Md. Code Regs. 10.07.10.13 - Program Review and Evaluation
A. The home health agency shall establish
policies and procedures for self-evaluation of its programs. These should
include, at a minimum:
(1) Evaluations of
staffing patterns to assure adequacy and appropriateness of service
delivered;
(2) An annual review of
programs to determine:
(a) Trends in service
needs and activities;
(b) Problems
and unmet needs of patients;
(c)
Anticipated changes in delivery of service;
(d) Linkages with related community
services.
B.
The home health agency shall review its written policies at least annually, and
revise them as necessary. The results of this review shall be presented, in
writing, to the professional advisory group and to the governing
body.
C. Utilization Review.
(1) The home health agency shall establish a
program of utilization review which, at a minimum, includes a utilization
review committee to review clinical records at least quarterly. The committee
members shall represent the scope of services offered by the agency. The
clinical record review shall consist of a minimal sampling of 10 percent of
unduplicated caseload records per annum or 40 records, whichever is less. All
services offered shall be included in the sample.
(2) Sixty Day Continuous Care Review. Each
active record shall be reviewed at least every 60 days to determine the
adequacy of the plan of treatment and appropriateness of continued service,
including renewal of physician orders.
D. The home health agency shall maintain a
documented statistical reporting system for each county and the City of
Baltimore, if served, which includes, at a minimum:
(1) Number of patients by age, sex, and race
receiving each service;
(2) Number
of patient visits conducted by each discipline;
(3) Diagnostic categories;
(4) Source of referrals;
(5) Reason for discharge; and
(6) Sources of reimbursement for all
services.
E. The home
health agency shall:
(1) Prepare a report
annually of its documented statistics within 90 days after the close of its
fiscal year; and
(2) Beginning with
the next fiscal year after adoption of this regulation, submit the report to
the Department in the form and manner prescribed by the Secretary with each
application for license renewal.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.