Services Through Proxy Caregivers

How HFRD classifies it

HFRD prints a scope-and-severity letter beside each citation, on the grid the federal nursing home survey uses: A to C is a deficiency with no actual harm and the potential for minimal harm, D to F no actual harm with the potential for more than minimal harm, G to I actual harm that is not immediate jeopardy, and J to L immediate jeopardy; within each band the letter rises from isolated to pattern to widespread. D is by far the most common.

Where it is cited

What the requirement says

HFRD’s requirement text as it appears on the inspection report, verbatim.

111-8-100-.04(4)(d) Where the licensed facility employs, contracts or refers proxy caregivers to deliver health maintenance activities to individuals with disabilities receiving services through the licensed facility, the licensed facility must do the following: ... (d) Ensure that a written plan of care is developed for the individual with a disability by a licensed healthcare professional in accordance with the written orders of an attending physician, an advanced practice registered nurse or physician ' s assistant working under a nurse protocol agreement or job description respectively, and that such plan of care specifies the frequency of training and evaluation requirements for the proxy caregiver and when additional training will be required for new duties added to the written plan of care for which the proxy caregiver has not been previously trained. The licensed facility must either use the written plan of care form made available by the Department or another form containing all the required elements. ...