TITLE 22 REGULATIONS MEDICARE CONDITIONS OF PARTICIPATION ...

1 TITLE 22 side BY side COMPARISON CAHSAHTABLE OF CONTENTS i TITLE 22 REGULATIONS MEDICARE CONDITIONS OF PARTICIPATION Section Article 1 - Definitions Page Section Definitions Page Home Health 1 1 Public 1 Public 1 Private 1 Nonprofit Proprietary 1 2 2 2 Parent and Primary Home Health 2 Parent Home Health Primary Home Health 2 2 Branch 2 Branch 2 .. No TITLE 22 .. 3 .. No TITLE 22 .. Bylaws or 3 .. No TITLE 22 .. Clinical 3 .. No TITLE 22 .. Progress 3 .. No TITLE 22 .. Summary 3 .. No TITLE 22 .. 3 Personnel 4 4 Administrator, Home Health 4 4 4 4 .. No MEDICARE .

2 4 .. No MEDICARE .. 4 .. No MEDICARE .. 4 .. No MEDICARE .. Home Health 5 Home Health 5 Home Health 5 .. No MEDICARE .. 5 .. No MEDICARE .. 5 .. No MEDICARE .. Licensed Vocational 6 Practical (Vocational) 6 Occupational 6 Occupational 6 Occupational Therapist 6 Occupational Therapy 6 7 .. No MEDICARE .. Physical 7 Physical 7 Physical Therapist 8 Physical Therapy 8 8 8 8 .. No MEDICARE .. Public Health 8 Public Health 8 TITLE 22 side BY side COMPARISON CAHSAHTABLE OF CONTENTS ii TITLE 22 REGULATIONS MEDICARE CONDITIONS OF PARTICIPATION Section Article 1 - Definitions Continued Page Section Personnel Qualifications Continued Page Registered 9 Registered 9 Skilled Nursing Services Criteria for Licensure of Home Health 9.

3 No MEDICARE .. Social 10 Social 10 Social Work 10 Social Work 10 Speech 10 Speech-Language 10 Section Article 2 - License Page Section Condition/Standard Page CONDITION: Compliance with Federal, State, and Local Laws, Disclosure and Ownership Information, and Accepted Professional Standards and 11 License 11 (a).. Standard: Compliance with Federal, State and Local Laws and 11 Application for 11 .. No MEDICARE .. Special CONDITIONS for 12 .. No MEDICARE .. Operation of a Home Health Agency Across State 12 .. No MEDICARE .. Disclosure 13 (b).. Standard: Disclosure of Ownership and Management 13 Report of 13 (b).

4 See Above 13 14 .. No MEDICARE .. Issuance, Denial, Expiration and 15 .. No MEDICARE .. 16 .. No MEDICARE .. Separate 16 .. No MEDICARE .. Availability of 17 .. No MEDICARE .. Voluntary Suspension of 17 .. No MEDICARE .. Voluntary Cancellation of 18 .. No MEDICARE .. Revocation or Involuntary Suspension of 18 .. No MEDICARE .. Pursuing Disciplinary Action to 18 .. No MEDICARE .. TITLE 22 side BY side COMPARISON CAHSAHTABLE OF CONTENTS iii TITLE 22 REGULATIONS MEDICARE CONDITIONS OF PARTICIPATION Section Article 2 - License Continued Page Section Condition/Standard Continued Page Reinstatement of Revoked or Suspended 19.

5 No MEDICARE .. Program 19 .. No MEDICARE .. Section Article 3 - Services Page Section Condition/Standard Page (c).. Standard: Compliance with Accepted Professional Standards and 20 Preventive, Treatment and Rehabilitative 20 (a).. (g) Standard: Services Standard: Coordination of Patient Services 20 20 Requirements for Acceptance of 21 CONDITION: Acceptance of Patients, Plan of Care, and Medical 21 Plan of Treatment; Plan of Care; Plan for Personal Care 21 (a).. (b).. Standard: Plan of Standard: Periodic Review of Plan of Care. 21 21 CONDITION: Comprehensive Assessment of 22 (a).. Standard: Initial Assessment 22 (b).. Standard: Completion of the Comprehensive 23 (c).

