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10-144 DEPARTMENT OF HEALTH AND HUMAN SERVICES
BUREAU OF MEDICAL SERVICES
Chapter 119: REGULATIONS GOVERNING THE LICENSING AND FUNCTIONING OF HOME HEALTH CARE SERVICES

TABLE OF CONTENTS
CHAPTER 1: GENERAL DEFINITIONS 1
CHAPTER 2: LICENSING APPLICATION PROCEDURES 8

A. Requirements 8

B. Application Procedure 10

C. Fees 12

D. Additional Information 12

E. Certificate of Compliance with Fire Codes 13

F. Compliance with All Local, State and Federal Regulations 13

G. Posting of License 14

H. Waiver Provisions 14

I. Changes in Licensed Home Health Care Services 15

J. Types of Licenses Issued 15

K. Specifications of Licenses 16


CHAPTER 3: LOSS OF, RENEWAL. PROVISIONAL AND CONDITIONAL LICENSES 17

A. Refusal to Issue a License 17

B. Right of Entry and inspection 17

C. Renewal of License 20

D. Provisional License 20

E. Conditional License 20

F. Suspension or Revocation of License 21

G. Emergency Revocation, Suspension or Refusal to Renew License 21

H. Receivership 21

I. Appeals 22

J. Public Notice 22
CHAPTER 4: GENERAL REQUIREMENTS 23

A. General Requirements 23


CHAPTER 5: ADMINISTRATION 25

A. Organizational Structure and Lines of Authority 25

B. Business Records 26

C. Qualifications for Professional Personnel 27

D. Quality Assurance 27
CHAPTER 6: QUALIFICATIONS FOR HOME HEALTH CARE

PARAPROFESSIONAL PERSONNEL 28

A. Qualifications for Home Health Care Paraprofessional Personnel 28

B. Duties of Home Health Paraprofessional Personnel 29

C. Paraprofessional Staff Hiring 29
CHAPTER 7: SERVICES 31

A. Physician Services 31

B. Nursing Services . 31

C. Other Health Care Professional Services 33

D. Health Care Services 34

E. Plan of Care 36

F. Patient/Client Records 36

G. Patient Transfer and Discharge 39

H. Records and Review 43

I. Behavioral Services (Community Support Services) 43


ADDENDUM 44


CHAPTER 1: GENERAL DEFINITIONS
The following terms used in these regulations shall have the meanings specified.
1. Activities of Daily Living (ADL): means the functions or tasks for self-care which are performed either independently or with supervision or assistance. Activities of Daily Living include at least mobility, transferring, ambulating, grooming, bathing, dressing, eating and toileting.
2. Acute Care Services: are services provided to address severe, significant or serious illness.
3. Administrator: is a person having the authority and responsibility for the operation of the home health care agency and for staff performance in accordance with applicable requirements and policies of the agency. The administrator is a licensed physician, registered nurse, or an individual who has training and experience in health services administration, with at least one (1) year of supervisory or administrative experience in home health care services or related health programs.
4. Advanced Directive: means a document signed by the client, guardian or durable power of attorney, specifying the scope of treatments and/or procedures that are not to be carried out by others in the event that the client becomes unable to provide that direction. This document must be in compliance with the Federal 1990 Patient Self Determination Act (Omnibus Budget Reconciliation Act, Section 4206) and the Maine Uniform Rights of the Terminally Ill Act (Title 18-A Maine Revised Statutes Annotated §5-801 et seq.).
5. Agency Contracting or Arranging for Home Health Care Services: means an agency whose employees do not directly provide home health care services in the home. These agencies develop contractual agreements with licensed or legally exempted home health care agencies for the provision of home health care services. Agencies that contract or arrange for home health care services to be delivered, but whose employees do not directly provide home health cue services, shall be exempt from the provisions of these regulations.
6. Applicant: means the individual who signs the application for a home health care service license. The applicant must be the individual who has the ultimate responsibility for ensuring that a facility operates in compliance with these regulations.
7. Branch Office: means a location or site from which a home health care services agency provides services within a portion of the total geographic area served by the parent agency. The branch office is part of the home health care services agency and is located sufficiently close to share administration, supervision, and services in a manner that renders it unnecessary for the branch independently to meet the State Home Health Care Services Licensing Regulations.
8. Bylaws: means a set of rules adopted by the home health care services agency for governing the agency's operation.
9. Certified Nursing Assistant (CNA): means a person whose duties are assigned by a registered professional nurse and who:
a. Has successfully completed a training program or course with a curriculum prescribed by the Maine State Board of Nursing, holds a certificate of training from that program or course and is listed on the Maine Registry of Certified Nursing Assistants, or
b. Was certified before September 29, 1987 and is listed on the Maine Registry of Certified Nursing Assistants.
10. Clinical Note: is a signed and dated clinical notation made at each patient visit by each health care staff person who renders a service to the patient. The clinical note shall be written or dictated on the day the service is rendered and shall be incorporated within a week into the patient's medical/health record according to the facility's policies and procedures The clinical note may include, but shall not be limited to:
