8.370.22 NMAC — Ariadne

8.370.22 NMAC active

Home Health Agencies

Jurisdiction: NM Agency: NM Health Care Authority

HOME_HEALTH (100%)

Plain-English summary

This New Mexico regulation establishes minimum licensing standards for home health agencies providing medically directed therapeutic or supportive services to patients in their place of residence. It covers initial licensure, renewal, branch office requirements, governing body and administrator qualifications, personnel supervision, home health aide training, and compliance survey procedures. Operators must maintain an official office, employ or contract licensed professionals, and submit plans of correction when deficiencies are identified.

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Regulation text

TITLE 8

SOCIAL SERVICES

CHAPTER 370

OVERSIGHT OF LICENSED HEALTHCARE FACILITIES
AND COMMUNITY BASED WAIVER PROGRAMS

PART 22

REQUIREMENTS FOR HOME HEALTH
AGENCIES

8.370.22.1

ISSUING AGENCY:

New Mexico Health Care Authority.

[8.370.22.1 NMAC - N, 7/1/2024]

8.370.22.2

SCOPE:

These regulations apply to:

public,
profit or nonprofit home health agencies providing services as outlined by
these regulations;

any
facility providing services as outlined by these regulations which by federal
regulation must be licensed by the state of New Mexico to obtain or maintain
full or partial, permanent or temporary federal funding.

[8.370.22.2 NMAC - N, 7/1/2024]

8.370.22.3

STATUTORY AUTHORITY:

The
regulations set forth herein which govern the licensing of home health agencies
have been pursuant to the general authority granted under Subsection E of
Section 9-8-6 NMSA 1978, and Subsection D of Section 24-1-2, Subsection I of
Section 24-1-3 and Section 24-1-5 of the Public Health Act NMSA 1978, as
amended.

Section 9-8-1 et seq. NMSA 1978
establishes the health care authority as a single, unified department to
administer laws and exercise functions relating to health care purchasing and
regulation.

[8.370.22.3 NMAC - N, 7/1/2024]

8.370.22.4

DURATION:

Permanent.

[8.370.22.4 NMAC - N, 7/1/2024]

8.370.22.5

EFFECTIVE DATE:

July
1, 2024, unless a different date is cited at the end of a section.

[8.370.22.5 NMAC - N, 7/1/2024]

8.370.22.6

OBJECTIVE:

Establish
minimum standards for licensing of home health agencies who provide medically
directed therapeutic or supportive services to a patient/client in their place
of residence.

Monitor
home health agencies’ compliance with these regulations through surveys to
identify any areas which could be dangerous or harmful to a patient/client or
staff.

Encourage
the establishment and maintenance of home health agencies to provide medically
directed therapeutic or supportive services, to a patient/client in their place
of residence, that maintain or improve the health and quality of life to
patients/clients who are in New Mexico.

[8.370.22.6 NMAC - N, 7/1/2024]

8.370.22.7

DEFINITIONS:

For purposes of these regulations the
following shall apply:

“Abuse”

means any act or failure to act performed intentionally, knowingly or
recklessly that causes or is likely to cause harm to a patient/client,
including:

(1)

physical contact that harms or is
likely to harm a patient/client of a home health agency;

(2)

inappropriate use of a physical
restraint, isolation or medication that harms or is likely to harm a
patient/client;

(3)

inappropriate use of a physical or
chemical restraint, medication or isolation as punishment or in conflict with a
physician’s order;

(4)

medically inappropriate conduct that
causes or is likely to cause physical harm to a patient/client;

(5)

medically inappropriate conduct that
causes or is likely to cause great psychological harm to a patient/client;

(6)

an unlawful act, a threat or menacing
conduct directed toward a patient/client that results and might reasonably be
expected to result in fear or emotional or mental distress to a patient/client.

“Administrator/director”

means a qualified individual, on-site, appointed by the governing body who
organizes and directs the agency’s on-going functions, maintains liaison among
the governing body, the group of professional personnel and other staff,
employs qualified personnel, ensures adequate staff education, ensures the
accuracy of public information materials and activities, and implements an
effective budgeting and accounting system.

A branch office must have a qualified on-site branch manager who receives
direction and supervision from the parent home health agency’s
administrator/director.

“Applicant”

means the individual who, or organization which, applies for a license.

If the applicant is an organization, then the
individual signing the application on behalf of the organization must have
authority from the organization.

The
applicant must be the owner.

“Auxiliary
work station”
means a non-licensed, non-staffed convenience work station
away from the licensed location of the home health agency’s office.

“Branch
office”
means a licensed location or site from which a home health agency
provides services and is located sufficiently close that it is not impractical
for it to receive direction and supervision from the parent home health agency
on a day-by-day basis.

“Bylaws”

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

“Clinical/service
note”
means a written notation dated and signed by a member of the health
team that summarizes facts about care furnished and the patient/client’s
response during a given period of time.

“Exploitation”

of a patient/client consists of the act or process, performed intentionally,
knowingly or recklessly, of using any patient/
clients

money or property, for another person’s profit, advantage or benefit.

Exploitation includes but is not limited to:

(1)

manipulating the patient/client by
whatever mechanism to give money or property to any agency staff or management
member;

(2)

misappropriation or misuse of monies
belonging to a patient/client or the unauthorized sale, transfer or use of a
patient/clients property;

(3)

loans of any kind from
patient/clients to agency staff or management;

(4)

accepting monetary or other gifts
from a patient/client or their family with a value in excess of $25 or gifts
which exceed a total value of $300 in one year.

All gifts received by agency operators, their families or staff of the
agency must be documented and acknowledged by the person giving the gift and
the recipient.

Exception:

Testamentary gifts, such as wills, are not,
per se, considered financial exploitation.

“Governing
body”
means the governing authority of a facility which has the ultimate
responsibility for all planning, direction, control and management of the
activities and functions of a home health agency licensed pursuant to these
regulations.

“Great
psychological harm”
means psychological harm that causes mental or
emotional incapacitation for a prolonged period of time or that causes extreme
behavioral change or severe physical symptoms that require psychological or
psychiatric care.

“Home
health agency”
means any business, entity or organization primarily engaged
in providing medically directed acute, restorative, rehabilitative,
maintenance, preventive or supportive services through professional or
paraprofessional personnel to a patient/client in the patient/client’s
residence.

