reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1103 - PHYSICAL THERAPY SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If an
				  agency provides physical therapy services, such services shall be provided by
				  or under the supervision of a licensed physical therapist and in accordance
				  with G.S. Chapter 90, Article 18B, Physical Therapy, and the plan of care and
				  shall include:
(1) assessment of the client
				  to determine level of physical function;
(2) establishment and implementation of the
				  physical therapy treatment plan;
(3) observation, recording, and reporting to
				  the physician any reaction to treatment or changes in the client's
				  condition;
(4) instruction of the
				  family in the client's total physical therapy program; and
(5) instructing of family members, in-home
				  aides and other health team personnel in performing appropriate therapy
				  treatment.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1104 - SPEECH THERAPY/PATHOLOGY SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
If an agency provides speech therapy, or services in speech
					 and language pathology or audiology such services shall be provided in
					 accordance with G.S. 90, Article 22, North Carolina Licensure Act for Speech
					 and Language Pathologists and Audiologists and the client's plan of care and
					 shall include the following at a minimum:
(1) assessment of clients with speech,
				  language, voice, dysphagia, and/or hearing disorders;
(2) establishment and implementation of the
				  speech therapy treatment plan;
(3)
				  recording and reporting to the physician any reaction to treatment or changes
				  in the client's condition;
(4)
				  teaching other health team personnel and family members techniques to help
				  improve and correct the client's speech, language, voice, dysphagia, or hearing
				  potential; and
(5) counseling the
				  client and family about the client's speech, language, voice, dysphagia, and/or
				  hearing disabilities.
Authority
					 G.S.
					 131E-140;
Eff. July 1,
					 1992;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1105 - OCCUPATIONAL THERAPY SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If an
				  agency provides occupational therapy, such services shall be provided by or
				  under the supervision of a licensed occupational therapist in accordance with
				  G.S. Chapter 90, Article 18D, Occupational Therapy and the client's plan of
				  care and shall include:
(1) assessment of the
				  client's functional ability to perform activities of daily living;
(2) establishment and implementation of the
				  occupational therapy treatment plan;
(3) observation, recording, and reporting to
				  the physician any reaction to treatment and any changes in the client's
				  condition;
(4) instruction of
				  family members, in-home aides and other health team personnel in appropriate
				  therapy methods; and
(5) design,
				  development and fitting orthotic devices and self-help devices.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1106 - MEDICAL SOCIAL WORK SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
If an agency provides medical social work services, such
					 services shall be provided by or under the supervision of a medical social
					 worker and in accordance with the client's plan of care and shall include the
					 following:
(1) assisting the physician
				  and other members of the health team in understanding the significant social
				  and emotional factors related to the client's health problems;
(2) assessing social and emotional factors in
				  order to estimate the client's capacity and potential to cope with problems of
				  daily living;
(3) helping the
				  client and family to understand, accept, and follow medical recommendations and
				  provision of services planned to restore the client to optimum social and
				  health adjustment within their capacity;
(4) assisting the client and family with
				  personal and environmental difficulties which predispose toward illness or
				  interfere with the client obtaining maximum benefits from medical care;
				  and
(5) assisting the client and
				  family in the utilization of appropriate community resources.
Authority
					 G.S.
					 131E-140;
Eff. July 1,
					 1992;
RRC Objection due to lack of statutory authority Eff.
					 November 16, 1995;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1107 - IN-HOME AIDE SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If an agency
				  provides in-home aide services, the services shall be provided in accordance
				  with the client's plan of care. The plan of care shall be signed and dated by
				  the health care practitioner and the client or the client's responsible party.
				  The client shall have access to a copy of the in-home aide plan of care in the
				  home.
(b) The plan of care shall
				  contain the level of assistance required by the client for each ADL. If the
				  client's plan of care requires the in-home aide to provide extensive
				  assistance, the in-home aide shall be listed on the Nurse Aide Registry
				  pursuant to
				  G.S.
				  131E-255. However, if the client's plan of
				  care requires the in-home aide to provide only limited assistance, the in-home
				  aide is not required to be listed on the Nurse Aide Registry.
