Policies & Procedures Needed
to Meet HFS 133 Requirements for HHA Licensure
Return to Home Health Agency
Application Process
Completion of these materials are critical to issuance of a license.
You must submit copies of policies and procedures and/or other
documents that define how your agency will comply with each of
these requirements, found in DHS 133 and DHS 13.
1. DHS 133.05: (1) (a) (b) (d) (e) Governance: (Provide Copies)
- Governing body policies: as they relate to agency's management
2. DHS 133.05(2): Professional Advisory Board Policies (Provide
Copies)
- Method of Program Evaluation (DHS 133.07)(2)
- Emergency Care (DHS 133.13)
- Supervisory Visits (DHS 133.18)
- Plan of Treatment (DHS 133.20 (1)
- Contents of plan; include a copy of a plan of care (DHS 133.20(2)
3. DHS 133.06(3)(a): Administration Policy Statements: (Provide
Copies)
- Recruitment (DHS 133.06(3)(a)
- Orientation of Personnel including DHS 133.06(4)(a)
- Staff Evaluation (DHS 133.06(4)(c))
- Communicable Disease Control (DHS 133.06(4)(d) 3.
- Continued Training of Staff (DHS 133.06(4)(e))
- Employee Background Checks and Reporting (DHS133.06(4)(g))
- Infection Control and Prevention (DHS133.06(5)(a)-(c))
4. DHS 133.08(1) and DHS 133.08(2)(a) - (j): Patient Rights Policies
and Statements: (Provide Copies)
- Patient Rights Statement
- Advance Directives
- Complaint Process (DHS 133.08(3))
5. DHS 133.09 Acceptance and Discharge of Patients: (Provide
Copies)
- Services under contract (DHS 133.19(1(a - f) and (2)
- Service Agreement (DHS 133.09(2)
- Discharge Statement (DHS 133.09(3)(a)1; 2 a.b; .3, a.b.c; 4, and 5
a.b.
- Aide Assignment Sheet (submit copy)
6. DHS 133.21(1 - 7): Medical Records Policies: (Provide Copies)
- Security Against Loss, Destruction or Unauthorized Use.
- Retention of Records
- Transfer of Records to Another Agency
- Form of Entries
- Abbreviations (DHS 133.21(7))
7. Submit copies of job descriptions for each of the following:
- Administrator
- Director of Nursing/Supervising Nurse
- Registered Nurse/LPN
- Home Health Aides
- Personal Care Workers
- Therapists (PT,OT,ST)
- Medical Social Worker
8. DHS 13.05(3) Misconduct Reporting & Investigation (Provide
Copies)
- Policy on conducting and documenting investigations
Last Revised: February 11, 2009 |
