{"pack":"tx-lhhs","path":"/policies/texas/home-health/","name":"Texas Home Health Policy and Procedure Manual (LHHS)","state":"Texas","service":"Home health","license":"HCSSA license, Licensed Home Health Services (LHHS or LCHHS)","count":56,"forms":42,"categories":[{"name":"Patient rights","count":5},{"name":"Service delivery","count":9},{"name":"Patient care","count":3},{"name":"Clinical tasks","count":10},{"name":"Safeguarding","count":2},{"name":"Infection control","count":3},{"name":"Emergency preparedness","count":1},{"name":"Records","count":2},{"name":"Privacy","count":3},{"name":"Human resources","count":5},{"name":"Governance","count":5},{"name":"Quality","count":3},{"name":"Business","count":3},{"name":"Ethics","count":2}],"policies":[{"ref":"TX-HH-CMP-01","path":"/policies/texas/home-health/complaints-and-grievances/","title":"Complaints and Grievances","category":"Patient rights","citation":"42 CFR §484.50(e)","summary":"Gives every patient and family a simple way to complain, by phone, in writing, or in person, to the Agency or to HHSC, without fear of reprisal. The complaint officer acknowledges each complaint within 5 days and resolves it within 30 days. Every complaint is logged, investigated within the time frames 26 TAC §558.250 sets, answered, and reviewed through QAPI.","sample":true},{"ref":"TX-HH-PR-01","path":"/policies/texas/home-health/patient-rights-and-responsibilities/","title":"Patient Rights and Responsibilities","category":"Patient rights","citation":"26 TAC §558.282","summary":"Sets out the rights and responsibilities of every patient, what written notices the Agency gives before care begins and when, how staff explain rights and confirm the patient understands them, how representatives exercise rights, and how the Agency protects rights in daily practice.","sample":false},{"ref":"TX-HH-PR-02","path":"/policies/texas/home-health/advance-directives/","title":"Advance Directives","category":"Patient rights","citation":"26 TAC §558.283","summary":"Sets out how the Agency tells every adult patient about the right to make health care decisions and advance directives, when the notice is given (including to someone else when the patient is incapacitated), how directives are recorded and shared with the care team, what the Agency can and cannot carry out, and how staff respond to an out-of-hospital do-not-resuscitate order.","sample":false},{"ref":"TX-HH-PR-03","path":"/policies/texas/home-health/patient-agreement-consent-and-disclosure-of-charges/","title":"Patient Agreement, Consent, and Disclosure of Charges","category":"Patient rights","citation":"26 TAC §558.292","summary":"Sets out the written services agreement every patient receives, how the Agency obtains and documents informed consent, what the patient is told about payment and charges before care begins and when they change, the written notices before non-covered care or before care is reduced or ended, and how a patient withdraws consent.","sample":false},{"ref":"TX-HH-PR-04","path":"/policies/texas/home-health/language-access-accessibility-and-nondiscrimination/","title":"Language Access, Accessibility, and Nondiscrimination","category":"Patient rights","citation":"42 CFR §484.50(f)","summary":"Sets out how the Agency identifies each patient’s language and communication needs, provides qualified interpreters, translated documents, and auxiliary aids at no cost, gives notice that this help is available, and makes sure no patient is discriminated against.","sample":false},{"ref":"TX-HH-ADM-01","path":"/policies/texas/home-health/referral-intake-and-patient-acceptance-to-service/","title":"Referral Intake and Patient Acceptance to Service","category":"Service delivery","citation":"42 CFR §484.105(i)","summary":"Sets out how the Agency receives referrals, gathers the information it needs, decides consistently whether it can accept a patient using the same capacity criteria for everyone, tells the referral source and patient the decision, and keeps its public information about services accurate.","sample":false},{"ref":"TX-HH-ADM-02","path":"/policies/texas/home-health/time-frames-for-initiation-of-care/","title":"Time Frames for Initiation of Care","category":"Service delivery","citation":"26 TAC §558.294","summary":"States the Agency’s own time frame for starting care after a referral, the federal time frames that also apply if the Agency is Medicare-certified, how the clock is measured, what staff do when the time frame cannot be met, and how services are placed on hold and resumed.","sample":false},{"ref":"TX-HH-ADM-03","path":"/policies/texas/home-health/medicare-eligibility-certification-and-face-to-face-encounter/","title":"Medicare Eligibility, Certification, and Face-to-Face Encounter","category":"Service delivery","citation":"42 CFR §424.22","summary":"For a