A. Private duty
nursing (PDN) providers must:
1. Have a
Division of Medicaid approved PDN proposal package.
1. Establish a provider agreement with the
Mississippi Division of Medicaid.
2. Satisfy all requirements in accordance
with Part 200, Rule
4.8 and must provide to the Division
of Medicaid:
a) A National Provider
Identifier (NPI) verification from National Plan and Provider Enumeration
System (NPPES), and
b) Written
confirmation from the Internal Revenue Service (IRS) confirming the provider's
tax identification number and legal business name,
3. Demonstrate prior successful health care
delivery for at least one (1) year,
4. Operate from a business office that is a
dedicated professional location and not part of a residence,
5. Disclose ownership information,
6. Maintain auditable medical records on each
beneficiary in the provider's business location, and
7. Maintain the highest level of ethical
standard in its business practices and adopt written standard of ethical
practice, which must include:
a) Neither the
owner nor any PDN provider employee shall knowingly mislead a patient, family
member or caretaker concerning services, charges, or use of
equipment.
b) Neither the owner nor
any PDN provider employee shall misuse or misappropriate any property-real or
personal-belonging to any patient, family member or caretaker.
c) Neither the owner nor any PDN provider
employee shall knowingly and actively recruit a patient under the care of
another PDN provider.
d) No
employee or patient of a PDN provider shall be coerced into participating in
provider fund raising activities.
e) The PDN provider shall accept patient
referrals in a professional manner with no remuneration provided to the
referring party.
f) Patient
clinical records, administrative records, and financial records shall not be
falsified by any individual for any reason.
B. PDN providers must, at a minimum:
1. Conduct licensure checks with the
Mississippi Board of Nursing, prior to employment and yearly
thereafter.
2. Conduct background
and abuse registry checks including,
a)
National criminal background check with fingerprints, including review of both
state and federal databases, on all employees or volunteers prior to employment
and every two (2) years thereafter, and maintain the record of the checks in
the employee's personnel file.
b)
Conduct registry checks, prior to employment and monthly thereafter, to ensure
employees are not listed on the Mississippi Nurse Aide Abuse Registry or listed
on the Office of Inspector General's Exclusion Database and maintain the record
of the checks in the employee's personnel file.
3. Not have been convicted of or pleaded
guilty or nolo contendere to a felony of possession or sale of drugs, murder,
manslaughter, armed robbery, rape, sexual battery, any sex offense listed in
Miss. Code Ann. §
45-33-23(f),
child abuse, arson, grand larceny, burglary, gratification of lust, aggravated
assault, or felonious abuse and/or battery of a vulnerable adult, or that any
such conviction or plea was reversed on appeal or a pardon was granted for the
conviction or plea.
4. Not employ
individuals or volunteers who have been, convicted of or pleaded guilty or nolo
contendere to a felony of possession or sale of drugs, murder, manslaughter,
armed robbery, rape, sexual battery, any sex offense listed in Miss. Code Ann.
§
45-33-23(f),
child abuse, arson, grand larceny, burglary, gratification of lust, aggravated
assault, or felonious abuse and/or battery of a vulnerable adult, or that any
such conviction or plea was reversed on appeal or a pardon was granted for the
conviction or plea.
5. Provide each
employee a thorough orientation to their position, the provider, policies and
objectives, the functions of other personnel and how they relate to each other
in caring for the beneficiary, standards of ethical practice, confidentiality
and patient's rights. All PDN providers must comply with the Centers for
Disease Control and/or the Mississippi Department of Health regarding baseline
and routine employee TB testing and education.
6. Provide mandatory annual in-service to RNs
and LPNs including, but not limited to:
a)
Beneficiary's rights,
b)
Requirements to report suspected abuse, neglect, or exploitation immediately
and how to report to the appropriate authority,
c) Requirements under Health Insurance
Portability and Accountability Act (HIPAA) of 1996 and other relevant laws
affecting privacy,
d) Infection
control, and
e) Emergency
procedures.
