Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XIII - Home Health Program › Subpart 1 - Home Health Services › Chapter 1 - General Provisions › Section XIII-101 - Definitions [Formerly LAC 50:XIX.101]

Current through Register Vol. 50, No. 6, June 20, 2024
A. The following words and terms, when used
				  in this Subpart 1, shall have the following meanings, unless the context
				  clearly indicates otherwise:
Authorized Healthcare Provider
-a
					 physician, nurse practitioner, clinical nurse specialist, or physician
					 assistant licensed, certified, registered, or otherwise authorized to order
					 home healthcare services consistent with Louisiana la w.
Home Health Aide Services
- direct care
					 services to assist in the treatment of the patient's illness or injury provided
					 under the supervision of a registered nurse and in compliance with the
					 standards of nursing practice governing delegation, including assistance with
					 the activities of daily living such as mobility, transferring, walking,
					 grooming, bathing, dressing or undressing, eating, or toileting.
Home Health Services
-patient care services
					 provided in the patient's home or place of residence under the order of an
					 authorized healthcare provider that are necessary for the diagnosis and
					 treatment of the patient's illness or injury, including one or more of the
					 following services:
a. skilled
				  nursing;
b. physical
				  therapy;
c. speech-language
				  therapy;
d. occupational
				  therapy;
e. home health aide
				  services; or
f. medical supplies,
				  equipment and appliances suitable for use in the patient's home or place of
				  residence.
NOTE: Medical supplies, equipment and appliances for home
					 health are reimbursed through the Durable Medical Equipment Program and must be
					 prior authorized.
Occupational Therapy Services
-medically
					 prescribed treatment to improve, maintain or restore a function which has been
					 impaired by illness or injury or, when the function has been permanently lost
					 or reduced by illness or injury, to improve the individuals ability to perform
					 those tasks required for independent functioning
Physical Therapy Services
-rehabilitative
					 services necessary for the treatment of the patient's illness or injury or,
					 restoration and maintenance of function affected by the patient's illness or
					 injury. These services are provided with the expectation, based on the
					 authorized healthcare provider's assessment of the patient's rehabilitative
					 potential, that:
a. the patient's
				  condition will improve materially within a reasonable and generally predictable
				  period of time; or
b. the services
				  are necessary for the establishment of a safe and effective maintenance
				  program.
Place of Residence
-location where normal
					 life activities take place but does not include a hospital, intermediate care
					 facility for individuals with intellectual disabilities, or any setting in
					 which payment is or could be made under Medicaid for inpatient services that
					 include room and board.
Skilled Nursing Services
- nursing
					 services provided on a part-time or intermittent basis by a registered nurse or
					 licensed practical nurse that are necessary for the diagnosis and treatment of
					 a patient's illness or injury. These services shall be consistent with:
a. established Medicaid policy;
b. the nature and severity of the recipient's
				  illness or injury;
c. the particular
				  medical needs of the patient; and
d.
				  the accepted standards of medical and nursing practice.
Speech-Language Therapy Services
- those
					 services necessary for the diagnosis and treatment of speech and language
					 disorders that result in communication disabilities, and for the diagnosis and
					 treatment of swallowing disorders (dysphagia), regardless of a communication
					 disability.