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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 52 Pa.B. 6828 (October 29, 2022).

28 Pa. Code § 601.21. Organization, services and administration.


§ 601.21. Organization, services and administration.

 (a)  Writing requirements. Organization, services provided, administrative control and lines of authority for the delegation of responsibility to the patient care level shall be clearly set forth in writing and shall be readily identifiable. Administrative and supervisory functions may not be delegated to another agency or organization and services not provided directly shall be monitored and controlled by the primary agency, including services provided through subunits of the parent agency. If an agency has subunits, appropriate administrative records shall be maintained for each subunit. The subunit, by virtue of the lack of accessibility between it and the parent agency, is judged incapable of sharing administration, supervision and services on a daily basis with the parent agency and shall independently meet this subpart.

 (b)  Services provided. Part-time or intermittent skilled nursing services and at least one other therapeutic service—physical therapy, occupational therapy, speech pathology, medical social services or home health aides—shall be made available on a visiting basis, in a place of residence used as a patient’s home. A home health care agency shall provide at least one of the qualifying services directly through agency employes, but may provide, by written contract, the second qualifying service and additional services under arrangements with another agency or organization.

 (c)  Governing body. A governing body or designated persons so functioning shall assume full legal authority and responsibility for the operation of the agency. The governing body shall appoint a qualified administrator, arrange for professional advice—see §  601.22 (relating to agency evaluation and review)—adopt and periodically review written bylaws, and oversee the management and fiscal affairs of the agency.

 (d)  Administrator. The administrator, who may also be the supervising physician or registered nurse—see subsection (e)—shall organize and direct the agency’s ongoing functions; maintain ongoing liaison among the governing body, the group of professional personnel and the staff, employ qualified personnel and ensure adequate staff education and evaluations; ensure the accuracy of public information materials and activities; and implement an effective budgeting and accounting system. A qualified person shall be authorized in writing to act in the absence of the administrator.

 (e)  Supervising physician or registered nurse. The skilled nursing and other therapeutic services provided shall be under the supervision and direction of a physician or a registered nurse with at least 1 year of nursing experience. This person, or a similarly qualified alternate, shall be available at all times during the operating hours and participate in activities relevant to the professional services provided, including the development of qualifications and assignments of personnel.

 (f)  Personnel policies. Personnel practices shall be supported by appropriate, written personnel policies. Personnel records shall include job descriptions, qualifications, licensure, performance evaluations, health examinations and documentation of orientation provided. Records shall be kept current.

 (g)  Civil rights. Home health care agencies shall comply with the Pennsylvania Human Relations Act (43 P. S. § §  951—963) and 16 Pa. Code Part II, Subpart A (relating to the Human Relations Commission).

 (h)  Coordination of patient services. Personnel providing services shall maintain liaison to assure their efforts effectively complement one another and support the objectives outlined in the plan of treatment. The clinical record or minutes of case conferences shall establish that effective interchange, reporting and coordinated patient evaluation does occur. A written summary report for each patient shall be sent to the attending physician at least every 60 days.

 (i)  Institutional planning. The home health care agency, under the direction of the governing body, and in conjunction with representatives of the administrative and health professional staff, shall prepare an overall plan and budget.

Cross References

   This section cited in 28 Pa. Code §  601.6 (relating to definitions).

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