled services, who shall be a physician licensed by the Virginia Board of Medicine or a registered nurse, responsible for the overall direction and management of skilled services including the availability of services, the quality of services and appropriate staffing. The individual shall have the appropriate experience for the scope of services provided by the organization.
A. Physical therapy, occupational therapy, speech therapy, or respiratory therapy services shall be provided according to the medical plan of care by or under the direction of an appropriately qualified therapist currently licensed in Virginia and may include, but are not limited to:
4. Educating the client and family regarding treatment modalities and use of equipment and devices;
1. The occupational therapy assistant shall be currently certified by the National Board for Certification in Occupational Therapy and shall practice under the supervision of a licensed occupational therapist.
D. Supervision of services shall be provided as often as necessary as determined by the client's needs, the assessment of the licensed therapist, and the organization's written policies not to exceed 90 days.
12VAC5-381-330. Home attendants assisting with skilled services.
A. Home attendants assisting with providing skilled services may:
1. Assist clients with (i) activities of daily living, (ii) ambulation and prescribed exercise, and (iii) other special duties with appropriate training and demonstrated competency;
2. Administer normally self-administered drugs as allowed by § 54.1-3408 of the Virginia Drug Control Act (Chapter 34 (§ 54.1-3400 et seq.) of Title 54.1 of the Code of Virginia);
3. Measure and record fluid intake and output;
4. Take and record blood pressure, pulse and respiration;
5. Record and report to the appropriate health care professional changes in the client's condition;
6. Document services and observations in the client's record; and
7. Perform any other duties that the attendant is qualified to do by additional training and demonstrated competency as allowed by state or federal guidelines.
B. Prior to the initial delivery of services, the home attendant shall receive specific written instructions for the client's care from the appropriate health care professional responsible for the care.
C. Home attendants shall work under the supervision of the appropriate health care professional responsible for the client's care.
D. Relevant in-service education or training for home attendants shall consist of at least 12 hours annually. In-service training may be in conjunction with on-site supervision.
Derived from Virginia Register Volume 22, Issue 3, eff. January 1, 2006; amended, Virginia Register Volume 27, Issue 26, eff. September 29, 2011.
A. Medical social services shall be provided according to the medical plan of care by or under the direction of a qualified social worker who holds, at a minimum, a bachelor's degree with major studies in social work, sociology, or psychology from a four-year college or university accredited by the Council on Social Work Education and has at least two years experience in case work or counseling in a health care or social services delivery system.
A. An organization may provide personal care services in support of the client's health and safety in his home. The organization shall designate a registered nurse responsible for the supervision of personal care services.
C. Such services shall be delivered based on a written plan of services developed by a registered nurse, in collaboration with the client and client's family. The plan shall include at least the following:
E. Supervision of services shall be provided as often as necessary as determined by the client's needs, the assessment of the registered nurse, and the organization's written policies not to exceed 90 days.