Washington Administrative Code › Title 182 - Health Care Authority › WASHINGTON APPLE HEALTH › Chapter 182-551 - Alternatives to hospital services › Subchapter II - HOME HEALTH SERVICES › Section 182-551-2010 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The following definitions and abbreviations and those found
					 in chapter 182-500 WAC apply to subchapter II:
"Acute care"
means care provided by a home
					 health agency for clients who are not medically stable or have not attained a
					 satisfactory level of rehabilitation. These clients require frequent
					 intervention by a registered nurse or licensed therapist.
"Authorized practitioner"
means:
(a) A physician, nurse practitioner, clinical
				  nurse specialist, or physician assistant who may order and conduct home health
				  services, including face-to-face encounter services; or
(b) A certified nurse midwife under
				  42 C.F.R.
				  440.70 when furnished by a home health agency
				  that meets the conditions of participation for medicare who may conduct home
				  health services, including face-to-face encounter services.
"Brief skilled nursing visit"
means a
					 registered nurse, or a licensed practical nurse under the supervision of a
					 registered nurse, performs only one of the following activities during a visit
					 to a client:
(a) An
				  injection;
(b) Blood draw;
				  or
(c) Placement of medications in
				  containers.
"Chronic care"
means long-term care for
					 medically stable clients.
"Electronic visit verification (EVV)"
means,
					 with respect to home health services, a system under which in-home visits
					 conducted as part of delivery of such services are electronically verified with
					 respect to:
(a) The type of service
				  performed;
(b) The individual
				  receiving the service;
(c) The date
				  of the service;
(d) The location of
				  service delivery;
(e) The
				  individual providing the service; and
(f) The time the service begins and
				  ends.
"Full skilled nursing visit"
means a
					 registered nurse, or a licensed practical nurse under the supervision of a
					 registered nurse, performs one or more of the following activities during a
					 visit to a client:
(a)
				  Observation;
(b)
				  Assessment;
(c)
				  Treatment;
(d) Teaching;
(e) Training;
(f) Management; and
(g) Evaluation.
"Home health agency"
means an agency or
					 organization that attests to the satisfaction of the medicaid agency that it
					 meets the requirements for participation in medicare or is certified under the
					 medicare program to provide comprehensive health care on an intermittent or
					 part-time basis to a patient in any setting where the patient's normal life
					 activities take place.
"Home health aide"
means a person registered
					 or certified as a nursing assistant under chapter 18.88 RCW who, under the
					 direction and supervision of a registered nurse or licensed therapist, assists
					 in the delivery of nursing or therapy related activities, or both.
"Home health aide services"
means services
					 provided by a home health aide only when a client has an acute, intermittent,
					 short-term need for the services of a registered nurse, physical therapist,
					 occupational therapist, or speech therapist who is employed by or under
					 contract with a home health agency. These services are provided under the
					 supervision of the previously identified authorized practitioners and include,
					 but are not limited to, ambulation and exercise, assistance with
					 self-administered medications, reporting changes in a client's condition and
					 needs, and completing appropriate records.
"Home health skilled services"
means skilled
					 health care (nursing, specialized therapy, and home health aide) services
					 provided on an intermittent or part-time basis by a home health agency. See
					 also WAC 182-551-2000.
"Long-term care"
is a generic term referring
					 to various programs and services, including services provided in home and
					 community settings, administered directly or through contract by the department
					 of social and health services' (DSHS) division of developmental disabilities
					 (DDD) or aging and long-term support administration (ALTSA) through home and
					 community services (HCS).
"Medical social services"
are services
					 delivered by a medical social worker that are intended to resolve social or
					 emotional problems that are expected to be an impediment to the effective
					 treatment of the client's medical condition or rate of recovery.
"Medical social worker"
has the same meaning
					 given for "social worker" in WAC
					 246-335-510.
"Plan of care (POC)"
(also known as
"plan of treatment (POT)"
) means a written plan of care that is
					 established and periodically reviewed and signed by both an authorized
					 practitioner and a home health agency provider. The plan describes the home
					 health care to be provided in any setting where the client's normal life
					 activities take place. See WAC
					 182-551-2210.
"Review period"
means the three-month period
					 the medicaid agency assigns to a home health agency, based on the address of
					 the agency's main office, during which the medicaid agency reviews all claims
					 submitted by that home health agency.
"Specialized therapy"
means skilled therapy
					 services provided to clients that include:
(a) Physical;
(b) Occupational; or
(c) Speech/audiology services.
(See WAC
					 182-551-2110.)
"Telemedicine"
- See WAC
					 182-501-0300 and
					 182-551-2125.
11-14-075, recodified as §
												182-551-2010, filed 6/30/11,
						effective 7/1/11. Statutory Authority:
						RCW
						74.08.090, chapter 74.09 RCW, and 2009 c 326.
						10-10-087, § 388-551-2010, filed 5/3/10, effective 6/3/10. Statutory
						Authority:
						RCW
						74.08.090,
						74.09.520,
						74.09.530, and
						74.09.500. 02-15-082, §
						388-551-2010, filed 7/15/02, effective 8/15/02. Statutory Authority:
						RCW
						74.08.090 and
						74.09.530. 99-16-069, §
						388-551-2010, filed 8/2/99, effective
						9/2/99.