1. (a)

   1. (1) Written policies and procedures must be:

      1. (A) Available for review; and
      2. (B) Designed to meet all the following standards.
   2. (2) Documentation of all staff training must be kept in each employee’s personnel file.
   3. (3) All local, state, and federal regulatory agency policies concerning home medical equipment and oxygen must be followed.

2. (b) Order intake.

   1. (1) A home medical equipment provider shall recognize the importance of order intake.

   2. (2) The provider is responsible for ensuring that order intake personnel are appropriately trained in the following:

      1. (A) Identifying equipment;
      2. (B) Determining patient/caregiver needs;
      3. (C) Determining referral sources needs;
      4. (D) Knowing equipment coverage criteria based on diagnosis;
      5. (E) Responding appropriately during a medical equipment emergency;
      6. (F) Explaining service procedures;
      7. (G) Billing third parties; and
      8. (H) Verifying insurance.
   3. (3) The provider must ensure that only trained order intake personnel receive referrals.

3. (c) Selection of appropriate equipment.

   1. (1) When providing equipment services for a patient, a provider shall consider:

      1. (A) Physician orders;
      2. (B) Equipment needs of the patient;
      3. (C) Economic situation of the patient and caregiver; and
      4. (D) Requirement of any third-party payer source.

   2. (2)

      1. (A) A provider shall recognize those items that require special fitting and evaluation.
      2. (B) Fitting of custom items shall be performed within a reasonable time frame by specially trained personnel.

4. (d) Delivery and set up — Patient and caregiver education.

   1. (1)

      1. (A) A provider shall maintain trained personnel to:

5. (i) Coordinate order fulfillment; and

   1. (ii) Schedule equipment services with timely delivery.

      1. (B) Documentation of training will be maintained.

   2. (2) A provider shall ensure delivery personnel are appropriately trained to:

      1. (A) Conduct an environment/equipment compatibility assessment;
      2. (B) Appropriately and safely set up the equipment;
      3. (C) Instruct patient and caregivers in the safe operation and client maintenance of the equipment; and
      4. (D) Recognize when additional education and/or follow-up patient compliance monitoring is appropriate.
   3. (3) Written instructions must be provided to the patient/caregiver upon delivery, and documentation of receipt of written instruction must be maintained in the patient record.

6. (e) Services during use.

   1. (1)

      1. (A) A provider shall document that patients are advised of service hours and emergency service procedures.
      2. (B) If equipment malfunction may threaten the customer’s health, access to twenty-four-hours-per-day, three-hundred-sixty-five-days-per-year emergency service must be available for equipment maintenance or replacement.

   2. (2) A provider shall establish a schedule at the time of the initial delivery for any appropriate follow-up home medical equipment services such as:

      1. (A) Periodic maintenance;
      2. (B) Supply delivery; and
      3. (C) Other related activities.

7. (f) Retrieval, disinfection, and maintenance of home medical equipment.

   1. (1) A provider shall ensure that state/federal requirements for equipment disinfection are followed, including:

      1. (A) Red-tagging for biohazards;
      2. (B) Maintaining dirty equipment isolation;
      3. (C) Equipment cleaning and disinfection areas and procedures; and
      4. (D) Appropriate staff training on hazard prevention.

   2. (2) Cleaning and disinfection solutions must be:

      1. (A) Bactericidal;
      2. (B) Tuberculocidal; and
      3. (C) Viricidal.
   3. (3) Centers for Disease Control and Prevention universal precautions and Occupational Safety and Health Administration regulations concerning equipment handling must be followed.

   4. (4)

      1. (A) Create and implement a preventative maintenance program based on manufacturers’ guidelines, which includes appropriate recordkeeping.
      2. (B) Trained staff must be utilized.

8. (g) Patient record.

   1. (1) A supplier must maintain a record for each customer when:

      1. (A) Required by state or federal law; or
      2. (B) A physician’s order is required.
   2. (2) The patient record must include an intake form and applicable physician’s orders.
   3. (3) Records should be safeguarded from loss and kept confidential.
   4. (4) Documentation of proper patient/caregiver instruction must be maintained in the patient record.

9. (h) Patient rights.

   1. (1) The patient has the right to considerate and respectful service.

   2. (2) The patient has the right to obtain service without regard to:

      1. (A) Race;
      2. (B) Creed;
      3. (C) National origin;
      4. (D) Sex;
      5. (E) Age;
      6. (F) Disability;
      7. (G) Diagnosis; or
      8. (H) Religious affiliation.

   3. (3)

      1. (A) Subject to applicable law, the patient has the right to confidentiality of all information pertaining to his or her medical equipment and service.
      2. (B) Individuals or organizations not involved in the patient’s care may not have access to the information without the patient’s written consent.
   4. (4) The patient has the right to a timely response to his or her request for home medical equipment services.
   5. (5) The patient has the right to select the home medical equipment supplier of his or her choice.
   6. (6) The patient has the right to voice grievances without fear of termination of service or other reprisals.
   7. (7) The patient has the right to expect reasonable continuity of service.

   8. (8) The patient has the right to an explanation of charges for equipment and supplies.

      1. (i) Quality assurance.

   9. (1) There is an ongoing continuous quality improvement program designed to monitor and evaluate the:

      1. (A) Quality of patient care;
      2. (B) Improvement of patient services, if applicable; and
      3. (C) Resolution of identified problems.
   10. (2) Continuous quality improvement activities are defined in a written plan.

   11. (3) Issues monitored should be determined by evaluating all complaints or incidents and items that are:

       1. (A) High-volume;
       2. (B) High-risk; or
       3. (C) Problem-prone.
10. (j) Liability insurance coverage for products provided and operations of each licensed entity is required in the amount of at least five hundred thousand dollars ($500,000).

11. (k) Prohibited practices. The following practices are prohibited:

    1. (1)

       1. (A) Patient freedom of choice.
       2. (B) Participation in any plan, agreement, or arrangement that eliminates the patient’s right to select a provider, licensed under this act, of his or her choice shall be considered a violation of this part;

    2. (2)

       1. (A) Bribes, kickbacks, and rebates.
       2. (B) It shall be considered a violation of this part for anyone to knowingly and willfully offer, pay, solicit, or receive any payment in return for referring an individual to another person for the furnishing, or arranging for the furnishing, of any item or service covered by this part;
    3. (3) The solicitation of DME business by providing prescribers with prescription blanks, patient order forms, or patient order invoices with the name of any home medical equipment, legend device, and/or medical gas provider printed thereon; and

    4. (4)

       1. (A) A provider of home medical equipment and/or medical gas may provide more than five percent (5%) of its annual sales to licensed practitioners or facilities.
       2. (B) The provider must, however, obtain a State Wholesale Legend Drug and/or Controlled Substance Distributor Permit.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: “(10/13/95, amended 8/23/96, and 11/13/2006)" "DME" means durable medical equipment.