a. A flow sheet, a written description of signs and symptoms, treatment and/or medication(s) administered, the patient's response and any changes in physical or mental status.
b. Progress note, a supplemental note concurrent with the plan of care whenever there is a change in the patient's condition or care which cannot dearly be documented on a flow sheet.
11. Commissioner. means the person who heads the Department of Health and Human Services.
12. Deeming: A Medicare certified home health agency is deemed to meet the State licensure requirements if it meets all Federal certification requirements.
13. Department: means the Maine Department of Health and Human Services.
14. Dietitian: is a person who is registered, or eligible for registration, by the Commission on Dietetic Registration of the American Dietetic Association and is licensed by the Maine State Board of Dietitians.
15. Director of Nurses: The Director of Nurses is a person having the authority and responsibility for the clinical services, in accordance with applicable requirements and policies of the agency. The Director of Nurses is a registered nurse currently licensed in the State of Maine, qualified by advanced education or management experience. The Director of Nurses must have one (1) year of clinical experience and at least two (2) years of supervisory or administrative experience in home health care services.
16. Documented: means written, signed and dated.
17. Full Time Equivalent Employee: is one or more individual(s) who is/are employed on the basis of at least 37 1/2 hours per week for the home health care service agency.
18. Governing Board: means the organization, person or persons designated to assume legal responsibility for the determination and implementation of policy and for the management, operation and financial viability of the facility.
19. Health Promotion: is any effort or combination of efforts designed to help bring about or further the development of the state of physical and mental well-being in individuals.
20. Home Health Aide: means a certified nursing assistant who meets both the requirements of this Chapter and the Code of Federal Regulations 42 CFR, Part 484.4.
21. Home Health Care Services Provider: is any business, entity or subdivision thereof, whether public or private, proprietary or not for profit, that is engaged in providing acute, restorative, rehabilitative, maintenance, preventive or health promotion services through professional nursing or another therapeutic service, such as physical therapy, home health aides, nurse assistants, medical social work, nutritionist services, or personal care services, either directly or through contractual agreement, in a patient's/client's place of residence. This term does not apply to any sole practitioner providing private duty nursing services or other restorative, rehabilitative, maintenance, preventative or health promotion services in a patient's/client's place of residence or to municipal entities providing health promotion services in a patient's/client's place of residence. This term does not apply to a federally qualified health center or a rural health clinic as defined in 42 United States Code, Section 1395x, subsection (aa) (1993) that is delivering case management services or health education in a patient's/client's place of residence. Beginning October 1, 1991, "home health care provider" includes any business entity or subdivision there of, whether public or private, proprietary or nonprofit, that is engaged in providing speech pathology services.
A Home Health Care Services Provider shall also be referred to as a home health care agency.
22. Home Health Care Services: are the in-home provision of professional nursing services, physical and/or occupational therapy, speech pathology, medical social work, nutritionist services and the supervised services of licensed practical nurses, home health aides and/or certified nurse assistants providing treatment and rehabilitation for illness or disability, aimed at restoring or maintaining independent functioning. These services are provided directly or through contractual agreement in the patient's/client's home and must be provided in the State of Maine. All licensed providers of home health care services must be located in the State of Maine, with a commercial address. The only exceptions are licensed home health care service providers located on the borders of Maine/New Hampshire and Maine/Canada.
23. Home Health Care Services Hotline: is a toll free number, established within the State of Maine, to receive complaints and/or questions about home health care services.
24. Home Health Paraprofessional Services: are health care services rendered by home health aides and certified nurse assistants involving selected technical nursing or personal care services delegated by registered professional nurses and supervised by them.
25. Instrumental Activities of Daily Living (IADL): means the functions or tasks for self-care which are performed either independently or with supervision or assistance. IADLs include preparing light and full meals, light housekeeping, personal laundry, handling money and using a telephone.
26. Job Description: means written specifications developed for each personnel position in the facility, containing the qualifications, duties, competencies, responsibilities, and accountability required of employees.
27. Licensed Health Care Professionals: are health care providers including physicians, registered professional nurses, licensed practical nurses, occupational therapists, speech pathologists, physical therapists, dietitians and social workers that have been authorized to practice a health care profession in accordance with state law.