7. Ensure
Full-time and part-time nurses employed by the PDN provider complete a minimum
of twelve (12) hours of pertinent continuing education programs per
year.
8. Employ a supervising RN
who does not provide direct patient care and must:
a) Conduct a home evaluation visit prior to
the initiation of services in the primary residence,
b) Complete the plan of care (POC) and revise
as needed,
c) Initiate appropriate
preventive and rehabilitative nursing procedures,
d) Inform the primary care physician of any
changes in the beneficiary's condition and needs when appropriate,
e) Assign nurses to provide PDN services
according to their licensure training, and level of experience,
f) Make a supervisory home visit at least:
(1) Monthly with the servicing LPN present,
and
(2) Every other week with the
servicing CNA alternately present and absent.
g) Document the following during the
supervisory visit:
1) PDN services are
provided according to the plan of care,
2) The beneficiary's and/or beneficiary
representative's satisfaction level with the PDN services, and
3) That the plan of care has been reviewed
and updated with the most current physician's orders.
h) Make a home visit in addition to the
monthly visit when:
1) The beneficiary's
condition has changed,
2) The
beneficiary's health, safety, or welfare is potentially at risk, and
3) Requested by the Division of Medicaid or
designee.
i) Make a
monthly telephone contact with the beneficiary's guardian or legal
representative to ensure satisfaction with services provided.
h) Use a person-centered approach to PDN
services and ensure personal goals of the beneficiary are respected,
i) Ensure freedom of choice of providers
and/or services is given to the beneficiary, the beneficiary's guardian or
legal representative as long as the provider is not an immediate family member
or a resident of the beneficiary's home,
j) Educate the beneficiary and
family/caregiver(s) in meeting nursing and related goals,
k) Ensure services are provided in a manner
that is in the best interest of the beneficiary and does not endanger the
beneficiary's health, safety, or welfare;
l) Recommend staff changes when
needed,
m) Report to the Division
of Medicaid any unethical or incompetent practices that jeopardize public
safety or cause a risk of harm to beneficiaries, including household issues
that may jeopardize the safety of the PDN, and
n) Ensure that all nurses and caregivers are
aware that timesheets must be accurate with arrival and departure time of the
nurse.
9. Ensure that an
emergency preparedness plan is in place for each beneficiary receiving
services,
10. Ensure that no
immediate family member or person residing in the home with the beneficiary is
providing PDN services submitted for Medicaid reimbursement,
C. An RN or LPN providing PDN
services must:
1. Be employed by a Mississippi
Medicaid enrolled PDN provider,
2.
Maintain a current Mississippi nursing license, and
3. Practice within the scope of their
license, and
4. Have at least one
(1) year of experience providing the type of care required by the beneficiary's
medical needs.
D. PDN
providers must provide beneficiaries a written notice at least thirty (30) days
prior to the discontinuation of services or closure of the PDN provider except
when the requirements of Miss. Admin. Code Title 23, Part 223, Rule
3.5.C. are met.
1. PDN providers must assist with the
beneficiary's transition to another provider.
2. PDN providers who fail to provide proper
written notice will not be reimbursed for services provided during the thirty
(30) day period the beneficiary should have been notified.
E. PDN providers must require all employees
to report incidents and/or accidents that result or could have resulted in harm
to the beneficiary and/or employee to the direct supervisor immediately and to
the Division of Medicaid within twenty-four (24) hours.
F. All PDN providers and their employees must
immediately report in writing to the Division of Medicaid Office of Medical
Services, the Mississippi Department of Human Services (MDHS), and any other
entity required by federal or state law, all alleged or reported instances the
following:
1. Abuse,
2. Neglect,
3. Exploitation,
4. Suspicious death, or
5. Unauthorized use of restraints, seclusion
or restrictive interventions.
Miss. Code Ann.
§§
43-13-117,
43-13-121.