reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-405 - Applicability

Current through Register Vol. 24-14, July 15, 2024
The requirements in WAC
					 246-335-405 through 246-335-455
					 apply to all in-home services agencies licensed to provide home care
					 services.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-410 - Definitions-Home care

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout WAC
					 246-335-405 through
					 246-335-455 unless the context
					 clearly indicates otherwise:
(1)
				  "Certified home care aide" or "home care aide" means an individual credentialed
				  under chapters 18.88B RCW and 246-980 WAC.
(2) "Client" means an individual receiving
				  home care services.
(3)
				  "Comprehensive assessment reporting evaluation" or "CARE" means the DSHS
				  assessment tool used by case managers to document a client's functional
				  ability, determine eligibility for long-term care services, evaluate what and
				  how much assistance a client will receive, and develop a plan of
				  care.
(4) "Home care agency" means
				  a person administering or providing home care services directly or through a
				  contract arrangement to individuals in places of permanent or temporary
				  residence. A home care agency that provides delegated tasks of nursing under
				  RCW
				  18.79.260(3)(e) is not
				  considered a home health agency for purposes of this chapter.
(5) "Home care services" means nonmedical
				  services and assistance provided to ill, disabled, or vulnerable individuals
				  that enable them to remain in their residences. Home care services include, but
				  are not limited to: Personal care such as assistance with dressing, feeding,
				  and personal hygiene to facilitate self-care; homemaker assistance with
				  household tasks, such as housekeeping, shopping, meal planning and preparation,
				  and transportation; respite care assistance and support provided to the family;
				  or other nonmedical services or delegated tasks of nursing under
				  RCW
				  18.79.260(3)(e).
(6) "Long-term care worker" means an
				  individual providing hands-on personal care services to the elderly or persons
				  with disabilities according to
				  RCW
				  74.39A.009. A long-term care worker employed
				  by a home care agency is either credentialed as a certified home care aide
				  under chapters 18.88A RCW and 246-980 WAC or meets the exemption criteria
				  according to chapter 246-980 WAC.
(7) "Supervisor of direct care services"
				  means an individual responsible for services that support the plan of care
				  provided by an in-home services agency licensed to provide home care
				  services.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-415 - Plan of operation

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and implement a
					 plan of operation which includes:
(1)
				  A description of the organizational structure;
(2) Personnel job descriptions according to
				  WAC 246-335-425(2);
(3) Responsibilities of contractors and
				  volunteers;
(4) Services to be
				  provided;
(5) The days and hours of
				  agency operation; and
(6) Criteria
				  for management and supervision of home care services throughout all approved
				  service areas, which includes:
(a) How the
				  initial intake and development of the plan of care will be completed per WAC
				  246-335-440;
(b) How supervision of personnel and
				  volunteers and monitoring of services provided by contractors will occur which
				  meet the requirements of WAC
				  246-335-445;
(c) How performance evaluations for personnel
				  and volunteers and evaluation of services provided by contractors will be
				  conducted per WAC
				  246-335-425(13) and
				  (14); and
(d) How the quality improvement program
				  required in WAC
				  246-335-455 will be applied
				  throughout all approved service areas.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-420 - Delivery of services

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and operationalize
					 delivery of services policies and procedures that describe:
(1) Admission, transfer, discharge, and
				  referral processes:
(a) In order to minimize
				  the possibility of client abandonment, clients must be given at least a
				  forty-eight hour written or verbal notice prior to discharge that will be
				  documented in the client record;
(b) Forty-eight hour notice is not required
				  if home care agency worker safety, significant client noncompliance, or
				  client's failure to pay for services rendered are the reason(s) for the
				  discharge;
(c) A home care agency
				  discharging a client that is concerned about their ongoing care and safety may
				  submit a self-report to appropriate state agencies which identifies the reasons
				  for discharge and the steps taken to mitigate safety concerns;
(d) Home care agencies under contract with
				  DSHS or the AAA may follow different time frames for notice of discharge as
				  established in the terms of the contract.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-425 - Personnel, contractor, and volunteer policies