(c) In-home aides shall follow instructions
				  for client care written by the health care practitioner. In-home aide duties
				  may include the following:
(1) help with
				  prescribed exercises that the client and in-home aides have been taught by a
				  health care practitioner;
(2)
				  provide or assist with ADLs;
(3)
				  assist client with self-administration of medications that are ordered by a
				  health care practitioner or other person authorized by state law to
				  prescribe;
(4) perform IADLs that
				  are essential to the client's care at home; and
(5) record and report changes in the client's
				  condition, family situation, or needs to the health care
				  practitioner.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1108 - INFUSION NURSING SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If an
				  agency provides infusion nursing services, the services shall be provided by or
				  under the supervision of a registered nurse with training in infusion services
				  or special training in the drug and nutritional therapies the agency offers, as
				  identified in agency policies, and in accordance with the North Carolina
				  Nursing Practice Act, G.S. Chapter 90, Article 9A, and a plan of care signed by
				  a physician.
(b) If an agency
				  provides or arranges for infusion services, the agency shall provide on-call
				  infusion nursing services on a 24 hour basis, seven days a week.
(c) If the agency provides or contracts for
				  infusion pharmacy services there shall be policies and procedures governing the
				  scope of pharmacy services provided. Pharmacy services shall be provided in
				  accordance with the Pharmacy Laws of North Carolina and related rules and shall
				  be provided on a 24-hour basis, seven days a week.
Authority
					 G.S.
					 131E-140;
Eff. July 1,
					 1992;
RRC Objection due to lack of statutory authority Eff.
					 November 16, 1995;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1109 - CLINICAL RESPIRATORY SERVICES, INCLUDING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If an
				  agency provides clinical respiratory services or ventilation services, the
				  services shall be provided by or under the supervision of a respiratory
				  therapist or a registered nurse with demonstrated competency in the delivery of
				  respiratory services under a plan of care signed by a physician. Within the
				  agency's defined scope of service, respiratory staff, including contractors,
				  shall maintain an active license, certification or registry and shall
				  demonstrate proof of education and experience sufficient for the safe delivery
				  of service.
(b) Clinical
				  respiratory services shall include the following:
(1) assessment of the client's ongoing need
				  for services;
(2) teach and train
				  client or caregivers to self-administer home respiratory care
				  procedures;
(3) collect laboratory
				  specimens;
(4) evaluate functioning
				  of ventilator support equipment;
(5) evaluate functioning of infant monitors;
				  and
(6) when ordered by a
				  physician, administration of aerosolized medication.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1110 - SUPERVISION AND COMPETENCY OF IN-HOME CAREGIVERS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) In-home
				  caregivers subject to occupational licensing laws shall meet requirements
				  consistent with the rules established by the occupational licensing board that
				  they are subject. Each agency shall document that its in-home caregivers are
				  competent to perform client care tasks or activities that they are assigned.
				  Meeting competency includes a demonstration of tasks to the health care
				  practitioner. In-home caregivers shall perform delegated activities under the
				  supervision of persons authorized by state law to provide such
				  supervision.
(b) Those in-home
				  caregivers who are not subject to occupational licensing laws shall only be
				  assigned client care activities that they have demonstrated competency, and the
				  documentation of competency is maintained by the agency. Meeting competency
				  includes a demonstration of tasks to the health care practitioner. Each agency
				  shall document that its in-home caregivers demonstrate competence for all
				  assigned client care tasks or activities. In-home caregivers shall be
				  supervised by the health care practitioner who may further delegate specific
				  supervisory activities to in-home caregivers as designated by agency policy,
				  provided that the following criteria are met:
(1) there is availability of the health care
				  practitioner for supervision and consultation; and
(2) accountability for supervisory activities
				  delegated is maintained by the health care practitioner.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1111 - ARRANGEMENTS FOR SERVICES WITH OTHER AGENCIES OR INDIVIDUALS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) When an agency makes arrangements for
				  providing services through other agencies or individuals, or where the agency
				  contracts with a state or county agency to provide licensed home care services,
				  there shall be a written agreement, signed by both parties, which includes the
				  following:
(1) specific service to be
				  provided;
(2) period of time the
				  contract is to be in effect;
(3)
				  availability of services;
(4)
				  financial arrangements;
(5)
				  verification that any individual providing service is appropriately licensed or
				  registered as required by statute;
(6) provision for supervision of contract
				  personnel where applicable;
(7)
				  assurance that individuals providing services under contractual arrangements
				  meet the same requirements as those specified for home care agency
				  personnel;
(8) provision for the
				  documentation of services rendered in the client's service record;
(9) provision for the sharing of assessment
				  and plan of care data; and
(10) the
				  geographic service area the contractor agrees to serve.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1100 - SCOPE OF SERVICES › Section 13J .1112 - HOME MEDICAL EQUIPMENT AND SUPPLIES

Current through Register Vol. 39, No. 2, July 15, 2024
If an agency provides medical supplies and equipment in
					 conjunction with home care services as defined in
					 G.S.