28. Licensed Practical Nurse: is an individual who possesses a current license and is authorized to perform tasks and responsibilities for compensation under the direction of a registered professional nurse, physician, or dentist, as authorized in Title 32 MRSA, Section 2101, et seq.
29. Maintenance Services: are activities designed to keep the patients/clients at their present level of functioning.
30. Multidisciplinary Team: is a group of health care professionals and paraprofessionals that may include, but are not limited to the following: physicians, registered professional nurses, care managers, physical and occupational therapists, dietitians, speech pathologists, medical social workers, licensed practical nurses, certified nursing assistants, and home health aides. These health care individuals work together in an attempt to meet the total health care needs of the patient/client in the home.
31. Occupational Therapist: is an individual who is currently registered with the American Occupational Therapist Association and possesses a current license authorized by Title 32 MRSA §2271 et seq.
32. Patient/Client: is a person who receives home health care services.
33. Personal Care Services: are those services provided in a patient’s/client’s residence by a home health aide or certified nursing assistant and which are delegated and supervised by a registered nurse (services provided by a personal care assistant (PCA), as defined in the Rules for the Home Based Care Program are not included in this definition).
34. Physical Therapist: is an individual who possesses a current license authorized by Title 32 MRSA §3111 et seq.
35. Plan of Care: is a systematic, individualized written plan developed by a home health cue services agency's professional staff in conjunction with the patient/client, family and/or significant others. This plan of care must be updated as the patient's needs change. These changes include at least those activities which shall be provided to the patient by the agency to meet their needs.
36. Policies: are written standards which govern the provisions of home health care services.
37. Preventive Services: are services provided in the home by health care professionals or paraprofessionals designed to promote the health of individuals so that illnesses will not occur.
38. Procedures: are specific, written directions to accomplish policies.
39. Progress Note: means a written notation, dated and signed by a member of the multidisciplinary team, that summarizes facts about care furnished and the patient's response during a given period of time.
40. Proprietary Agency: means a private profit making agency licensed by the state.
41. Protocols: are written guidelines that define the limits and extent of practice for health care in a home health care services agency.
42. Registered Professional Nurse: is an individual who possesses a current license authorized by the Maim State Board of Nursing pursuant to Tide 32 MRSA §2102(5), and 32 MRSA §§2101 et seq.
43. Rehabilitative Services: are services provided by home health care providers which are designed to assist patients/clients regain their former functional abilities.
44. Restorative Services: are services which provide treatment or therapy to improve patient/client health and functioning in order that he/she may achieve or maintain an optimum level of self care and independence.
45. Signature: means at least the first initial and full surname and title (for example, S. Jones, R.N.) of a person, legibly written, generated by computer with authorization safeguards, or communicated by a facsimile communications system (FAX).
46. Social Worker: is an individual who possesses a current license authorized by Title 32 MRSA §705 et seq. If the individual is not a Master's level licensed Social Worker, he/she must be supervised in accordance with the requirements of the Board of Social Work.
47. Speech Pathologist: is an individual who is currently licensed by the State of Maine Speech Pathology and Audiology Licensing Board to act as a speech pathologist pursuant to Tide 32 MRSA §6020 et seq.
48. Staff Education Plan: means a written plan, developed at least annually by agency professional staff and implemented throughout the year, which describes a coordinated program for staff education, including inservice programs and on the job training.
49. Staff Orientation Plan: means a written plan for the orientation of each new employee to the duties and responsibilities of the services to which he/she has been assigned, as well as to the personnel policies of the facility.
50. Sub Unit: means a semi-autonomous organization that:
a. Serves patients in a geographic area different from that of the parent agency; and
b. Must independently meet the Home Health Care Services Regulations because, geographically, the parent agency is unable to share administration, supervision and services on a daily basis.
51. Supervision: means authoritative procedural guidance by a qualified person for the accomplishment of a function or activity within his/her sphere of competence, with initial direction and periodic on-site inspection of the actual act of accomplishing the function or activity.
52. Therapeutic Service: is a healing act based upon a knowledge of disease and of the remedies employed. Therapeutic services are provided by health care professionals and paraprofessionals in accordance with the plan of care developed by a licensed health care professional.