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and operationalize
					 personnel, contractor, and volunteer policies and procedures that
					 describe:
(1) Employment criteria
				  regarding discrimination consistent with chapter 49.60 RCW;
(2) Job descriptions that contain
				  responsibilities and are consistent with health care professional credentialing
				  and scope of practice as defined in relevant practice acts and rules;
(3) References for personnel, contractors and
				  volunteers;
(4) Contracting process
				  when using a contractor. The contract should include, at minimum, a description
				  of the duties the contractor will perform, and a statement indicating that the
				  contractor, not the employer, is responsible for withholding any necessary
				  taxes. As with personnel and volunteers, contractors are subject to all
				  applicable requirements in this chapter;
(5) Credentials of health care professionals
				  that are current and in good standing;
(6) Criminal history background checks and
				  disclosure statements for personnel, contractors, volunteers, students, and any
				  other individual associated with the licensee having direct contact with
				  children under sixteen years of age, people with developmental disabilities or
				  vulnerable persons according to
				  RCW
				  43.43.830 through
				  43.43.842 and the following:
(a) Criminal history background checks must
				  be processed through the Washington state patrol (WSP);
(b) Disclosure statements must be approved by
				  the department; and
(c) All
				  criminal history background checks and disclosure statements required under
				  this chapter must be renewed within two years from the date of the previous
				  check;
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-430 - Personnel, contractor, and volunteer records

Current through Register Vol. 24-14, July 15, 2024
The licensee must maintain records on all personnel and
					 volunteers and have access to records on all contractors to include:
(1) Current practice certification,
				  credential, licensure, or documentation that noncredentialed long-term care
				  workers meet the exemption criteria in chapter 246-980 WAC, as applicable;
(2) Documentation of
				  references;
(3) Evidence of
				  orientation to current agency policies and procedures;
(4) Contracts when using
				  contractors;
(5) Verification of
				  personnel, contractor, and volunteer skills or training specific to meeting the
				  care needs of clients;
(6) Evidence
				  of initial and subsequent criminal history background checks and disclosure
				  statements according to
				  RCW
				  43.43.830 through
				  43.43.842 and this
				  chapter;
(7) Training on current
				  and revised agency policies and procedures, including client care
				  issues;
(8) Documentation for
				  personnel, contractors, and volunteers who prepare food for the client
				  independent of the client's assistance, including:
(a) A current food worker card per chapter
				  246-215 WAC; or
(b) Training
				  equivalent to United States Food and Drug Administration; or
(c) Home care aide certification for
				  personnel, contractors, and volunteers involved in food preparation services on
				  behalf of clients.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-440 - Home care plan of care

Current through Register Vol. 24-14, July 15, 2024
Except as provided in subsections (5) and (6) of this
					 section, the licensee must:
(1)
				  Develop and implement a written home care plan of care for each client with
				  input and written approval by the client, designated family member, or legal
				  representative;
(2) Ensure each
				  plan of care is developed by appropriately trained or credentialed agency
				  personnel, lists services requested or recommended to meet client needs, and is
				  based on an on-site visit and according to agency policies and
				  procedures;
(3) Ensure the home
				  care plan of care includes:
(a) The client's
				  functional limitations;
(b)
				  Nutritional needs and food allergies for meal preparation;
(c) Home medical equipment and supplies
				  relevant to the plan of care;
(d)
				  Indication that the client has a signed advanced directive or POLST, if
				  applicable;
(e) Nurse delegation
				  tasks, if applicable; and
(f)
				  Specific nonmedical services to be provided and their frequency.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-445 - Supervision of home care services

Current through Register Vol. 24-14, July 15, 2024
(1)
				  The licensee must employ a supervisor of direct care services;
(2) The supervisor of direct care services
				  must designate in writing a similarly qualified alternate to act in the
				  supervisor's absence;
(3) The
				  licensee shall ensure the supervisor of direct care services and the designated
				  alternate completes a minimum of ten hours of training annually. Training must
				  be documented and maintained in the personnel files. Training may include a
				  combination of topics related to supervisory duties and the delivery of home
				  care services. Examples of appropriate training include, but are not limited
				  to:
(a) Agency sponsored
				  in-services;
(b) Community
				  venues;
(c) Community
				  classes;
(d) Conferences;
(e) Seminars;
(f) Continuing education related to the
				  supervisor's professional credential, if applicable; and
(g) Supervisory responsibilities in the event
				  of a natural disaster, man-made incident, or public health emergency.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-450 - Client records

