480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services)

What this rule requires your agency to do

• 1Providers must comply with all applicable Medicaid provider participation requirements in 471 NAC Chapters 1, 2, and 3 (§ 002.01).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))
• 2Service authorization must be complete before services are performed; providers must know and understand the tasks they are authorized to perform for each participant (§ 002.02).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))
• 3Providers must report all incidents with reasonable cause to believe a participant was subjected to abuse, neglect, or exploitation to law enforcement and to DHHS (§ 002.06(R); § 002.08(B)).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))
• 4Agency providers must allow DHHS to review agency hiring/reporting policies and records to ensure appropriate abuse, neglect, and law-violation procedures are in place, and must screen employees for the listed provider standards (§ 002.06(N); § 002.07; § 002.08).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))
• 5Providers must retain all enrollment and service records, including financial records, for at least a six-year retention period and allow federal/state/local audit review on site (§ 002.06(E), (F); § 002.12).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))
• 6Providers must have the knowledge, skills, and physical/mental ability to respond to emergencies and safely perform authorized services (§ 002.03).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))
• 7DHHS conducts an annual in-person review of each provider, including screening of the sex offender, Adult Protective Services, and Child Protective Services Central Registries and may include an additional criminal background check (§ 002.09).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))
• 8Providers must not engage in or have an ongoing history of criminal activity that may endanger participants, including listing on child/adult abuse-neglect central registries or sex-offender registries (§ 002.06(M)).(480 NAC Chapter 4, Section 480-4-002 — General Provider Requirements (Home and Community-Based Services))