CHAPTER 2: LICENSING APPLICATION PROCEDURES
2.A. Requirements
2.A.1. No home health care agency may provide home health care services without receiving a license from the Department authorizing such services or operation.
2.A.2. The applicant shall comply with all applicable Maine Statutes and rules and regulations.
2.A.3. No home health care agency shall accept any remuneration for delivering home health care services without having first secured a license authorizing its operation in accordance with these regulations.
2.A.4. Any person, organization or corporation seeking home health licensure shall make an appointment for a preliminary conference at the Division of Licensing and Certification at least forty-five (45) days prior to the initial survey.
2.A.5. The following are exempt from the provisions of this chapter in accordance with 22 MRSA §2147:
a. Hospice organizations; volunteer services. Hospice organizations in which services are provided substantially by volunteers;
b. Families, friends and neighbors,
c. Sole practitioners. Sole practitioners otherwise licensed by the State;
d. Physicians. Services provided directly by physicians;
e. Elderly nutrition programs;
f. Chore services;
g. Pharmacy or medical supply company. Any pharmacy or medical supply company which furnishes no home health services to persons in their homes except supplies;
h. Persons or agencies contracting or arranging home health services. Anyone contracting or arranging for home health services provided by home health care providers licensed or excluded under this chapter,
i. Departments. Departments of State Government;
j. Facilities licensed pursuant to Chapter 405. Hospitals, nursing care facilities, skilled nursing facilities, or other facilities licensed pursuant to Chapter 405 when the services are provided either to clients residing in those facilities or to six (6) or fewer clients at any one time in their homes under a plan of care approved by the Department or its designee when it is documented in the patient's record that the licensed home health care agency or agencies serving the patient's area:
1. Have indicated that they are unable to provide those services; or
2. Agree that the plan of care is an acceptable plan.
The plan of care must meet standards for staff qualifications and supervision consistent with the standards required of licensed home health care providers;
k. Licensed Boarding Care Facilities. Boarding care facilities licensed pursuant to Chapters 1663 and 1665 when the services are provided to clients residing in those facilities;
l. Municipal Entities. Municipal departments or agencies or other municipal entities in their provision of nontherapeutic preventive and promotional health educational services where persons providing those services are employed by the municipality.
2.A.6. The following are exempt from the provisions of this chapter in accordance with Title 22 MRSA Section 2142, Sub-section 3:
Federally qualified health center or a rural health clinic as defined in 42 United States Code, Section 1395X Sub-section (aa) (1993) that is delivering case management services or health education in a client's place of residence.
2.B. Application Procedure
2.B.1. Film of Application
Any person, partnership, association or corporation desiring a license to engage in home health care services shall, prior to the commencement of such operation, file an application with the Department. Applications submitted on behalf of a corporation or association shall be made by any two officers thereof or by its administrator. All applicants shall comply with the rules and regulations adopted pursuant to Title 22 MRSA §2141 et seq.
2.B.2. Contents of Application
Each application shall contain:
a. The name by which the Home Health Care Services Provider is to be legally known and the name under which it shall be doing business;
b. A description of all facilities utilized by the Home Health Care Services Provider. This will include the address(es), telephone number(s) and name of owner(s) of all buildings utilized by the home health care agency. All branches and sub units must be identified by address(es), telephone number(s), and identifying names;
