{"ref":"MI-HH-CS-02","title":"Skilled Nursing Services and Michigan Nursing Practice","category":"Clinical tasks","summary":"Sets out how the Agency furnishes skilled nursing: who may furnish and supervise it, what registered nurses and licensed practical nurses each do under the Michigan Public Health Code, how nursing tasks are delegated, the responsibilities every nurse carries under 42 CFR §484.75, and the Michigan Medicaid rules on covered and noncovered nursing visits and RN co-signature of LPN notes for Michigan Medicaid patients.","inShort":["Every nurse holds a current Michigan license and works within the plan of care and Agency policy.","LPNs work under a named RN. They do not do assessments, change the plan of care, take verbal orders or supervise aides.","For Michigan Medicaid patients, the RN co-signs every LPN note.","Only an RN delegates nursing tasks, and the RN stays responsible for them.","Do a specialized procedure only after the Agency has checked your competency.","Write your visit note the same day and report changes to the RN or the physician."],"primaryCitation":"42 CFR §484.75","citations":["MCL 333.17201 et seq.","MCL 333.16215","Mich. Admin. Code R 338.10104","Michigan Medicaid Provider Manual, Home Health, Section 8"],"federalCitations":["42 CFR §484.75","42 CFR §484.115(e)","42 CFR §484.115(k)","42 CFR §484.110(b)","42 CFR §409.44(b)"],"surveyorAsks":["Who supervises your LPNs, and how do you show it?","Show me the RN co-signature on LPN notes for a Michigan Medicaid patient."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.75)","5. Responsibilities of Every Nurse","6. What Registered Nurses Do","7. What Licensed Practical Nurses Do","8. Delegation of Nursing Tasks","9. Nursing Visits and Documentation","10. Competency for Specialized Procedures","11. Michigan Medicaid Nursing Coverage","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"mi-hha","state":"Michigan","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}