.18 Special Requirements for the Provision of Ventilator Services.

A. A provider of ventilator services shall meet the requirements of this regulation in addition to meeting the requirements of Regulations .01—.16 of this chapter.

B. This regulation applies to ventilator services provided in the home, including:

(1) Volume ventilation;

(2) Pressure ventilation;

(3) Emergency back-up power systems;

(4) Alarms and troubleshooting equipment;

(5) Emergency resuscitation; and

(6) All related medical equipment used with the provision of ventilator services, including but not limited to:

(a) Nebulizers;

(b) Suction equipment; and

(c) Oxygen.

C. Education and Training. When an agency provides ventilator services, the agency shall:

(1) Use either a licensed registered nurse or a licensed respiratory care practitioner to supervise the provision of education and training and written instruction to the client, client representative, or individual caring for the client; and

(2) Provide retraining and review on a monthly basis, and as frequently as necessary.

D. Client Record. For a client receiving ventilator services, the agency shall maintain a clinical record, in addition to the documents required to be maintained in accordance with the provisions set forth in Regulations .14 and .15 of this chapter, that includes the following:

(1) An evaluation of use of the ventilator and all related medical equipment by the client, client representative, or individual caring for the client that includes:

(a) Training at least monthly on the provision of ventilator services; and

(b) Retraining, more frequently as needed, on the provision of ventilator services;

(2) A prescription that includes the mode, frequency, and ventilator settings;

(3) Respiratory and all specialized services, including the results, complications, and outcomes;

(4) Physician orders and pharmacy-dispensed respiratory medications;

(5) Evidence that the client, client representative, or individual caring for the client was instructed that medications are to be obtained from a licensed pharmacy; and

(6) A discharge summary when a client is no longer receiving ventilator-related services.