NYS Medicaid Home Health Manual — Policy Guidelines

What this rule requires your agency to do

• 1Changes in provider, functions, or hours of personal care service delivered must not be made without notification to and approval of the local department of social services; immediate-need personal care may be authorized for only 30 calendar days.(NYS Medicaid Home Health Manual — Policy Guidelines)
• 2A CHHA must maintain a confidential clinical record for each patient accepted for service, including identifying data, the original plan of care signed by the authorized practitioner, a comprehensive initial assessment on DOH-prescribed forms, source of referral, diagnosis/prognosis/goals, and therapist plan of care where applicable.(NYS Medicaid Home Health Manual — Policy Guidelines)
• 3Prior authorization by the local department of social services official is required for home health aide or personal care services; no authorization for personal care services shall exceed six months unless an exception (up to twelve months) is granted by DOH.(NYS Medicaid Home Health Manual — Policy Guidelines)
• 4Each patient's clinical record must be kept on file at the agency office for at least six years after discharge (and for minors until age 24).(NYS Medicaid Home Health Manual — Policy Guidelines)
• 5For continuous service, the clinical record must include progress notes after each patient contact, bi-monthly review notations of the total plan of care, a comprehensive reassessment every 120 days, and all changes in the medical regimen signed by the practitioner and reviewed at least every 60 days.(NYS Medicaid Home Health Manual — Policy Guidelines)
• 6The CHHA must perform the initial nursing assessment; for personal care services the assessment must be completed and returned to the local department of social services within 15 working days of referral.(NYS Medicaid Home Health Manual — Policy Guidelines)
• 7All persons providing home health aide services must be supervised by a public health nurse in the CHHA under direct RN supervision, with aide assignments based on a physician's plan of treatment and RN assessment of need.(NYS Medicaid Home Health Manual — Policy Guidelines)
• 8All persons providing personal care services must be subject to a program of supervision by a registered nurse who orients each aide to each patient's needs within the first week after assignment, makes supervisory visits per the RN-determined need, evaluates the aide's ability, maintains records of supervisory visits (with a copy to the local DSS case manager), and reports changes in patient condition or inappropriate actions.(NYS Medicaid Home Health Manual — Policy Guidelines)