Medicare-certified agency, sets out how the Agency confirms a patient meets the Medicare home health eligibility criteria, verifies homebound status, makes sure the physician or allowed practitioner certifies and recertifies eligibility with the required content and timing, and makes sure the face-to-face encounter happened in time and is documented.","sample":false},{"ref":"TX-HH-CC-01","path":"/policies/texas/home-health/coordination-of-services-and-case-conferences/","title":"Coordination of Services and Case Conferences","category":"Service delivery","citation":"26 TAC §558.288","summary":"Sets out how Agency staff, contracted staff, practitioners, other providers, and any facility where the patient lives share information and coordinate care, when case conferences are held, and how coordination is documented in the patient’s record.","sample":false},{"ref":"TX-HH-CC-02","path":"/policies/texas/home-health/backup-services-after-hours-care-and-on-call/","title":"Backup Services, After-Hours Care, and On-Call","category":"Service delivery","citation":"26 TAC §558.290","summary":"Sets out how the Agency makes sure care continues when an assigned staff member is not available, how patients reach the Agency or other care after business hours, how the on-call registered nurse and on-call administrator are scheduled and respond, and how missed visits are handled.","sample":false},{"ref":"TX-HH-CS-01","path":"/policies/texas/home-health/client-care-policies-and-scope-of-home-health-services/","title":"Client Care Policies and Scope of Home Health Services","category":"Service delivery","citation":"26 TAC §558.281","summary":"States which home health services the Agency provides and how, maps every client care element that 26 TAC §558.281 requires to the policy that covers it, sets the extra standards for intravenous therapy, psychoactive treatments, home dialysis, pediatric care, and terminal illness, and requires the Agency to publish accurate information on its services and review it at least once a year. It also sets out the workplace violence prevention committee, policy, plan, training and incident response that Texas Health and Safety Code Chapter 331 requires while the Agency employs at least two registered nurses.","sample":false},{"ref":"TX-HH-CS-04","path":"/policies/texas/home-health/laboratory-services-and-waived-testing/","title":"Laboratory Services and Waived Testing","category":"Service delivery","citation":"26 TAC §558.284","summary":"Requires the Agency to hold a CLIA certificate of waiver before any staff member performs a laboratory test, limits testing to waived tests done exactly as the manufacturer directs, sets out how staff help patients test themselves with their own devices, and covers specimen collection, referral laboratories, and reporting results to the practitioner.","sample":false},{"ref":"TX-HH-DC-01","path":"/policies/texas/home-health/discharge-planning-and-transitions-of-care/","title":"Discharge Planning and Transitions of Care","category":"Service delivery","citation":"42 CFR §484.58","summary":"Sets out how the Agency plans for each patient’s discharge from the start of care, helps patients choose a post-acute provider using quality and resource use data, sends the receiving provider or practitioner the information needed for a safe transition, and completes and sends discharge and transfer summaries on time.","sample":false},{"ref":"TX-HH-DC-02","path":"/policies/texas/home-health/patient-transfer-and-discharge-including-discharge-for-cause/","title":"Patient Transfer and Discharge, Including Discharge for Cause","category":"Service delivery","citation":"26 TAC §558.295","summary":"Sets out the only grounds on which the Agency transfers or discharges a patient, the written notice the patient receives and when, the situations in which no advance notice is required, the Medicare termination notice, and the steps the Agency must take before discharging a patient for cause.","sample":false},{"ref":"TX-HH-ASM-01","path":"/policies/texas/home-health/initial-and-comprehensive-assessment/","title":"Initial and Comprehensive Assessment","category":"Patient care","citation":"42 CFR §484.55","summary":"Sets out who assesses each patient, when the initial assessment, comprehensive assessment, and each update are done, what every comprehensive assessment must contain, including the medication review and the patient’s individual emergency plan, and how the Agency tracks every assessment deadline.","sample":false},{"ref":"TX-HH-ASM-02","path":"/policies/texas/home-health/oasis-data-collection-accuracy-and-transmission/","title":"OASIS Data Collection, Accuracy, and Transmission","category":"Patient care","citation":"42 CFR §484.45","summary":"For a Medicare-certified agency, sets out how OASIS data are collected as part of the comprehensive