Presented by: Mary Ann Knee RN,CRNI, COS-C
|
|
- Berenice Atkins
- 6 years ago
- Views:
Transcription
1 Presented by: Mary Ann Knee RN,CRNI, COS-C 64B Definitions. (1) Administration of Intravenous Therapy is the therapeutic infusion and/or injection of substances through the venous peripheral system, consisting of activity which includes: observing, initiating, monitoring, discontinuing, maintaining, regulating, adjusting, documenting, planning, intervening and evaluating. KNEE,&MARY&ANN&1&
2 Infusion Therapy to increase revenue base Develop a niche in the home care market Meet the needs of a current referral source TPN (supplies paid for under the DME as a prosthetic Antibiotics Hydration Pain management Chemotherapy Ionotropics Steroids Antifungals KNEE,&MARY&ANN&2&
3 Cancer CHF Crohn s Disease Hemophelia Immune deficiencies MS Rheumatoid Arthritis Cellulitis Sepsis Osteomyelitis UTI Pneumonia Sinusitis Although drugs and biologicals are specifically excluded from coverage by the statute ( 1861(m)(5) of the Act, the services of a nurse that are required to administer the medications safely and effectively may be covered if they are reasonable and necessary to the treatment of the illness or injury KNEE,&MARY&ANN&3&
4 Injections (coverage in Medicare Benefit Manual under injections) Intravenous, intramuscular, or subcutaneous injections and infusions, and hypodermoclysis or intravenous feedings require the skills of a licensed nurse to be performed (or taught) safely and effectively. Where these services are reasonable and necessary to treat the illness or injury, they may be covered. For these services to be reasonable and necessary, the medication being administered must be accepted as safe and effective treatment of the patient's illness or injury, and there must be a medical reason that the medication cannot be taken orally.. KNEE,&MARY&ANN&4&
5 Moreover, the frequency and duration of the administration of the medication must be within accepted standards of medical practice, or there must be a valid explanation regarding the extenuating circumstances to justify the need for the additional injections Antibiotic regimens very often require peak and trough as well as other labs Parenteral nutrition requires management of electrolytes as well as other labs Are they covered? KNEE,&MARY&ANN&5&
6 Venipuncture (Rev. 1, ) A B.13, HHA B.13 Effective February 5, 1998, venipuncture for the purposes of obtaining a blood sample can no longer be the sole reason for Medicare home health eligibility. KNEE,&MARY&ANN&6&
7 If a beneficiary qualifies for home health eligibility based on a skilled need other than solely venipuncture (e.g., eligibility based on the skilled nursing service of wound care and meets all other Medicare home health eligibility criteria), medically reasonable and necessary venipuncture coverage may continue during the 60-day episode under a home health plan of care. Sections 1814(a)(2)(C) and 1835(a)(2)(A) of the Act specifically exclude venipuncture, as a basis for qualifying for Medicare home health services if this is the sole skilled service the beneficiary requires. However, the Medicare home health benefit will continue to pay for a blood draw if the beneficiary has a need for another qualified skilled service and meets all home health eligibility criteria. KNEE,&MARY&ANN&7&
8 If a beneficiary qualifies for home health eligibility based on a skilled need other than solely venipuncture (e.g., eligibility based on the skilled nursing service of wound care and meets all other Medicare home health eligibility criteria), medically reasonable and necessary venipuncture coverage may continue during the 60-day episode under a home health plan of care. This specific requirement applies to home health services furnished on or after February 5, KNEE,&MARY&ANN&8&
9 For venipuncture to be reasonable and necessary: The physician order for the venipuncture for a laboratory test should be associated with a specific symptom or diagnosis, or the documentation should clarify the need for the test when it is not diagnosis/illness specific. In addition, the treatment must be recognized (in the Physician's Desk Reference, or other authoritative source) as being reasonable and necessary to the treatment of the illness or injury for venipuncture and monitoring the treatment must also be reasonable and necessary. KNEE,&MARY&ANN&9&
10 The frequency of testing should be consistent with accepted standards of medical practice for continued monitoring of a diagnosis, medical problem, or treatment regimen. Even where the laboratory results are consistently stable, periodic venipuncture may be reasonable and necessary because of the nature of the treatment. An unstable insulin dependent or noninsulin dependent diabetic would require FBS more frequently than once per month if ordered by the physician. Where there is a new diagnosis or where there has been a recent exacerbation, but the patient is not unstable, monitoring once per month would be reasonable and necessary. KNEE,&MARY&ANN&10&
11 Where the results are stable within the therapeutic ranges, monthly monitoring would be reasonable and necessary. Where the results are stable within nontherapeutic ranges, there must be documentation of other factors which would indicate why continued monitoring is reasonable and necessary. What labs are frequently performed for patients receiving infusions? CBC CMP Electrolytes Pharmacokinetics for antibiotics Drug levels Trace metals for TPN KNEE,&MARY&ANN&11&
12 Medical Supplies (Except for Drugs and Biologicals Other Than Covered Osteoporosis Drugs) and the Use of Durable Medical Equipment (Rev.26, Issued , Effective: , Implementation: ) Medical Supplies (Rev. 1, ) A A, HHA A Medicare pays for the nursing Who pays for the supplies? Supplies are bundled as a medical supply Medical Supplies (Except for Drugs and Biologicals Other Than Covered Osteoporosis Drugs) & the Use of Durable Medical Equipment (Rev.26, Issued , Effective: , Implementation: ) Medical Supplies (Rev. 1, ) A A, HHA A KNEE,&MARY&ANN&12&
