[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR440.70]



[Page 237-238]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 440_SERVICES: GENERAL PROVISIONS--Table of Contents

 

                          Subpart A_Definitions

 

Sec. 440.70  Home health services.



    (a) ``Home health services'' means the services in paragraph (b) of 

this section that are provided to a recipient--

    (1) At his place of residence, as specified in paragraph (c) of this 

section; and

    (2) On his or her physician's orders as part of a written plan of 

care that the physician reviews every 60 days, except as specified in 

paragraph (b)(3) of this section.

    (b) Home health services include the following services and items. 

Those listed in paragraphs (b) (1), (2) and (3) of this section are 

required services; those in paragraph (b)(4) of this section are 

optional.

    (1) Nursing service, as defined in the State Nurse Practice Act, 

that is provided on a part-time or intermittent basis by a home health 

agency as defined in paragraph (d) of this section, or if there is no 

agency in the area, a registered nurse who--

    (i) Is currently licensed to practice in the State;

    (ii) Receives written orders from the patient's physician;

    (iii) Documents the care and services provided; and

    (iv) Has had orientation to acceptable clinical and administrative 

recordkeeping from a health department nurse.

    (2) Home health aide service provided by a home health agency,



[[Page 238]]



    (3) Medical supplies, equipment, and appliances suitable for use in 

the home.

    (i) A recipient's need for medical supplies, equipment, and 

appliances must be reviewed by a physician annually.

    (ii) Frequency of further physician review of a recipient's 

continuing need for the items is determined on a case-by-case basis, 

based on the nature of the item prescribed;

    (4) Physical therapy, occupational therapy, or speech pathology and 

audiology services, provided by a home health agency or by a facility 

licensed by the State to provide medical rehabilitation services. (See 

Sec. 441.15 of this subchapter.)

    (c) A recipient's place of residence, for home health services, does 

not include a hospital, nursing facility, or intermediate care facility 

for the mentally retarded, except for home health services in an 

intermediate care facility for the mentally retarded that are not 

required to be provided by the facility under subpart I of part 483. For 

example, a registered nurse may provide short-term care for a recipient 

in an intermediate care facility for the mentally retarded during an 

acute illness to avoid the recipient's transfer to a nursing facility.

    (d) ``Home health agency'' means a public or private agency or 

organization, or part of an agency or organization, that meets 

requirements for participation in Medicare, including the capitalization 

requirements under Sec. 489.28 of this chapter.

    (e) A ``facility licensed by the State to provide medical 

rehabilitation services'' means a facility that--

    (1) Provides therapy services for the primary purpose of assisting 

in the rehabilitation of disabled individuals through an integrated 

program of--

    (i) Medical evaluation and services; and

    (ii) Psychological, social, or vocational evaluation and services; 

and

    (2) Is operated under competent medical supervision either--

    (i) In connection with a hospital; or

    (ii) As a facility in which all medical and related health services 

are prescribed by or under the direction of individuals licensed to 

practice medicine or surgery in the State.



[43 FR 45224, Sept. 29, 1978, as amended at 45 FR 24888, Apr. 11, 1980; 

62 FR 47902, Sept. 11, 1997; 63 FR 310, Jan. 5, 1998]