A. Certified
Nursing Assistants (CNAs) providing personal care services (PCS) must be hired
and managed by private duty nursing (PDN) providers. PDN providers employing
CNAs must:
1. Enter into a provider agreement
with the Mississippi Division of Medicaid.
2. Satisfy all requirements set forth in 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,
and
6. Maintain auditable medical
records on each beneficiary in the provider's business location.
B. PDN providers employing CNAs
must, at a minimum:
1. Conduct certification
checks prior to employment and yearly thereafter.
2. Conduct background and abuse registry
checks including,
a) National criminal
background check with fingerprints 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
mandatory annual in-service to CNAs including, but not limited to:
a) Beneficiary's rights, including but not
limited to rights protected by HIPPA,
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.
6. Employ a
supervising registered nurse (RN) who does not provide direct patient care and
must:
a) Conduct an initial 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 procedures,
d) Inform the primary care physician of any
changes in the beneficiary's condition and needs when appropriate,
e) Assign CNAs to provide PCS according to
their certification, training, and level of experience,
f) Make a supervisory visit at least every
other week with the servicing RN, LPN, or CNA alternately present and absent
and document the following:
1) PCS services
are provided according to the plan of care,
2) The beneficiary's and/or beneficiary
representative's satisfaction level with the PCS services, and
3) That the plan of care has been reviewed
and updated with the most current physician's orders.
g) 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/or
3) Requested by the Division
of Medicaid or designee.
h) Use a person-centered approach to PCS 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 PCS 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 CNA, and
n) Ensure that all CNAs and caregivers are
aware that timesheets must be accurate with arrival and departure time of the
CNA.
7. Ensure that an
emergency preparedness plan is in place for each beneficiary receiving
services,
8. Ensure that no
immediate family member or person residing in the home with the beneficiary is
providing PCS submitted for Medicaid reimbursement,
9. Ensure certified nursing assistants
employed by the PDN provider complete a minimum of twelve (12) hours of
pertinent continuing education programs per year.
C. A CNA providing PCS must:
1. Be employed by a Mississippi Medicaid
enrolled PDN provider that is approved to provide CNAs,
2. Maintain a current Mississippi
certification as required to be a CNA per Rule
4.1.D of this chapter, and
3. Practice within the scope of their
certification and training.
D. Effective January 1, 2021, all PDN
providers providing PCS services must utilize a Mississippi Medicaid approved
Electronic Visit Verification (EVV) system for the submission of claims.
Approved EVV systems must include the:
1. Type
of service performed,
2. Individual
receiving the services,
3. Date of
the service,
4. Location of the
services,
5. Individual providing
the service, and
6. Time the
services begins and ends.
E. 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.
Miss. Code Ann.
§§
43-13-117,
43-13-121.