This term does not apply to
any individual, licensed practitioner providing services within the scope of their
practice or to any business, entity or organization providing non-medically
directed services in a patient/client’s place of residence.

“Home
health aide”
means a person who has successfully completed a course of
training or demonstrated competency in assisting patient/clients to meet basic
personal care needs.

A home health aide
provides medically directed personal care to patient/clients such as, but not
limited to, taking and recording vital signs, bathing, grooming, feeding,
ambulation, exercise, oral hygiene and skin care.

“Home
health services”
means those medically directed therapeutic or supportive
services provided by a home health agency to a patient/client in
theirplace
of residence.

“Homemaker”

means a person who has successfully demonstrated competency to provide
household services such as cleaning, meal preparation, laundry, shopping and to
assist a patient/client with activities of daily living.

“Level
of care”
means the long term care assessment abstract which medically
qualifies a patient/client for
medicaid
waiver
services.

“Licensed
practical nurse”
means a person licensed as a practical nurse in the state
of New Mexico under the Nursing Practice Act, Sections 61-3-1 to 61-3-31 NMSA
1978.

“Licensee”

means the person(s) who, or organization which, has an ownership or similar
interest in the home health agency and in whose name a license for a home
health agency has been issued and who is legally responsible for compliance
with these regulations.

“Licensing
authority”
means the New Mexico health care authority.

“Medically
directed services”
means in-home services that are provided in accordance
with a patient/client’s plan or level of care which is reviewed and approved by
a physician at least annually.

“Neglect”

means subject to the patient/client’s right to refuse treatment and subject to
the caregiver’s right to exercise sound medical discretion, the grossly
negligent:

(1)

failure to provide any treatment,
services, care, medication or item that is necessary to maintain the health or
safety of a patient/client;

(2)

failure to take any reasonable
precaution that is necessary to prevent damage to the health or safety of a
patient/client;

(3)

failure to carry out a duty to
supervise properly or control the provision of any treatment, care, good,
service or medication necessary to maintain the health or safety of a
patient/client.

“Occupational
therapist”
is a person who is licensed by the state of New Mexico as an
occupational therapist, pursuant to Sections 61-12A-1 to 61-12A-24 NMSA 1978.

“Occupational
therapist assistant”
is a person who is licensed by the state of New Mexico
as a certified occupational therapist assistant, pursuant to Sections 61-12A-1
to 61-12A-24 NMSA 1978.

“Parent
home health agency”
means an agency that develops and maintains
responsibility for the operation and administrative control of branch
office(s).

“Patient/client”

means a person who is receiving home health care services.

“Personal
care attendant/provider”
means a person who has successfully demonstrated
competency to provide assistance with personal care such as bathing, grooming,
bowel and bladder needs.

“Physical
therapist”
is a person who is licensed by the state of New Mexico as a
physical therapist, pursuant to Sections 61-12-1 to 61-12-21 NMSA 1978.

AA.

“Physical
therapist assistant”
is a person who is licensed by the state of New Mexico
as a physical therapist assistant, pursuant to Sections 61-12-1 to 61-12-21
NMSA 1978.

BB.

“Plan
of care”
means a written plan of treatment which sets forth each service
that the home health agency agrees to provide to a patient/client.

CC.

“Plan
of correction”
means a plan written and signed by the licensee or
representative addressing how and when the licensing authority’s identified
deficiencies will be corrected.

DD.

“Physician”

is a person who is a doctor of medicine, osteopathy or podiatry licensed to
practice medicine.

EE.

“Policy”

means a statement of principle that guides and determines present and future
decisions and actions.

FF.

“Procedure”
means the action(s)
that must be taken in order to implement a policy.

GG.

“Professional
personnel”
means the staff of the agency or personnel under contract or
agreement with the agency who require a license, registration or certification
by the state of New Mexico.

HH.

“Quality
improvement”
means an on-going assessment program which addresses clinical
care and program evaluation.

II.

“Registered
nurse”
means a person who holds a certificate of registration as a
registered nurse in the state of New Mexico under the Nursing Practice Act,
Sections 61-3-1 to 61-3-31 NMSA 1978.

JJ.

“Residence”

means the place in New Mexico where a patient/client is residing at the time
home health services are provided.

KK.

“Social
worker”
is a person who is licensed by the state of New Mexico as a social
worker, pursuant to Sections 61-31-1 to 61-31-25 NMSA 1978.

LL.

“Speech
language pathologist”
is a person licensed by the state of New Mexico to
practice speech language pathology, pursuant to Sections 61-14B-1 to 61-14B-25
NMSA 1978.

MM.

“Supervision”

means direction, guidance and oversight by a qualified person, within their
sphere of competence, of an individual providing services in accordance with a
patient/client’s plan of care.

NN.

“Supportive
services”
means medically or non-medically directed assistance to
patient/clients to meet basic activities of daily living.

OO.

“Therapeutic
services”
means a medically directed activity or activities to
patients/clients based upon a knowledge of disease processes provided by a home
health agency.

PP.

“Waive/waiver”

means to refrain from pressing or enforcing compliance with a portion or
portions of these regulations for a limited period of time in which the health,
safety, or welfare of the patient/clients and staff are not in danger.

Waivers are issued at the sole discretion of
the licensing authority.

[8.370.22.7 NMAC - N, 7/1/2024]

8.370.22.8

STANDARD OF COMPLIANCE:

The degree of compliance required throughout
these regulations is designated by the use of the words “shall” or “must” or
“may”.

“Shall” or “must” means
mandatory.

“May” means permissive.

The use of the words “adequate”, “proper”,
and other similar words means the degree of compliance that is generally
accepted throughout the professional field by those who provide services of
home health agencies as outlined in these regulations.

[8.370.22.8 NMAC - N, 7/1/2024]

8.370.22.9

HOME HEALTH AGENCY AND SCOPE OF
SERVICES:

An agency or organization meeting the
following criteria must be licensed as a home health agency:

Provides
at least one medically directed service, such as, but not limited to:

(1)

skilled nursing
;

(2)

physical therapy;

(3)

occupational therapy;

(4)

inhalation therapy;

(5)

infusion therapy;

(6)

speech language pathology;

(7)

social work;

(8)

home health aide;

(9)

personal care attendant;

(10)

homemaker.