Current through Register Vol. 24-14, July 15, 2024
The licensee must:
(1) Maintain a current record for each client
				  consistent with chapter 70.02 RCW;
(2) Ensure that client records are:
(a) Accessible in the licensee's office
				  location for review by appropriate direct care personnel, volunteers,
				  contractors, and the department;
(b) Written legibly in permanent ink or
				  retrievable by electronic means;
(c) On the licensee's standardized forms or
				  electronic templates;
(d) In a
				  legally acceptable manner;
(e) Kept
				  confidential;
(f) Chronological in
				  its entirety or by the service provided;
(g) Fastened together to avoid loss of record
				  contents (paper documents); and
(h)
				  Kept current with all documents filed according to agency time frames per
				  agency policies and procedures.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 2 - Requirements Specific to Home Care Agency Services › Section 246-335-455 - Quality improvement program

Current through Register Vol. 24-14, July 15, 2024
Every home care licensee must develop and operationalize a
					 quality improvement program to ensure the quality of care and services provided
					 throughout all approved service areas including, at a minimum:
(1) A complaint process that includes a
				  procedure for the receipt, investigation, and disposition of complaints
				  regarding services provided;
(2) A
				  method to identify, monitor, evaluate, and correct problems identified by
				  clients, families, personnel, contractors, or volunteers; and
(3) A system to assess client satisfaction
				  with the overall services provided by the agency.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-505 - Applicability

Current through Register Vol. 24-14, July 15, 2024
The requirements in WAC
					 246-335-505 through 246-335-560
					 apply to all in-home services agencies licensed to provide home health
					 services.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-510 - Definitions-Home health

Current through Register Vol. 24-14, July 15, 2024
The definitions in the section apply throughout WAC
					 246-335-505 through
					 246-335-560 unless the context
					 clearly indicates otherwise:
(1)
				  "Acute care" means care provided by an in-home services agency licensed to
				  provide home health services for patients who are not medically stable or have
				  not attained a satisfactory level of rehabilitation. These patients require
				  frequent monitoring by a registered nurse licensed under chapter 18.79 RCW, a
				  physical therapist licensed under chapter 18.74 RCW, a respiratory therapist
				  licensed under chapter 18.89 RCW, an occupational therapist licensed under
				  chapter 18.59 RCW, a speech therapist licensed under chapter 18.35 RCW, a
				  dietitian or nutritionist as defined in subsection (5) of this section, or
				  social worker licensed under chapter 18.320 RCW to assess health status and
				  progress.
(2) "Assessment" means an
				  evaluation performed by an appropriate health care professional of a patient's
				  needs.
(3) "Audio-only
				  telemedicine" means the delivery of health care services through the use of
				  HIPAA-compliant audio-only technology (including web-based applications),
				  permitting real-time communication between the patient and the agency provider
				  for the purpose of consultation, education, diagnosis, or treatment, as
				  appropriate per scope of practice. "Audio-only telemedicine" also includes
				  supervision of home health aide services to evaluate compliance with the plan
				  of care and patient satisfaction with care. "Audio-only telemedicine" does not
				  include the use of facsimile, electronic mail, or text messages.
(4) "Authorizing practitioner" means the
				  individual practitioners licensed in Washington state, or another state
				  according to the exemption criteria established in chapters 18.57, 18.71, and
				  18.79 RCW, and authorized to approve a home health plan of care:
(a) A physician licensed under chapter 18.57
				  or 18.71 RCW;
(b) A podiatric
				  physician and surgeon licensed under chapter 18.22 RCW;
(c) A physician assistant licensed under
				  chapter 18.71A RCW; or
(d) An
				  advanced registered nurse practitioner (ARNP), as authorized under chapter
				  18.79 RCW.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-515 - Plan of operation