					 131E-136(3), the agency
					 shall have policies and procedures governing their management. These policies
					 shall address the following:
(1)
				  set-up, delivery, electrical safety, and environmental requirements for
				  equipment.
(2) proper cleaning and
				  storage, preventive maintenance, and repair according to manufacturer's
				  guidelines.
(3) transportation,
				  tracking, and recall of equipment to meet all applicable regulatory
				  requirements.
(4) emergency
				  preparedness and backup of systems for equipment or power failure.
(5) client instruction materials for each
				  item of home medical equipment or supplies provided.
Authority
					 G.S.
					 131E-140;
Eff. February 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1200 - CASE REVIEW AND PLAN OF CARE › Section 13J .1201 - POLICIES

Current through Register Vol. 39, No. 2, July 15, 2024
An agency shall develop and implement written policies and
					 procedures to assure that services and items to be provided are specified under
					 a plan of care.
Authority
					 G.S.
					 131E-140;
Eff. July 1,
					 1992;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1200 - CASE REVIEW AND PLAN OF CARE › Section 13J .1202 - CASE REVIEW AND PLAN OF CARE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The plan of
				  care shall be established in collaboration with the client and incorporated in
				  the service record. The plan of care shall be reviewed every 90 days by the
				  health care practitioner and revised as needed based on the client's needs. If
				  the client record is purged, the original and updated authorization or orders
				  for care shall be maintained in the client's record. All records shall be
				  available to Department staff for review if requested. If physician orders are
				  needed for the services, the health care practitioner shall notify the
				  physician of any changes in the client's condition that indicates the need for
				  altering the plan of care or for terminating services. Based upon the findings
				  of the client assessment, the plan of care shall include the following:
(1) type of service(s) and care to be
				  delivered;
(2) frequency and
				  duration of service;
(3) activity
				  restrictions;
(4) safety measures;
				  and
(5) service objectives and
				  goals.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1300 - PHARMACEUTICALS AND MEDICAL TREATMENT ORDERS › Section 13J .1301 - POLICIES, PROCEDURES, AND STAFF RESPONSIBILITY

Current through Register Vol. 39, No. 2, July 15, 2024
If the agency administers any pharmaceuticals or medical
					 treatments, it shall develop and implement policies and procedures relative to
					 the administration of pharmaceuticals and treatments. The policies shall
					 specify staff accountability for:
(1)
				  recognizing side effects;
(2)
				  recognizing toxic effects;
(3)
				  recognizing allergic reactions;
(4)
				  recognizing immediate desired effects;
(5) recognizing unusual and unexpected
				  effects;
(6) recognizing changes in
				  the client's condition that contraindicates continued administration of the
				  medication;
(7) anticipating those
				  effects which may rapidly endanger a client's life or well-being; and
(8) notifying the physician of any
				  problems.
Authority
					 G.S.
					 131E-140;
Eff. July 1,
					 1992;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1300 - PHARMACEUTICALS AND MEDICAL TREATMENT ORDERS › Section 13J .1302 - ORDERS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Orders for pharmaceuticals and medical
				  treatments, or orders for in-home aide services when orders for in-home aide
				  services are required, shall be signed by the physician or other person
				  authorized by State law to prescribe such treatments and the original
				  incorporated in the client's service records. Care may commence in the interim
				  with a verbal order.
