Section 410IAC17-13-1. Medical plan of care

   (a) Patients shall be accepted for care on the basis of a reasonable expectation that the patient's health needs can be adequately met by the home health agency in the patient's place of residence. Medical care shall follow a written medical plan of care established and periodically reviewed by the physician, dentist, chiropractor, optometrist, or podiatrist as follows:

(1) As follows, the medical plan of care shall:

(A) Be developed in consultation with the home health agency staff.

(B) Include all services to be provided if a skilled service is being provided.

(C) Cover all pertinent diagnoses.

(D) Include the following:

(i) Mental status.

(ii) Types of services and equipment required.

(iii) Frequency and duration of visits.

(iv) Prognosis.

(v) Rehabilitation potential.

(vi) Functional limitations.

(vii) Activities permitted.

(viii) Nutritional requirements.

(ix) Medications and treatments.

(x) Any safety measures to protect against injury.

(xi) Instructions for timely discharge or referral.

(xii) Therapy modalities specifying length of treatment.

(xiii) Any other appropriate items.

(2) The total medical plan of care shall be reviewed by the attending physician, dentist, chiropractor, optometrist, or podiatrist and home health agency personnel as often as the severity of the patient's condition requires, but at least once every two (2) months. The health care professional staff of the home health agency shall promptly alert the person responsible for the medical component of the patient's care to any changes that suggest a need to alter the medical plan of care. A written summary report for each patient shall be sent to the:

(A) physician;

(B) dentist;

(C) chiropractor;

(D) optometrist; or

(E) podiatrist;

at least every two (2) months.

  (b) A home health agency may accept written orders for home health services from a physician, a dentist, a chiropractor, a podiatrist, or an optometrist licensed in Indiana or in any other state. If the home health agency receives an order from a physician, dentist, chiropractor, podiatrist, or optometrist who is licensed in another state, the home health agency shall take reasonable immediate steps to determine the following:

(1) The order complies with the laws of the state where the order originated.

(2) The individual who issued the order:

(A) examined the patient; and

(B) is licensed to practice in that state.

  (c) All orders issued by:

(1) a physician;

(2) a dentist;

(3) a chiropractor;

(4) a podiatrist; or

(5) an optometrist;

for home health services must meet the same requirements whether the order originates in Indiana or another state. Orders issued from another state may not exceed the authority allowed under orders from the same profession in Indiana under IC 25.

  (d) Home health agency personnel shall promptly notify a patient's physician or other appropriate licensed professional staff and legal representative, if any, of any significant physical or mental changes observed or reported by the patient. In the case of a medical emergency, the home health agency must know in advance which emergency system to contact. (Indiana State Department of Health; 410 IAC 17-13-1; filed Mar 18, 2002, 3:40 p.m.: 25 IR 2486; filed Sep 26, 2006, 9:56 a.m.: 20061025-IR-410050260FRA; readopted filed Jul 14, 2008, 2:14 p.m.: 20080806-IR-410080322RFA; readopted filed Sep 10, 2014, 2:08 p.m.: 20141008-IR-410140299RFA)