16 Del. Admin. Code § 3350-1.0

Current through Register Vol. 28, No. 5, November 1, 2024
Section 3350-1.0 - Definitions
1.1 The following words and terms, when used in this regulation, should have the following meaning unless the context clearly indicates otherwise:

"Activities of daily living" means the tasks for self-care which are performed either independently, with supervision or with assistance. Activities of daily living include ambulating, transferring, grooming, bathing, dressing, eating and toileting.

"Agency" means a home health agency licensed by the Department.

"Allowable provider" means a person currently licensed as an advanced practice nurse pursuant to 24 Del.C. Ch. 17, or a person currently licensed as a physician's assistant pursuant to 24 Del.C. Ch. 19.

"Audiologist" means an individual who is licensed to practice audiology pursuant to 24 Del.C. Ch. 37 and who offers the services to the public under any title or description of services incorporating the words "audiologist", "hearing clinician", "hearing therapist", "aural rehabilitator" or any other similar title or description of service.

"Audiology aide" means an individual who is certified by the Council of Accreditation of Occupational Hearing Conservationists pursuant to 24 Del.C. Ch. 37 and who performs services only under the direct supervision of an audiologist licensed in this State.

"Audiology services" means those services defined pursuant to 24 Del.C. Ch. 37.

"Bylaws" means a set of rules adopted by a home health agency for governing the agency's operation.

"Caregivers" means those individuals employed by or under contract to a home health agency to provide personal care services or health care services to patients.

"Change of ownership (CHOW)" see "Modification of ownership and control (MOC)".

"Clinical Director" means a registered nurse who is sufficiently qualified to provide general supervision and direction of the services offered by the home health agency and who has at least one year of home health care experience and at least one year of administrative or supervisory health care experience. The "Clinical Director" and "Director" may be the same individual if that individual is dually qualified.

"Companion" means a person who provides social interaction for an individual primarily in her/his place of residence. A companion may provide such services as cooking, housekeeping, errands, etc.

"Complaint" means a formal or informal written or verbal notification of patient issues that can be immediately addressed by staff who are present at the time of the complaint.

"Contractor" means an entity or individual that does not meet the definition of employee, who holds a valid business license and provides services for the agency.

"Department" means the Delaware Department of Health and Social Services.

"Dietitian" means an individual who engages in the provision of nutrition services pursuant to 24 Del.C. Ch. 38. The terms nutritionist and dietitian are used interchangeably.

"Director" means the individual appointed by the governing body to act on its behalf in the overall management of the home health agency. The director shall:

(1) Have a baccalaureate degree with five years health care experience and at least one year supervisory experience (full-time or equivalent) in home health care, or
(2) Be a registered nurse with five years health care experience and at least one year of supervisory experience (full-time or equivalent) in home health care.

"Full-time" means the established business hours of the home health agency.

"Governing Body or Other Legal Authority" means the individual, partnership, agency, group, or corporation designated to assume full legal responsibility for the policy determination, management, operation and financial liability of the home health agency.

"Grievance" means a formal or informal written or verbal complaint that is made to the agency by a patient, or the patient's representative. A grievance cannot be immediately resolved by staff present at the time of the complaint.

"Health care experience" means the direct participation of an individual in the maintenance or improvement of health via the prevention, diagnosis, treatment, recovery, or cure of disease, illness, injury, and other physical and mental impairments in patients.

"Health care facility" means any facility that is licensed under 16 Del.C. Ch. 10 or 11.

"Home health agency" or "HHA" means any business entity or sub-division thereof, whether public or private, proprietary or not-for-profit, which provides, to an individual primarily in their place of residence, two (2) or more home care services, one of which must be either licensed nursing services or home health aide services.

"Home health aide" means a non-licensed person who provides personal care services, companion services, homemaker services and who may perform tasks delegated by a licensed nurse as permitted by 24 Del.C. Ch. 19. A home health aide (A) has at least one year of practical experience in a Department licensed or approved hospital, nursing home, or home care setting; or (B) has satisfactorily completed an appropriate home care course which includes the training requirements contained within these regulations; or (C) is a student nurse pursuing a degree in nursing who has completed the clinical practicum portion of their training.