A
home health agency must provide at least one of the above services, in its
entirety, directly through employees, but may provide other services under
arrangements with another agency or organization or provider.

A
licensed home health agency may also provide non-medically directed services.

Home
health agency excludes:

(1)

independent or sole practitioners
providing in-home services under their respective professional practice acts;

(2)

medical suppliers who do not provide
services listed above;

(3)

family, friends, volunteers and paid
individuals not under the direct control of a home health agency.

Branch
office:

Means a licensed location from which a home
health agency provides services to patient/clients.

A home health agency may not apply for a
license to open a branch office unless the parent agency has been in operation
for at least one year, had an annual survey conducted by the licensing
authority, and is found to be in substantial compliance with these regulations.

(1)

A branch office must be located
within 100 miles distance from the licensed location of the parent home health
agency.

(2)

A branch office must have a qualified
on-site administrator who receives direction and supervision from the parent
home health agency’s administrator/director.

(3)

A branch office must be able to
provide the same services as the parent home health agency.

(4)

Original patient/client records, if
stored at the parent home health agency, shall be made available upon request
of the licensing authority within two hours.

Service
area:

A home health agency may only
provide services to patient/clients who reside within one hundred (100) miles
distance from the licensed location of the agency.

(1)

The licensing authority may grant a
temporary exception to the 100 mile distance limitation when the following
conditions exist:

(a)

no other home health agency service
for the patient/client is available;

(b)

no home health agency in the area
within the 100 miles distance limitation is able or willing to provide services
to the patient/client.

(2)

Home health agencies not previously
required to be licensed by the licensing authority shall have twelve months
from the date these regulations are adopted to comply.

Auxiliary
work station:

A non-licensed,
non-staffed convenience work station away from the licensed location of the
home health agency’s office for the limited purposes of storage of supplies and
a work area for documentation by staff where a telephone and fax may be
available for communication.

The
auxiliary work station shall not function as a branch office and the following
requirements are intended to insure that the work station does not become a
branch office:

(1)

must not be utilized to increase the
geographical service area of a home health agency or as a substitute for a
branch operation of the agency;

(2)

the name of the agency must not be
identified by signage at the work station;

(3)

the telephone number for the work
station shall not be advertised or otherwise made available to persons or
individuals other than staff of the agency;

(4)

patient/clients shall only be
admitted by and through the licensed location of the agency;

(5)

no orders for patient/client care
from physicians shall be accepted by agency staff at its auxiliary work station;

(6)

no original patient/client records,
copies of patient/client records or personnel records shall be maintained by
the agency at the auxiliary work station.

[8.370.22.9 NMAC - N, 7/1/2024]

8.370.22.10

INITIAL LICENSURE PROCEDURES:

The authority to determine if a person(s) or
organization is subject to regulation under the statute is inherent in the
responsibility to regulate agencies that are within the definitions of the
statute and these regulations.

To obtain
an initial license for a home health agency pursuant to these regulations, the
following procedures must be followed by the applicant:

These
regulations should be thoroughly understood by the applicant and used as
reference prior to applying for initial licensure.

The
following documents must be submitted to the licensing authority:

(1)

Letter of intent:

Submit to the licensing authority a letter of
intention to open a home health agency pursuant to these regulations.

(2)

Application for initial license:

All information requested by the licensing
authority must be provided.

All
applications for an initial license must be accompanied by the required
non-refundable fee.

(3)

Functional program outline:

Each application for initial licensure must
be accompanied by a functional program outline that provides the following
information:

(a)

scope of Services to be provided by
the proposed home health agency;

(b)

estimated number of patient/clients
to be served monthly;

(c)

services that will be contracted or
arranged with another health provider, i.e., homemaker, I.V. therapy, etc.;

(d)

hours and days of operation.

(4)

Home health agency policies:

Submit for review and approval by the
licensing authority, a copy of the home health agency policies and a copy of
these licensing regulations annotated to the agency’s policies and
procedures.

Note:

Each regulation must be referenced to the
appropriate policy by writing the page or policy number by the corresponding
regulation.

Upon
the licensing authority’s approval of documents listed above, a temporary
license will be issued.

Upon receipt of
the temporary license, the home health agency may admit patients/clients.

Upon
becoming fully operational and accepting a patient/client, a home health agency
must submit a written request to the licensing authority for the initial
survey.

Upon
completion of the initial survey and determination that the facility is in
compliance with these regulations, the licensing authority will issue an annual
license.

[8.370.22.10 NMAC - N, 7/1/2024]

8.370.22.11

LICENSES:

Annual license:

An annual license is issued for a one
year period to a home health agency which has met all requirements of these
regulations.

Temporary license:

The licensing authority may, at its sole
discretion, issue a temporary license prior to the initial survey, or when the
licensing authority finds partial compliance with these regulations, or for
administrative purposes.

(1)

A temporary license shall cover a
period of time, not to exceed 120 days, during which the facility must correct
all specified deficiencies.

(2)

In accordance with Subsection D of Section
24-1-5 NMSA 1978, no more than two consecutive temporary licenses shall be
issued.

Amended license:

A licensee must apply to the licensing
authority for an amended license when there is a change of
administrator/director, or when there is a change of name for the facility.

(1)

application must be on a form
provided by the licensing authority.

(2)

application must be accompanied by
the required fee for an amended license.

(3)

application must be submitted within 10
working days of the change.

[8.370.22.11 NMAC - N, 7/1/2024]

8.370.22.12

LICENSE RENEWAL:

The
licensee must submit renewal application on forms provided by the licensing
authority, along with the required fee at least 30 days prior to expiration of
the current license.

Upon
receipt of renewal application, required fee and an on-site survey, the
licensing authority will issue a new license effective the day following the
date of expiration of the current license, if the agency is in substantial
compliance with these regulations.

If
the licensee fails to submit a renewal application with the required fee and
the current license expires, the agency shall cease operations until it obtains
a new license through the initial licensure procedures.

Subsection A of Section 24-1-5 NMSA 1978, as
amended, provides that no health facility shall be operated without a license.

[8.370.22.12 NMAC - N, 7/1/2024]

8.370.22.13

POSTING OF LICENSE:

The agency’s current, original license must be
posted in a conspicuous place at the licensed location, as identified in the
application for licensure.

