Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 245 - HOME HEALTH, HOME SERVICES, AND HOME NURSING AGENCY CODE › Subpart A - GENERAL PROVISIONS › Section 245.20 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
Act - the Home Health, Home Services and Home Nursing Agency
				  Licensing Act.
Activities of Daily Living or ADL - include, but are not
				  limited to, eating, dressing, bathing, toileting, transferring, or personal
				  hygiene.
Advanced Practice Registered Nurse or APRN - a person who is
				  licensed as an advanced practice registered nurse under the Nurse Practice
				  Act.
Advocate - a person who represents the rights and interests
				  of an individual as though they were the person's own, to realize the rights to
				  which the individual is entitled, obtain needed services, and remove barriers
				  to meeting the individual's needs.
Agency - a home health agency, home nursing agency,
				  or home services agency, unless specifically stated otherwise.
(Section 2.03 a of the Act)
Agency Manager - the individual designated by the governing
				  body or the entity legally responsible for the agency, who has overall
				  responsibility for the organization and day-to-day operation of the home
				  services or home nursing agency.
Applicant - a firm, partnership, or association, or any of
				  their members, or, if the applicant is a corporation, any of its officers or
				  directors, or the person designated to manage or supervise the agency.
Audiologist - a person who has received a license to practice
				  audiology pursuant to the Illinois Speech-Language Pathology and Audiology
				  Practice Act.
Branch Office - an office location or site other than the
				  parent agency from which an agency provides services within a portion of the
				  total geographic area served by the parent agency. The branch office is part of
				  the agency and is located sufficiently close to share administration,
				  supervision and services on a daily and emergency basis in a manner that
				  renders it unnecessary for the branch to be independently licensed.
Bylaws or Equivalent - a set of rules adopted by an agency
				  for governing the agency's operation.
Client - an individual receiving services from a home nursing
				  agency, a home services agency or a placement agency. This term includes the
				  client's advocate or designee.
Client Record - a written or electronic record that includes,
				  but is not limited to, personal information, emergency notification
				  information, plans of service agreed to between the client and the home
				  services agency, a copy of the home services contract or agreement, and
				  documentation of the services provided at each visit.
Clinical Note - a dated, written notation or electronic entry
				  by a member of the health team of a contact with a patient, containing a
				  description of signs and symptoms, treatment and any drug given, the patient's
				  reaction, and any changes in physical or emotional condition.
Clinical Record - an accurate account of services and care
				  provided for each patient that is maintained by a home health or home nursing
				  agency in accordance with accepted professional standards.
Companionship - services that provide fellowship, care and
				  protection for a client who, because of advanced age or physical or mental
				  infirmity, cannot care for his or her own needs. Services requested may
				  include, but are not limited to: household work related to the care of the
				  client, such as meal preparation, bed making, or laundry; shopping or errands;
				  or other similar services.
"Data Driven" - an agency uses quality indicator data,
				  including patient care, and other relevant data, in the design of its program.
				  The data collected is used to monitor the effectiveness and safety of services
				  and quality of care and to identify opportunities and priorities for
				  improvement. The frequency and detail of the data collection is approved by the
				  governing body of the agency.
Department
or IDPH
- the Department
				  of Public Health of the State of Illinois.
(Section
				  2.01 of the Act)
Director - the Director of Public Health of the State
				  of Illinois, or his or her designee.
(Section
				  2.02 of the Act)
Discharge Summary - the written report of services rendered,
				  goals achieved, and final disposition at the time of discharge from service of
				  a home health or home nursing agency.
Documentary Evidence - evidence that an agency covered under
				  this Part maintains as documentation of its quality assessment and performance
				  improvement program. Documentary evidence used to demonstrate the agency's
				  operation to the Centers for Medicare and Medicaid Services includes program
				  scope, program data, program activities, performance improvement projects, and
				  executive responsibilities.
Drop-site - an office or site of the parent agency that does
				  not render services but is used by the parent agency only as a location for
				  administrative tasks, which may include hiring or training staff and a location
				  for staff to obtain supplies.
Employee - a person who works in the service of another
				  person, or company, under an express or implied contract for hire, under which
				  the employer has the right to control the details of work performance for
				  wages, salary, fee or payment.
Geographic Service Area - an area of contiguous counties
				  (recognizable boundaries) in which the agency has been approved by the
				  Department to provides services.
Health Care Professional - a physician licensed to practice
				  medicine in all of its branches, a podiatrist, an advanced practice registered
				  nurse (APRN) licensed under the Nurse Practice Act, or a physician assistant,
				  licensed under the Physician Assistant Practice Act of 1987.
