N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review

What this rule requires your agency to do

• 1Home health aide and PCA services must be provided in accordance with the plan of care, with aides arriving and leaving as scheduled and services within the scope of practice of assigned personnel.(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)
• 2Appropriate training and orientation must be provided by licensed personnel to assure delivery of required services.(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)
• 3Registered-nurse-delegated tasks may only be provided by LPNs, CNAs, or certified home health aides (CHHAs).(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)
• 4Upon MACC request, the provider must submit a plan of care and other documentation for beneficiaries selected for post-payment quality assurance review.(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)
• 5There must be documented evidence that the beneficiary/caregiver participated in developing the plan of care, and beneficiaries/caregivers must be promptly informed of changes in aides/schedules and know the agency name, phone number, and contact person.(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)
• 6The agency must document significant changes in the beneficiary's health/social status in progress notes and make appropriate plan-of-care changes, and provide initial evaluations/progress notes to the MACC on request.(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)
• 7Recordkeeping must be timely, accurate, complete, and legible, including a current aide assignment sheet for each beneficiary dated and signed by the nurse and based on a nursing assessment.(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)
• 8The provider must make an initial visit to evaluate the need for home health or PCA services; for PCA services the provider agency must request prior authorization using form FD-365 and a State-approved PCA Assessment tool, and PCA services must not be rendered until authorization is provided by DDS.(N.J.A.C. 10:60-1.8 - Standards of performance for concurrent and post payment quality assurance review)