(b) Verbal
				  orders for the administration of pharmacological agents and other medical
				  treatment interventions shall be given to a licensed nurse, or other person
				  authorized by state law to receive such orders. The order once recorded shall
				  include the date and signature of the person receiving the order, shall be
				  recorded in the client record, and shall be countersigned by the physician or
				  other person authorized by State law to prescribe.
(c) Verbal orders for allied health services
				  personnel, other than nursing or other than in-home aide services, shall be
				  given to either a licensed nurse or the appropriate health professional. The
				  order once recorded shall include the date and signature of the person
				  receiving the order, shall be recorded in the client record and shall be
				  countersigned by the physician or other person authorized by State law to
				  prescribe.
(d) The home care agency
				  shall develop and implement written policies and procedures for obtaining
				  countersignatures on verbal orders within 60 days of the date of the verbal
				  order.
Authority
					 G.S.
					 131E-140;
Eff. July 1,
					 1992;
Amended Eff. February 1, 2004; February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1300 - PHARMACEUTICALS AND MEDICAL TREATMENT ORDERS › Section 13J .1303 - RESERVED FOR FUTURE CODIFICATION

Current through Register Vol. 39, No. 2, July 15, 2024
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1400 - SERVICE RECORDS › Section 13J .1401 - REQUIREMENT

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The agency
				  shall develop and implement written policies governing content and handling of
				  client records.
(b) The agency
				  shall maintain a client record for each client. Each page of the client record
				  shall have the client's name. All entries in the record shall reflect the
				  actual date of entry. When agency staff make additional, late, or out of
				  sequence entries into the client record, the documentation shall include the
				  following applicable notations: addendum, late entry, or entry out of sequence,
				  and the date of the entry. A system for maintaining originals and copies shall
				  be described in the agency policies and procedures.
(c) The agency shall assure that originals of
				  client records are kept confidential and secure on the licensed premises unless
				  in accordance with Rule.0905 of this Subchapter, or subpoenaed by a court of
				  legal jurisdiction, or to conduct an evaluation as required in Rule.1004 of
				  this Subchapter.
(d) If a record is
				  removed to conduct an evaluation, the record shall be returned to the agency
				  premises within five working days. The agency shall maintain a sign out log
				  that includes to whom the record was released, client's name and date removed.
				  Only authorized staff or other persons authorized by law may remove the record
				  for these purposes.
(e) A copy of
				  the client record for each client must be readily available to the appropriate
				  health professional(s) providing services or managing the delivery of such
				  services.
(f) Client records shall
				  be retained for a period of not less than five years from the date of the most
				  recent discharge of the client, unless the client is a minor in which case the
				  record must be retained until three years after the client's 18th birthday.
				  When an agency ceases operation, the Department shall be notified in writing
				  where the records will be stored for the required retention period.
Authority
					 G.S.
					 131E-140;
Eff. July 1,
					 1992;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1400 - SERVICE RECORDS › Section 13J .1402 - CONTENT OF RECORD

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If the agency
				  is providing services to a client, the service record shall contain the
				  following information:
(1) Admission data:
(A) identification data such as name,
				  address, telephone number, date of birth, sex, and marital status;
(B) a copy of the signed client's rights form
				  or documentation of its delivery;
(C) names of next of kin, legal guardian, or
				  other family members;
(D) source of
				  referral; and
(E) assessment of
				  home environment.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1500 - COMPANION, SITTER, AND RESPITE SERVICES › Section 13J .1501 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
The following definitions shall apply throughout this
					 Section:
(1) "Companion, sitter, or
				  respite services personnel" means an individual as used in
				  G.S.
				  131E-136, who spends time with or provides
				  non-hands-on care services for clients.
(2) "Non-Hands-on Care Services" means basic
				  home management tasks, shopping, meal preparation, transportation, companion
				  services, socialization, medication reminders, and other services that do not
				  require the service provider to use "hands-on care" as defined in Rule.0901 of
				  this Subchapter and which do not require training or verification of skills by
				  a Registered Nurse.
