{"ref":"NC-HC-BUS-03","title":"NC Medicaid Personal Care Services and Other Public Programs","category":"Business","summary":"If the Agency provides State Plan personal care services (PCS) paid by NC Medicaid, sets the provider requirements of NC Medicaid Clinical Coverage Policy 3L: enrollment, the Provider Interface, the on-line service plan and its deadlines, aide documentation, the conviction billing bar, the ban on inducements, cooperation with audits, the internal quality improvement program and its December 31 attestation, abuse reporting, and supervision and training. Refers to CAP/DA and block grant programs for their own requirements.","inShort":["Medicaid personal care services follow a service plan built from the state assessment, plus the nurse's own plan of care.","Do the tasks on the service plan on the days shown. If a task is not done, write down why.","Never offer a client or family a gift or anything else to choose or stay with the Agency.","A registered nurse visits every client at least every 90 days.","Report any suspected abuse, neglect or exploitation of a Medicaid client right away."],"primaryCitation":"NC Medicaid Clinical Coverage Policy 3L, §6.0","citations":["NC Medicaid Clinical Coverage Policy 3L, §6.0","NC Medicaid Clinical Coverage Policy 3L, §6.1","NC Medicaid Clinical Coverage Policy 3L, §6.1.3","NC Medicaid Clinical Coverage Policy 3L, §6.1.4","NC Medicaid Clinical Coverage Policy 3L, §6.1.5","NC Medicaid Clinical Coverage Policy 3L, §6.1.6","NC Medicaid Clinical Coverage Policy 3L, §5.4.5(c)","NC Medicaid Clinical Coverage Policy 3L, §5.4.6","NC Medicaid Clinical Coverage Policy 3L, §5.4.11","NC Medicaid Clinical Coverage Policy 3L, §7.1-§7.10","NC Medicaid Clinical Coverage Policy 3K-2","10A NCAC 13J .1107(g)","10A NCAC 13J .1502(a)"],"federalCitations":[],"surveyorAsks":["Show me the PCS service plan for this beneficiary, the date you accepted the referral, and the date the plan was validated.","Where is the separate plan of care your registered nurse developed for this beneficiary?"],"forms":[{"ref":"NC-HC-BUS-03-A","title":"Medicaid PCS Referral and Service Plan Checklist"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (NC Medicaid Clinical Coverage Policy 3L, §6.0)","5. Enrollment and Changes","6. Referrals and the Service Plan","7. Developing the Service Plan","8. Delivering and Documenting PCS","9. Staff Requirements and the Billing Bar","10. No Gifts or Inducements","11. Reviews and Audits","12. Internal Quality Improvement Program","13. Health, Welfare and Safety","14. Training and Orientation","15. Other Public Programs","16. Responsibilities","17. Records and Compliance Monitoring","18. Staff Training","19. References","20. Related Policies and Forms","21. Approval","22. Revision History"],"version":"1.0","sample":false,"pack":"nc-hca","state":"North Carolina","service":"Home care","guides":[{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}