[8.370.22.13 NMAC - N, 7/1/2024]

8.370.22.14

NON-TRANSFERABLE RESTRICTION ON
LICENSE:

A license shall not be transferred by
assignment or otherwise to other persons or locations.

The license shall be void and must be
returned to the licensing authority when any one of the following situations
occur:

ownership
of the agency changes;

the
agency changes location of its office;

licensee
of the agency changes;

the
agency discontinues operation;

an
agency wishing to continue operation as a licensed home health agency under
circumstances listed above must submit an application for initial licensure in
accordance with Section 10 of these regulations, at least 30 days prior to the
anticipated change.

[8.370.22.14 NMAC - N, 7/1/2024]

8.370.22.15

AUTOMATIC EXPIRATION OF LICENSE:

A
license will automatically expire at midnight on the day indicated on the
license as the expiration date, unless sooner renewed, suspended, revoked, or:

on
the day an agency discontinues operation;

on
the day an agency is sold, leased, or otherwise changes ownership or licensee;

on
the day an agency changes location of its office.

[8.370.22.15 NMAC - N, 7/1/2024]

8.370.22.16

SUSPENSION OF LICENSE WITHOUT PRIOR
HEARING:

In accordance with Subsection H of Section
24-1-5 NMSA 1978, as amended, if immediate action is required to protect human
health and safety, the licensing authority may suspend a license pending a
hearing, provided such hearing is held within five working days of the
suspension, unless waived by the licensee.

[8.370.22.16 NMAC - N, 7/1/2024]

8.370.22.17

GROUNDS FOR REVOCATION OR SUSPENSION
OF LICENSE, DENIAL OF INITIAL OR RENEWAL APPLICATION FOR LICENSE, OR IMPOSITION
OF INTERMEDIATE SANCTIONS OR CIVIL MONETARY PENALTIES:

A
license may be revoked or suspended, an initial or renewal application for
license may be denied, or intermediate sanctions or civil monetary penalties
may be imposed after notice and opportunity for a hearing, for any of the
following reasons:

failure
to comply with any provision of these regulations;

failure
to allow survey by authorized representatives of the licensing authority;

any
person active in the operation of an agency licensed pursuant to these
regulations shall not be under the influence of alcohol or narcotics or
convicted of a felony;

misrepresentation
or falsification of any information on application forms or other documents
provided to the licensing authority;

discovery
of repeat violations of these regulations during surveys;

failure
to provide the required care and services as outlined by these regulations for
the patients/clients receiving care from the agency.

[8.370.22.17 NMAC - N, 7/1/2024]

8.370.22.18

EARING PROCEDURES:

Hearing
procedures for adverse action taken by the licensing authority against an
agency’s license as outlined in Section 16 and 17 above will be held in
accordance with adjudicatory hearings, New Mexico health care authority, 8.370.2
NMAC.

A
copy of the above regulations may be requested at any time by contacting the
licensing authority.

[8.370.22.18 NMAC - N, 7/1/2024]

8.370.22.19

AGENCY SURVEYS:

Application
for licensure, whether initial or renewal shall constitute permission for entry
into and survey of a home health agency by authorized licensing authority
representatives during pendency of the application, and if licensed, during the
licensure period.

The
licensing authority shall perform, as it deems necessary, unannounced on-site
surveys to determine compliance with these regulations, to investigate
complaints, or to investigate the appropriateness of licensure for any alleged
unlicensed facility.

The licensing
authority may include patient/client home visits as part of any survey or
investigation.

Upon
receipt of the official deficiency statement from the licensing authority, the
licensee or their representative will be required to submit a plan of
correction to the licensing authority within 10 working days, stating how the
agency intends to correct each violation noted and the expected date of
completion.

The
licensing authority may, at its sole discretion, accept the plan of correction
as written or require modifications of the plan by the licensee.

[8.370.22.19 NMAC - N, 7/1/2024]

8.370.22.20

ACCEPTANCE OF PATIENTS/CLIENTS:

Patients/clients must be accepted for
treatment by the agency when there is a reasonable expectation that the
patient/client’s health care or supportive service needs can be met adequately
in the patient/client’s place of residence.

[8.370.22.20 NMAC - N, 7/1/2024]

8.370.22.21

OFFICE REQUIREMENTS:

An
agency licensed pursuant to these regulations shall establish and maintain an
official office for the conduct of its business with posted hours of operation.

The
office space must be able to maintain, store and safeguard agency records.

[8.370.22.21 NMAC - N, 7/1/2024]

8.370.22.22

HEALTH AND AGE REQUIREMENTS:

All
staff or contracted personnel involved in the care of patients/clients shall be
at least 18 years of age.

All
staff, contracted personnel, or volunteers having patient/client contact must
have a TB test in accordance with the requirements of the infectious disease
bureau, of the public health division, health care authority.

[8.370.22.22 NMAC - N, 7/1/2024]

8.370.22.23

REQUIREMENTS FOR LICENSURE OF
PROFESSIONALS:

Any health professional employed or contracted
by the home health agency, such as, but not limited to, physicians, physician’s
assistants, nurse practitioners, physical or occupational therapists, speech
language pathologists, registered professional nurses, licensed practical
nurses, licensed or certified social workers, physical therapy assistants or
certified occupational therapy assistants, must have a current license,
registration or certification from the state of New Mexico.

Proof of licensure must be maintained on file
by the agency.

[8.370.22.23 NMAC - N, 7/1/2024]

8.370.22.24

GOVERNING BODY:

Each agency licensed pursuant to these
regulations must have a governing body who adopts and reviews, at least
annually, written by-laws or policies and procedures which govern the day to
day operation of the agency.

The
governing body may include the licensee of the agency.

The
governing body must have full legal authority and responsibility for the
operation of the agency.

The
governing body must appoint a qualified administrator.

The
governing body must oversee the management and fiscal affairs of the agency.

The
governing body must meet at least annually.

These meetings shall be documented by dated minutes and a copy of these
minutes shall be kept on file in the agency.

[8.370.22.24 NMAC - N, 7/1/2024]

8.370.22.25

ADVISORY GROUP:

Each agency licensed pursuant to these shall
have an advisory group.

The
advisory group shall consist of:

(1)

at least three individuals;

(2)

an individual representing at least
one of the services offered by the agency;

(3)

at least one member of the group must
be neither an owner or an employee of the agency;

(4)

governing body members may also be
part of the advisory group.