(3) "Respite
				  Care" means planned or emergency care provided to an individual in order to
				  provide temporary relief to the family caregiver.
Authority
					 G.S.
					 131E-140;
Eff. January 1,
					 2010;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. June 25,
					 2016.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1500 - COMPANION, SITTER, AND RESPITE SERVICES › Section 13J .1502 - SCOPE OF SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If an agency
				  provides In-home companion, sitter, or respite services, the services shall be
				  provided in accordance with the client's plan of care. Agencies participating
				  in the Home and Community Care Block Grant or Social Services Block Grant
				  through the Division of Aging and Adult Services shall comply with the service
				  level rulescontained in
				  10A NCAC
				  06A and
				  10A NCAC
				  06X. All other agencies providing in-home
				  companion, sitter, or respite services shall comply with the provisions of the
				  rules in this Section.
(b) In-home
				  companion, sitter, or respite services personnel shall follow the plan of care
				  written by the in-home companion, sitter, or respite services
				  supervisor.
Authority
					 G.S.
					 131E-140;
Eff. January 1,
					 2010;
Readopted Eff. June 1,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1500 - COMPANION, SITTER, AND RESPITE SERVICES › Section 13J .1503 - AGENCY MANAGEMENT AND SUPERVISION

Current through Register Vol. 39, No. 2, July 15, 2024
Notwithstanding the requirements in Rule.1001 of this
					 Subchapter, the agency shall meet the following requirements:
(1) The agency shall designate an individual
				  to serve as agency director. The agency director shall have the authority and
				  responsibility for administrative direction of the agency. The agency director
				  shall be a high school graduate, or be certified under the G.E.D. Program, and
				  shall meet one or more of the following qualifications:
(a) shall be a health care practitioner as
				  defined in
				  G.S.
				  90-640(a); or
(b) shall have one year experience in home
				  care, companion, sitter, or respite services, or any other provider licensed
				  pursuant to G.S. 131E or G.S. 122C.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter J - THE LICENSING OF HOME CARE AGENCIES › Section .1500 - COMPANION, SITTER, AND RESPITE SERVICES › Section 13J .1504 - SUPERVISION AND COMPETENCY OF COMPANION, SITTER, AND RESPITE SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
In addition to the requirements in Rule.1110 of this
					 Subchapter, an agency providing In-home companion, sitter, or respite care
					 services shall meet the following requirements:
(1) Each agency shall have documentation that
				  its companion and sitters are competent to perform client care tasks or
				  activities to which they are assigned. Such individuals shall perform delegated
				  activities under the supervision of a supervisor designated by agency policy
				  for the services assigned.
(2) The
				  agency designated supervisor shall supervise the companion and sitter staff by
				  contacting the client receiving care every three months and by making a
				  supervisory visit to each client's place of residence at least every six
				  months, with or without the companion and sitter's presence, and at least
				  annually, while the companion or sitter is in the home providing services to
				  the client.
(3) The supervisory
				  visit shall include a review of the client's general condition, monitoring
				  progress and response to the services provided by the companion or sitter, and
				  updates to the plan of care as needed.
(4) Documentation of supervisory visits shall
				  be maintained in the agency's records and shall contain the following:
(a) date of visit;
(b) findings of visit; and
(c) signature of person performing the
				  visit.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0200 - LICENSE › Section 13K .0201 - LICENSE REQUIRED

Current through Register Vol. 39, No. 2, July 15, 2024
Each hospice agency premises shall obtain a license unless
					 exempted by
					 G.S.
					 131E-203.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0200 - LICENSE › Section 13K .0202 - APPLICATION FOR AND ISSUANCE OF A LICENSE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) An
				  application for a license to operate a hospice agency or facility shall be
				  submitted to the Department prior to the scheduling of an initial licensure
				  survey. The hospice agency shall establish, maintain and make available for
				  inspection such documents, records and policies as required in this Section and
				  statistical data sufficient to complete the licensure application and upon
				  request of the Department, to submit an annual data report, including all
				  information required by the Department as noted in Rule.0303 of this
				  Subchapter.