assessment, checked for accuracy, encoded, and transmitted to CMS within 30 days, how errors are corrected, and how patient-identifiable OASIS information is protected.","sample":false},{"ref":"TX-HH-CP-01","path":"/policies/texas/home-health/plan-of-care-and-care-planning/","title":"Plan of Care and Care Planning","category":"Patient care","citation":"42 CFR §484.60","summary":"Sets out how the Agency develops, gets signed, carries out, reviews, and revises each patient’s individualized plan of care (or, where no skilled care is ordered, the care plan), how orders are recorded in the plan, how changes are communicated, and the written instructions every patient receives.","sample":false},{"ref":"TX-HH-AID-01","path":"/policies/texas/home-health/home-health-aide-qualifications-training-and-competency/","title":"Home Health Aide Qualifications, Training, and Competency","category":"Clinical tasks","citation":"26 TAC §558.701","summary":"Sets out who may work as a home health aide, the 24-month lapse rule, the content and length of any aide training program the Agency runs, how an RN evaluates aide competency before the aide works alone, what happens after an unsatisfactory rating, and the yearly 12 hours of in-service training.","sample":false},{"ref":"TX-HH-AID-02","path":"/policies/texas/home-health/home-health-aide-assignment-and-supervision/","title":"Home Health Aide Assignment and Supervision","category":"Clinical tasks","citation":"42 CFR §484.80(h)","summary":"Requires an RN or therapist to assign each aide to a patient with written care instructions, limits aides to tasks that are ordered, in the plan of care, allowed by Texas law, and within their training, and sets the supervisory visit schedule: every 14 days for patients receiving skilled services and every 60 days for patients who are not, with on-site observation of each aide and retraining when a deficiency is found.","sample":false},{"ref":"TX-HH-CS-02","path":"/policies/texas/home-health/skilled-nursing-services-and-nursing-practice/","title":"Skilled Nursing Services and Nursing Practice","category":"Clinical tasks","citation":"26 TAC §558.299","summary":"Requires every nurse to hold a current Texas license or multistate privilege and to practice within the Texas Board of Nursing standards, sets out what RNs and LVNs each do, requires LVNs to work under RN supervision, and sets the rules for clinical notes, reporting changes in condition, clarifying orders, and nursing procedures.","sample":false},{"ref":"TX-HH-CS-03","path":"/policies/texas/home-health/therapy-and-medical-social-services/","title":"Therapy and Medical Social Services","category":"Clinical tasks","citation":"42 CFR §484.75","summary":"Sets out who may provide physical therapy, occupational therapy, speech-language pathology, and medical social services, how therapy assistants and social work assistants are supervised, when a therapist may do the initial and comprehensive assessment for a therapy-only patient, and what each discipline documents and reports.","sample":false},{"ref":"TX-HH-CS-05","path":"/policies/texas/home-health/pronouncement-of-death/","title":"Pronouncement of Death","category":"Clinical tasks","citation":"26 TAC §558.302","summary":"Records the governing body’s decision on whether Agency RNs pronounce death, tells every staff member what to do when a patient appears to have died, and sets out the written policy that applies if Agency RNs are authorized to pronounce, in line with Texas Health and Safety Code §671.001.","sample":false},{"ref":"TX-HH-DEL-01","path":"/policies/texas/home-health/physician-delegation/","title":"Physician Delegation","category":"Clinical tasks","citation":"26 TAC §558.296","summary":"Records the governing body’s decision that the Agency does not honor physician delegation, tells staff what to do when a physician tries to delegate a medical act to an Agency staff member, and sets out the six items and the Texas Occupations Code conditions that would apply if the Agency ever decided to honor physician delegation.","sample":false},{"ref":"TX-HH-DEL-02","path":"/policies/texas/home-health/rn-delegation-to-unlicensed-personnel/","title":"RN Delegation to Unlicensed Personnel","category":"Clinical tasks","citation":"26 TAC §558.298","summary":"Requires every delegation of a nursing task to a home health aide or other unlicensed person to be made by an RN under the Texas Board of Nursing rules: Chapter 225 for stable and predictable conditions in an independent living environment, Chapter 224 for acute or unstable conditions. Sets out the RN’s assessment, the tasks that may and may not be delegated, the extra rules for pill reminder containers and insulin, written delegation, teaching, supervision, and re-evaluation.","sample":false},{"ref":"TX-HH-MED-01","path":"/policies/texas/home-health/medication-management-administration-and-drug-regimen-review/","title":"Medication