Home Health Agency
-
a public agency
				  or private organization that provides skilled nursing services and at least one
				  other home health service as defined
in this Part. (Section
				  2.04 of the Act)
Home Health Agency Administrator - an employee of the home
				  health agency who is any one of the following:
A physician who has experience in health service
				  administration, with at least one year of supervisory or administrative
				  experience in home health care or in related health provider programs;
A registered professional nurse (RN) who has experience in
				  health service administration, with at least one year of supervisory or
				  administrative experience in home health care or in related health provider
				  programs;
An individual with an undergraduate degree with experience in
				  health service administration, with at least one year of supervisory or
				  administrative experience in home health care or in related health provider
				  programs; or
An individual who meets the requirements for Public Health
				  Administrator as contained in Section
				  600.310 of the Certified Local
				  Health Department Code who has experience in health service administration,
				  with at least one year of supervisory or administrative experience in home
				  health care or in related health provider programs.
Home Health Aide - a person who provides nursing, medical, or
				  personal care and emotional comfort to assist the patient toward independent
				  living in a safe environment. A person may not be employed as a home health
				  aide unless the person meets the requirements of Section
				  245.70.
Home Health Services
-
services
				  provided to a person at his or her residence according to a plan of treatment
				  for illness or infirmity prescribed by a physician licensed to practice
				  medicine in all its branches, a licensed physician assistant, or a licensed
				  advanced practice registered nurse
.
Such services include
				  part-time and intermittent nursing services and other therapeutic services such
				  as physical therapy, occupational therapy, speech therapy, medical social
				  services or services provided by a home health aide.
(Section
				  2.05 of the Act)
Home Nursing Agency - an agency that provides
				  services directly, or acts as a placement agency, in order to deliver skilled
				  nursing and home health aide services to persons in their personal residences.
				  A home nursing agency provides services that would
be required to be
				  performed by an individual licensed under the Nurse Practice Act
. Home
				  health aide services are provided under the direction of a registered
				  professional nurse or advanced practice registered nurse. A home nursing agency
				  does not require licensure as a home health agency under
the
Act. "Home nursing agency" does not include an individually licensed
				  nurse acting as a private contractor or a person that provides or procures
				  temporary employment in health care facilities, as defined in the Nurse Agency
				  Licensing Act.
(Section
				  2.11 of the Act)
Home Nursing Services - services that would be required to be
				  performed by an individual licensed under the Nurse Practice Act on a shift
				  schedule, one-time, full-time or part-time, and/or intermittent basis.
Home Services Agency - an agency that provides
				  services directly, or acts as a placement agency, for the purpose of placing
				  individuals as workers providing home services for consumers in their personal
				  residences. Home services agency does not include agencies licensed under the
				  Nurse Agency Licensing Act, the Hospital Licensing Act, the Nursing Home Care
				  Act, the ID/DD Community Care Act, the MC/DD Act, the Specialized Mental Health
				  Rehabilitation Act of 2013, or the Assisted Living and Shared Housing Act and
				  does not include an agency that limits its business exclusively to providing
				  housecleaning services. Programs providing services exclusively through the
				  Community Care Program of the Illinois Department on Aging, the Department of
				  Human Services Office of Rehabilitation Services, or the United States
				  Department of Veterans Affairs are not considered to be a home services agency
				  under
the
Act.
(Section
				  2.08 of the Act)
Home Services or In-Home Services or In-Home Support
				  Services - assistance with activities of daily living, housekeeping, personal
				  laundry, and companionship provided to an individual in his or her personal
				  residence, which are intended to enable that individual to remain safely and
				  comfortably in his or her own personal residence. "Home services" or "in-home
				  services" does not include services that would be required to be performed by
				  an individual licensed under the Nurse Practice Act.
(Section
				  2.09 of the Act) Home services
				  are focused on providing assistance that is not medical in nature, but is based
				  upon assisting the client in meeting the demands of living independently and
				  maintaining a personal residence, such as companionship, cleaning, laundry,
				  shopping, meal preparation, dressing, and bathing.
Home Services Worker or In-Home Services Worker - an
				  individual who provides home services to a consumer in the consumer's personal
				  residence.
(Section
				  2.10 of the Act) The terms
				  homemaker and companion are commonly used to refer to this type of
				  worker.
Licensed Practical Nurse - a person who is licensed as a
				  licensed practical nurse under the Nurse Practice Act.
Occupational Therapist - a person who is licensed as an
				  occupational therapist under the Illinois Occupational Therapy Practice
				  Act.
Occupational Therapy Assistant - a person who is licensed as
				  an occupational therapy assistant under the Illinois Occupational Therapy
				  Practice Act.
Parent Agency - the agency location responsible for
				  developing and maintaining administrative control of all DPH-approved
				  locations. The parent agency address/location appears on the Department-issued
				  license.
Part-Time or Intermittent Care - home health services given
				  to a patient at least once every 60 days or as frequently as a few hours a day,
				  several times per week.
Patient - a person who is under treatment or care for
				  illness, disease, injury or conditions appropriately responsive to home health
				  or home nursing services to maintain health or prevent illness.
Patient Care Plan - a coordinated and combined care plan
				  prepared by and in collaboration with each discipline providing service to the
				  patient, to the patient's family, or, for home health agencies, to both.
Person
-
any individual, firm,
				  partnership, corporation, company, association or any other legal
				  entity.
