Code of Massachusetts Regulations › 101 CMR - EXECUTIVE OFFICE FOR HEALTH AND HUMAN SERVICES › Title 101 CMR 350.00 - Rates for Home Health Services › Section 350.02 - General Definitions

Current through Register 1525, July 5, 2024
As used in
				101 CMR
				350.00, unless the context requires otherwise, terms
				have the meanings set forth in
				101
				CMR 350.02.
Activities of Daily Living (ADL)
.
				Activities related to personal care, specifically bathing, grooming, dressing,
				toileting/continence, transferring/ambulation, and eating.
ADL Support Visit
. A home visit
				performed by an eligible provider to a member for assistance with ADLs when the
				member is not receiving concurrent home health skilled nursing or therapy
				services.
Eligible Provider
. An organization
				certified as a provider of services under the Medicare Health Insurance Program
				for the Aged (Title XVIII) and that meets such conditions of participation as
				have been or may be adopted by a governmental unit purchasing home health
				services.
EOHHS.
The Executive Office of Health
				and Human Services established under M.G.L. c. 6A.
Governmental Unit
. The Commonwealth of
				Massachusetts and any department, agency, board, commission, division, or
				political subdivision of the Commonwealth.
Home Health Agency
. An organization
				that meets the requirements of
				130 CMR
				403.000:
Home Health Agency
to
				provide home health services.
Home Health Aide Service
. The
				provision of personal care and other health-related services in the home, as
				described in
				130
				CMR 403.416(B) through (D)
				by a home health aide as defined in
				130
				CMR 403.402:
Home Health
				Aide
.
Home Health Services
. Skilled nursing
				visits, physical therapy, occupational therapy, speech therapy, and home health
				aide services provided in the individual's home.
Home Visit
. A morbidity visit rendered
				in the home by a qualified employee of a home health agency.
Medication Administration Visit
. A
				skilled nursing visit for the purpose of administration of medications when the
				member is unable to perform the task due to impaired physical, cognitive,
				behavioral, and/or emotional issues; no able caregiver is present; or the
				member has a history of failed medication compliance resulting in a documented
				exacerbation of the member's condition, and/or the task including the route of
				administration of medication requires a licensed nurse to provide the service.
				A medication administration visit may include administration of oral,
				intramuscular, and/or subcutaneous medication or administration of medications
				other than oral, intramuscular and/or subcutaneous medication, but does not
				include intravenous administration.
Nursing Services
. Services as defined
				in 130 CMR 403.402:
Nursing Services
and described at
				130
				CMR 403.415:
Nursing
				Services
.
Occupational Therapy
. Services as
				defined in
				130
				CMR 403.402:
Occupational Therapy
provided by an occupational therapist as defined in
				130
				CMR 403.402:
Occupational
				Therapist
and occupational therapy assistant as defined in
				130
				CMR 403.402:
Occupational Therapy
				Assistant
.
Office Visit
. A health promotion or
				therapeutic visit rendered in a home health agency's office.
Physical Therapy
. Services as defined
				in 130 CMR 403.402:
Physical Therapy
provided by a physical therapist or
				physical therapy assistant as defined in
				130
				CMR 403.402:
Definitions
.
Publicly Aided Individual
. A person
				who receives health care and services for which a governmental unit is in whole
				or part liable under a statutory program.
Reasonable Costs
. Those reasonable and
				necessary costs incurred by an eligible provider of home health services,
				subject to the requirements and limitations of
				101 CMR
				350.00. In determining the reasonableness of costs,
				EOHHS may consider the particular services offered, the introduction of
				efficiency measures, the requirements for staffing, and the costs of providing
				comparable service.
Security/Escorts
. The provision of
				security services to direct care personnel in the performance of a reimbursable
				home health visit.
Speech/Language Therapy
. Services as
				defined in
				130
				CMR 403.402:
Speech/Language
				Therapy
provided by a qualified speech/language therapist
				(speech/language pathologist) as defined in
				130
				CMR 403.402:
Speech/Language
				Therapist (Speech/Language Pathologist)
.
Therapeutic
or
Morbidity
				Home Visit
. A home visit rendered by an eligible provider to an
				individual and/or family for the purpose of treating one or more diagnosed
				illnesses or disabilities.
Visit.
A visit as defined in
				130
				CMR 403.402:
Visit
that is up to eight 15-minute units.
Weekday
. The hours from 7:00 A.M. to
				3:00 P.M., Monday through Friday.
Weekend and Nights
.
(a)
Weekend
. The
			 hours from 3:00 P.M., Friday, to 7:00 A.M., Monday.
(b)
Nights
. The
			 hours from 3:00 P.M. to 7:00 A.M., Monday through Friday.
(c)
Holidays
. All
			 official Commonwealth of Massachusetts holidays. For purposes of
			 101 CMR
			 350.00, holidays that occur on a weekend are observed
			 on that day and not the preceding Friday or following Monday.
New Year's Day
Martin Luther King Jr. Day
Presidents' Day
Patriots' Day
Memorial Day
Juneteenth
Independence Day
Labor Day
Indigenous Peoples Day
Veterans Day
Thanksgiving Day
Christmas Day