i received this list from my consultant and thought it would be useful for others. just remember this was in texas, sooooo. by compliance review services, inc. houston, tx.
1. failure of the agency to ensure client/patient rights are protected under applicable laws.
2. failure of the agency to provide care, including care coordination, assessments, drug/treatment orders, etc., in accordance with a client's care/service plan.
3. failure of the agency to ensure client's resources were not exploited for personal benefit, profit, or gain by agency staff who have an ongoing relationship with the client.
4. failure of the agency to ensure responsible mgmt of agency operations to ensure compliance with policies and procedures and/or applicable state and federal regulations; or failure of administrator or designee to be available during the agency's operating hours; and/or failure of supervising nurse or designee to be available to the agency at all times.
5. failure of the agency to ensure accuracy of billing/insurance claims.
6. failure to adopt/enforce policy to ensure compliance with the occupations code, chapter 102 (concerning the solicitation of patients); or, the agency was operating in violation of chapter 142 of the health and safety code by providing home health and/or personal assistant services, or representing to the public that the person is a provider of home health/ and/or pas for pay without an appropriate license.
7. failure of the agency to maintain current and accurate client records; failure to treat records with confidentiality, and maintain according to professional standards of practice.
8. failure of the agency to ensure a client was not verbally or emotionally harmed (chapter 48 of texas human resources code) by agency staff who have an ongoing relationship with a client.
9. failure of the agency to ensure a client received all goods and services to avoid physical harm, mental anguish, or mental illness.
10. failure of the agency to maintain adequate staff to provide services and/or to supervise the provision of services.
hope this is informative.
Jan 10, '05
Yikes! It seems like some of these may be specific to a PCA, or home health aide agency.
Welcome back BTW!