Rule 111-8-31-.08 - Scope of ServicesA home health agency shall provide part-time or intermittent skilled nursing services and at least one other therapeutic service, e.g., physical, speech, or occupational therapy; medical social services; or home health aide services. Services shall be made available on a visiting basis, in a place of residence, as a patient's home.
(a) Nursing Services. A home health agency shall provide skilled nursing service by or under the supervision of a registered nurse and in accordance with the plan of treatment. 1. Duties of the Registered Nurse (RN). A registered nurse shall make the initial evaluation visit, regularly reevaluate the patient's nursing needs, initiate the plan of treatment and necessary revisions, provide those services requiring substantial specialized nursing skill, initiate appropriate preventive and rehabilitative nursing procedures, prepare clinical and progress notes, coordinate services inform the physician and other personnel of changes in the patient's condition and needs, counsel the patient and family in meeting nursing and related needs, participate in inservice programs, and supervise and teach other personnel.2. Duties of the Licensed Practical Nurse (LPN). The licensed practical nurse shall provide services in accordance with agency policies, prepare clinical and progress notes, assist the physician and/or registered nurse in performing specialized procedures, prepare equipment and materials for treatments observing aseptic technique as required and assist the patient in learning appropriate self-care techniques.(b) Therapy Services. All therapy services offered by the home health agency directly or under arrangement shall be given by a qualified therapist in accordance with the plan of treatment. The qualified therapist shall assist the physician in evaluating level of function, help develop the plan of treatment (revising as necessary), prepare clinical and progress notes, advise and consult with the family and other agency personnel, and participate in inservice programs. Therapy services include, but are not limited to:(c) Medical Social Services. Medical social services, when provided, shall be given by a qualified social worker in accordance with the plan of treatment. The social worker shall assist the physician and other team members in understanding the significant social and emotional factors related to the health problems, participate in the development of the plan of treatment, prepare clinical and progress notes, work with the family, utilize appropriate community resources, participate in discharge planning and inservice programs, and act as a consultant to other agency personnel.(d) Home Health Aide Services.1. Home health aides shall be selected on the basis of such factors as a sympathetic attitude toward the care of the sick; ability to read, write, and carry out directions; and maturity and ability to deal effectively with the demands of the job. Aides shall be carefully trained in at least the following areas: methods of assisting patients to achieve maximum self-reliance, principles of nutrition and meal preparation, the aging process and emotional problems of illness, procedures for maintaining a clean, healthful, and pleasant environment, recognizing changes in a patient's condition that should be reported, work of the agency and the health team; ethics, confidentiality, and recordkeeping. Aides shall be closely supervised to assure their competence in providing care.2. A home health aide shall be assigned to a particular patient by a registered nurse. Written instructions for patient care shall be prepared by a registered nurse or therapist as appropriate. Home health aide duties shall be limited to the performance of simple procedures such as an extension of therapy services, personal care, ambulation and exercise, household services essential to health care at home, assistance with medications that are ordinarily self-administered, reporting changes in the patient's condition and needs, and completing appropriate records.3. A registered nurse, or other appropriate professional staff member, if other services are provided, shall make a supervisory visit to the patient's residence at least every two weeks, either when the aide is present to observe and assist, or when an aide is absent, to assess relationships and determine whether goals are being met. A record of the supervisory visit shall be dated and documented by a clinical note in the patient clinical record.(e) Coordination of Patient Services. All personnel providing services shall maintain a liaison with the home health agency to assure that their efforts effectively complement one another and sup- port the objectives outlined in the plan of treatment. The clinical record shall contain dated minutes of case conferences verifying that effective interchange, reporting, and coordinated patient evaluation does occur. A written summary report of clinical and progress notes for each patient shall be sent to the attending physician at least every sixty (60) days and upon discharge. A copy of these reports shall become a permanent part of the patient's clinical record.(f) Services Under Arrangements. All services provided under arrangements shall be subject to a written contract. Contracts for home health services shall conform with the specific requirements of Rule 111-8-31.07(6)(a)through(g).Ga. Comp. R. & Regs. R. 111-8-31-.08
O.C.G.A. §§ 31-2-4et seq. and 31-7-150 et seq.
Original Rule entitled "Scope of Services" adopted. F. Feb. 20, 2013; eff. Mar. 12, 2013.