13 Medical supplies are items that, due to their therapeutic or diagnostic characteristics, are essential in enabling HHA personnel to conduct home visits or to carry out effectively the care the physician has ordered for the treatment or diagnosis of the patient's illness or injury. All supplies which would have been covered under the cost-based reimbursement system are bundled under home health PPS. Payment for the cost of supplies has been incorporated into the per visit and episode payment rates. KNEE,&MARY&ANN&13&
14 Routine - because they are used in small quantities for patients during the usual course of most home visits; or Non-routine - because they are needed to treat a patient's specific illness or injury in accordance with the physician's plan of care and meet further conditions discussed in more detail below. All HHAs are expected to separately identify in their records the cost of medical and surgical supplies that are not routinely furnished in conjunction with patient care visits and the use of which are directly identifiable to an individual patient. KNEE,&MARY&ANN&14&
15 The Law, Routine and Nonroutine Medical Supplies, and the Patient's Plan of Care (Rev. 1, ) A A.2, HHA-206.4A3, 4, 5 The Medicare law governing the home health PPS is specific to the type of items and services bundled to the HHA and the time the services are bundled. Medical supplies are bundled while the patient is under a home health plan of care KNEE,&MARY&ANN&15&
16 HHA is required to provide the medical supply while the patient is under a home health plan of care during an open episode. The physician orders in the plan of care must reflect all nonroutine medical supplies provided and used while the patient is under a home health plan of care during an open 60-day episode. The consolidated billing requirement is not superseded by the exclusion of certain medical supplies from the plan of care and then distinguishing between medical supplies that are related and unrelated to the plan of care. Failure to include medical supplies on the plan of care does not relieve HHAs from the obligation to comply with the consolidated billing requirements. The comprehensive nature of the current patient assessment and plan of care requirements looks at the totality of patient needs. KNEE,&MARY&ANN&16&
17 There could be a circumstance where a physician could be uncomfortable with writing orders for a preexisting condition unrelated to the reason for home health care. In those circumstances, PRN orders for such supplies may be used in the plan of care by a physician. Primary physician would not need to order supplies for infusion, the specialist can write the order All medical supplies are bundled while the patient is under a home health plan of care during an open 60-day episode. This includes, but is not limited to, the above listed medical supplies as well as the Part B items provided in the final PPS rule. The latter item lists are subsequently updated in accordance with the current process governing the deletion, replacement and revision of Medicare Part B codes. KNEE,&MARY&ANN&17&
18 Both Medicare and Veteran's Administration (VA) benefits are primary. The beneficiary who is a veteran has some choices in cases where the benefits overlap. The beneficiary must select one or the other program as primary when obtaining active care. If the VA is selected as primary for home health care, then Medicare becomes a secondary payer. An HHA must provide the medical supplies a Medicare beneficiary needs no matter the payer; it is not obligated to provide medical supplies that are not needed KNEE,&MARY&ANN&18&
19 If a patient has medical supplies provided by the VA because of the patient's preference, then the HHA must not duplicate the supplies under Medicare. The beneficiary's choice is controlling. The HHA may not require the beneficiary to obtain or use medical supplies covered by the primary payer from any other source, including the VA Non-routine Supplies (Reportable) (Rev. 1, ) A A.2, HHA A.2 The item is recognized as having the capacity to serve a therapeutic or diagnostic purpose in a specific situation; and The item is required as a part of the actual physician-prescribed treatment of a patient's existing illness or injury KNEE,&MARY&ANN&19&
20 Non-routine supplies are identified by the following conditions: 1. The HHA follows a consistent charging practice for Medicare and other patients receiving the item; 2. The item is directly identifiable to an individual patient; 3. The cost of the item can be identified and accumulated in a separate cost center; And 4. The item is furnished at the direction of the patient's physician and is specifically identified in the plan of care. KNEE,&MARY&ANN&20&
21 All non-routine supplies must be specifically ordered by the physician or the physician's order for services must require the use of the specific supplies to be effectively furnished. The charge for nonroutine supplies is excluded from the per visit costs. Dressings/Wound Care Sterile dressings; Sterile gauze & toppers; Kling and Kerlix rolls; Telfa pads; Eye pads; Sterile solutions, ointments; Sterile applicators; & Sterile gloves. I.V. Supplies Ostomy Supplies Catheters & Catheter Supplies to name a few KNEE,&MARY&ANN&21&
22 Yes they are! The infusion pharmacy will bill the agency Remember to include the supplies in your RAP and Final billing AHCA CMS Florida Nurse Practice Act Accrediting Organizations such as: CHAP ACHC The Joint Commission Remember you are providing specialized care and are held to the standards of the clinical specialty such as the Infusion Nurses Society and the Oncology Nursing Society KNEE,&MARY&ANN&22&
23 Standards of Practice for INS Keep a copy of the current standards available Policies and Procedures INS has policies & procedures that have been written according to the standards Is intended to reflect current knowledge & practices of the clinical nursing specialty of infusion therapy. Because clinical practice continually evolves based on ongoing research, users should make an independent assessment of the appropriateness & applicability of a standard in any specific instance, & should also consider the applicable federal and state laws and regulations, as well as the standard of care in a particular jurisdiction, as these may take precedence. KNEE,&MARY&ANN&23&