c. A listing of specific home health care services provided by the agency,
d. For proprietary corporations: the full name and address of each person, firm or corporation having (directly or indirectly) an ownership interest of 5% or more in the agency,
e. For business entities with one owner or business partnerships: the full name and address of each partner,
f. For not-for-profit organizations: the full name and address of the President of the Board of Directors or appropriate municipal government representative;
g. The name, home address, home telephone number and office telephone number of the individual designated by the applicant as the administrator of the Home Health Care Services Provider,
h. The name of the Director of Nursing;
i. The number of full time equivalent staff
2.B.3. Suitability of Applicant
In acting upon any application for license or relicensure, the Department shall determine the suitability of the applicant to operate the home health care services facility.
a. A determination of suitability shall require the applicant to demonstrate their willingness and ability to operate and manage the facility with compliance with these regulations and all relevant laws. In making this determination, the Department shall consider each of the following factors to the extent they are relevant to the proposed agency, ownership interest, and/or equipment:
1. Record and reputation for lawful conduct in business and personal affairs (including, but not limited to, a criminal conviction).
2. Financial ability and fiscal responsibility (such as a history of withholding taxes, a good credit rating from an appropriate agency and/or financial institution, capability of obtaining financing for working capital and repairs required by these rules).
3. Management and supervisory experience, including the capacity to manage the financial operations and staff of the agency for which the license is sought.
4. Experience in the field of health care, social services or areas related to the provision of home health services.
5. Conduct which demonstrates an understanding of, and compliance with, clients’ rights.
6. Information which relates to the ability in complying with all applicable laws and regulations.
7. Any information reasonably related to the ability to provide safe services at the level of care for which the license is sought.
2.C. Fees
2.C.1. Each application under this chapter shall be accompanied by an annual fee of $300.00.
2.C.2. All licenses shall be renewed annually upon payment of the appropriate fee and demonstration of continued compliance with these rules and regulations.
2.C.3. No fee shall be refunded.
2.D. Additional Information
2.D.1. Copy of the Lease
When a building(s) is/are leased to the person(s) to operate as a Home Health Care Services Provider, a copy of the lease shall be filed with the application for a license This lease agreement shall clearly demonstrate which party is to be held responsible for the maintenance and upkeep of the property. The Department shall be notified within seventy-two (72) hours if there are any changes in the lease agreement that may in any way affect the responsibility for maintenance and upkeep of the property.
2.D.2. Home Health Care Services Providers Operated by Same Management on Different Premises
Sub units of licensed Home Health Care Services Providers will require separate licenses. Home Health Care Services Providers operated by the same management on different grounds shall be required to have in effect a separate license for each sub unit.
2.D.3. Physician Ownership
The Division of Licensing and Certification will investigate whether the physician ordering the need for home health care services has a financial interest or ownership in an agency. A current listing of physicians associated with financial interests or ownership must be submitted to the Division of Licensing and Certification. See Chapter 7.A..5.
2.D.4. Change in Ownership of Home, Health Care Services Provider
a. No license shall be assigned or transferred.
Effective At least thirty (30) days advance written notice shall be given to