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and implement a
					 plan of operation which includes:
(1)
				  A description of the organizational structure;
(2) Personnel job descriptions according to
				  WAC 246-335-525(2);
(3) Responsibilities of contractors and
				  volunteers;
(4) Services to be
				  provided;
(5) The days and hours of
				  agency operation;
(6) Criteria for
				  management and supervision of home health services throughout all approved
				  service areas, which include:
(a) How the
				  initial assessment and development of the plan of care will be completed per
				  WAC 246-335-540;
(b) How supervision of personnel and
				  volunteers and monitoring of services provided by contractors will occur which
				  meet the requirements of WAC
				  246-335-545;
(c) How performance evaluations for personnel
				  and volunteers and evaluation of services provided by contractors will be
				  conducted per WAC
				  246-335-525(16) and
				  (17); and
(d) How the quality improvement program
				  required in WAC
				  246-335-555 will be applied
				  throughout all approved service areas.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-520 - Delivery of services

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and operationalize
					 delivery of services policies and procedures that describe:
(1) Admission, transfer, discharge, and
				  referral processes:
(a) In order to minimize
				  the possibility of patient abandonment, patients must be given at least a
				  forty-eight hour written or verbal notice prior to discharge that will be
				  documented in the patient record;
(b) Forty-eight hour notice is not required
				  if home health agency worker safety, significant patient noncompliance, or
				  patient's failure to pay for services rendered are the reason(s) for the
				  discharge;
(c) A home health agency
				  discharging a patient that is concerned about their ongoing care and safety may
				  submit a self-report to appropriate state agencies which identifies the reasons
				  for discharge and the steps taken to mitigate safety concerns;
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-525 - Personnel, contractor, and volunteer policies

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and operationalize
					 personnel, contractor, and volunteer policies and procedures that
					 describe:
(1) Employment criteria
				  regarding discrimination consistent with chapter 49.60 RCW;
(2) Job descriptions that contain
				  responsibilities and are consistent with health care professional credentialing
				  and scope of practice as defined in relevant practice acts and rules;
(3) References for personnel, contractors and
				  volunteers;
(4) Contracting process
				  when using a contractor. The contract should include, at minimum, a description
				  of the duties the contractor will perform, and a statement indicating that the
				  contractor, not the employer, is responsible for withholding any necessary
				  taxes. As with personnel and volunteers, contractors are subject to all
				  applicable requirements in this chapter;
(5) Credentials of health care professionals
				  that are current and in good standing;
(6) Criminal history background checks and
				  disclosure statements for personnel, contractors, volunteers, students, and any
				  other individual associated with the licensee having direct contact with
				  children under sixteen years of age, people with developmental disabilities or
				  vulnerable persons, according to
				  RCW
				  43.43.830 through
				  43.43.842 and the following:
(a) Criminal history background checks must
				  be processed through the Washington state patrol;
(b) Disclosure statements must be approved by
				  the department; and
(c) All
				  criminal history background checks and disclosure statements required under
				  this chapter must be renewed within two years from the date of the previous
				  check;
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-530 - Personnel, contractor, and volunteer records

Current through Register Vol. 24-14, July 15, 2024
The licensee must maintain records on all personnel and
					 volunteers and have access to records on all contractors, to include:
(1) Current practice certification,
				  credential or licensure, as applicable;
(2) Documentation of references;
(3) Contracts when using
				  contractors;
(4) Evidence of
				  orientation to current agency policies and procedures;
(5) Verification of personnel, contractor,
				  and volunteer skills or training specific to meeting the care needs of
				  patients;
(6) Documentation that
				  personnel and contractors holding a nursing assistant registration became
				  credentialed as a nursing assistant certified under chapter 246-841 WAC within
				  twelve months of the date of hire or met the exemption criteria in WAC
				  246-335-525(10)(c);
(7) Evidence of initial and subsequent
				  criminal history background checks and disclosure statement(s) according to
				  RCW
				  43.43.830 through
				  43.43.842 and this
				  chapter;
(8) Training on current
				  and revised agency policies and procedures, including patient care
				  issues;
(9) Current CPR training
				  for direct care personnel and contractors;
(10) Documentation for personnel,
				  contractors, and volunteers who prepare food for the patient independent of the
				  patient's assistance, including:
(a) A
				  current food worker card per chapter 246-215 WAC; or
(b) Training equivalent to United States Food
				  and Drug Administration for personnel, contractors, and volunteers involved in
				  food preparation services on behalf of patients;
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-540 - Home health plan of care