The
advisory group shall meet at least semi-annually to perform the following
functions:

(1)

to review the agency’s required
policies and procedures and on-going quality improvement program and make
recommendations to the governing body, at least annually;

(2)

to participate in the agency’s
program evaluation, at least annually;

(3)

to advise the agency on professional
issues;

(4)

to assist the agency in maintaining
liaison with other health care providers in the community and in its community
information efforts.

The
advisory group meetings shall be documented by dated minutes and a copy of
these minutes shall be kept on file in the agency.

[8.370.22.25 NMAC - N, 7/1/2024]

8.370.22.26

ADMINISTRATOR:

Each agency licensed pursuant to these
regulations must have an administrator appointed by the governing body who:

is
a licensed physician; or

is
a registered nurse; or

has
at a minimum, a high school diploma or general equivalency diploma, training
and experience in health services administration, and at least one year of
supervisory or administrative experience in home health care.

may
also be the supervising physician or registered nurse.

is
responsible for implementing the directions of the governing body and
organizing and directing the on-going functions of the agency in compliance
with these regulations.

A qualified person is authorized in
writing to act in the absence of the administrator.

[8.370.22.26 NMAC - N, 7/1/2024]

8.370.22.27

RESPONSIBILITIES OF AGENCY PERSONNEL:

Home health agencies utilizing any of the
following personnel for provision of home care services must assure the
responsibilities listed below are met.

Primary
service personnel:

including, but
not limited to, registered nurses, physical therapists, occupational
therapists, speech therapists, social workers, shall:

(1)

provide necessary professional care
and guidance within the scope of their licensure;

(2)

evaluate the home for its suitability
for the patient/client’s care;

(3)

teach the patient/client and
caregivers how to provide care;

(4)

develop, evaluate and coordinate the
patient/client’s plan of care on a continuing basis;

(5)

inform the physician and other
personnel of changes in the patient/client’s condition and needs;

(6)

perform an evaluation visit and
follow-up visits as needed;

(7)

prepare clinical notes.

Secondary
service personnel:

Other licensed
personnel, including, but not limited to, respiratory therapists, licensed
practical nurses, physical therapy assistants, certified occupational therapist
assistants, shall:

(1)

provide services in accordance with
an established plan of care and agency policies;

(2)

provide necessary professional care
and guidance within the scope of their licensure;

(3)

prepare clinical notes;

(4)

evaluate the home for its suitability
for the patient/client’s care;

(5)

teach the patient/client and
caregiver how to provide care;

(6)

inform the physician and other
personnel of changes in the patient/client’s condition and needs.

Non-licensed
personnel:

Individuals, including,
but not limited to, home health aides, homemakers, personal care attendants,
shall:

(1)

provide personal care including
assistance in the activities of daily living;

(2)

assist to maintain a safe and clean
environment;

(3)

perform household services and other
activities as assigned;

(4)

communicate with appropriate
supervisor about changes or variations in the patient/client or home situation;

(5)

teach the patient/client and
caregivers how to provide care, within the level of their competency;

(6)

prepare patient/client notes.

[8.370.22.27 NMAC - N, 7/1/2024]

8.370.22.28

SUPERVISING PERSONNEL:

The
medically directed services provided by the agency must be supervised by a
licensed professional or an appropriately qualified staff member.

The
supervising staff member or their alternate who is similarly qualified must be
available at all times during operating hours of the agency.

The
supervising staff member or alternate who is similarly qualified must
participate in all activities relevant to the services provided, including
developing qualifications for assignments of personnel.

[8.370.22.28 NMAC - N, 7/1/2024]

8.370.22.29

SUPERVISION OF SECONDARY AND
NON-LICENSED PERSONNEL:

Licensed practical nurses:

Services and care provided by a
licensed practical nurse will be furnished under the supervision of a
registered nurse who has a minimum of one year home health experience or a
minimum of two (2) years nursing experience.

Such supervision will include, at a minimum:

(1)

Identify appropriate tasks to be
performed by the licensed practical nurse.

(2)

Conduct and document a supervisory
visit to at least one patient/client residence at least every sixty (60) days,
or more often as indicated.

Physical therapy assistants:

Services and care provided by a
physical therapy assistant will be furnished under the supervision of a
physical therapist, with a minimum of one year experience.

Such supervision will include, at a minimum:

(1)

Identify appropriate tasks to be
performed by the physical therapy assistant.

(2)

Conduct and document a supervisory
visit to the patient/client residence at least every thirty (30) days or as
indicated.

(3)

Be on-call and readily available and
within a 100 mile radius, or have appointed another physical therapist in their
absence.

(4)

Supervise no more than two physical
therapy assistants.

Certified occupational therapy assistants:

Services and care provided by a
certified occupational therapy assistant will be furnished under the
supervision of an occupational therapist, with a minimum of one (1) year
experience.

Such supervision will
include, at a minimum:

(1)

Identify appropriate tasks to be
performed by the certified occupational therapy assistant.

(2)

Conduct and document a supervisory
visit to the patient/client residence:

(a)

at a minimum of every two weeks for
intermediate-level certified occupational therapy assistants;

(b)

at a minimum of every 30 days for
advanced-level certified occupational therapy assistants.

Home health aides:

Services and care provided by a
home health aide will be furnished under the supervision of an appropriately
licensed professional, such as, registered nurse, physical therapist,
occupational therapist, or a speech language pathologist with a minimum of one
year experience.

Such supervision will
include, at a minimum:

(1)

Preparation of written patient/client
instructions which identify appropriate tasks to be performed by the home
health aide.

(2)

Conduct and document a supervisory
visit to the patient/client residence at least every 62 days or as often as the
condition of the patient/client requires.

Note:

Patient/clients who have
multiple home health aides require only one supervisory visit.

This home health aide need not be present in
the patient/client’s residence at the time of the supervisory visit.

Personal care attendants or equivalent:

Services and care provided by a
personal care attendant or equivalent will be supervised by a licensed
professional or by an appropriately qualified staff member who has one year
direct patient care experience.

Such
supervision will include, at a minimum:

(1)

Preparation of written patient/client
care instructions which identify appropriate tasks to be performed by the
personal care attendant or equivalent.