Management, Administration, and Drug Regimen Review","category":"Clinical tasks","citation":"26 TAC §558.300","summary":"Requires a current medication profile for every patient, a drug regimen review at each comprehensive assessment and whenever medications change, medication administration only on a practitioner’s order with a current administration record, same-day reporting of adverse reactions, a written medication schedule for the patient, and clear limits on what aides may do with medications.","sample":false},{"ref":"TX-HH-MED-02","path":"/policies/texas/home-health/sterile-water-saline-vaccines-tuberculin-and-dangerous-drugs/","title":"Sterile Water, Saline, Vaccines, Tuberculin, and Dangerous Drugs","category":"Clinical tasks","citation":"26 TAC §558.303","summary":"Records whether the Agency itself buys, stores, or carries sterile water or saline, vaccines or tuberculin, or the emergency and infusion drugs listed in 26 TAC §558.303, and sets out the standing order, sealed container, oral order, and pharmacy return rules that apply if it does. Also covers influenza and pneumococcal vaccines for patients.","sample":false},{"ref":"TX-HH-ORD-01","path":"/policies/texas/home-health/physician-and-practitioner-orders-including-verbal-orders/","title":"Physician and Practitioner Orders, Including Verbal Orders","category":"Clinical tasks","citation":"26 TAC §558.297","summary":"Sets out who may order care, who may take a verbal order, how verbal orders are read back, written, signed, dated, and timed, the Agency’s time frame for the practitioner to sign them, how faxed and electronic orders are protected, and what staff do when an order is unclear or cannot be carried out.","sample":false},{"ref":"TX-HH-SG-01","path":"/policies/texas/home-health/abuse-neglect-and-exploitation-recognition-and-reporting/","title":"Abuse, Neglect, and Exploitation: Recognition and Reporting","category":"Safeguarding","citation":"Tex. Hum. Res. Code §48.051","summary":"Teaches every staff member to recognize abuse, neglect, exploitation, injuries of unknown source, and misappropriation of patient property, and to report: abuse, neglect, or exploitation by Agency staff to HHSC immediately and never later than 24 hours; abuse, neglect, or exploitation by anyone else, or self-neglect, to DFPS immediately; suspected child abuse or neglect to DFPS immediately, and by licensed professionals no later than the 24th hour. Reporting is a personal legal duty that cannot be passed to a supervisor.","sample":true},{"ref":"TX-HH-SG-02","path":"/policies/texas/home-health/self-reported-incidents-to-hhsc/","title":"Self-Reported Incidents to HHSC","category":"Safeguarding","citation":"26 TAC §558.249","summary":"Sets out the Agency’s own self-reporting of alleged abuse, neglect, and exploitation of a patient by an Agency employee, volunteer, or contractor: the Administrator reports to HHSC Complaint and Incident Intake immediately and never later than 24 hours, starts an investigation at once, sends Form 3613 no later than the 10th day after the report, completes the investigation within 30 days, and cooperates with HHSC, including any referral to the Employee Misconduct Registry.","sample":false},{"ref":"TX-HH-IC-01","path":"/policies/texas/home-health/infection-prevention-and-control-program/","title":"Infection Prevention and Control Program","category":"Infection control","citation":"26 TAC §558.285","summary":"Sets up the Agency’s infection prevention and control program: standard precautions and hand hygiene on every visit, transmission-based precautions, bag technique and equipment cleaning, surveillance and documentation of every infection a patient acquires while in service with the details 26 TAC §558.285 lists, reporting of notifiable conditions, staff illness and screening, and education for staff, patients, and caregivers, all as part of QAPI.","sample":true},{"ref":"TX-HH-IC-02","path":"/policies/texas/home-health/bloodborne-pathogens-exposure-control-plan/","title":"Bloodborne Pathogens Exposure Control Plan","category":"Infection control","citation":"29 CFR §1910.1030","summary":"Is the Agency’s written Exposure Control Plan under the OSHA bloodborne pathogens standard: who has occupational exposure and in which tasks, engineering and work practice controls, protective equipment, hepatitis B vaccination within 10 working days of assignment, what to do after a needlestick or splash, the 15-day written opinion, annual training and plan review, and record retention.","sample":false},{"ref":"TX-HH-IC-03","path":"/policies/texas/home-health/disposal-of-special-waste/","title":"Disposal of Special Waste","category":"Infection control","citation":"26 TAC §558.286","summary":"Requires special waste that