July 1, 2004 the Division of Licensing and Certification, Bureau of Medical Services, prior to the transfer of ownership of any home health care agency.


b. At least thirty (30) days advance written notice shall be give to the Division of Program Analysis and Development, Office of Health Planning and Development, and the Division of Licensing and Certification, Bureau of Medical Services, prior to the transfer of ownership of any home health care agency.
c. Each application for a license from a new owner shall be accompanied by a statement from the previous owner or his duly authorized representative concerning the change of ownership. In lieu of this statement, a copy of the deed or other validating document shall be submitted. In addition, an application fee, calculated in accordance with Section 2.C of this chapter, shall be submitted to the Department. When the ownership of a Home Health Care Services Provider changes, upon receipt of a completed application and fee, the Department may issue a provisional license for a period not to exceed ninety (90) days. The new owner's application must demonstrate that the agency will continue to comply with the requirements for licensure.
2.E. Certificate of Compliance with Fire Codes
Fire safety inspections are not required for home health care services licensure.
2.F. Compliance with All Local, State and Federal Regulations
2.F.1. The Home Health Care Services Provider and its staff must operate and furnish services in compliance with all applicable federal, state and local laws and regulations.
2.F.2. The applicant shall submit a letter from the appropriate municipal official(s) that demonstrates compliance with all local ordinances relative to zoning and building codes and a certificate of occupancy, if appropriate, which includes electrical and life safety code compliance.
2.F.3. The applicant will submit proof of a Clinical Laboratory number (if appropriate) under the Clinical Laboratory Improvement Amendments of 1988.
2.F.4. The applicant will submit proof of a Department of Environmental Protection number (if appropriate).
2.G. Posting of License
The license granted by the Department shall be conspicuously posted in an area where business is conducted/coordinated for the home health care services.
2.H. Waiver Provisions
2.H.1. The Department may upon written request waive or modify any provision contained herein which is not mandated by Maine Statutes. The applicant or licensee shall provide clear and convincing evidence that the alternative method will comply with the intent of the regulation for which a waiver is sought. Requests for a waiver shall be made on forms approved by the Department, and shall include:
a. A statement of the regulation for which a waiver is requested;
b. An explanation of the reasons why the provisions cannot be met and a waiver is being requested; and
c. A description of the alternative method proposed for meeting the intent of the provision sought to be waived. Waivers, when approved, shall be time limited. Prior to the expiration of the approval, if the waiver continues to be necessary, an extension of time may be granted by the Department on receipt of a new application.
2.H.2. Home Health Care Services Providers regulated by the State Government or the Federal Government may apply for consideration of a waiver to be granted by the Commissioner of the Department of Health and Human Services. Home Health Care Services Providers that are regulated by the State Government or the Federal Government that may apply for than waiver include:
a. Alcohol and substance abuse treatment agencies possessing a current license authorized by Title 22 MRSA §7801-7815.
b. Pre-school coordination sites which are regulated by the Department of Education.
c. Public schools and private educational agencies winch are regulated by the Department of Education.
d. Mental health services providers which are licensed and regulated by the Department of Behavioral and Developmental Services as authorized by Title 34B MRSA §3606.
2.H.3. These providers will be eligible for the waiver solely for those home health care services for which they are regulated by a Bureau of the Department of Health and Human Services or another Department within State Government.
2.H.4. The Commissioner of the Department of Health and Human Services may grant a full, provisional, or conditional license to those entities otherwise regulated by the State Government or the Federal Government, if he/she determines that those providers meet the purpose and intent of this chapter This shall be determined through submission of information in accordance with the waiver forms described in Chapter 2.I.1. of these regulations.
2.I. Changes in Licensed Home Health Care Services
Each Home Health Care Services Provider will notify the Bureau of Medical Services in writing of any changes in:
2.I.1. Ownership;
2.I.2. Scope and nature of services provided,
2.I.3. Relocation or change of business address and telephone;
2.I.4. Administrator,
2.I.5. Addition/deletion of a branch or sub unit, or
2.J.6. Deeming.
2.J. Types of Licenses Issued
The Department will issue the following types of licenses to Home Health Care Services Providers:
2.J.1. Full License-effective for the period of twelve (12) months to an applicant who complies with all applicable laws and rules.
2.J.2. Provisional License- effective for a minimum of three (3) months and not to exceed twelve (12) months, to an applicant who:
a. Has not previously operated as a Home Health Care Services Provider or is licensed but has not operated during the term of that license;
b. Complies with all applicable laws and rules, except those which can be complied with only once clients are served by the applicant; and
c. Demonstrates the ability to comply with all applicable laws and rules by the end of the provisional license term
2.J.3. Conditional License-effective for a specific period not to exceed one (1) year to an applicant who has not fully complied with all applicable laws and rules, and in the judgment of the Commissioner, the best interest of the public would be so served by issuing a conditional license. The conditional license shall specify when and what corrections shall be made during the term of the conditional license.
2.K. Specifications of License
Each license issued by the Department shall identify:
2.K. 1. The name of the Home Health Care Services Provider,
2.K.2. The name of the administrator,
2.K.3. The geographical location of each unit or subunits, if so designated;
2.K.4. The type of home health care services provided;
2.K.5. Any waiver(s) that have been granted;
2.K.6. The period of licensure and date of licensure expiration; and
2.K.7. The date issued, and type of license.