(b) The Department
				  shall issue a license to each hospice agency premises when determined to be in
				  compliance with licensure rules. Initial licensure inspections shall be
				  conducted at the Department offices. On-site inspections shall include one or
				  all sites as described in Rule.0209 of this Subchapter. Initial licensure shall
				  be for a period of not more than one year. Subsequent licensure shall extend
				  for a minimum of one year and a maximum of three years, at the discretion of
				  the Department. Each license shall expire at midnight on the expiration date on
				  the license and is renewable upon application.
(c) The license shall be posted in a
				  prominent location accessible to public view within the premises. The agency
				  shall also post a sign at the public access door with the hospice agency
				  name.
(d) The license shall be
				  issued for the premise and persons named in the application and shall not be
				  transferable. The name and street address under which the agency operates shall
				  appear on the license. If the agency operates an inpatient facility or unit, or
				  a residential facility to provide inpatient or residential hospice care, the
				  number of beds for each shall be reflected on the license.
(e) Prior to change of ownership or the
				  establishment of a new hospice agency, the agency shall be in compliance with
				  all the applicable statutes and rules established under Article 10 of G.S.
				  131E.
(f) The licensee shall notify
				  the Department in writing of any proposed change in ownership or name at least
				  30 days prior to the effective date of the change.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. April 1, 1996; June 1, 1991; November 1,
					 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0200 - LICENSE › Section 13K .0206 - ADVERSE ACTION

Current through Register Vol. 39, No. 2, July 15, 2024
A hospice may appeal any adverse decision made by the
					 Department concerning its license by making such appeal in accordance with the
					 Administrative Procedure Act, G.S. 150B and Departmental Rules
					 10ANCAC 01 et seq. As
					 provided for in
					 G.S.
					 131E-206, the Department shall seek
					 injunctive relief to prevent an entity from establishing or operating a hospice
					 agency without a license.
(1) The
				  Department may amend a license by reducing it from a full license to a
				  provisional license whenever the Department finds that:
(a) the licensee has substantially failed to
				  comply with the provisions of Article 10 of G.S. 131E and the rules promulgated
				  under that Part; and
(b) there is a
				  reasonable probability that the licensee can remedy the licensure deficiencies
				  within a reasonable length of time; and
(c) there is a reasonable probability that
				  the licensee will be able thereafter to remain in compliance with the hospice
				  licensure rules for the foreseeable future.
The Department shall give the licensee written notice of
					 the amendment of its license. This notice shall be given by registered or
					 certified mail or by personal service and shall set forth the reasons for the
					 action.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0200 - LICENSE › Section 13K .0208 - INSPECTIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Any hospice
				  agency or facility shall be subject to inspections by authorized
				  representatives of the Department at any time as a condition of holding such
				  license.
(b) Any person or
				  organization subject to licensure which presents itself to the public as a
				  hospice which does not hold a license, and is or may be in violation of
				  Rule.0202 of this Section and
				  G.S.
				  131E-203(a) shall be subject
				  to proper inspections at any time by authorized representatives of the
				  Department.
(c) Representatives of
				  the Department shall make their identities known to the person in charge prior
				  to the inspection.
(d) Licensure
				  inspection of medical records shall be carried out in accordance with
				  G.S.
				  131E-207.
(e) An inspection shall be conducted whenever
				  the purpose of the inspection is to determine whether the agency complies with
				  the provisions of this Subchapter or whenever there is reason to believe that
				  some condition exists which is not in compliance with the rules in this
				  Subchapter. The agency shall allow immediate access to its premises and the
				  records necessary to conduct an inspection and determine compliance with the
				  rules of this Subchapter. Failure to do so shall result in termination of the
				  survey and may result in injunctive relief as outlined in
				  G.S.
				  131E-206.
(f) An agency shall file a plan of correction
				  for cited deficiencies within 10 working days of receipt of a report of
				  deficiencies. The Department shall review and respond to a written plan of
				  correction within 10 working days of receipt.