Agency staff generate while providing home health services, such as used needles and blood-soaked dressings, to be contained, handled, and disposed of under the Texas special waste rules, and requires the Agency to give every patient both spoken and written instructions on how to dispose of sharps at home.","sample":false},{"ref":"TX-HH-EP-01","path":"/policies/texas/home-health/emergency-preparedness-program/","title":"Emergency Preparedness Program","category":"Emergency preparedness","citation":"42 CFR §484.102","summary":"Sets out the Agency’s emergency preparedness program: the all-hazards risk assessment, the written emergency preparedness and response plan, the disaster coordinator and alternate, continuity of operations, patient triage categories and individual patient emergency plans, help registering with STEAR, the communication plan, staff training, annual drills and exercises, notices to HHSC, and how Texas annual requirements and federal two-year requirements fit together.","sample":false},{"ref":"TX-HH-REC-01","path":"/policies/texas/home-health/clinical-records-content-authentication-access-and-retention/","title":"Clinical Records: Content, Authentication, Access, and Retention","category":"Records","citation":"26 TAC §558.301","summary":"Sets out how the Agency builds and keeps a complete clinical record for every patient: what goes in it, how entries are written, signed, dated, timed, and corrected, how fast visit notes reach the record, where originals are stored, who may see or take a record, how patients get a free copy, and how long records are kept.","sample":false},{"ref":"TX-HH-REC-02","path":"/policies/texas/home-health/patient-list-and-service-records/","title":"Patient List and Service Records","category":"Records","citation":"26 TAC §558.293","summary":"Requires a current list of patients for each licensed category of service, showing each patient’s name, record number, start-of-care date, certification period, diagnoses, and the disciplines serving them, including contracted services, and explains how the list is kept current, protected, used in an emergency, and produced to surveyors.","sample":false},{"ref":"TX-HH-PRV-01","path":"/policies/texas/home-health/hipaa-privacy-and-oasis-confidentiality/","title":"HIPAA Privacy and OASIS Confidentiality","category":"Privacy","citation":"45 CFR Part 164 Subpart E","summary":"Explains who may see or receive a patient’s health information and when, the patient’s privacy rights and the time limits for each, the Notice of Privacy Practices and the OASIS privacy notice, the extra confidentiality of OASIS data, Texas rules on electronic disclosure and training, and how staff protect privacy in the home.","sample":false},{"ref":"TX-HH-PRV-02","path":"/policies/texas/home-health/hipaa-security/","title":"HIPAA Security","category":"Privacy","citation":"45 CFR §§164.302-164.318","summary":"Sets out how the Agency keeps electronic patient information confidential, accurate, and available: the risk analysis and risk management plan, access control, rules for laptops, tablets, and phones used at the point of care, OASIS transmission, backups and the contingency plan, business associates, device disposal, and incident response.","sample":false},{"ref":"TX-HH-PRV-03","path":"/policies/texas/home-health/hipaa-breach-notification/","title":"HIPAA Breach Notification","category":"Privacy","citation":"45 CFR §§164.400-164.414","summary":"Explains what every staff member does when patient information is lost, stolen, misdirected, or seen by the wrong person, how the Administrator decides whether it is a breach, and who must be notified and by when under HIPAA and Texas law: patients, the HHS Secretary, the media, the Texas Attorney General, and consumer reporting agencies.","sample":false},{"ref":"TX-HH-HR-01","path":"/policies/texas/home-health/staffing-personnel-qualifications-orientation-and-evaluation/","title":"Staffing, Personnel Qualifications, Orientation, and Evaluation","category":"Human resources","citation":"26 TAC §558.245","summary":"Requires enough qualified staff to carry out every patient’s plan of care, a written job description with qualifications for every position, orientation and competency checks before staff work alone, a signed statement that staff will follow Agency policies, and a yearly written evaluation of every employee and volunteer.","sample":false},{"ref":"TX-HH-HR-02","path":"/policies/texas/home-health/personnel-records/","title":"Personnel Records","category":"Human resources","citation":"26 TAC §558.246","summary":"Lists what must be in every personnel file, including the signed job description, application, license and reference verification, evaluations, the signed policy statement, and printed registry search results, and explains how the files are kept