6 Drug Regimen 23 (d).. Update of the Comprehensive 23 (e).. Incorporation of OASIS Data 24 CONDITION: Reporting OASIS 24 (a).. Standard: Encoding OASIS 24 (b).. Standard: Accuracy of Encoded OASIS 24 (c).. Standard: Transmittal of OASIS 24 (d).. Standard: Data 25 Orders for Medication and 25 (c).. Standard: Conformance with Physician s 25 Director of Patient Care 26 (d).. Standard: Supervising Physician or Registered 26 TITLE 22 side BY side COMPARISON CAHSAHTABLE OF CONTENTS iv TITLE 22 REGULATIONS MEDICARE CONDITIONS OF PARTICIPATION Section Article 3 - Services Continued Page Section Condition/Standard Continued Page Nurse 27.

7 No MEDICARE .. Skilled Nursing 28 CONDITION: Skilled Nursing 28 (a).. Standard: Duties of the Registered 28 (b).. Standard: Duties of the Licensed Practical 28 .. No TITLE 22 .. (j).. Standard: Laboratory 29 Home Health Aide/Personal Care Services 29 (d).. (a).. Standard: Standard: Supervision of Physical Therapy Assistant and Occupational Therapy 29 31 .. No TITLE 22 .. (e).. Personal Care Attendant: Evaluation 32 Personal Care/Home Health Aide 32 (c).. CONDITION: Home Health Aide Services Standard: Assignment and Duties of the Home Health 32 32 Therapy 33 (b).. CONDITION: Therapy Standard: Supervision of Speech Therapy 33 33 Medical Social 34 CONDITION: Medical Social 34 Diet Counseling 34.

8 No MEDICARE .. No TITLE 22 .. CONDITION: Qualifying to Furnish Outpatient Physical or Speech Pathology 35 Section Article 4 - Administration Page Section Condition/Standard Page Governing 36 (b).. Standard: Governing 36 36 (c).. Standard: 36 Services Arranged By 37 (h).. Standard: Services Under 37 CONDITION: Release of Patient Identifiable OASIS 37 (f).. Standard: Personnel Under Hourly or Per Visit 37 TITLE 22 side BY side COMPARISON CAHSAHTABLE OF CONTENTS v TITLE 22 REGULATIONS MEDICARE CONDITIONS OF PARTICIPATION Section Article 4 - Administration Continued Page Section Condition/Standard Continued Page.

9 No TITLE 22 .. (i).. Standard: Institutional 38 Written Administrative 39 (e).. CONDITION: Organization, Services, Standard: Personnel 39 40 Employee s Health Assessments and Health 40 .. No MEDICARE .. Reporting of Communicable 41 .. No MEDICARE .. Reporting of 42 .. No MEDICARE .. Annual 42 .. No MEDICARE .. Patients Health Records 42 (b).. (a).. (d).. Standard: Protection of Standard: Retention of Standard: Confidentiality of Medical 42 42 43 Patient Health 44 CONDITION: Clinical 44 Quality 45 (b).. (a).. (a).. Standard: Clinical Record CONDITION: Evaluation of the Agency s Standard: Policy and Administrative CONDITION: Group of Professional Standard: Advisory and Evaluation 45 46 46 46 47 Patient 47 CONDITION: Patient 47 (a).

10 Standard: Notice of 47 (b).. Standard: Exercise of Rights and Respect for Property and 47 (c).. Standard: Right to be Informed and to Participate in Planning Care and Treatment 48 (d).. Standard: Confidentiality of Medical 49 (e).. Standard: Patient Liability for 49 TITLE 22 side BY side COMPARISON CAHSAHTABLE OF CONTENTS vi TITLE 22 REGULATIONS MEDICARE CONDITIONS OF PARTICIPATION Section Article 4 - Administration Continued Page Section Condition/Standard Continued Page (f).. Standard: Home Health 49 Plans of 50 .. No MEDICARE .. Section Article 5 - Qualifications for Home Health Aide Certification Page Section Condition/Standard Page Home Health Aide 51 Repeat of Definition for Home Health 51 Home Health Aide 51 (a).