RULES AND REGULATIONS FOR LICENSURE OF HOME HEALTH AGENCIES

CHAPTER 10

  Section 1. Authority. These rules are promulgated by the Department of Health pursuant to the Health Facilities Act at W.S. §35-2-901 et seq. and the Wyoming Administrative Procedures Act at W.S. §16-3-101 et.seq.

  Section 2. Purpose. These licensure rules have been adopted to protect the health, safety, and welfare of clients and employees of Home Health Agencies.

  Section 3. Severability. If any portion of these rules is found to be invalid or unenforceable, the remainder shall continue in effect.

  Section 4. Definitions. The following definitions shall apply in the interpretation and enforcement of these rules. Where the context in which words are used in these rules indicates that such is the intent, words in the singular number shall include the plural and vice versa. Throughout these rules gender pronouns are used interchangeable. The drafters have attempted to utilize each gender pronoun in equal numbers, in random distribution. Words in each gender shall include individuals of the other gender. For purpose of these rules, the following shall apply:

  (a) "Acceptable plan of correction" means the Licensing Division approved the plan to correct the deficiencies identified during an on-site survey conducted by the Survey Division or its designated representative. The plan of correction shall be a written document and shall provide:

    (i) Who is responsible for the correction;

    (ii) What was done or will be done to correct the problem;

    (iii) Who will monitor to ensure that the situation does not develop again; and

    (iv) An appropriate date, not to exceed sixty (60) days after the last day of survey, for the correction of deficiencies.

  (b) "Branch office" means a location or site from which a home health agency provides services within a portion of the total geographic area served by the parent agency. The branch office is a part of the home health agency and is located sufficiently close to share administration, supervision, and services in a manner that renders it unnecessary for the branch to independently meet the licensure as a home health agency. Exception: Branch offices located out of state will be individually licensed in the State of Wyoming.

  (c) "Client" means a person served by, or using the services of a home health agency, either with or without charge.

  (d) "Complaint Investigations" means those investigations required to be performed by the Long Term Care Ombudsman per W.S. §9-2-1301 through W.S. §9-2-1309 or by the State Survey Agency as per the agreement dated June 18, 1985 between the Secretary of the U.S. Department of Health and Human Services and the State of Wyoming.

  (e) "Health Care Services" includes, but is not limited to, nursing, physical therapy, speech therapy, occupational therapy, respiratory therapy, medical social work, home health aide, and dietary services. All staff shall be licensed in accordance with Wyoming State Statutes.

  (f) "Home Health Agency" means any group, public agency, private organization, or any individual person who is primarily engaged in arranging for and directly providing two or more health care services to persons at their residence.

  (g) "License" means the authority granted by the Licensing Division to operate a Home Health Agency.

  (h) "Licensee" means any person, association, partnership, or corporation to whom a Home Health Agency license is issued.

  (i) "Licensing Division" means the Department of Health, Office of Health Quality.

  (j) "Primarily Engaged" means a relationship between a provider of services and a client whereby a provider offers to arrange for or directly provide health care services at a client's residence and the client accepts the offer. When this relationship is agreed upon, the provider becomes primarily engaged in providing health care services to the client.

  (k) "Program Administration" means the rules and regulations promulgated by the Depart- ment of Health and developed by the Program Division for the day-to-day operation of the Home Health Agency per W.S. §9-2-1208.

  (l) "Program Division" means the Department of Health, Division on Aging.

  (m) "Provider" means a licensed home health agency.

  (n) "State Survey Agency" means the Department of Health, Office of Health Quality which has the primary responsibility to determine whether health care providers/suppliers do or do not meet federal certification standards to participate in the Medicaid and/or Medicare programs as per the agree- ment between the Secretary of U.S. Department of Health and Human Services and the State of Wyo- ming dated June 18, 1985.

  (o) "Survey" means an on-site evaluation conducted by the Survey Division or its desig- nated representative to determine compliance with State rules and regulations for Home Health Agen- cies.

  (p) "Survey Division" means the Department of Health, Office of Health Quality.

  Section 5. Licensure. Applicants must demonstrate full compliance with paragraphs (a) and

  (b) of this section.

  (a) Licensing Procedure.

    (i) For an initial license to be issued, the Licensing Division shall receive:

      (A) A completed application form as supplied by the Licensing Division;

      (B) Each completed application shall be accompanied by the required licen- sure fee identified in Chapter 1, Rules and Regulations for Health Care Facilities Licensure Fees. The check or money order shall be made payable to the Treasurer, State of Wyoming; and

      (C) An applicant shall demonstrate full compliance with the licensure re- quirements in paragraph (b) of this section. The effective date of the initial license shall be: The date of the survey, if there are no defi- ciencies.