confidential, audited, and retained.","sample":false},{"ref":"TX-HH-HR-03","path":"/policies/texas/home-health/background-checks-and-verification-of-employability/","title":"Background Checks and Verification of Employability","category":"Human resources","citation":"26 TAC §558.247","summary":"Requires a criminal history check, Nurse Aide Registry search, and Employee Misconduct Registry search through SEMARC before anyone has face-to-face contact with a patient, repeats the registry searches at least every 12 months and exclusion screening every month, and requires immediate removal of anyone who is listed or has a barring conviction.","sample":false},{"ref":"TX-HH-HR-04","path":"/policies/texas/home-health/drug-testing-policy-and-disclosure/","title":"Drug Testing Policy and Disclosure","category":"Human resources","citation":"26 TAC §558.253","summary":"States that the Agency tests employees who have direct contact with patients for drugs, describes when and how testing is done, and requires a copy of this policy to be given to every person who applies for services and to anyone who asks.","sample":false},{"ref":"TX-HH-HR-05","path":"/policies/texas/home-health/volunteers/","title":"Volunteers","category":"Human resources","citation":"26 TAC §558.248","summary":"Allows volunteers only under the supervision of a named Agency employee, requires them to meet the same standards and checks as employees doing the same work, limits what they may do, and requires them to document their services.","sample":false},{"ref":"TX-HH-GOV-01","path":"/policies/texas/home-health/governing-body-organization-and-lines-of-authority/","title":"Governing Body, Organization, and Lines of Authority","category":"Governance","citation":"26 TAC §558.243","summary":"Names the governing body as the body legally responsible for the Agency, sets out what it decides and reviews, and requires a current written organizational chart showing every line of authority from the governing body down to the staff who give care in the home.","sample":false},{"ref":"TX-HH-GOV-02","path":"/policies/texas/home-health/administrator-alternate-administrator-and-supervising-nurse/","title":"Administrator, Alternate Administrator, and Supervising Nurse","category":"Governance","citation":"26 TAC §558.244","summary":"Sets out who may serve as Administrator, Alternate Administrator, supervising nurse, and alternate supervising nurse, what each must do, when each must be available, the training the Administrator and Alternate Administrator must complete, and how changes are reported to HHSC.","sample":false},{"ref":"TX-HH-GOV-03","path":"/policies/texas/home-health/license-conditions-changes-reported-to-hhsc-and-branch-offices/","title":"License Conditions, Changes Reported to HHSC, and Branch Offices","category":"Governance","citation":"26 TAC §558.218","summary":"Lists the changes the Agency must report to HHSC and the time allowed for each, sets out how operating hours, the service area, and branch offices are managed, and explains the federal disclosure and branch rules that apply if the Agency is Medicare-certified.","sample":false},{"ref":"TX-HH-GOV-04","path":"/policies/texas/home-health/services-under-arrangement-and-independent-contractors/","title":"Services Under Arrangement and Independent Contractors","category":"Governance","citation":"26 TAC §558.289","summary":"Requires a written contract for every service the Agency provides through an independent contractor or another organization, sets out what the contract must say, and keeps the Agency responsible for admission, care planning, supervision, background checks, and quality of those services.","sample":false},{"ref":"TX-HH-GOV-05","path":"/policies/texas/home-health/agency-dissolution-and-closure/","title":"Agency Dissolution and Closure","category":"Governance","citation":"26 TAC §558.291","summary":"Sets out the plan the Agency follows if it closes, so that every patient is transferred safely with the right notice, physicians and HHSC are told, and patient and personnel records stay safe and available for as long as the law requires.","sample":false},{"ref":"TX-HH-QA-01","path":"/policies/texas/home-health/quality-assessment-and-performance-improvement-qapi/","title":"Quality Assessment and Performance Improvement (QAPI)","category":"Quality","citation":"42 CFR §484.65","summary":"Sets up the Agency’s data-driven quality assessment and performance improvement (QAPI) program: the QAPI Committee and how often it meets, the written plan, the measures it reviews (record reviews, adverse events, complaints, infections, medication errors, competency, timeliness, OASIS and hospitalization data), performance improvement projects, immediate correction of threats to patient safety, the annual evaluation, and the governing body’s