(g) Representatives of the Department may
				  visit patients in their homes to assess the agency's compliance with the
				  patients' plans of care and with the licensure rules. Patients shall be
				  contacted by the hospice agency staff in the presence of the Department staff
				  for permission to visit.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. February 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0200 - LICENSE › Section 13K .0209 - MULTIPLE PREMISES

Current through Register Vol. 39, No. 2, July 15, 2024
If a person operates multiple hospice agency
					 premises:
(1) the Department may
				  conduct inspections at any or all of the premises and may issue a license to
				  each of the premises based upon inspection of any or all of the
				  premises;
(2) with 72 hours advance
				  notice, the Department may request records from any of the premises necessary
				  to ensure compliance with the rules of this Subchapter be brought to the site
				  being inspected, including the portions of personnel records subject to review.
				  For agencies for whom a business or government policy precludes the disclosure
				  of employee evaluations, a statement signed by the employee's supervisor
				  attesting to its completion shall be accepted;
(3) the premises may share staff or
				  administrative staff, and may centralize the maintenance of records.
Authority
					 G.S.
					 131E-202;
Eff. February 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0200 - LICENSE › Section 13K .0210 - COMPLIANCE WITH LAWS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  agency shall be in compliance with all applicable federal, state and local
				  laws, rules and regulations.
(b)
				  Staff of the hospice agency shall be currently licensed, listed or registered
				  in accordance with applicable laws of the State of North Carolina.
Authority
					 G.S.
					 131E-202;
Eff. February 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0300 - ADMINISTRATION › Section 13K .0303 - ADMINISTRATIVE FINANCIAL AND STATISTICAL RECORDS

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				  The hospice shall establish, maintain and make available for inspection the
				  hospice annual budget.
(b) The
				  hospice shall record, maintain and make available to the Department statistical
				  records as requested. Records shall include: hours worked by staff, including
				  patient family volunteers; patient census information regarding the numbers of
				  referrals, admissions and discharges; and patient diagnoses and service
				  location (home or inpatient).
(c)
				  Records shall be retained for a period of not less than five years.
(d) When a hospice agency or facility
				  operates as a part of a health care facility licensed under Article 5 or 6 of
				  G.S. 131E, or as part of a larger diversified agency, records of hospice
				  activities and expenditures that are separate and identifiable shall be
				  maintained for the hospice agency.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. February 1, 1996; November 1, 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0400 - PERSONNEL › Section 13K .0402 - INSERVICE EDUCATION AND TRAINING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Written
				  policies shall be established and implemented which include orientation,
				  patient family volunteer training and inservice education for all hospice
				  staff. Hospice residential facilities shall establish and implement a policy
				  addressing hospice caregiver training. Attendance records on training shall be
				  kept. Patient family care volunteers shall be required to meet the requirements
				  of Rule.0401 of this Section. Training hours for patient family care volunteers
				  shall include a minimum of 12 hours. Staff shall be required to participate in
				  a minimum of eight hours included with other job specific training.
(b) Training for hospice staff, including
				  patient family volunteers, providing direct patient and family services shall
				  include, but not be limited to the following:
(1) an introduction to hospice;
(2) the patient family volunteer role in
				  hospice care;
(3) concepts of death
				  and dying;
(4) communication
				  skills;
(5) care and comfort
				  measures;
(6) diseases and medical
				  conditions;
(7) psychosocial and
				  spiritual issues related to death and dying;
(8) the concept of the hospice
				  family;
(9) stress
				  management;
(10)
				  bereavement;
(11) infection
				  control;
(12) safety;
(13) confidentiality; and
(14) patient rights.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0500 - SCOPE OF SERVICES › Section 13K .0501 - SERVICE REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
The governing body shall ensure through policies and
					 implemented procedures that the following services encompassing the essential
					 elements of hospice care be provided, either directly by hospice personnel, or
					 by contractual arrangement:
(1)
				  Hospice nursing services, available 24 hours a day, by or under the supervision
				  of a registered nurse; provided in accordance with the North Carolina Nurse
				  Practice Act (G.S. 90, Article 9A) and the hospice care plan; and sufficient to
				  ensure that nursing needs of each patient are met.
