Utah Admin. Code R414-40-3 - Program Access Requirements
(1) Only a
licensed home health agency enrolled as a Medicaid provider may be reimbursed
for private duty nursing services.
(2) A member shall have a written physician
order establishing the need for private duty nursing services. The private duty
nursing provider shall develop a care plan consistent with the member's
diagnosis, severity of illness, and intensity of services. If medically
necessary nursing services require four hours or fewer of skilled nursing, the
service is covered under the home health program.
(3) Private duty nursing is only available if
a parent, guardian, or primary caregiver is committed to and capable of
performing the medical skills necessary to ensure safe, quality care.
(4)
(a) The
home health agency shall verify that the hospital has provided specialized
training for the caregiver before patient discharge to enable the caregiver to
provide hands-on care in the home.
(b) The private duty nurse shall initially
supervise the caregiver who provides this care to ensure that training has been
assimilated to ensure safe, quality patient care.
Notes
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