24 INS is not responsible for injury to persons or property, or other harm, arising from the use of the Standards. RNs must be proficient in performance of all aspects of infusion therapy LPNs must have 30 hour continuing education program including management of central lines If LPNs are performing visits for infusion, there must be an RN available with infusion experience for consultation KNEE,&MARY&ANN&24&
25 (1) The practice of practical nursing as defined by Section (3)(b), Florida Statutes, includes the administration of treatments and medication, under direction, and holds the licensed practical nurse responsible & accountable for making decisions...based upon the individual s educational preparation & experience in nursing. As medical science advances and the demands for health care in Florida grow, the scope of nursing practice, in general, & of the practice of practical nursing, in particular, is expanding. when qualified by training and education and when approved by the institution at which the licensed practical nurse is employed, engage in the limited administration of intravenous therapy both to serve the public and to allow the professional nurse to better perform those acts requiring professional nursing specialized knowledge, judgment and skill.. KNEE,&MARY&ANN&25&
26 (2) The purpose of this rule is to protect the public by ensuring the availability of intravenous therapy and its competent administration in the care of the ill, injured or the infirm the qualified licensed practical nurse to administer those aspects of intravenous therapy within the scope of practice of the licensed practical nurse, enumerates those aspects of intravenous therapy outside the scope of practice of the licensed practical nurse, & sets out the educational and/or competency verification necessary to administer, under direction, limited forms of intravenous therapy KNEE,&MARY&ANN&26&
27 means that the registered professional nurse has delegated intravenous therapy functions to a qualified licensed practical nurse. The registered professional nurse does not in all instances have to be on the premises in order for the licensed practical nurse to perform the delegated functions. (3) Direct supervision means on the premises and immediately physically available. (1) Aspects of intravenous therapy which are outside the scope of practice of the licensed practical nurse unless under the direct supervision of the registered professional nurse or physician and which shall not be performed or initiated by licensed practical nurses without direct supervision include the following: KNEE,&MARY&ANN&27&
28 (a) Initiation of blood and blood products; (b) Initiation or administration of cancer chemotherapy; (c) Initiation of plasma expanders; (d) Initiation or administration of investigational drugs; (e) Mixing IV solution; (f) IV pushes, except heparin flushes and saline flushes. (2) Although this rule limits the scope of licensed practical nurse practice, it is appropriate for licensed practical nurses to care for patients receiving such therapy. KNEE,&MARY&ANN&28&
29 The board endorses the Intravenous Therapy Course Guidelines issued by the Education Department of the National Federation of Licensed Practical Nurses, November, The intravenous therapy education must contain the following components: Policies and procedures of both the Nurse Practice Act and the employing agency in regard to intravenous therapy. This includes legalities of both the Licensed Practical Nurse role and the administration of safe care. Principles of charting are also included. KNEE,&MARY&ANN&29&
30 Psychological preparation and support for the patient receiving IV therapy as well as the appropriate family members/ significant others. (c) Site and function of the peripheral veins used for veinpuncture. (d) Procedure for veinpuncture, including physical and psychological preparation, site selection, skin preparation, palpation of veins, and collection of equipment. Relationship between intravenous therapy and the body s homeostatic and regulatory functions, with attention to theclinical manifestations of fluid and electrolyte imbalance. f) Signs and symptoms of local and systemic complications in the delivery of fluids and medications and the preventive and treatment measures for these complications.. KNEE,&MARY&ANN&30&
31 (g) Identification of various types of equipment used in administering intravenous therapy with content related to criteria for use of each and means of trouble shooting for malfunction. (h) Formulas used to calculate fluid and drug administration rate (i) Methods of administering drugs intravenously and advantages and disadvantages of each. (j) Principles of compatibility and incompatibility of drugs and solutions. (k) Nursing management of the patient receiving drug therapy, including principles of chemotherapy, protocols, actions, and side effects. KNEE,&MARY&ANN&31&
32 (l) Nursing management of the patient receiving blood and blood components, following institutional protocol. Include indications and contraindications for use; identification of adverse reactions. (m) Nursing management of the patient receiving parenteral nutrition, including principles of metabolism, potential complications, and physical and psychological measures to ensure the desired therapeutic effect. (n) Principles of infection control in IV therapy, including aseptic technique and prevention and treatment of iatrogenic infection. KNEE,&MARY&ANN&32&
33 (o) Nursing management of special IV therapy procedures that are commonly used in the clinical setting, such as heparin lock, central lines, and arterial lines. (p) Glossary of common terminology pertinent to IV fluid therapy. (q) Performance check list by which to evaluate clinical application of knowledge and skills. RNs are expected to meet the competency criteria same as the LPNs since they oversee the care provided by the LPN INS provides an excellent program of testing the competencies of RNs and LPNs in the maintenance of infusion therapy They are available on ins1.org KNEE,&MARY&ANN&33&