(Section
				  2.03 of the Act)
Personal Care Services - services that are furnished to a
				  client in the client's personal residence to meet the client's physical,
				  maintenance, and supportive needs, when those services are not considered
				  skilled personal care, as described in Section
				  245.40(c), and
				  do not require a health care provider's orders or the supervision of a
				  nurse.
Physical Therapist - a person who is licensed as a physical
				  therapist under the Illinois Physical Therapy Act.
Physical Therapist Assistant - a person who is licensed as a
				  physical therapist assistant under the Illinois Physical Therapy Act.
Physician - any person licensed to practice medicine in all
				  of its branches under the Medical Practice Act of 1987. For a patient who has
				  received medical care in another state, or has moved from another state, and
				  who has not secured the services of a physician licensed in Illinois, an
				  individual who holds an active license to practice medicine in another state
				  will be considered the physician for the patient during this emergency (as
				  determined by the physician) as provided in Section 3 of the Medical Practice
				  Act of 1987. An emergency may not extend more than six months in any
				  case.
Physician Assistant - any person who meets the licensing
				  requirements of the Physician Assistant Practice Act of 1987.
Placement Agency - any person engaged for gain or
				  profit,
regardless of the agency tax status,
in the business
				  of securing or attempting to secure work for hire for persons seeking work or
				  workers for employers. The term includes a private employment agency and any
				  other entity that places a worker for private hire by a consumer in that
				  consumer's residence for purposes of providing home services. The term does not
				  include a person that provides or procures temporary employment in health care
				  facilities, as defined in the Nurse Agency Licensing Act.
(Section
				  2.12 of the Act) For the
				  purposes of this Part, there are two types of placement agencies: Home Nursing
				  Placement Agencies (see Section
				  245.212) and Home Services
				  Placement Agencies (see Section
				  245.214). A placement agency
				  does not provide ongoing, continuous client support and management of
				  services.
Plan of Treatment - a plan based on the patient's diagnosis
				  and the assessment of the patient's immediate and long-range needs and
				  resources. The plan of treatment is established in consultation with, in the
				  case of a home health agency, the home health services team, which includes the
				  attending physician or podiatrist, pertinent members of the agency staff, the
				  patient, and members of the family.
Podiatrist - a person who is licensed to practice under the
				  Podiatric Medical Practice Act of 1987.
Progress Notes - a dated, written notation by a member of the
				  health team, summarizing facts about care and the patient's response during a
				  given period of time.
Purchase of Services or Contractual - the provision of
				  services through a written agreement with other providers of services.
Quality Assessment and Performance Improvement or QAPI - the
				  coordinated application of two mutually-reinforcing aspects of a quality
				  management system. QAPI takes a systematic, comprehensive, and data-driven
				  approach to maintaining and improving safety and quality in home health
				  agencies while involving all home health caregivers in practical and creative
				  problem solving. Quality assessment is the specification of standards for
				  quality of service and outcomes, and is a process used throughout the
				  organization to ensure care is maintained at acceptable levels in relation to
				  those standards. Performance improvement is the continuous study and
				  improvement of processes with the intent to better services or outcomes, and to
				  decrease the likelihood of problems, by identifying areas of
				  opportunity.
Registered Professional Nurse or RN - a person who is
				  licensed as a registered professional nurse under the Nurse Practice
				  Act.
Service Plan - a plan based on the client's needs and
				  identification of the client's immediate and long-range goals and resources
				  needed to meet these goals.
Service Contract - a written contract between the client and
				  the agency, printed in no less than 12-point font, which includes, at a
				  minimum, all elements listed in Sections
				  245.220 and
				  245.225, as applicable.
Skilled Nursing Services - those services that, due to their
				  nature and scope, would require the performing individual to be licensed under
				  the Nurse Practice Act. These services are acts requiring the basic nursing
				  knowledge, judgment and skills acquired by means of completion of an approved
				  nursing education program and include, but are not limited to: assessment of
				  healthcare needs; nursing diagnosis; planning, implementation and nursing
				  evaluation; counseling; patient education; health education; the administration
				  of medications and treatments; and the coordination or management of a nursing
				  or medical plan of care.
Skilled Personal Care -care that may be provided by a home
				  health aide, a registered professional nurse, a licensed practical nurse, a
				  social worker, an occupational therapist, a physical therapist, or a
				  speech-language pathologist as ordered by a health care professional.
Social Work Assistant - a person who has a baccalaureate
				  degree in social work, psychology, sociology, or other field related to social
				  work and has at least one year of social work experience in a health care
				  setting.
Social Worker - a person who is a licensed social worker or a
				  licensed clinical social worker under the Clinical Social Work and Social Work
				  Practice Act.
Speech-Language Pathologist - a person who is licensed as a
				  speech-language pathologist under the Illinois Speech-Language Pathology and
				  Audiology Practice Act.
Student - an individual who is enrolled in an educational
				  institution and who is receiving training in a health-related
				  profession.
Substantially Meets - meeting requirements except for
				  variance from the strict and literal performance, which results in unimportant
				  omissions or defects given the particular circumstances involved.
Supervision - authoritative procedural guidance by a
				  qualified person of the appropriate discipline.