role.","sample":false},{"ref":"TX-HH-QA-02","path":"/policies/texas/home-health/incident-reporting-and-agency-investigations/","title":"Incident Reporting and Agency Investigations","category":"Quality","citation":"26 TAC §558.250","summary":"Requires every incident, adverse event, complaint, and allegation to be reported on an incident report, logged, and investigated, and sets the time frames: an abuse, neglect, or exploitation investigation starts immediately and HHSC Form 3613 is sent within 10 days of the report; a complaint investigation starts within 10 days of receipt; every investigation is completed within 30 days unless a documented reasonable cause justifies a delay.","sample":false},{"ref":"TX-HH-QA-03","path":"/policies/texas/home-health/nursing-peer-review/","title":"Nursing Peer Review","category":"Quality","citation":"26 TAC §558.251","summary":"Makes every licensed discipline follow its own practice act on reporting and peer review, sets up (or contracts for) a nursing peer review committee when the Agency regularly uses eight or more nurses, explains incident-based peer review and Safe Harbor peer review for nurses asked to do something they believe violates their duty to a patient, and protects nurses who report or ask for peer review.","sample":false},{"ref":"TX-HH-BUS-01","path":"/policies/texas/home-health/financial-solvency-institutional-planning-and-business-records/","title":"Financial Solvency, Institutional Planning, and Business Records","category":"Business","citation":"26 TAC §558.252","summary":"Requires the Agency to keep enough money to meet payroll, never to pay staff with checks that bounce, to keep business records in their original state and available to HHSC, and, if Medicare-certified, to prepare and review each year an operating budget and a capital expenditure plan.","sample":false},{"ref":"TX-HH-BUS-02","path":"/policies/texas/home-health/billing-claims-and-medicare-payment-conditions/","title":"Billing, Claims, and Medicare Payment Conditions","category":"Business","citation":"26 TAC §558.254","summary":"Requires every bill and claim to be accurate and supported by the record, and, for Medicare, sets out the checks the billing office makes before a claim goes out: certification, face-to-face encounter, signed plan of care, countersigned verbal orders, and OASIS. It also explains how charges are disclosed and how overpayments are returned.","sample":false},{"ref":"TX-HH-BUS-03","path":"/policies/texas/home-health/electronic-visit-verification-for-medicaid-home-health-services/","title":"Electronic Visit Verification for Medicaid Home Health Services","category":"Business","citation":"1 TAC §354.4006","summary":"Explains which Texas Medicaid home health visits must be documented through electronic visit verification (EVV), how nurses, therapists, and aides clock in and out, how the office corrects visit records, and why no EVV-required visit is billed without an accepted EVV record.","sample":false},{"ref":"TX-HH-ETH-01","path":"/policies/texas/home-health/prohibition-of-solicitation-of-patients/","title":"Prohibition of Solicitation of Patients","category":"Ethics","citation":"26 TAC §558.255","summary":"Forbids anyone acting for the Agency from paying, offering, asking for, or accepting anything of value in return for patient referrals, sets rules for marketing, gifts, and arrangements with referral sources, and protects every patient’s free choice of home health agency.","sample":false},{"ref":"TX-HH-ETH-02","path":"/policies/texas/home-health/compliance-program-exclusion-screening-and-fraud-prevention/","title":"Compliance Program, Exclusion Screening, and Fraud Prevention","category":"Ethics","citation":"1 TAC §371.1655","summary":"Sets out the Agency’s compliance program: written standards and a code of conduct, a compliance officer, training, a safe way to report concerns, monthly exclusion screening, auditing, prompt correction and repayment, and protection for anyone who reports in good faith.","sample":false}],"copy":{"reviewed":"2026-11-08","intro":"For Texas agencies licensed by HHSC as a Home and Community Support Services Agency (HCSSA) in the Licensed Home Health Services category (LHHS) or the Licensed and Certified Home Health Services category (LCHHS). The manual has 56 policies and 42 forms, with the patient forms in English and Spanish, written to 26 TAC Chapter 558, the HCSSA licensing rules, and, for certified agencies, the home health Conditions of Participation (42 CFR Part 484). Each policy opens with a plain-English summary and names the rule section it follows, and every one is filled in with your agency's name and details. You get Word and PDF files to keep, and your staff read and sign each policy on their phone.","rulesTitle":"What 26 TAC Chapter 558 asks your policies to cover","rules":[{"head":"Patient rights.","text":"Written