Skilled Pediatric Home Health Agency - Policies and Procedures - Massachusetts state Licensure

Introducing our comprehensive Skilled Pediatric Home Health Agency Policies and Procedures package designed specifically for Massachusetts 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.

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Table of Contents

Introduction    
Vision    
Mission    
Core Values    
Document Control    
Statement of Policy    
Compliance with MassHealth Regulations and Service Standards    
Eligibility for Home Health Services    
Provider Eligibility for In-State Participation    
Provider Eligibility for Out-of-State Participation    
Provision of Services Under Contract    
Administrative Requirements for Service Provision    
Clinical Eligibility Criteria for Home Health Services    
Prior Authorization Requirements    
Skilled Nursing and Medication Administration Visits    
Prior Authorization for Home Health Aide Services    
Prior Authorization for Therapy Services    
Prior Authorization for MassHealth Members Enrolled in a Capitated Program    
Notice of Approval or Denial of Prior Authorization    
Scope of Home Health Services    
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services    
Nursing Services    
Home Health Aide Services    
Physical, Occupational, and Speech/Language Therapy Services    
Medical Supplies    
Provider Responsibilities    
Plan-of-Care Requirements    
Content of the Plan of Care    
Plan-of-Care Certification Period    
Verbal Orders    
Face-to-Face Encounter Requirements    
Quality Management and Utilization Review    
Transfers and Discharge Planning    
Conditions of Payment    
Intermittent or Part-time Requirement    
Maximum Allowable Fees    
Denial of Services and Administrative Review    
Prohibited Marketing Activities    

Forms    
Client Intake Form    
Physician Form with Responsible Party Info    
Nurse Assessment Form    
HIPAA Form    
Neglect and Abuse Form    
Client Consent Form    
Three Emergency Contacts    
Staff Supervisory Review Form    
Confidentiality Form    
Pediatric Home Health Assessment Form    
Plan of Care (POC) Form    
Safety Evaluation Form    
MassHealth Eligibility Verification Form    
Incident/Accident Report Form