{"ref":"NC-HH-CS-01","title":"Scope of Services, Service Categories on the License, and Services Offered","category":"Service delivery","summary":"Describes the home care services the Agency is licensed for and offers, where and how each is given (directly or under arrangement), the federal rule that skilled nursing and at least one other therapeutic service be made available with one given directly, how services are added, stopped or changed with written notice to the Division of Health Service Regulation, and how accurate public information about services and their limits is kept current.","inShort":["We offer only the services shown on our North Carolina license, and only in the counties we serve for each one.","Skilled nursing is always given by our own staff. Some other services may come from a contractor, but we stay responsible for them.","Describe our services only with the approved wording. Never promise a service, visit frequency or result we do not offer.","If we cannot meet a patient’s needs, tell the referral source and help find another agency.","We tell the Division of Health Service Regulation in writing at least 30 days before we add a service."],"primaryCitation":"10A NCAC 13J .1001(a)(1)","citations":["G.S. 131E-136","10A NCAC 13J .0901","10A NCAC 13J .0903(d)","10A NCAC 13J .0903(g)","10A NCAC 13J .0903(h)","10A NCAC 13J .1001(a)(1)","10A NCAC 13J .1001(f)","10A NCAC 13J .1001(g)","10A NCAC 13J .1101(5)","10A NCAC 13J .1101(8)","10A NCAC 13J .1111","NC Medicaid Clinical Coverage Policy 3A"],"federalCitations":["42 CFR §484.105(f)","42 CFR §484.105(i)(2)","42 CFR §484.75","42 CFR §484.80","42 CFR §484.100(b)"],"surveyorAsks":["Which services are on your license, and which of them do you provide directly and which under arrangement?","Show me your written description of the scope of services and the geographic area for each service."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (10A NCAC 13J .1001(a)(1) and .0903(d); 42 CFR §484.105(f))","5. Services the Agency Offers","6. Services Provided Directly and Under Arrangement","7. Where Services Are Given","8. Adding, Changing, or Stopping a Service","9. Accurate Public Information About Services and Limits","10. Standards of Practice","11. NC Medicaid Home Health Services","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"nc-hha","state":"North Carolina","service":"Home health","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"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}