Cal. Code Regs. Tit. 22, § 54419 - Utilization Review Committee

(a) Each adult day health center shall establish a utilization review committee. Membership in this committee shall include, but is not limited to, a representative from the adult day health center, and professional personnel such as a physician, psychiatrist, nurse, social worker, occupational, physical or speech therapist who are not employed by the center.

(b) The committee shall evaluate the appropriateness of the health care provided by reviewing individual records of participants and shall make recommendations to the center to correct any deficiencies identified. Procedures for the utilization review committee and the method of selecting records for review shall be approved by the Department. This committee shall meet at least quarterly.

(c) All activities of the utilization review committee shall be reported quarterly to the Department in a format approved by the Department. As a minimum, the report shall include the:

(1) Number of cases reviewed.

(2) Nature and extent of the problems encountered.

(3) Summaries of the actions taken by the review system.

(d) Each provider of adult day health care services shall permit the Department and the Department of Health, Education and Welfare to inspect, audit and otherwise, evaluate the quality and appropriateness of care being rendered to participants served by the center.

Notes

Cal. Code Regs. Tit. 22, § 54419

1. Amendment of subsection (a) filed 9-19-79; effective thirtieth day thereafter (Register 79, No. 38).

Note: Authority cited: Chapter 1066, Statutes of 1977. Reference: Chapter 1066, Statutes of 1977.

1. Amendment of subsection (a) filed 9-19-79; effective thirtieth day thereafter (Register 79, No. 38).