Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES
Chapter 9 - HOME HEALTH AGENCIES AND SKILLED NURSING SERVICES
Section 471-9-003 - PROVIDER REQUIREMENTS
Universal Citation: 471 NE Admin Rules and Regs ch 9 ยง 003
Current through September 17, 2024
003.01 GENERAL PROVIDER REQUIREMENTS. Providers of home health services must comply with all applicable provider participation requirements codified in 471 Nebraska Administrative Code (NAC) 2 and 3. In the event that participation requirements in 471 NAC 2 or 3 conflict with requirements outlined in this chapter, the participation requirements in this chapter will govern.
003.02 SPECIFIC PROVIDER REQUIREMENTS.
003.02(A)
PLAN OF CARE AND
TREATMENT RECORD. The home health agency must maintain a clinical
record that includes the plan of care signed by the attending physician, nurse
practitioner, physician assistant, or clinical nurse specialist responsible for
the client's care. The attending physician, nurse practitioner, physician
assistant, or clinical nurse specialist and home health agency personnel must
review the total plan of care and treatment record at least every 60 days. The
home health agency must maintain these records on all Medicaid clients and make
them readily available upon the Department's request.
003.02(B)
COST
REPORTS. The home health agency must provide a cost report upon a
request made by the Department.
003.02(C)
LICENSING.
Providers of nursing services must be licensed by the Department of Health and
Human Services Division of Public Health or by the appropriate licensing agency
of the state in which they practice, as an individual registered nurse (RN) or
licensed practical nurse (LPN).
003.02(D)
PROVIDER
DOCUMENTATION. The nurse must maintain records to document
services provided and the time worked for which payment is claimed. These
records must be available to the Department upon request. Records must be
retained for no fewer than six years for audit purposes. Records must include:
(i) Current, signed physician, nurse
practitioner, physician assistant, or clinical nurse specialist orders for the
care provided;
(ii) Assessment of
the client's health status;
(iii)
Plan of care;
(iv) Nurse's notes
documenting the care provided; and
(v) Time sheets documenting the date and
times that care was provided.
003.03 SPECIFIC PROVIDER REQUIREMENTS FOR PRIVATE-DUTY NURSE.
003.03(A)
CLIENT
RECORDS. The private-duty nurse must maintain a medical record in
the client's home or current living arrangement which includes the Form MS-81:
Certification and Plan of Care For Private-Duty Nursing.
003.03(B)
MULTIPLE REGISTERED
NURSE (RN) AND LICENSED PRACTICAL NURSE (LPN) PROVIDERS. When more
than one registered nurse (RN) or licensed practical nurse (LPN) is providing
skilled nursing services for a client, the providers and client must determine
which registered nurse (RN) or licensed practical nurse (LPN) will be the
coordinator of services. The coordinator must complete the Form MS-81:
Certification and Plan of Care For Private-Duty Nursing, obtaining physician,
nurse practitioner, physician assistant, or clinical nurse specialist orders,
obtaining authorization for providing services, and making copies available to
the other providers.
003.03(D)
PROVIDER REQUIREMENTS. To participate in the Medicaid
program, the provider must:
(i) Be a
participant in the home health and nursing services program;
(ii) Be licensed to provide home health care
by the Department of Health and Human Services Division of Public
Health;
(iii) Assume full
responsibility of the professional management of the client's home health care;
(iv) Maintain
certification;
(v) Develop the plan
of care as identified by client;
(vi) Follow all applicable regulations put in
place by the Department;
(vii)
Comply with the requirements of 471 NAC 1; and
(viii) Be a participant in the Medicare home
health program.
Disclaimer: These regulations may not be the most recent version. Nebraska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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