CMS SOM App. B, Tag G974

branches.

Interpretive Guidelines §484.105(d)(2)

The parent location must provide supervision and administrative control of its branches

daily to the extent that the branches depend upon the parent’s supervision and

administrative functions to meet the CoPs, and could not do so as independent entities.

The parent agency must be available to meet the needs of any situation and respond to

issues that could arise with respect to patient care or administration of a branch. A

violation of a CoP in a branch would apply to the entire HHA. Therefore, it is essential

for the parent to exercise adequate control, supervision, and guidance for all branches

under its leadership.

“Direct support and administrative control” of a branch includes that the parent agency

maintains responsibility for:

• The governing body oversight of the branch;

• Any branch contracts for services;

• The branch’s quality assurance and performance improvement plan;

• Policies and procedures implemented in the branch;

• How and when management and direct care staff are shared between the parent

and branch, particularly in the event of staffing shortfalls or leave coverage;

• Human resource management at the branch;

• Assuring the appropriate disposition of closed clinical records at the branch; and

• Ensuring branch personnel training requirements are met.

Survey Procedures §484.105(d)(2)

HHAs must demonstrate compliance through evidence of established policies and

procedures to ensure adequate control, supervision, and guidance for all branches under

an HHA’s leadership.