"Home health aide care plan" means a written plan developed by the nurse or professional therapist that specifies the tasks that are to be performed by the aide primarily in the patient's residence. The written plan specifies scope, frequency and duration of services.

"Home health aide services" means services, provided to an individual primarily in their place of residence, that are limited to personal care services, companion services, homemaker services, medication reminders and tasks delegated by a licensed nurse as permitted by 24 Del.C. Ch. 19.

"Home health care experience" means the provision of services by a home health agency to meet the needs of patients being cared for in their residence for an illness or injury.

"Home health care services" means services, provided to an individual primarily in her/his place of residence, that include but are not limited to:

(A) licensed nursing services;
(B) physical therapy services;
(C) speech therapy services;
(D) audiology services;
(E) occupational therapy services;
(F) nutritional services;
(G) social services; or
(H) home health aide services.

"Homemaker" means a person who performs household chores for an individual primarily in her/his place of residence. Household chores may include but are not necessarily limited to housekeeping, meal preparation and shopping.

"Immediate jeopardy" means a crisis situation in which the health and safety of patients is at risk. It is a deficient practice which indicates an inability to furnish safe care and services.

"Legal entity" means a business organizational structure that is recognized as such by 6 Del.C. or 8 Del.C.

"License" means a license issued by the Department.

"Licensed clinical social worker" means an individual licensed pursuant to 24 Del.C. Ch. 39.

"Licensed nursing services" means those services defined pursuant to 24 Del.C. Ch. 19.

"Licensee" means the individual, corporation or legal entity with whom rests the ultimate responsibility for maintaining approved standards for the home health agency.

"Located" means the physical address of the agency's business office.

"Majority interest" means the largest percentage of ownership interest.

"Medication reminder" means a verbal prompt to the patient to take their medication. A medication reminder does not include the administration or any physical touching of the medication.

"Minority interest" means any percentage of ownership less than the majority interest.

"Modification of ownership and control (MOC)" means the sale, purchase, transfer or re-organization of ownership rights.

"Nurse" means an individual who is currently licensed to practice nursing pursuant to 24 Del.C. Ch. 19.

"Nutritional services" means those services defined pursuant to 24 Del.C. Ch. 38.

"Occupational therapist" means an individual who is currently licensed to practice occupational therapy pursuant to 24 Del.C. Ch. 20 and who offers the services to the public under any title incorporating the words "occupational therapy," "occupational therapist" or any similar title or description of occupational therapy services.

"Occupational therapist assistant" means an individual licensed to assist in the practice of occupational therapy pursuant to 24 Del.C. Ch. 20, under the supervision of an occupational therapist.

"Occupational therapy services" means those services defined pursuant to 24 Del.C. Ch. 20.

"Office" means the physical location in which the business of the home health agency is conducted and in which the records of personnel, contractors and patients of the agency are stored. The office shall be located in the State of Delaware.

"Owner" means an individual or legal entity with ownership rights of the agency.

"Ownership" means the state or fact of exclusive possession and control of the agency.

"Ownership interest" means the percentage of ownership an individual or legal entity possesses.

"Patient" means the individual receiving home health agency services as defined in this chapter.

"Patient record" means a written account of all services provided to a patient by the home health agency, as well as other pertinent information necessary to provide care.

"Personal care services" means the provision of services that do not require the judgment and skills of a licensed nurse or other professional. The services are limited to individual assistance with/or supervision of activities of daily living, companion services, transportation services, homemaker services, reporting changes in patient's condition and completing reports.

"Physical therapist" means an individual who is currently licensed to practice physical therapy pursuant to 24 Del.C. Ch. 26.

"Physical therapist assistant" means an individual who assists licensed physical therapists pursuant to 24 Del.C. Ch. 26.

