Skilled and Non Skilled Nursing Care Agency - Policies and Procedures - Pennsylvania state Licensure

Introducing our comprehensive Skilled and Non-Skilled Nursing Care Agency Policies and Procedures package designed specifically for Pennsylvania State Licensure. We understand the critical importance of adhering to state regulations and maintaining the highest standards of care in the home health industry. Our meticulously crafted set of policies and procedures is your key to achieving and sustaining compliance while delivering exceptional healthcare services.

PDF Preview:  Download

Table of Contents         

Introduction    
Vision    
Mission    
Values    
Document Control    
Statement of Policy    
Chapter 1181 Applicability and Compliance Policy    
Scope of Benefits for Categorically Needy Recipients Policy    
Scope of Benefits for Medically Needy Recipients Policy    
Scope of Benefits for State Blind Pension Recipients Policy    
Scope of Benefits for Qualified Medicare Beneficiaries Policy    
Scope of Benefits for General Assistance Recipients Policy    
General Payment Policy    
Payment Conditions Policy    
Initial Need for Care and Payment Authorization Policy    
Continued Need for Care and Payment Authorization Policy    
General Limitations on Payment Policy    
Reserved Bed Payment Limitations Policy    
Reserved Bed Billing Interpretation Policy    
Charges for Bed Hold Days Policy    
Hospital Reserved Bed Reimbursement During Medicare Benefit Period Policy    
Prescription Drug Payment Limitations Policy    
Payment During Strike or Disaster Evacuation Policy    
Payment for Intermediate and Heavy Care Services in Dually Certified Skilled Beds Policy    
Medicare as a Payment Resource Policy    
Services Included in the Interim Per Diem Rate Policy    
Nurse Aide Program Reimbursement Policy    
Noncompensable Services Policy    
Method of Payment Policy    
Cost Reporting Policy    
Cost-Finding Policy    
Allowable Net Operating Cost Ceiling Policy    
Interim Per Diem Rate Setting Policy    
Upper Limits of Payment Policy    
Annual Payment Adjustment Policy    
Annual Reporting Policy    
Interim Reporting Policy    
Final Reporting Policy    
Cost Report Audit Requirements Policy    
Patient Personal Fund Audit and Recordkeeping Policy    
Claims Review and Utilization Review Policy    
Admission Need Review Policy    
Inspection of Care Policy    
Facility Corrective Action Response Policy    
Facility Utilization Review Policy    
Provider Misutilization Prevention Policy    
Failure to File Cost Report Policy    
Adequate Financial and Statistical Records Policy    
Certification and Recertification Compliance Policy
Medical Evaluation Compliance Policy    
Patient Fund Restitution and Compliance Policy    
Facility Right to Hearing and Appeal Policy    
Admission and Assessment Policy    
Plan of Care Policy    
Skilled Nursing Care Policy    
Non-skilled Care Policy    
Client Rights and Responsibilities Policy    
Staffing and Supervision Policy    
Personnel Qualifications and Training Policy
Medication Management Policy    
Change in Condition Policy    
Infection Control Policy    
Safety and Emergency Policy    
Incident and Abuse Reporting Policy    
Complaint and Grievance Policy   
Documentation and Confidentiality Policy
Transfer and Discharge Policy 

Forms  

Client Intake Form    
Admission and Level of Care Form    
Consent for Services and Acknowledgment Form    
Plan of Care Form    
Plan of Care Review Form    
Skilled Nursing Service Note Form    
Non-skilled Care Service Note Form    
Hospitalization / Therapeutic Leave Notification Form    
Client Funds Management Form    
Complaint Form    
Discharge / Transfer Summary Form    
Employee Orientation Checklist    
License / Certification Verification Form    
Background Check and Clearance Tracking Form    
Training and Competency Checklist    
Skilled Care Competency Checklist    
Non-skilled Care Competency Checklist    
Staff Incident Report Form    
Corrective Action Form    
Inspection of Care Corrective Action Plan Form    
Continued Need for Care Review Form    
Claims Review Checklist    
Audit and Documentation Checklist