(2)

Conduct and document a supervisory
visit to the patient/client’s residence at least every sixty-two (62) days or
as often as the condition of the patient/client requires.

Note:

Patient/clients
who have multiple personal care attendants or equivalent require only one
supervisory visit.

The personal care
attendant need not be present in the patient/client’s residence at the time of
the supervisory visit.

Homemakers:

Services and care provided by a
homemaker will be supervised by a licensed professional or by an appropriately
qualified staff member who has one year direct patient care experience.

Such supervision will include, at a minimum:

(1)

Preparation of written patient/client
care instructions which identify appropriate tasks to be performed by the
homemaker.

(2)

Conduct and document a supervisory
visit to the patient/client’s residence at least every sixty-two (62) days or
as often as the condition of the patient/client requires.

Note:

Patient/clients
who have multiple homemakers require only one supervisory visit.

The homemaker need not be present in the
patient/client’s residence at the time of the supervisory visit.

[8.370.22.29 NMAC - N, 7/1/2024]

8.370.22.30

HOME HEALTH AIDE TRAINING
REQUIREMENTS:

General:

No agency licensed pursuant to these regulations may employ
an individual as a home health aide on a full-time, part-time, temporary, per
diem, or other basis unless:

(1)

that individual is competent to
provide services as a home health aide;

(2)

that individual has completed a
training program or a competency evaluation program as outlined in these
regulations.

Source of training:

Any agency licensed pursuant to
these regulations may provide training under the following conditions:

(1)

The agency must submit, in writing,
its intent to conduct home health aide training and the training curriculum to
the licensing authority.

Approval of the
curriculum must be obtained from the licensing authority prior to instituting
training.

(2)

Agencies electing not to provide
formal training must identify the method by which they will establish the
competency of home health aides and document that each is determined competent.

(3)

The licensing authority may deny a
home health agency the right to conduct home health aide training or competency
evaluation, for a specified period of time, not to exceed two years, if the
licensing authority finds the agency in substantial non-compliance with these
regulations.

Course requirements:

Home health aides:

The home health aide training program must
address each of the subject areas listed below through classroom and supervised
practical training totaling at least 75 hours, with at least 16 hours devoted
to supervised practical training.

“Supervised practical training” means training in a laboratory or other
setting in which the trainee demonstrates knowledge while performing tasks on
an individual under the direct supervision of a registered nurse or licensed
practical nurse.

(1)

The individual being trained must
complete at least 16 hours of classroom training before beginning the
supervised practical training;

(2)

communications skills;

(3)

observation, reporting and
documentation of patient status and the care or service furnished;

(4)

reading and recording of vital signs;

(5)

basic infection control procedures;

(6)

basic elements of body functioning
and changes in body function that must be reported to an aide’s supervisor;

(7)

maintenance of a clean, safe and
healthy environment;

(8)

recognizing emergencies and knowledge
of emergency procedures (including CPR and first aid);

(9)

the physical, emotional and
developmental needs of and ways to work with the populations served by the home
health agency, including the need for respect for the patient, their privacy
and their property;

(10)

appropriate and safe techniques in
personal hygiene and grooming that include, but are not limited to, bathing,
shampooing, nail and skin care, oral hygiene and toileting;

(11)

safe transfer techniques and
ambulation;

(12)

normal range of motion and positioning;

(13)

nutrition and hydration;

(14)

patient/client rights, including
respect for cultural diversity;

(15)

any other task that the home health
agency may choose to have the home health aide perform.

Instructor personnel:

(1)

The training of home health aides
must be performed by, or under the supervision of, a registered nurse who
possesses a minimum of two years of nursing experience, at least one year of
which must be in the provision of home health services.

(2)

Other pertinent personnel from the
health professions may also be utilized as supplemental instructors.

Documentation of training or competency
evaluation:

(1)

All agencies which provide home
health aide training courses or competency evaluations must document such
training or competency evaluation for each individual taking the training or
competency evaluation.

Competency
evaluation includes both a written test and a skills demonstration.

Skills demonstration must be observed and
documented by a registered nurse or licensed practical nurse.

(2)

Documentation must include at least
the following information:

(a)

Training:

(
i
)

name
of individual taking training;

(ii)

title, purpose and objectives of
class;

(iii)

name of instructor and qualifications;

(iv)

number of hours of instruction;

(v)

date instruction was given.

(b)

Competency:

(
i
)

name
of individual being evaluated for competency;

(ii)

date and method used to determine
competency.

Annual in-service training:

Each home health aide must participate
in at least 12 documented hours of in-service training during each 12 month
period.

This requirement may be
fulfilled on a prorated basis during the home health aide’s first year of
employment at the home health agency.

Annual performance review:

A performance review, including
written evaluation and skills demonstration must be completed on each home
health aide no less frequently than every 12 months.

[8.370.22.30 NMAC - N, 7/1/2024]

8.370.22.31

HOMEMAKER/PERSONAL CARE ATTENDANT OR
EQUIVALENT TRAINING REQUIREMENTS:

General:

No agency licensed pursuant to these regulations may employ
an individual as a homemaker/personal care attendant or equivalent on a
full-time, part time, temporary, per diem or other basis unless:

(1)

That individual is competent to
provide assigned tasks as a homemaker/personal care attendant or equivalent.

(2)

That individual has completed a
training program or a competency evaluation program as outlined in these
regulations.

Source of training:

Any agency licensed pursuant to
these regulations may provide training under the following conditions:

(1)

The agency must submit, in writing,
its intent to conduct homemaker/personal care attendant or equivalent training
and the source of training material.

Approval of the curriculum must be obtained from the licensing authority
prior to instituting training.

(2)

Agencies electing not to provide
formal training must identify the method by which they will establish the
competency of homemaker/personal care attendant or equivalent and document that
each is determined to be competent.

(3)

The licensing authority may deny a
home health agency the right to conduct homemaker/personal care attendant or
equivalent training or competency evaluation, for a specified period of time,
not to exceed two (2) years, if the licensing authority finds the agency in
substantial noncompliance with these regulations.

Course requirements:

The home health agency’s homemaker/personal
care attendant or equivalent training program must consist of no less than 40
hours of training, to be completed by the homemaker/personal care attendant or
equivalent in the first year of employment.

Ten hours of training must be completed prior to placing the
homemaker/personal care employee in a patient/client home.