        (II) If deficiencies exist, the date that an acceptable plan of correc- tion is developed after the survey.

    (ii) For renewal of a full license for one year beginning July 1st and, unless sus- pended or revoked, expiring on June 30th of the following year, the Licensing Division shall receive:

      (A) A completed application form by the date stated in the application cover letter supplied by the Licensing Division; and

      (B) The license fee as required in paragraph (a)(i)(B) of this section.

  (b) Requirements for Licensure. The Licensing Division shall consider:

    (i) Initial and periodic renewal licensure survey deficiencies cited by the Survey Division;

    (ii) Complaint investigations and resolutions; and

    (iii) Compliance with all laws and standards relating to communicable and report- able diseases as required by the Department of Health, State Health Officer and Public Health Division.

  (c) Transfer of License.

    (i) No license shall be assigned or transferred by the licensee without prior written approval of the Licensing Division.

      (A) Requests to assign or transfer a Home Health Agency license shall be submitted in writing by the licensee to the Licensing Division at least thirty (30) days prior to the planned date of assignment or transfer.

      (B) Any license approved for assignment or transfer by the Licensing Divi- sion shall be subject to the plan of correction for licensure submitted by the previous licensee.

    (ii) If the Home Health Agency name is changed, the Licensing Division shall be advised in writing, before the name is changed, by the current licensee and a new license shall be issued upon the receipt of an application and licensure fee.

  (d) Conditions for Denying, Revoking, or Suspending a License.

    (i) Denial, revocation, or suspension of a license may occur for noncompliance with any provisions of these licensure rules.

  (e) Hearings.

    (i) Any Home Health Agency aggrieved by a decision of the Licensure Division may request a hearing by submitting a written request to the Licensure Division within ten (10) days of receipt of the adverse action.

    (ii) Except in matters concerned with the spread of communicable disease, the Li- censure Division (Nurse Administrator or designated representative) shall present the preliminary de- cisions and reasons for the decision to the parties concerned and shall provide an opportunity for a hearing. Any request for hearing shall adhere to the time frames of (i) above.

    (iii) In matters concerned with the spread of communicable disease, the Wyoming State Health Officer or designated representative shall present the preliminary decisions and reasons for the decision to the parties concerned and shall provide an opportunity for a hearing. Any request for hearing shall adhere to the time frames in (i) above.

    (iv) Hearings requested under the terms of these licensure rules shall be held in ac- cordance with the provisions of the Wyoming Administrative Procedures Act.

  (f) Posting of License.

    (i) The current license issued by the Licensing Division shall be displayed in a public area within the Home Health Agency.

  (g) Surveys for Licensure.

    (i) The Survey Division shall perform initial and periodic surveys for renewal of licensure.

      (A) These surveys shall be based on but not limited to:

    (i) The requirements of the current Licensure and Program Admin- istration Rules and Regulations for Home Health Agencies as promulgated by the Wyoming Depart- ment of Health. If there are conflicts between the Licensure and Program Administration Rules, the Licensure Rules take precedence.

    (ii) Results of in home visits performed by survey staff;

    (iii) Review of client medical records; and the

    (iv) Effectiveness of the home health agency's quality management program.

      (B) The Survey Division shall provide within ten (10) working days after the last day of survey, copies of its cited deficiencies to the Home Health Agency and the Program Division.

      (C) The Home Health Agency shall provide an acceptable plan of correction for all cited survey deficiencies, within ten (10) working days after receipt of the deficiencies, to the Licensing Division.

      (D) The Licensing Division shall provide written notification to the Home Health Agency and to the Program Division as to whether the plan of correction is or is not acceptable. This notification shall be provided within ten (10) working days after receipt of the plan of correction.

  (h) Voluntary Closure.

    (i) If a Home Health Agency voluntarily ceases to operate, it shall notify the Li- censing Division in writing at least thirty (30) calendar days prior to the closure.

    (ii) The first working day after closure, the Home Health license shall be hand car- ried or sent by certified mail to the Office of Health Quality; 2020 Carey Avenue, Eighth Floor; Chey- enne, WY 82002.

    (iii) Personnel, financial and client medical records shall be maintained by the lic- ensee for a minimum of six (6) years after the month of closure.