34 The Board recognizes that through appropriate education and training, a Licensed Practical Nurse is capable of performing intravenous therapy via central lines under the direction of a registered professional nurse as defined in subsection 64B (2), F.A.C. Appropriate education and training requires a minimum of four (4) hours of instruction. The education and training required shall include, at a minimum, didactic & clinical practicum instruction in the following areas: (a) Central venous anatomy & physiology; (b) CVL site assessment; (c) CVL dressing & cap changes; CVL flushing; (d) CVL medication & fluid administration; (f) CVL blood drawing; and (g) CVL complications and remedial measures. KNEE,&MARY&ANN&34&
35 the Licensed Practical Nurse shall be assessed on both theoretical knowledge and practice, as well as clinical practice and competence. The clinical practice assessment must be witnesses by an RN who shall file a proficiency statement regarding the LPN s ability to perform intravenous therapy via central lines. The proficiency statement shall be kept in the Licensed Practical Nurse s personnel file shall be the responsibility of each institution employing a licensed practical nurse based on institutional protocol. Such verification shall be given through a signed statement of a Florida licensed registered nurse. KNEE,&MARY&ANN&35&
36 Every effort should be made to have the patient discharged early in the day to establish a workable schedule Evening discharges impact your ability to schedule clinicians Prior to discharge, establish a realistic expectation for the patient or caregiver to participate in the administration of the therapy to prevent an outlier situation. I have the patient/caregiver sign a responsibility statement If multiple visits are need daily, arrange for a pump if able to do so. Be aware you need to pay for the daily rental of the pump as well Be prepared to negotiate with the for an acceptable per diem rate. Be aware even once you have a family member trained, the per diem rate continues and the costs mount up KNEE,&MARY&ANN&36&
37 Competencies Cost of supplies Scheduling issues On call RN for questions and complications Competencies Cost of supplies Scheduling issues On call RN for questions and complications KNEE,&MARY&ANN&37&
38 Infusion Therapy, Should I or Shouldn t I? Thank you! Questions? KNEE,&MARY&ANN&38&
DEMONSTRATED NEED FOR SKILLED CARE FOR MEDICARE PATIENTS: SKILLED NURSING SERVICES
DEMONSTRATED NEED FOR SKILLED CARE FOR MEDICARE PATIENTS: SCOPE: All Ascension At Home, LLC colleagues. For purposes of this policy, all references to colleague or colleagues include temporary, part-time
More informationWYOMING STATE BOARD OF NURSING ADVISORY OPINION INTRAVENOUS THERAPY BY LICENSED PRACTICAL NURSES
WYOMING STATE BOARD OF NURSING ADVISORY OPINION INTRAVENOUS THERAPY BY LICENSED PRACTICAL NURSES Advisory Opinion Number: 03-123 Board Meeting Date: April 28-May 1, 2003 January 7-10, 2008 February 18,
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: skilled_nursing_services 07/2001 2/2018 2/2019 2/2018 Description of Procedure or Service Skilled Nursing
More informationADOPTED REGULATION OF THE STATE BOARD OF NURSING. LCB File No. R Effective April 4, 2016
ADOPTED REGULATION OF THE STATE BOARD OF NURSING LCB File No. R091-15 Effective April 4, 2016 EXPLANATION Matter in italics is new; matter in brackets [omitted material] is material to be omitted. AUTHORITY:
More informationWYOMING STATE BOARD OF NURSING ADVISORY OPINION
WYOMING STATE BOARD OF NURSING ADVISORY OPINION INTRAVENOUS THERAPY BY LICENSED PRACTICAL NURSES Advisory Opinion Number: 03-123 Board Meeting Date: April 28-May 1, 2003 January 7-10, 2008 Introduction:
More informationJuly 2011 Quarterly CMS OCCB Q&As
July 2011 Quarterly CMS OCCB Q&As Category 1 - Applicability Face-to-Face Question 1: If the F2F does not occur within 30 days, but it does occur, for example, on the 35th day, does the agency have to
More informationCHAPTER 64B9-11 MAINTENANCE OF MEDICAL RECORDS
CHAPTER 64B9-11 MAINTENANCE OF MEDICAL RECORDS 64B9-11.001 64B9-11.002 Medical Records of Deceased Nurse Medical Records of Nurses Relocating or Terminating Practice 64B9-11.001 Medical Records of Deceased
More informationDepartment Policy. Code: D: MM Entity: Fairview Pharmacy Services. Department: Fairview Home Infusion. Manual: Policy and Procedure Manual
Department Policy Code: D: MM-5615 Entity: Fairview Pharmacy Services Department: Fairview Home Infusion Manual: Policy and Procedure Manual Category: Home Infusion Subject: Chemotherapy Purpose: Ensure
More informationTexas Medicaid. Provider Procedures Manual. Provider Handbooks. Home Health Nursing and Private Duty Nursing Services Handbook
Texas Medicaid Provider Procedures Manual Provider Handbooks January 2018 Home Health Nursing and Private Duty Nursing Services Handbook The Texas Medicaid & Healthcare Partnership (TMHP) is the claims
More informationAnthem Blue Cross and Blue Shield Commercial Professional Reimbursement Policy
Subject: Injection and Infusion Administration and Related Services & Supplies IN, KY, MO, OH, WI Policy: 0015 Effective: 05/01/2017 Coverage is subject to the terms, conditions, and limitations of an
More informationDuring pre-briefing, you will be assigned one of these roles according to the description below to participate in the simulation as a nurse.
Student Instructions for Standardized Simulation NR 452 Eric Chilton PURPOSE The following information is to be used in guiding your preparation and participation in the scenario for this course. This
More informationLimitations and Guidelines Revised for Elastomeric Devices and IV Supplies and Equipment
Limitations and Guidelines Revised for Elastomeric Devices and IV Supplies and Equipment Information posted January 8, 2007 Effective for dates of service on or after March 1, 2007, benefit limitations
More information5/1/2017 THE BEST DEFENSE IS A GOOD OFFENSE OBJECTIVES. Preparing for a Home Health Medicare Recertification Survey
THE BEST DEFENSE IS A GOOD OFFENSE Preparing for a Home Health Medicare Recertification Survey OBJECTIVES To gain an understanding how the Medicare Conditions of Participation (CoPs), the individual G-tags,
More informationDelegation for the Newly Licensed Practical Nurse
