7 AAC 12.512. Quality improvement

(a) A home health agency shall have a quality improvement program to assess the extent to which the agency's program is appropriate, effective, and efficient. The quality improvement program must include an analysis of:

(1) a quarterly clinical record review;

(2) quality indicator data derived from patient assessments;

(3) current clinical practice guidelines and professional practice standards applicable to patients in the home;

(4) utilization data;

(5) measures of staff performance;

(6) medical and other professional evaluation of the home health agency's care giving system;

(7) patient satisfaction surveys; and

(8) patient complaints and the resolution process.

(b) The quality improvement program must include problem identification, corrective action, and follow-up monitoring of identified problems.

(c) A home health agency shall review a patient's clinical record for each 62-day period that a patient receives home health services to determine adequacy of the plan of care and appropriateness of continued care.

(d) The quarterly clinical review required by (a) of this section must be conducted by a multidisciplinary team of health professionals representing the services provided by the agency. The review must consist of at least 10 percent of both active and closed records in that quarter to determine if state and federal laws and agency policies are followed in providing services by employees or contractors of the agency.

(e) A home health agency shall take whatever corrective action is necessary in response to the findings of the quality improvement program.

History: Eff. 9/6/96, Register 139

Authority: AS 18.05.040

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