Current through Register Vol. 24-14, July 15, 2024
Except as provided in subsections (5) and (6) of this
					 section, the licensee must:
(1)
				  Develop and implement a written home health plan of care for each patient with
				  input from the patient, designated family member, or legal representative and
				  authorizing practitioner;
(2)
				  Ensure each plan of care is developed by appropriately trained or credentialed
				  agency personnel and is based on a patient assessment;
(3) Ensure the home health plan of care
				  includes:
(a) Current diagnoses and
				  information on health status;
(b)
				  Goals and outcome measures which are individualized for the patient;
(c) Types and frequency of services to be
				  provided;
(d) Palliative care, if
				  applicable;
(e) Use of telehealth
				  or telemedicine, if applicable;
(f)
				  Home medical equipment and supplies used by the patient;
(g) Orders for treatments and their frequency
				  to be provided and monitored by the licensee;
(h) Special nutritional needs and food
				  allergies;
(i) Orders for
				  medications to be administered and monitored by the licensee including name,
				  dose, route, and frequency;
(j)
				  Medication allergies;
(k) The
				  patient's physical, cognitive and functional limitations;
(l) Discharge and referral plan;
(m) Patient and family education needs
				  pertinent to the care being provided by the licensee;
(n) Indication that the patient has a signed
				  advanced directive or POLST, if applicable. Include resuscitation status
				  according to advance directives or POLST, if applicable; and
(o) The level of medication assistance to be
				  provided.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-545 - Supervision of home health services

Current through Register Vol. 24-14, July 15, 2024
(1)
				  A licensee must employ a director of clinical services.
(2) The director of clinical services must
				  designate in writing a similarly qualified alternate to act in the director's
				  absence.
(3) The licensee shall
				  ensure the director of clinical services and the designated alternate completes
				  a minimum of 10 hours of training annually. Written documentation of trainings
				  must be available upon request by the department. Training may include a
				  combination of topics related to clinical supervision duties and the delivery
				  of home health services. Examples of appropriate training include, but are not
				  limited to:
(a) Agency sponsored
				  in-services;
(b) Community
				  venues;
(c) Community
				  classes;
(d) Conferences;
(e) Seminars;
(f) Continuing education related to the
				  director's health care professional credential, if applicable; and
(g) Supervisory responsibilities in the event
				  of a natural disaster, man-made incident, or public health emergency.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-550 - Patient records

Current through Register Vol. 24-14, July 15, 2024
The licensee must:
(1) Maintain a current record for each
				  patient consistent with chapter 70.02 RCW;
(2) Ensure that patient records are:
(a) Accessible in the licensee's office
				  location for review by appropriate direct care personnel, volunteers,
				  contractors, and the department;
(b) Written legibly in permanent ink or
				  retrievable by electronic means;
(c) On the licensee's standardized forms or
				  electronic templates;
(d) In a
				  legally acceptable manner;
(e) Kept
				  confidential;
(f) Chronological in
				  its entirety or by the service provided;
(g) Fastened together to avoid loss of record
				  contents (paper documents); and
(h)
				  Kept current with all documents filed according to agency time frames per
				  agency policies and procedures.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-555 - Quality improvement program

Current through Register Vol. 24-14, July 15, 2024
Every home health licensee must develop and operationalize
					 a quality improvement program to ensure the quality of care and services
					 provided throughout all approved service areas including, at a minimum:
(1) A complaint process that includes a
				  procedure for the receipt, investigation, and disposition of complaints
				  regarding services provided;
(2) A
				  method to identify, monitor, evaluate, and correct problems identified by
				  patients, families, personnel, contractors, or volunteers; and
(3) A system to assess patient satisfaction
				  with the overall services provided by the agency.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 3 - Requirements Specific to Home Health Agency Services › Section 246-335-560 - Home medical supplies and equipment