notice of patient rights, given and explained before care is furnished, a grievance process free of reprisal, and the Rights of the Elderly for patients 60 or older.","cite":"26 TAC §558.282"},{"head":"Starting care.","text":"A written policy that sets the agency's own time frame for starting care or services after a referral, and the agency enforces it.","cite":"26 TAC §558.294"},{"head":"Physician orders.","text":"Who may take an order, the agency's own time frame for the practitioner to countersign a verbal order, and safeguards for faxed orders.","cite":"26 TAC §558.297"},{"head":"Plan of care reviews.","text":"Where skilled treatment is ordered, the plan of care is reviewed at least every six months, or at least every 60 days for a Medicare-certified agency.","cite":"26 TAC §558.401(b)(2)(B); 42 CFR §484.60(c)(1)"},{"head":"Abuse, neglect and exploitation.","text":"Staff report at once. Abuse by agency staff goes to HHSC immediately, never later than 24 hours, and HHSC Form 3613 follows no later than the 10th day after the report.","cite":"26 TAC §558.249; §558.250(b)(3)"},{"head":"Transfer and discharge notice.","text":"Written notice delivered no later than five days before a transfer or discharge, or mailed at least eight working days before, except in the situations the rule lists.","cite":"26 TAC §558.295"}],"asks":[{"ref":"TX-HH-PR-01","title":"Patient Rights and Responsibilities","category":"Patient rights","q":"Show me where this patient signed for the notice of rights, and show me that it was given before care was furnished.","path":"/policies/texas/home-health/patient-rights-and-responsibilities/"},{"ref":"TX-HH-ADM-02","title":"Time Frames for Initiation of Care","category":"Service delivery","q":"What is your time frame for starting care, and where is it written?","path":"/policies/texas/home-health/time-frames-for-initiation-of-care/"},{"ref":"TX-HH-ORD-01","title":"Physician and Practitioner Orders, Including Verbal Orders","category":"Clinical tasks","q":"What is your policy time frame for the practitioner to sign a verbal order, and how do you track unsigned orders?","path":"/policies/texas/home-health/physician-and-practitioner-orders-including-verbal-orders/"},{"ref":"TX-HH-SG-02","title":"Self-Reported Incidents to HHSC","category":"Safeguarding","q":"Show me your last self-report: when did you have cause to believe, when did you call HHSC, and when did you send Form 3613?","path":"/policies/texas/home-health/self-reported-incidents-to-hhsc/"},{"ref":"TX-HH-EP-01","title":"Emergency Preparedness Program","category":"Emergency preparedness","q":"Pick an active patient. What is her triage category, does she need evacuation help, and did you offer STEAR registration?","path":"/policies/texas/home-health/emergency-preparedness-program/"}],"faq":[{"q":"Is this the right manual for my license?","a":"It is for HCSSAs licensed in the Licensed Home Health Services category, licensed only (LHHS) or licensed and certified (LCHHS). Agencies licensed only for Personal Assistance Services, or for hospice, need the Texas PAS or Texas hospice manual."},{"q":"Does it suit an agency that is not Medicare-certified?","a":"Yes. The policies follow Chapter 558 for every licensed home health agency. Where a duty comes only from the federal Conditions of Participation, the policy says it applies if the agency is Medicare-certified (LCHHS)."},{"q":"Does it cover workplace violence prevention?","a":"Yes. Health and Safety Code Chapter 331 has applied to a home health agency that employs at least two registered nurses since September 1, 2023 (S.B. 240). Policy TX-HH-CS-01 sets out the committee, the written policy and plan, how incidents are handled and the yearly review."},{"q":"What about HHSC's proposed rewrite of Chapter 558?","a":"HHSC proposed a rewrite of most of Chapter 558 in the Texas Register on September 18, 2026. It was not in force when this manual was last reviewed, so the policies follow the rules in force today."},{"q":"What do the 56 policies cover?","a":"Patient rights (5), service delivery (9), patient care (3), clinical tasks (10), safeguarding (2), infection control (3), emergency preparedness (1), records (2), privacy (3), human resources (5), governance (5), quality (3), business (3) and ethics (2)."}]},"guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"},{"path":"/guides/home-health-qapi/","h1":"What is QAPI in home health, and what does §484.65 require?"},{"path":"/guides/home-health-emergency-preparedness/","h1":"What does a home health emergency preparedness plan need to include?"},{"path":"/guides/abuse-neglect-exploitation-reporting/","h1":"Abuse, neglect and exploitation policies: what each state requires"},{"path":"/guides/infection-control-policy/","h1":"What should a home care infection control policy include?"}]}