State of Nebraska Transition Grant Delegation for the Newly Licensed Practical Nurse Education Module Copyright 2011 Title: Delegation Learning Objectives: Upon completion of this education module, the
More informationFlorida Medicaid. Outpatient Hospital Services Coverage Policy. Agency for Health Care Administration. Draft Rule
Florida Medicaid Agency for Health Care Administration Draft Rule Table of Contents Florida Medicaid 1.0 Introduction... 1 1.1 Description... 1 1.2 Legal Authority... 1 1.3 Definitions... 1 2.0 Eligible
More informationALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS
ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS 610 X 6.01 610 X 6.02 610 X 6.03 610 X 6.04 610 X 6.05 610 X 6.06 610 X 6.07 610 X 6.08 610
More informationMedical Review Criteria Skilled Nursing Facility & Subacute Care
Medical Review Criteria Skilled Nursing Facility & Care Subject: Skilled Nursing Facility and Care Background: Skilled nursing facilities () provide facility-based skilled nursing care and related services
More informationToday s educational presentation is provided by. The software that powers HOME HEALTH. THERAPY. PRIVATE DUTY. HOSPICE
Today s educational presentation is provided by The software that powers HOME HEALTH. THERAPY. PRIVATE DUTY. HOSPICE At Kinnser, we believe post-acute care businesses need the right software solution for
More informationE: Nursing Practice. Alberta Licensed Practical Nurses Competency Profile 51
E: Nursing Practice Alberta Licensed Practical Nurses Competency Profile 51 Competency: E-1 Critical Thinking E-1-1 E-1-2 E-1-3 Demonstrate knowledge and ability to apply critical thinking concepts throughout
More informationSubject: Skilled Nursing Facilities (Page 1 of 6)
Subject: Skilled Nursing Facilities (Page 1 of 6) Objective: I. To ensure that Tuality Health Alliance (THA) and delegated Providence Health Plan Medicare members are appropriately placed in skilled nursing
More informationALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610-X-6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS
ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610-X-6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS 610-X-6-.01 610-X-6-.02 610-X-6-.03 610-X-6-.04 610-X-6-.05 610-X-6-.06 610-X-6-.07 610-X-6-.08
More informationHome Health Eligibility Requirements
Presented By: Melinda A. Gaboury, COS-C Chief Executive Officer Healthcare Provider Solutions, Inc. healthcareprovidersolutions.com Home Health Eligibility Requirements Meets eligibility for home health
More informationNEW JERSEY. Downloaded January 2011
NEW JERSEY Downloaded January 2011 SUBCHAPTER 25. MANDATORY NURSE STAFFING 8:39 25.1 Mandatory policies and procedures for nurse staffing (a) There shall be a full time director of nursing or nursing administrator
More informationWyoming STATE BOARD OF NURSING
David D. Freudenthal Governor Wyoming STATE BOARD OF NURSING Mary Kay Goetter, PhD, RNC, NEA-BC Executive Director 1810 Pioneer Avenue Cheyenne, Wyoming 82002 Phone: 307-777-7601 FAX: 307-777-3519 http://nursing.state.wy.us
More informationU: Medication Administration
U: Medication Administration Alberta Licensed Practical Nurses Competency Profile 199 Competency: U-1 Pharmacology and Principles of Administration of Medications U-1-1 U-1-2 U-1-3 U-1-4 Demonstrate knowledge
More information201 KAR 20:490. Licensed practical nurse intravenous therapy scope of practice.
201 KAR 20:490. Licensed practical nurse intravenous therapy scope of practice. RELATES TO: KRS 314.011(10)(a), (c) STATUTORY AUTHORITY: KRS 314.011(10)(c), 314.131(1), 314.011(10)(c) NECESSITY, FUNCTION,
More informationHome Infusion Therapy Corporate Medical Policy
File name: Home Infusion Therapy File Code: UM.DME.15 Origination: 10/04 Last Review: 03/2018 Next Review: 03/2019 Effective Date: 08/01/2018 Home Infusion Therapy Corporate Medical Policy Description/Summary
More informationMedical, Surgical, and Routine Supplies (including but not limited to 99070)
Manual: Policy Title: Reimbursement Policy Medical, Surgical, and Routine Supplies (including but not limited to 99070) Section: Administrative Subsection: none Date of Origin: 1/1/2002 Policy Number:
More informationREVISED PROPOSED REGULATION OF THE STATE BOARD OF NURSING. LCB File No. R June 11, 2004
REVISED PROPOSED REGULATION OF THE STATE BOARD OF NURSING LCB File No. R091-04 June 11, 2004 EXPLANATION Matter in italics is new; matter in brackets [omitted material] is material to be omitted. AUTHORITY:
More informationHome Infusion Payment Policy
Home Infusion Payment Policy Policy Blue Cross Blue Shield of Massachusetts (Blue Cross)* reimburses contracted providers for covered, medically necessary home infusion services. General Benefit Information
More informationALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS
Nursing Chapter 610 X 6 ALABAMA BOARD OF NURSING ADMINISTRATIVE CODE CHAPTER 610 X 6 STANDARDS OF NURSING PRACTICE TABLE OF CONTENTS 610 X 6.01 610 X 6.02 610 X 6.03 610 X 6.04 610 X 6.05 610 X 6.06 610
More informationFlorida Medicaid. Private Duty Nursing Services Coverage Policy
Florida Medicaid Agency for Health Care Administration November 2016 Table of Contents Florida Medicaid 1.0 Introduction... 1 1.1 Description... 1 1.2 Legal Authority... 1 1.3 Definitions... 1 2.0 Eligible
More informationNon-Chemotherapy Injection and Infusion Services Policy, Professional
Non-Chemotherapy Injection and Infusion Services Policy, Professional Policy Number Annual Approval Date 3/14/2018 Approved By Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy
More informationCARE OF THE PATIENT REQUIRING CONTINUOUS FLOLAN INFUSION GUIDELINE
Page Number: 1 of 5 TITLE: CARE OF THE PATIENT REQUIRING CONTINUOUS FLOLAN INFUSION GUIDELINE PURPOSE: To provide guidelines for the nursing care of the patient with a Flolan infusion delivered thru continuous
More informationHOME HEALTH CARE. Guideline Number: CS137.H Effective Date: December 1, 2017
HOME HEALTH CARE UnitedHealthcare Community Plan Coverage Determination Guideline Guideline Number: CS137.H Effective Date: December 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE... 1 BENEFIT CONSIDERATIONS...