Current through Register Vol. 24-14, July 15, 2024
This section applies to home health agencies providing or
					 contracting for medical supplies or equipment services.
(1) The applicant or licensee must develop
				  and implement policies and procedures to:
(a)
				  Maintain medical supplies and equipment;
(b) Clean, inspect, repair and calibrate
				  equipment per the manufacturers' recommendations, and document the date and
				  name of individual conducting the activity;
(c) Ensure safe handling and storage of
				  medical supplies and equipment;
(d)
				  Inform the patient, designated family member, or legal representative of the
				  cost and method of payment for equipment, equipment repairs and equipment
				  replacement;
(e) Document the
				  patient, designated family member, or legal representative's
				  approval;
(f) Instruct each
				  patient, designated family member, or legal representative to use and maintain
				  supplies and equipment in a language or format the patient or family
				  understands, using one or more of the following:
(i) Written instruction;
(ii) Verbal instruction; or
(iii) Demonstration.
(g) Document the patient, designated family
				  member, or legal representative understanding of the instructions
				  provided;
(h) Replace supplies and
				  equipment essential for the health or safety of the patient; and
(i) Identify and replace equipment recalled
				  by the manufacturer.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-605 - Applicability

Current through Register Vol. 24-14, July 15, 2024
The requirements in WAC
					 246-335-605 through 246-335-660
					 apply to all in-home services agencies licensed to provide hospice
					 services.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-610 - Definitions-Hospice

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout WAC
					 246-335-605 through
					 246-335-660 unless the context
					 clearly indicates otherwise:
(1)
				  "Assessment" means an evaluation performed by an appropriate health care
				  professional of a patient's physical, psychosocial, emotional and spiritual
				  status related to their terminal illness and other health conditions. This
				  includes evaluating the caregiver's and family's willingness and capability to
				  care for the patient.
(2)
				  "Audio-only telemedicine" means the delivery of health care services through
				  the use of HIPAA-compliant audio-only technology (including web-based
				  applications), permitting real-time communication between the patient and the
				  agency provider for the purpose of consultation, education, diagnosis, or
				  treatment, as appropriate per scope of practice. "Audio-only telemedicine" also
				  includes supervision of home health aide services to evaluate compliance with
				  the plan of care and patient satisfaction with care. "Audio-only telemedicine"
				  does not include the use of facsimile, electronic mail, or text
				  messages.
(3) "Authorizing
				  practitioner" means the individual practitioners licensed in Washington state
				  and authorized to approve a hospice plan of care:
(a) A physician licensed under chapter 18.57
				  or 18.71 RCW; or
(b) An advanced
				  registered nurse practitioner as authorized under chapter 18.79 RCW.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-615 - Plan of operation

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and implement a
					 plan of operation which includes:
(1)
				  A description of the organizational structure;
(2) Personnel job descriptions according to
				  WAC 246-335-625(2);
(3) Responsibilities of contractors and
				  volunteers;
(4) Services to be
				  provided;
(5) The days and hours of
				  agency operation; and
(6) Criteria
				  for management and supervision of hospice services throughout all approved
				  service areas, which include:
(a) How the
				  initial assessment and development of the plan of care will be completed per
				  WAC 246-335-640;
(b) How supervision of personnel and
				  volunteers and monitoring of services provided by contractors will occur which
				  meet the requirements of WAC
				  246-335-645;
(c) How performance evaluations for personnel
				  and volunteers and evaluation of services provided by contractors will be
				  conducted per WAC
				  246-335-625(15) and
				  (16); and
(d) How the quality improvement program
				  required in WAC
				  246-335-655 will be applied
				  throughout all approved service areas.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-620 - Delivery of services

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and operationalize
					 policies and procedures that describe:
(1) Admission, transfer, discharge, and
				  referral processes:
(a) In order to minimize
				  the possibility of patient abandonment, patients must be given at least a
				  forty-eight hour written or verbal notice prior to discharge that will be
				  documented in the patient record;
(b) Forty-eight hour notice is not required
				  if hospice agency worker safety, significant patient noncompliance, or
				  patient's failure to pay for services rendered are the reason(s) for the
				  discharge;
(c) A Hospice agency
				  discharging a patient that is concerned about their ongoing care and safety may
				  submit a self-report to appropriate state agencies which identifies the reasons
				  for discharge and the steps taken to mitigate safety concerns;
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-625 - Personnel, contractor, and volunteer policies

