There are more than 30 Delaware private pay and Medicare/Medicaid-certified home care agencies, which deliver skilled nursing and unskilled, supportive services. Delaware home health agencies must be licensed to deliver in-home care, and the Bureau of Home and Community Services is responsible for the statewide Medicare/Medicaid certification of home health programs for all Delaware counties.
License
The Office of Health Facilities Licensing and Certification (HFLC) is the regulatory oversight organization for home health agencies. Agencies may apply for aide services only, or skilled services. Delaware requires a separate license for each office managed by a home health agency, and licenses are not transferable. All applicants must undergo an onsite survey evaluation within the first 90 days of operation. Agencies must be in compliance with all required regulations and standards of care.
Staffing
Home care agencies must have a minimum number of qualified employees on staff; however, they may contract with a staffing agency for additional staff if needed. Contracted individuals must meet the same requirements as agency employees. Agencies must provide job qualifications, pre-employment requirements, position descriptions, orientation programs, inservice education and competency testing for all employees and contractors. Annual performance reviews and competency testing are also required. Agencies must verify the credentials and current licensing of all employees or contractors.
Governing Body
The agency must have a full-time director to oversee delivery of clinical staff with authority for daily operations and management. Responsibilities must be clearly outlined in writing, and a designee must be appointed to act in the director's absence. The director must also appoint a full-time clinical director to assure delivery of patient care services and ensure patient health and safety.
Policies
Delaware home care agencies must have clearly detailed, written policies and procedures to be followed by employees, contractors and others involved with the agency. Required policies relate to patient rights and responsibilities, handling of confidential documents, adherence to privacy and confidentiality standards and handling emergency situations. They should also include policies on controlling exposure of patients and staff to communicable diseases and reporting to the appropriate entities. Ongoing education and staff development programs are required.
Services
Delaware agencies may be licensed for nonmedical or medical services. Nonmedical services include supportive services such as assisting patients with bathing, grooming, dressing and other personal care. They may also include meal preparation, housekeeping and shopping assistance. Medical or skilled services include nursing care, physical, occupational, speech and respiratory therapy delivered by registered nurses or licensed professionals. Skilled services often include social services and hospice or end-of-life care, and a physician's plan of treatment is required for all medical home care services.
Quality
Home care agencies must develop, implement and maintain an ongoing quality improvement program that includes performance measurement, review of program goals and objectives annually, review of the complaint/grievance process and a process to monitor and address patient satisfaction.
Facilities
Delaware's Office of Health Facilities Licensing and Certification maintains a listing of licensed home health agencies. Agencies are listed by type of agency and include address and phone number. Care Pathways also provides a list of private pay and Medicare/Medicaid home care agencies for Delaware, searchable by city.