More informationCOURSE INFORMATION FORM
DATE SUBMITTED 6/24/13 CATALOG NO. PNUR 136 DATE DICC APPROVED 9/24/2013 DATE LAST REVIEWED 8/25/2009 DISCIPLINE COURSE TITLE COURSE INFORMATION FORM Practical Nursing Venous Access and Intravenous Infusion
More informationRegistered Nurse Intravenous Therapy and Peripheral Cannulation Competency Framework
Registered Nurse Intravenous Therapy and Peripheral Cannulation Competency Framework Name: Location: Date commenced: Contents Competency: Page No: Page 1. Core: Introduction Demonstrate knowledge that
More information60 Memorial Medical Parkway Palm Coast, Florida 32164
POLICY & PROCEDURES TITLE: Privileges of Student Nurses and Student Nursing Assistants POLICY # EDU 001 POLICY CATEGORY: Administrative / Education Origination Date: 12/2008 Last Review/Revision Date:
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Medication Administration Observation
: Make random medication observations of several staff over different shifts and units, multiple routes of administration -- oral, enteral, intravenous (IV), intramuscular (IM), subcutaneous (SQ), topical,
More informationCONSULTANT PHARMACIST LICENSING PROGRAM SELF-ASSESSMENT EXAMINATION **** 2014 ANSWER SHEET ****
CONSULTANT PHARMACIST LICENSING PROGRAM SELF-ASSESSMENT EXAMINATION **** 2014 ANSWER SHEET **** (Mark all correct answers, may be more than one answer per question) 1. Pharmaceutical Services in the Long
More informationHOME HEALTH CARE. Guideline Number: CDG Effective Date: December 1, 2017
HOME HEALTH CARE UnitedHealthcare Commercial Coverage Determination Guideline Guideline Number: CDG.022.10 Effective Date: December 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE... 1 BENEFIT CONSIDERATIONS...
More informationMLN Matters Number: MM6699 Related Change Request (CR) #: 6699
News Flash Medicare will cover immunizations for H1N1 influenza also called the "swine flu." There will be no coinsurance or copayment applied to this benefit, and beneficiaries will not have to meet their
More informationReimbursement for Anticoagulation Services
Journal of Thrombosis and Thrombolysis 12(1), 73 79, 2001. # 2002 Kluwer Academic Publishers, Manufactured in The Netherlands. Reimbursement for Anticoagulation Services Paul W. Radensky McDermott, Will
More informationStudent s Objectives:
Fulton-Montgomery Community College Senior Preceptorship Preceptorship: A clinical experience designed to provide a transition from the student to graduate nurse role. For this 40 hour experience, the
More informationNBCP PO C Administration of injections
POLICY CATEGORY: POLICY FOCUS: POLICY NAME: Administration of injections policy (EN) LAST UPDATED: February 2014 MOTION NUMBER: C-14-02-08 OTHER: GM-PP-I-03 (Supplement to administration of injections
More informationCMS OASIS Q&As: CATEGORY 2 - COMPREHENSIVE ASSESSMENT
CMS OASIS Q&As: CATEGORY 2 - COMPREHENSIVE ASSESSMENT Q1. When are we required to collect OASIS? [Q&A EDITED 06/14] A1. The Condition of Participation (CoP) published in January 1999 requires a comprehensive
More informationMedicare Part C Medical Coverage Policy
Clinical Trial Services Origination: June 28, 1999 Review Date: April 18, 2018 Next Review: April, 2020 Medicare Part C Medical Coverage Policy DESCRIPTION OF PROCEDURE Clinical trials (or clinical research
More informationMARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa
MARSHALLTOWN MEDICAL & SURGICAL CENTER Marshalltown, Iowa CARE OF PATIENT POLICY & PROCEDURES Policy Number: 4.37 Subject: Implanted Venous Access Device (Infus-A-Port), Nursing Management Of (Indwelling
More informationSASKATCHEWAN ASSOCIATIO. RN Specialty Practices: RN Guidelines
SASKATCHEWAN ASSOCIATIO N RN Specialty Practices: RN Guidelines July 2016 2016, Saskatchewan Registered Nurses Association 2066 Retallack Street Regina, SK S4T 7X5 Phone: (306) 359-4200 (Regina) Toll Free:
More informationPHYSICIAN FEE SCHEDULE PAYMENT GROUND RULES: A COMPARISON OF THE OMFS AND MEDICARE *
PHYSICIAN FEE SCHEDULE PAYMENT GROUND RULES: A COMPARISON OF THE OMFS AND MEDICARE * Ground Rule and/or OVERALL FEE SCHEDULE DESIGN Conversion factor Separate conversion factors for: Evaluation & Management
More informationSchedule of Benefits - HMO Group - MEDFORD AREA SCHOOL DISTRICT Benefit Year: January 1st through December 31st Effective Date: 01/01/2016
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
More informationHome Care Auditing: What s all the MOOing About? Objectives. Medicare Home Care Conditions of Participation
Home Care Auditing: What s all the MOOing About? Catherine Niland AHIA 2008 Annual Conference September 2008 Objectives Overview of Home Care Medicare Home Care Prospective Payment System Financial and
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES
Use for a resident who has potentially unnecessary medications, is prescribed psychotropic medications or has the potential for an adverse outcome to determine whether facility practices are in place to
More informationSurvey Protocol for Long Term Care Facilities
Attachment B Survey Protocol for Long Term Care Facilities The provision of home dialysis treatments in a Long Term Care (LTC) facility place an increased burden on the LTC facility staff and may place
More informationReview Process. Introduction. InterQual Level of Care Criteria Long-Term Acute Care Criteria
InterQual Level of Care Criteria Long-Term Acute Care Criteria Review Process Introduction InterQual Level of Care Criteria support determining the appropriateness of Long-Term Acute Care (LTAC) admission,
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Entity: Fairview Pharmacy Services Department:
More informationMolina Healthcare Michigan Health Care Services Department Phone: (855) Fax: (800)
Utilization Management Program Molina Healthcare of Michigan s Utilization Management (UM) program utilizes a care management approach based upon empirically validated best practices, where experience
More informationEFFECTIVE OUTCOMES THROUGH IV THERAPY
EFFECTIVE OUTCOMES THROUGH IV THERAPY PROGRAM GUIDE FOR HEALTH CARE PROFESSIONALS National Educational Video, Inc. TM is an approved provider of continuing education. State Board provider numbers: Florida
More informationRN Delegation ALF & RCF
RN Delegation ALF & RCF Raeann J Voorhies RN, MBA, AL-C & Heather Madden RN, AL-C VOORHIES AND ASSOCIATES SENIOR LIVING MANAGEMENT AND CONSULTING OUTLINE Definitions- Delegation Definition- Unlicensed
More informationSchedule of Benefits - Point of Service MOSINEE SCHOOL DISTRICT Benefit Year: January 1st Through December 31st Effective Date: 07/01/2016
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
More informationRisk Assessment Form HS 9 (1)
s Full Name: Date of Birth: NHS Number 1. The fully implanted port system Sitimplant is not regularly used in the community and nursing staff may be unfamiliar with the recommended care of this system
More informationObservation Coding and Billing Compliance Montana Hospital Association
Observation Coding and Billing Compliance Montana Hospital Association Sue Roehl, RHIT, CCS sroehl@eidebaill.com 701-476-8770 IP versus Observation considerations Severity of patient s signs and symptoms
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: private_duty_nursing_services 11/3/2005 2/2018 2/2019 2/2018 Description of Procedure or Service Private
More informationNursing Services for the Individual Options Waiver. Donna Patterson, RN Medicaid Development and Administration
Nursing Services for the Individual Options Waiver Donna Patterson, RN Medicaid Development and Administration Waiver Nursing Services Services provided to an individual that require the skill of an RN
More informationCRAIG HOSPITAL POLICY/PROCEDURE
CRAIG HOSPITAL POLICY/PROCEDURE Approved: P&T, MEC, NPC, P&P 03/09 Effective Date: 02/95 P&T, MEC, P&P 08/09; P&P 08/10; P&T, MEC 10/10, P&T, P&P 12/10 ; MEC 01/11; P&T, MEC 02/11, 04/11 ; P&T, P&P 12/11
More informationRenal Dialysis. Chapter
Renal Dialysis Chapter.1 Enrollment..................................................................... -2.2 Client Eligibility................................................................. -2.3 Benefits,
More information(M1025) Case-Mix Diagnosis (Optional) OPTIONAL Complete only if a Z-code in Column 2 is reported in place of a resolved condition
HOME HEALTH 2017 PPS CALCULATION WORKSHEET PATIENT NAME: ID NUMBER: DATE: TYPE OF ASSESSMENT: Start of care Follow-up M0110 - EPISODE TIMING: Is the Medicare home health payment episode f which this assessment
More informationEmpire BlueCross BlueShield Professional Reimbursement Policy
Subject: Bundled Services and Supplies NY Policy: 0008 Effective: 02/24/2014 06/30/2014 Coverage is subject to the terms, conditions, and limitations of an individual member s programs or products and
More informationELECTIVE COMPETENCY AREAS, GOALS, AND OBJECTIVES FOR POSTGRADUATE YEAR ONE (PGY1) PHARMACY RESIDENCIES
ELECTIVE COMPETENCY AREAS, GOALS, AND OBJECTIVES FOR POSTGRADUATE YEAR ONE (PGY1) PHARMACY RESIDENCIES Introduction The competency areas, goals, and objectives are for use with the ASHP Accreditation Standard
More informationCigna Medical Coverage Policy
Cigna Medical Coverage Policy Subject Observation Care Table of Contents Coverage Policy... 1 General Background... 2 Coding/Billing Information... 4 References... 5 Effective Date... 10/15/2014 Next Review
More informationSkills/Experience Checklist Home Health Registered Nurse
This form is a self-assessment of your current skills and abilities. This form is also used to document skill demonstration. EMPLOYEE PROFILE Last Name First Name Middle Initial Employee Number Direct
More informationCENTRAL IOWA HEALTHCARE Marshalltown, Iowa
CENTRAL IOWA HEALTHCARE Marshalltown, Iowa CARE OF PATIENT POLICY & PROCEDURES Policy Number: 4.37 Subject: Implanted Venous Access Device (Infus-A-Port), Nursing Management Of (Indwelling Vascular Access
More informationReimbursement guide. IODOSORB/IODOFLEX are Cadexomer Iodine-based products, available in two forms gel or pad.
Reimbursement guide IODOSORB/IODOFLEX are Cadexomer Iodine-based products, available in two forms gel or pad. IODOSORB/IODOFLEX remove barriers to healing by its dual action antimicrobial and desloughing
More informationThe Greater Dayton Area Hospital Association (GDAHA) Nursing Student Experience
The Greater Dayton Area Hospital Association (GDAHA) Nursing Student Experience Current Situation: Student nurses have clinical experiences in every hospital within the Dayton and surrounding areas. Each
More informationLPN 8 Hour Didactic IV Education
LPN 8 Hour Didactic IV Education Nurse Practice Act and Regulations By Pamela Truscott, MSN, Nurse Educator, RN Provision of Nursing Care 172 NAC 99 99-003.01B - LPNs contribute to assessment of health
More informationU: Medication Administration
U: Medication Administration College of Licensed Practical Nurses of Alberta, Competency Profile for LPNs, 3rd Ed. 173 Major Competency Area: U Medication Administration Competency: U-1 Principles of Pharmacology
More informationRENAL DIALYSIS CSHCN SERVICES PROGRAM PROVIDER MANUAL
RENAL DIALYSIS CSHCN SERVICES PROGRAM PROVIDER MANUAL JANUARY 2018 CSHCN PROVIDER PROCEDURES MANUAL JANUARY 2018 RENAL DIALYSIS Table of Contents 35.1 Enrollment......................................................................