Current through Register Vol. 24-14, July 15, 2024
The applicant or licensee must develop and operationalize
					 personnel, contractor, and volunteer policies and procedures that
					 describe:
(1) Employment criteria
				  regarding discrimination consistent with chapter 49.60 RCW;
(2) Job descriptions that contain
				  responsibilities and are consistent with health care professional credentialing
				  and scope of practice as defined in relevant practice acts and rules;
(3) References for personnel, contractors and
				  volunteers;
(4) Contracting process
				  when using a contractor. The contract should include, at minimum, a description
				  of the duties the contractor will perform, and a statement indicating that the
				  contractor, not the employer, is responsible for withholding any necessary
				  taxes. As with personnel and volunteers, contractors are subject to all
				  applicable requirements in this chapter;
(5) Credentials of health care professionals
				  that are current and in good standing;
(6) Criminal history background checks and
				  disclosure statements for personnel, contractors, volunteers, students, and any
				  other individual associated with the licensee having direct contact with
				  children under sixteen years of age, people with developmental disabilities, or
				  vulnerable persons according to
				  RCW
				  43.43.830 through
				  43.43.842 and the following:
(a) Criminal history background checks must
				  be processed through the Washington state patrol;
(b) Disclosure statements must be approved by
				  the department; and
(c) All
				  criminal history background checks and disclosure statements required under
				  this chapter must be renewed within two years from the date of the previous
				  check.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-630 - Personnel, contractor, and volunteer records

Current through Register Vol. 24-14, July 15, 2024
The licensee must maintain records on all personnel and
					 volunteers and have access to records on all contractors to include:
(1) Current practice certification,
				  credential or licensure, as applicable;
(2) Documentation of references;
(3) Evidence of orientation to current agency
				  policies and procedures;
(4)
				  Contracts when using contractors;
(5) Verification of personnel, contractor,
				  and volunteer skills or training specific to meeting the care needs of
				  patients;
(6) Evidence of initial
				  and subsequent criminal history background checks and disclosure statements
				  according to
				  RCW
				  43.43.830 through
				  43.43.842 and this
				  chapter;
(7) Training on current
				  and revised agency policies and procedures, including patient care
				  issues;
(8) Current CPR training
				  for direct care personnel and contractors;
(9) Documentation for personnel, contractors,
				  and volunteers who prepare food for the patient independent of the patient's
				  assistance, including:
(a) A current food
				  worker cards per chapter 246-215 WAC; or
(b) Training equivalent to United States Food
				  and Drug Administration for personnel, contractors, and volunteers involved in
				  food preparation services on behalf of patients;
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-640 - Hospice plan of care

Current through Register Vol. 24-14, July 15, 2024
Except as provided in subsection (5) of this section, the
					 licensee must:
(1) Develop and
				  implement a written hospice plan of care for each patient with input from the
				  authorizing practitioner, appropriate interdisciplinary team members, and the
				  patient, designated family member, or legal representative;
(2) Ensure each plan of care is developed by
				  appropriately trained or credentialed agency personnel and is based on a
				  patient and family assessment;
(3)
				  Ensure the hospice plan of care includes:
(a)
				  Current diagnoses and information on health status;
(b) Goals and outcome measures which are
				  individualized for the patient;
(c)
				  Symptom and pain management;
(d)
				  Types and frequency of services to be provided;
(e) Palliative care, if applicable;
(f) Use of telehealth or telemedicine, if
				  applicable;
(g) Home medical
				  equipment and supplies used by the patient;
(h) Orders for treatments and their frequency
				  to be provided and monitored by the licensee;
(i) Special nutritional needs and food
				  allergies;
(j) Orders for
				  medications to be administered and monitored by the licensee including name,
				  dose, route, and frequency;
(k)
				  Medication allergies;
(l) The
				  patient's physical, cognitive and functional limitations;
(m) Patient and family education needs
				  pertinent to the care being provided by the licensee;
(n) Indication that the patient has a signed
				  advanced directive or POLST, if applicable. Include resuscitation status
				  according to advance directives or POLST, if applicable; and
(o) The level of medication assistance to be
				  provided.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-645 - Supervision of hospice services

