CMS SOM App. B, Tag G940

The HHA must organize, manage, and administer its resources to attain and

maintain the highest practicable functional capacity, including providing optimal

care to achieve the goals and outcomes identified in the patient’s plan of care, for

each patient’s medical, nursing, and rehabilitative needs. The HHA must assure

that administrative and supervisory functions are not delegated to another agency

or organization, and all services not furnished directly are monitored and

controlled. The HHA must set forth, in writing, its organizational structure,

including lines of authority, and services furnished.

Interpretive Guidelines §484.105

The roles of the governing body, administrator and clinical manager may not be

delegated. In other words, an HHA must ensure that the responsibilities of the governing

body, administrator and clinical manager (for the day-to-day operation of the HHA) are

not relinquished to another person or organization on an on-going basis. This does not

apply to periodic “acting” employees in the absence of the administrator or clinical

manger. In addition, the use of payroll services, OASIS transmission contractors, and

personnel training programs are not considered to be delegation of administrative and

supervisory functions; these are service contracts that the agency may use to optimize

administrative and supervisory efficiencies.