Quality Management: Semi-Annual Clinical Record Review and Annual Evaluation of Agency Functioning
Sets out the quality management system California requires of every home health agency (22 CCR §74742): a semi-annual review of a stratified sample of clinical records (five percent of the total patient census, at least 20 and at most 100 records every six months, both concurrent and retrospective, against preset criteria of practice for each discipline, by a reviewer of equivalent or higher training), and an organized, documented evaluation of overall agency functioning at least once a year by a group that includes the Administrator, the Director of Patient Care Services, another licensed health care professional employed by the Agency, and at least one physician, with a documented plan to correct deficiencies within specified time frames.
- Policy number
- CA-HH-QA-01
- Version
- 1.0
- Main rule
- 22 CCR §74742
- Library
- California home health · 58 policies
- Category
- Quality
- Sections
- 22
In short
- Every six months, nurses and therapists review a sample of patient records against set criteria to check the care is right, on time, and safe.
- A record is reviewed only by someone with the same or higher training than the person who gave the care.
- If a review finds a patient at risk, the DPCS acts that day.
- Once a year the Administrator, the DPCS, another licensed professional, and a physician evaluate how the whole Agency is working.
- Every problem found gets a fix, a person responsible, and a deadline, and the fix is checked.
What's inside
22 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (22 CCR §74742)
- 5. Review Calendar
- 6. Choosing the Sample
- 7. Criteria of Practice
- 8. Who Reviews
- 9. Doing the Review and Recording the Results
- 10. Annual Evaluation of Overall Agency Functioning
- 10.1 The evaluation group
- 10.2 What is evaluated
- 10.3 Results and correction plan
- 11. Link With QAPI and Other Reviews
- 12. Responsibilities
- 13. Records and Compliance Monitoring
- 14. Staff Training
- 15. References
- 16. Related Policies and Forms
- 17. Approval
- 18. Revision History
An inspector may ask
- Show me your last two semi-annual clinical record reviews. How did you choose the sample, and how many records did you review?
- Who reviewed the physical therapy records, and what is their discipline?
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