Current through Register Vol. 24-14, July 15, 2024
(1)
				  A licensee must employ a director of clinical services.
(2) The director of clinical services must
				  designate in writing a similarly qualified alternate to act in the director's
				  absence.
(3) The licensee shall
				  ensure the director of clinical services and the designated alternate completes
				  a minimum of 10 hours of training annually. Written documentation of trainings
				  must be available upon request by the department. Training may include a
				  combination of topics related to clinical supervision duties and the delivery
				  of hospice services. Examples of appropriate training include, but are not
				  limited to:
(a) Agency sponsored
				  in-services;
(b) Community
				  venues;
(c) Community
				  classes;
(d) Conferences;
(e) Seminars;
(f) Continuing education related to the
				  director's health care professional credential, if applicable; and
(g) Supervisory responsibilities in the event
				  of a natural disaster, man-made incident, or public health emergency.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-650 - Patient records

Current through Register Vol. 24-14, July 15, 2024
The licensee must:
(1) Maintain a current record for each
				  patient consistent with chapter 70.02 RCW;
(2) Ensure that patient records are:
(a) Accessible in the licensee's office
				  location for review by appropriate direct care personnel, volunteers,
				  contractors, and the department;
(b) Written legibly in permanent ink or
				  retrievable by electronic means;
(c) On the licensee's standardized forms or
				  electronic templates;
(d) In a
				  legally acceptable manner;
(e) Kept
				  confidential;
(f) Chronological in
				  its entirety or by the service provided;
(g) Fastened together to avoid loss of record
				  contents (paper documents); and
(h)
				  Kept current with all documents filed according to agency time frames per
				  agency policies and procedures.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-655 - Quality improvement program

Current through Register Vol. 24-14, July 15, 2024
Every hospice licensee must establish and implement a
					 quality improvement program to ensure the quality of care and services provided
					 throughout all approved service areas or within a hospice care center that
					 includes, at a minimum:
(1) A
				  complaint process that includes a procedure for the receipt, investigation, and
				  disposition of complaints regarding services provided;
(2) A method to identify, monitor, evaluate,
				  and correct problems identified by patients, families, personnel, contractors,
				  or volunteers; and
(3) A system to
				  assess patient satisfaction with the overall services provided by the
				  agency.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 4 - Requirements Specific to Hospice Agency Services › Section 246-335-660 - Home medical supplies and equipment

Current through Register Vol. 24-14, July 15, 2024
This section applies only to hospice agencies and hospice
					 care centers providing or contracting for medical supplies or equipment
					 services.
(1) The applicant or
				  licensee must develop and implement policies and procedures to:
(a) Maintain medical supplies and
				  equipment;
(b) Clean, inspect,
				  repair and calibrate equipment per the manufacturers' recommendations, and
				  document the date and name of individual conducting the activity;
(c) Ensure safe handling and storage of
				  medical supplies and equipment;
(d)
				  Inform the patient, designated family member, or legal representative of the
				  cost and method of payment for equipment, equipment repairs and equipment
				  replacement;
(e) Document the
				  patient, designated family member, or legal representative's
				  approval;
(f) Instruct each patient
				  or family to use and maintain supplies and equipment in a language or format
				  the patient or family understands, using one or more of the following:
(i) Written instruction;
(ii) Verbal instruction; or
(iii) Demonstration.
(g) Document the patient, designated family
				  member, or legal representative understanding of the instructions
				  provided;
(h) Replace supplies and
				  equipment essential for the health or safety of the patient; and
(i) Identify and replace equipment recalled
				  by the manufacturer.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 5 - Requirements Specific to Licensing and Operation of Hospice Care Centers › Section 246-335-705 - Applicability

Current through Register Vol. 24-14, July 15, 2024
The requirements in WAC
					 246-335-705 through 246-335-768
					 apply to hospice care center services.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-335 - In-home services agencies › Part 5 - Requirements Specific to Licensing and Operation of Hospice Care Centers › Section 246-335-710 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout WAC
					 246-335-705 through
					 246-335-768 unless the context
					 clearly indicates otherwise:
(1)
				  "Construction" means:
(a) New building(s) to
				  be used as a hospice care center;
(b) Addition(s) to or conversion(s), either
				  in whole or in part, of an existing building or buildings to be used as a
				  hospice care center or a portion thereof; or
(c) Alteration or modification to a hospice
				  care center.