"Physical therapy services" means those services defined pursuant to 24 Del.C. Ch. 26.

"Physician" means an individual currently licensed as such by 24 Del.C. Ch. 17.

"Plan of care" means a written plan that specifies scope, frequency and duration of services.

"Plan of correction" means a home health agency's written response to findings of regulatory non-compliance. Plans must adhere to the format specified by the licensing agency, must include acceptable timeframes in which deficiencies will be corrected and must be approved by the licensing agency.

"Professional" means a person currently licensed in the State as an advance practice nurse, registered nurse, physician, physician assistant, physical therapist, occupational therapist, speech therapist, dentist, dietitian, social worker, respiratory care practitioner or psychologist.

"Professional therapy" means those services provided by a licensed professional in one of the following areas: physical therapy, occupational therapy, speech therapy, audiology or nutrition.

"Qualified professional" means an occupational therapist, a physical therapist, or a speech/language pathologist.

"Representative" means a person acting on behalf of the patient under Delaware law.

"Residence" means the domicile of the patient either personally owned by that patient or considered the place of residence of that patient where the home health care services will be provided.

"Service area" means the county in the state of Delaware in which the agency office is located and may also include the county or counties in the state of Delaware which are immediately adjacent.

"Serious injury" means physical injury that creates a substantial risk of death, or that causes serious disfigurement, serious impairment of health or serious loss or impairment of the function of any bodily organ.

"Skilled services" means those services provided directly by a licensed professional for the purpose of promoting, maintaining, or restoring the health of an individual or to minimize the effects of injury, illness or disability. Skilled services must be ordered by a physician or an allowable provider.

"Social services" means activity designed to promote social well-being. The services provided by the social worker depend on the needs of the patient. The social worker acts as an advocate to secure the patient's rights, directly counsels the patient and the patent's family, and refers the patient to other social agencies, community resources or facilities that can meet the patient's immediate and long-term needs.

"Social worker" means an individual who has met the requirements of a graduate curriculum, leading to a master's degree, in a school of social work that is accredited by the council on Social Work Education.

"Social work assistant" means an individual with a baccalaureate degree in social work, psychology, sociology or other related field and has had at least one (1) year of social work experience in a health care setting or has an associate degree in psychology, sociology or other related field and has had at least two (2) years of social work experience in a health care setting. This individual works under the supervision of a social worker.

"Speech/language pathologist" means an individual who is currently licensed pursuant to 24 Del.C. Ch. 37 and who offers the services to the public under any title or description of services incorporating the words "speech/language pathologist," "speech pathologist," "language pathologist," "speech and/or language therapist," "speech and/or language correctionist," "speech and/or language clinician," "voice therapist," "communicologist," "aphasiologist" or any other similar title or description of service.

"Speech pathology aide" means an individual who meets minimum qualifications pursuant to 24 Del.C. Ch. 37, which permit a speech pathology aide to assist speech/language pathologists in their professional endeavors, but only while under the direct supervision of a licensed speech/language pathologist.

"Speech therapy services" means those services defined pursuant to 24 Del.C. Ch. 37.

"Supervision of services" means authoritative procedural guidance by a qualified person for the accomplishment of a function or activity with initial direction and periodic inspection of the actual act of accomplishing the function or activity.

"Telehealth Mechanism" means the use of information exchange from 1 site to another via an electronic interactive telecommunication system. Telehealth is provided with specialized equipment at each site including real-time streaming via the use of video streaming and audio equipment. The telecommunications must permit real-time encryption of the interactive audio and video exchanges with the home health agency. The consumer must consent to the use of telehealth.

16 Del. Admin. Code § 3350-1.0

12 DE Reg. 1217 (03/01/09)
18 DE Reg. 133(8/1/2014)
19 DE Reg. 849(3/1/2016)
25 DE Reg. 527(11/1/2021)
26 DE Reg. 912( 5/1/2023) (Emer.)
27 DE Reg. 44( 7/1/2023) (Final)