(a) Registered nurse duties include the
				  following as a minimum:
(i) regularly assess
				  the nursing needs of the hospice patient;
(ii) develop and implement the patient's
				  hospice nursing care plan;
(iii)
				  provide hospice nursing services, treatment, and diagnostic and preventive
				  procedures;
(iv) initiate nursing
				  procedures appropriate for the patient's hospice care and safety;
(v) observe signs and symptoms and report to
				  the physician any unexpected changes in the patient's physical or emotional
				  condition;
(vi) teach, supervise,
				  and counsel the hospice patient and family members about providing care for the
				  patient at home; and
(vii)
				  supervise and train other nursing service personnel.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0500 - SCOPE OF SERVICES › Section 13K .0504 - HOME MEDICAL EQUIPMENT AND SUPPLIES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The hospice
				  shall make arrangements for obtaining any necessary supplies, equipment or
				  prosthetic devices needed by the patient in the home, e.g., dressings,
				  catheters, and oxygen. If the agency provides its own equipment and supplies,
				  such services shall be in compliance with
				  G.S.
				  90-85.22 unless exempted by the
				  law.
(b) The agency shall have
				  policies that address at a minimum:
(1)
				  Set-up, delivery, electrical safety and environmental requirements for
				  equipment.
(2) Proper cleaning and
				  storage, preventive maintenance and repair according to manufacturer's
				  guidelines.
(3) Transportation,
				  tracking and recall of equipment to meet all applicable regulatory
				  requirements.
(4) Emergency
				  preparedness and backup of systems for equipment or power failure.
(5) Patient instruction materials for each
				  item of home medical equipment or supplies provided. Appropriate staff shall
				  document the instruction.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0500 - SCOPE OF SERVICES › Section 13K .0505 - SERVICES ARRANGED WITH OTHER AGENCIES AND INDIVIDUALS

Current through Register Vol. 39, No. 2, July 15, 2024
(a)
				  When a hospice makes arrangements for the provision of services by other
				  agencies and individuals; there shall be a written agreement, signed by both
				  parties prior to the initiation of services, which includes the following:
(1) the specific service to be
				  provided;
(2) the period of time
				  the contract is to be in effect;
(3) the availability of service;
(4) the financial arrangements;
(5) the provision for supervision of
				  contracted personnel where applicable;
(6) the verification that any individual
				  providing services is appropriately licensed or registered as required by
				  statute;
(7) the assurance that
				  individuals providing services under contractual arrangement meet the same
				  requirements as found in this Subchapter for hospice staff;
(8) the provision for the documentation of
				  services provided in the patient's medical record; and
(9) provision for the sharing of assessment
				  and care plan data.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter K - HOSPICE LICENSING RULES › Section .0600 - PATIENT/FAMILY CARE › Section 13K .0601 - ACCEPTANCE OF PATIENTS FOR HOSPICE SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
A hospice shall implement and follow written policies
					 governing the acceptance of patients which include at the minimum:
(1) Involvement of the interdisciplinary care
				  team in making decisions regarding acceptance of patients and families and the
				  designation of a primary caregiver.
(2) Initial assessment of the patient prior
				  to acceptance to ensure that its resources are sufficient to meet the needs of
				  the patient and family.
(3)
				  Provision for a determination by the patient's physician that hospice care is
				  appropriate and agreement to continue as the attending physician while the
				  patient receives hospice services. All care and services provided shall be in
				  accordance with the attending physician's written orders and the plan of care.
				  Physician's orders shall be reviewed and signed by the physician at least every
				  90 days.
(4) Informed consent
				  signed by the patient thereby agreeing to hospice services being
				  provided.
(5) Advance notification
				  of at least 48 hours to the patient or family when service provision is to be
				  terminated, except in cases where the patient is in agreement with changes or
				  there is a danger to a patient or staff member.
(6) Each patient or family accepted for
				  hospice care shall receive written information pertaining to services
				  available, including the means for contacting "on-call" personnel when needed
				  and other information as necessary.
Authority
					 G.S.
					 131E-202;
Eff. November 1,
					 1984;
Amended Eff. February 1, 1996; June 1, 1991; November 1,
					 1989;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. December 22,
					 2018.