{"ref":"NC-HSP-DME-01","title":"Home Medical Equipment and Supplies","category":"Clinical tasks","summary":"Requires the Agency to arrange the supplies, equipment and prosthetic devices each patient needs at home (for example dressings, catheters and oxygen), and sets the policies 10A NCAC 13K .0504(b) requires: set-up, delivery, electrical safety and environment; cleaning, storage, maintenance and repair to the manufacturer's guidelines; transportation, tracking and recall; emergency back-up for equipment or power failure; and written patient instruction for each item, documented by staff.","inShort":["We arrange the equipment and supplies each patient needs at home, such as oxygen, a hospital bed and dressings.","Check that equipment is safe at set-up: good cords, a proper outlet, no extension cords for oxygen.","Give the family written instructions for each item, watch them use it, and write down the teaching.","No smoking or open flames near oxygen. Keep cylinders upright and secured.","Every patient who depends on powered equipment has a back-up plan for a power failure.","If equipment fails, tag it \"do not use\" and call the supplier or (919) 555-0199."],"primaryCitation":"10A NCAC 13K .0504","citations":["10A NCAC 13K .0504(a), (b)","10A NCAC 13K .0301(a)(10)","10A NCAC 13K .0505","G.S. 90-85.22","NC Medicaid Clinical Coverage Policy 3D, section 5.10(a)"],"federalCitations":["42 CFR §418.106 (introductory text) and (f)","42 CFR §418.56(c)(5)","42 CFR §418.112(c)(6)","42 CFR §418.202(f)","42 CFR §424.57"],"surveyorAsks":["How do you get oxygen and a hospital bed to a patient, and how fast?","Show me the patient instruction materials for this equipment and where staff documented the instruction."],"forms":[{"ref":"NC-HSP-DME-01-A","title":"Home Medical Equipment Delivery and Instruction Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (10A NCAC 13K .0504)","5. What the Agency Provides","6. Suppliers and Contracts","7. Set-Up, Delivery, Electrical Safety and Environment","8. Cleaning, Storage, Maintenance and Repair","9. Transportation, Tracking and Recall","10. Emergency Back-Up for Equipment or Power Failure","11. Patient and Caregiver Instruction","12. Oxygen Safety","13. Removal After Discharge or Death","14. Responsibilities","15. Records and Compliance Monitoring","16. Staff Training","17. References","18. Related Policies and Forms","19. Approval","20. Revision History"],"version":"1.0","sample":false,"pack":"nc-hospice","state":"North Carolina","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}