(b)

1. (1) Agencies shall be required to obtain a license if the following services are provided to an individual in their home or place of residence.

2. (2) These services include:

   1. (A) Skilled nursing services;
   2. (B) Physical therapy services;
   3. (C) Occupational therapy services;
   4. (D) Speech-language pathology services;
   5. (E) Medical social work services;
   6. (F) Home health aide services;
   7. (G) Personal care aide services; and
   8. (H) Extended care services.

(c)

1. (1) Prior to applying for a license, an agency shall obtain a Permit of Approval (POA).

2. (2) Each agency:

   1. (A) Must serve the area that is consistent with its Certificate of Need or POA; and
   2. (B) May serve up to a one-hundred-mile radius of the parent agency or branch office.
3. (3) Only under conditional emergency circumstances approved by the Division of Health Facilities Services may an agency provide care outside the boundaries of its POA.
4. (4) See requirements for conditional emergency service, 20 CAR § 46-114.

(d)

1. (1) Annual license applications shall be:

   1. (A) On forms prescribed by the division; and
   2. (B) Effective on a calendar-year basis with an expiration date of December 31.

2. (2)

   1. (A) Each agency shall receive either a Class A or Class B license.
   2. (B) If the agency is certified to participate in the Medicare program, Title XVIII of the Social Security Act, 42 U.S.C. § 1395 et seq., a Class A license shall be issued.
   3. (C) A Class A agency shall meet the conditions of participation as a home health agency under Title XVIII of the Social Security Act and the regulations adopted thereunder (42 C.F.R. § 405.1201 et seq.), which regulations are adopted by reference herein for all purposes.
3. (3) If the agency is not certified to participate in the Medicare program but provides home health services as defined by Arkansas Code § 20-10-801 et seq., a Class B license shall be issued.

4. (4)

   1. (A) Any agency holding a Class A license may obtain a derivative Class B license from the division provided that the agency holding said Class A license meets the licensing standards set forth in Arkansas Code § 20-10-801 et seq., and the rules herein for Class B licensure.
   2. (B) A Class B license so issued to the holder of a Class A license shall not be severed from the underlying Class A license nor separately extended into geographic areas apart from the Class A service area.
   3. (C) A separate POA from the holder of a Class A license shall not be required by the division in order to issue a derivative Class B license.

5. (5) Each Class A or Class B license shall designate whether an agency provides the following categories of service:

   1. (A) Intermittent skilled care;
   2. (B) Extended care; and/or
   3. (C) Personal care.

6. (6)

   1. (A) When a category of service is added, the agency shall notify the division of the intent.
   2. (B) The division shall then request from the agency the appropriate information needed to determine if the agency meets the regulatory requirements for the category of service being requested.
   3. (C) Once this determination is made, the division shall make the appropriate changes to the license.

7. (7)

   1. (A) If a category of service is being discontinued, the agency shall notify the division.
   2. (B) Notification must include information on how the agency will ensure appropriate transfer of patients.

8. (8)

   1. (A) Each agency that is licensed Class A or Class B shall meet the general requirements section of this part.
   2. (B) According to services provided, agencies shall also be required to meet other sections as follows:

(i) Skilled care — general requirements, 20 CAR § 46-110, and standards for skilled care services, 20 CAR § 46-111;

1. (ii) Extended care — general requirements, 20 CAR § 46-110, standards for skilled care services, 20 CAR § 46-111, and standards for extended care services, 20 CAR § 46-112; and

   1. (iii) Personal care — general requirements, 20 CAR § 46-110 and standards for personal care services, 20 CAR § 46-113.

(e) The agency shall notify the division of any of the following:

1. (1) Change of name;
2. (2) Change of location;
3. (3) Addition or deletion of services provided;
4. (4) Request to change license classification;
5. (5) If a Class A agency, notification of changes in certified status;

6. (6) Change in contact information including:

   1. (A) Correspondence address;
   2. (B) Telephone number;
   3. (C) Email; and
   4. (D) Fax number; and
7. (7) Change of ownership.

(f) Agency closure. If a licensed agency closes it shall:

1. (1) Notify the division in writing of:

   1. (A) The effective date;
   2. (B) Plans for transfer of current patients; and
   3. (C) Plans for storage and retrieval of medical records; and
2. (2) Return original license to the division.