Two of the 10 hours may include agency
orientation.

Eight of the 10 hours
training must be patient/client service specific.

The training must address, at a minimum, the
following areas:

(1)

communication skills;

(2)

patient/client rights, including
respect for cultural diversity;

(3)

recording of information for
patient/client records;

(4)

nutrition and meal preparation;

(5)

housekeeping skills;

(6)

care of the ill and disabled,
including the special needs populations;

(7)

emergency response (including CPR and
first aid);

(8)

basic infection control;

(9)

home safety.

Instructor personnel:

(1)

The training of homemaker/personal
care attendant or equivalent must be performed by or under the direction of a
licensed professional or an appropriately qualified person.

(2)

Other pertinent personnel from the
health professions may also be utilized as supplemental instructors.

Documentation of training or competency
evaluation:

(1)

All agencies which provide
homemaker/personal care attendant or equivalent training courses or competency
evaluations must document such training or competency evaluation for each
individual taking the training or competency evaluation.

The training or competency evaluation must be
observed and documented by a licensed professional or an appropriately
qualified person.

(2)

Documentation must include at least
the following information:

(a)

Training:

(
i
)

name
of individual taking training;

(ii)

title, purpose, and objectives of
class;

(iii)

name of instructor;

(iv)

number of hours of instruction;

(v)

date instruction was given.

(b)

Competency:

(
i
)

name
of individual being evaluated for competency;

(ii)

date and method used to determine
competency.

(3)

Annual in-service training:

Each homemaker/personal care attendant or
equivalent shall participate in at least 10 documented hours of in-service
training during each 12-month period.

[8.370.22.31 NMAC - N, 7/1/2024]

8.370.22.32

PATIENT/CLIENT RIGHTS:

A
home health agency licensed pursuant to these regulations must protect and
promote the rights of each individual under its care, including each of the
following rights:

the
right to be fully informed in advance about the care and treatment to be
provided by the agency;

the
right to refuse or terminate treatment;

the
right to be fully informed in advance of any changes in the care or treatment
to be provided by the agency that may affect the individual’s well-being;

the
right to participate in planning care and treatment or changes in care or
treatment, except for those individuals adjudged incompetent;

the
right to be treated with dignity and respect and to be free from abuse,
neglect, and exploitation.

No home
health agency to whom a patient/client’s money or valuables have been entrusted
shall mingle the patient/client’s monies, valuables or property, with that of
the licensee, staff or management;

the
right to voice grievances, with respect to treatment or care that is or fails
to be furnished, without discrimination or reprisal for voicing such
grievances;

the
right to confidentiality of medical care and patient/client records;

the
right to have one’s property treated with respect;

the
right to be fully informed, orally and in writing, of all charges for services
to be performed by the agency and of any changes in these charges;

the
right to be informed of the New Mexico home health agency hotline number (1-800-752-8649),
hours of operation (8:00 am-5:00 pm, Monday-Friday), and purpose of the
hotline, which is to receive complaints, questions about local home health
agencies, or to lodge complaints concerning the implementation of the advance
directives requirements;

the
right to be fully informed regarding advance directives, prior to care being
given.

This information must include
agency policies on advance directives and a description of applicable state
law;

the
right to be fully informed, in writing, of the patient/client’s rights pursuant
to these regulations.

[8.370.22.32 NMAC - N, 7/1/2024]

8.370.22.33

PLAN OF CARE:

Care of a patient/client by the agency must
follow a written plan of care which is reviewed at least annually.

Medically directed care:

An agency must follow a written plan
of care established and periodically reviewed by a physician, and care
continues under the supervision of a physician.

(1)

The plan of care shall be developed
in consultation with appropriate agency staff and cover all pertinent
diagnoses, including but not limited to:

(a)

mental status;

(b)

types of services and equipment
required;

(c)

frequency and duration of visits;

(d)

functional limitations;

(e)

activities permitted;

(f)

nutritional requirements;

(g)

medications and treatments;

(h)

safety measures to protect against
injury;

(
i
)

plans
or goals for care;

(j)

any other appropriate items.

(2)

If a physician refers a
patient/client under a plan of care which cannot be completed until after an
evaluation visit, the physician must be consulted to approve additions or
modifications to the original plan.

(3)

The plan of care must be reviewed by
the attending physician and home health agency personnel at least annually or
as often as the condition of the patient/client requires.

(4)

Agency professional staff must
promptly alert the physician to any changes that suggest a need to alter the
plan of care.

(5)

Conformance with physician’s orders:

(a)

Drugs and treatments shall be
administered by agency staff only as ordered by the physician.

(b)

Licensed professionals must
immediately record and sign oral orders and obtain the physician’s
countersignature.

(c)

For a patient/client receiving
nursing services, all medications a patient/client may be taking must be
checked to identify possible ineffective drug therapy, adverse reactions,
significant side effects, drug allergies and contraindicated medications.

Medication problems must be promptly reported
to the physician.

Non-medically directed care:

An agency must follow a written plan
of care, which includes goals and objectives appropriate to the patient/client
being served, and which is established and reviewed at least annually by agency
staff.

[8.370.22.33 NMAC - N, 7/1/2024]

8.370.22.34

PATIENT/CLIENT RECORDS:

Each agency licensed pursuant to these
regulations must maintain the original record for each patient/client receiving
services.

Patient/client records shall
be made available for review upon request of the licensing authority.

Every record must be accurate, legible,
promptly completed and consistently organized.

A patient/client record must meet the following criteria:

Content of patient/client record:

(1)

Medically directed patient/client
record must include:

(a)

past and current medical findings in
accordance with accepted professional standard;

(b)

plan of care;

(c)

identifying information;

(d)

name of physician;

(e)

medications, diet,
treatment/services, and activity orders;

(f)

signed and dated notes on the day
service(s) provided;

(g)

copies of summary reports sent to the
physician;

(h)

evidence of patient/client being
informed of rights;

(
i
)

evidence
of coordination of care provided by all personnel providing patient/client
services;

(j)

discharge summary.

(2)

Non-medically directed patient/client
records must include:

(a)

plan of care;

(b)

identifying information;

(c)

signed and dated notes on the day
service(s) provided;

(d)

evidence of patient/client being
informed of rights;

(e)

evidence of coordination of care of
all personnel providing patient/client services;

(f)

evidence of discharge.