CHAPTER 3: LOSS OF, RENEWAL, PROVISIONAL AND CONDITIONAL LICENSES
3.A. Refusal to Issue a License
The Department shall refuse to issue a license to the applicant if it finds that any or all of the following conditions exist:
3.A.1. The Department finds that the information submitted in the application is incorrect or incomplete,
3.A.2. The applicant does not meet all requirements of these laws and regulations;
3.A.3. The applicant has violated applicable laws and rules and regulations and the Department finds that these practices of the agency are detrimental to the welfare of persons to whom home health care services are provided.
3.B. Right of Entry and Inspection
3.B.1. Any duly designated employee of the Department shall have the right to enter upon and into the premises of any Home Health Care Services Provider who has applied for a license or who is licensed pursuant to these rules and regulations. These employees can inspect relevant agency documents to determine whether the agency is in compliance with these rules and regulations. The right of entry and inspection shall extend to any premises and documents of providers whom the Department has reason to believe are providing home health care services without a license. Such entries or inspections shall be made with permission of the owner or person in charge unless a warrant is first obtained from the District Court authorizing that entry or inspection (22 MRSA §2148). Surveyors, with the permission of the patient/client, may also make patient/client home visits at their discretion.
3.B.2. The Department and any duly designated representative thereof shall have the right to enter upon and into the premises of any facility licensed pursuant to these rules and regulations at any time, without threat of injury, verbal abuse or harassment and in the spirit of mutual cooperation, in order to determine the state of compliance with the provisions of rules and regulations in force pursuant thereto. Such right of entry and inspection shall extend to any premises which the Department has reason to believe are being operated or maintained as a home health care services agency without a license, but no such entry or inspection of any premises shall be made without the permission of the owner or person in charge thereof, unless a warrant is first obtained from the court of jurisdiction authorizing the same. Any application for a license made pursuant to these rules and regulations shall constitute permission for, and complete acquiescence in, any entry or inspection of the premises for which the license is sought in order to facilitate, verification of the information submitted on or in connection with such application. (Title 22, §2148). Application for licensure, whether initial or renewal, shall constitute permission for entry into, and survey of, a home health care services provider by authorized licensing authority representatives at reasonable times during pendency of the application and, if licensed, during the licensure period.
3.B.3. Surveys may be announced or unannounced at the sole discretion of the licensing authority. All complaint investigations will be unannounced.
3.B.4. Upon receipt of a notice of deficiency from the licensing authority, the licensee or his/her representative will be required to submit a written plan of correction to the licensing authority within ten (10) working days of the date of the statement of deficiencies stating how the agency intends to correct each violation noted and the expected date of completion.
3.B.5. The licensing authority may, at its sole discretion, accept the plan of correction as written or request modification of the plan by the licensee.
Effective 3.B.6. Regardless of the term of the license, the Department shall monitor for

January 1, 2005 continued compliance with applicable laws and rules on at least a biennial basis.


3.B.7. Licensing Survey Frequency
The Department shall survey the Home Health Care Services Provider on at least a biennial basis, except that State licensing surveys need not be performed during a year when a Medicare certification survey is performed.

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