If
the patient/client is discharged or transferred to another provider of health
care, upon receipt of a signed request from the patient/client, a copy of the
original record or an abstract of the same must be made available to the
receiving facility, within 24 hours.

Protection
of patient/client records:

(1)

The agency must insure that the
original patient/client records and information is safeguarded against loss or
unauthorized use.

(2)

The agency must have written policies
and procedures governing the use and removal of patient/client records and
conditions for release of information.

(3)

Patient/client’s written consent is
required for release of information not authorized by law.

Retention of patient/client records:

(1)

Original patient/client records shall
be retained for at least 10 years after the patient/client is discharged.

(2)

Original patient/client records shall
be maintained for the requisite period even if the agency has discontinued
operations.

(3)

The licensing authority must be
notified, in writing, prior to discontinuing operation of the storage location
of patient/client records.

[8.370.22.34 NMAC - N, 7/1/2024]

8.370.22.35

REPORTS AND RECORDS REQUIRED TO BE ON
FILE IN THE AGENCY:

a
copy of the last survey conducted by the licensing authority;

licensing
regulations:

A copy of these regulations,
8.370.22 NMAC;

agreements
or contracts to provide services or care;

patient/client
records;

staff
records;

training
and in-service records as applicable;

minutes
of advisory group and governing board meetings;

quality
improvement program records;

grievances
and resolutions;

state
board of pharmacy certificates as applicable.

[8.370.22.35 NMAC - N, 7/1/2024]

8.370.22.36

CONTRACTED SERVICES:

Services that are provided under
arrangement by an individual or entity and the home health agency, shall
include a written contract between those individuals or entities and the
agency, that specifies the following:

that
patients are accepted for care only by the primary (admitting) home health
agency;

the
services to be furnished under the contract.

the
necessity to conform to all applicable agency policies including personnel
qualifications;

the
responsibility for participating in developing plans of care;

the
manner in which services will be controlled, coordinated and evaluated by the
primary agency;

the
procedures for submitting clinical notes, scheduling of visits and conducting
periodic patient evaluation;

the
procedures for payment for services furnished under the contract.

[8.370.22.36 NMAC - N, 7/1/2024]

8.370.22.37

STAFF RECORDS:

Each agency licensed pursuant to these
regulations must maintain a complete record on file for each staff member and
for all volunteers with in-home contact or working more than half-time.

Staff records shall be made available for
review upon request of the licensing authority within four hours.

Staff records must contain at least the
following:

name;

address;

position for which employed;

date of employment;

health certificate for all staff
having contact with patient/clients stating that the employee is free from
tuberculosis in a transmissible form as required by the infectious disease
bureau, of the public health division, health care authority;

a copy or proof of the current
license, registration or certificate for each staff member for whom a license,
registration, or certification is required by the State of New Mexico.

[8.370.22.37 NMAC - N, 7/1/2024]

8.370.22.38

POLICIES AND PROCEDURES:

Each agency licensed pursuant to these
regulations must have written policies and procedures for at least the
following:

scope
of services offered;

providing
of services through arrangement or contract with individuals or agencies;

admission
and discharge;

written
job descriptions for all categories of personnel;

personnel
policies;

staff
training;

emergency
and after normal business hour care policies/procedures;

preparation,
safeguarding, and release of information from patient/client records;

quality
improvement program;

complaints
and grievances, including timely resolution.

[8.370.22.38 NMAC - N, 7/1/2024]

8.370.22.39

QUALITY IMPROVEMENT:

Each agency must establish an on-going
quality improvement program to ensure an adequate and effective operation.

To be considered on-going, the quality
improvement program must document quarterly activity that addresses, but is not
limited to:

Clinical care:

Assessment of patient/client goals
and outcome, such as, diagnosis(es), plan of care, services provided, and
standards of patient/client care.

Operational activities:

Assessment of the total operation
of the agency, such as, policies and procedures, statistical data (i.e.,
admissions, discharges, total visits by discipline, etc.), summary of quality
improvement activities, summary of patient/client complaints and resolutions,
and staff utilization.

Quality improvement action plan:

Written responses to address existing
or potential problems which have been identified.

Documentation of activities:

The results of the quality improvement
activities shall be compiled annually in report format and formally reviewed
and approved by the governing body and advisory group of the home health
agency.

No more than one year may lapse
between evaluations of the same part.

The
licensing authority may, at its sole discretion, request quarterly activity
summaries of an agency’s on-going quality improvement activities or may direct
the agency to conduct specific quality improvement studies.

[8.370.22.39 NMAC - N, 7/1/2024]

8.370.22.40

COMPLAINTS:

The home health agency must investigate
complaints made by a patient/client, caregiver, or guardian regarding treatment
or care, or regarding the lack of respect for the patient/client’s property and
must document both the existence of the complaint and the resolution of the
complaint.

The agency’s investigation of
a complaint(s) must be initiated within three working days.

[8.370.22.40 NMAC - N, 7/1/2024]

8.370.22.41

INCIDENTS:

Reporting:

All home health agencies licensed pursuant to these
regulations must report to the licensing authority any of the following which
has, or could threaten the health, safety and welfare of the patient/clients or
staff:

(1)

any serious incident or unusual
occurrence;

(2)

injuries of unknown origin or known,
suspected or alleged incidents of patient/client abuse, neglect, exploitation,
or mistreatment by staff or person(s) contracted by the home health agency.

Documentation:

The agency is responsible for
documenting all incidents, within five days of the incident, and having on file
the following:

(1)

a narrative description of the
incident;

(2)

evidence contact was made to the
licensing authority;

(3)

results of the facility’s
investigation;

(4)

the facility action, if any.

[8.370.22.41 NMAC - N, 7/1/2024]

8.370.22.42

RELATED REGULATIONS AND CODES:

Facilities subject to these regulations are
also subject to other regulations, codes and standards as the same may from
time to time be amended as follows:

Health
facility licensure fees and procedures, New Mexico health care authority, 8.370.3
NMAC.

Health
facility sanctions and civil monetary penalties, New Mexico health care
authority, 8.370.4 NMAC.

Adjudicatory
hearings, New Mexico health care authority, 8.370.2 NMAC.

[8.370.22.42 NMAC - N, 7/1/2024]

HISTORY OF 8.370.22 NMAC:

RESERVED