More information2017 FOCUSED ON DOCUMENTATION NECESSITIES & PRE-CLAIM REVIEW
2017 FOCUSED ON DOCUMENTATION NECESSITIES & PRE-CLAIM REVIEW PRESENTED BY: MELINDA A. GABOURY, COS-C CHIEF EXECUTIVE OFFICER HEALTHCARE PROVIDER SOLUTIONS, INC. HEALTHCAREPROVIDERSOLUTIONS.COM ADDITIONAL
More informationSTANDARDIZED PROCEDURE HEPATIC ARTERY INFUSION OF CHEMOTHERAPY (Adults, Peds)
I. Definition Hepatic arterial infusion (HAI) of chemotherapy is accomplished by a small drug delivery system or pump that is implanted in a subcutaneous pocket in the lower abdomen. The pump reservoir
More informationAdministration of Medications A Self-Assessment Guide for Licensed Practical Nurses
Administration of Medications A Self-Assessment Guide for Licensed Practical Nurses March 2018 College of Licensed Practical Nurses of Nova Scotia http://clpnns.ca Starlite Gallery, 302-7071 Bayers Road,
More informationUNDERSTANDING THE CONTENT OUTLINE/CLASSIFICATION SYSTEM
BOARD OF PHARMACY SPECIALTIES CRITICAL CARE PHARMACY SPECIALIST CERTIFICATION CONTENT OUTLINE/CLASSIFICATION SYSTEM FINALIZED SEPTEMBER 2017/FOR USE ON FALL 2018 EXAMINATION AND FORWARD UNDERSTANDING THE
More informationCOLORADO COMMUNITY HEALTH NETWORK SCOPE OF PRACTICE MATRIX FIELD OF PRACTICE: NURSING (BOARD OF NURSING)
COLORADO COMMUNITY HEALTH NETWORK MATRIX FIELD OF : NURSING (BOARD OF NURSING) ADVANCED NURSES: NURSE PRACTITIONER (NP) According to the Colorado Nurse Practice Act: 12-38-111.5. Requirements for advanced
More informationOncology Home Care: A Strategy for Growth & Improved Clinical Performance. Our Story. What s So Special About Specialty Care?
Oncology Home Care: A Strategy for Growth & Improved Clinical Performance Bringing the best of oncology care home Our Story Oncology Care Home Health Specialists, Inc. started in 1989 in Newark, Delaware.
More informationAPHERESIS UNIT ORIENTATION
INTRODUCTION What is Apheresis? Apheresis is a procedure by which fluid or cellular components are separated from the circulating blood either for the preparation of transfusion products (donor apheresis)
More informationIntravenous Injection of Contrast Media COMPETENCY PROFILE. Prepared by The Ontario Association of Medical Radiation Sciences
Intravenous Injection of Contrast Media COMPETENCY PROFILE Prepared by The www.oamrs.org Assumptions Assumed prerequisite knowledge, skills and professional attributes: The Participant: 1. Has completed
More informationUsing Clinical Criteria for Evaluating Short Stays and Beyond
Using Clinical Criteria for Evaluating Short Stays and Beyond Georgeann Edford I. History A. Social Security Act Medical Necessity and Utilization Review 1. Items or services necessary for the diagnosis
More informationCorporate Reimbursement Policy
Corporate Reimbursement Policy Code Bundling Rules Not Addressed in ClaimCheck or Correct File Name: code_bundling_rules_not_addressed_in_claim_check Origination: 6/2004 Last Review: 12/2017 Next Review:
More informationPatient Self Administration of Intravenous (IV) Antibiotics at Home
Trust Policy Document Ref. No: PP(16)319 Patient Self Administration of Intravenous (IV) Antibiotics at Home For use in: For use by: For use for: Document owner: Status: Clinical Areas Clinical Staff Patient
More information2. Unlicensed assistive personnel: any personnel to whom nursing tasks are delegated and who work in settings with structured nursing organizations.
XVIII. A. General Information: The judgments that you make in about coordinating and facilitating client care situations have to be based on knowledge. You MUST know your content, and then you can move
More informationSchedule of Benefits - Indemnity Group - MEDFORD AREA SCHOOL DISTRICT Benefit Year: January 1st through December 31st Effective Date: 01/01/2016
Security Health Plan certifies that you and any covered dependents have coverage as described in your Certificate and Schedule of Benefits as of the effective date shown on the letter you received with
More informationCURRENT OIG ENFORCEMENT INITIATIVES: A ROAD MAP FOR HIGH RISK COMPLIANCE AREAS
10 th Annual HCCA Compliance Institute Session Las Vegas, NV April 25, 2006 CURRENT OIG ENFORCEMENT INITIATIVES: A ROAD MAP FOR HIGH RISK COMPLIANCE AREAS MARK HARDIMAN HOOPER, LUNDY & BOOKMAN, INC. 1875
More informationAll about Your Implanted Venous Access Device (IVAD, Port )
All about Your Implanted Venous Access Device (IVAD, Port ) Your doctor has chosen an Implanted Venous Access Device (IVAD) for you based on your treatment needs. Because the IVAD can remain in place for
More informationSpecifications. RE: Concierge In-Home Nursing Service $27,911 $446,446 $69,000. Nebraska. 1 RN, 1 LPN, 5 CNA s $69,777
Business Overview RE: Concierge In-Home Nursing Service Specifications Price $69,000 Revenue $446,446 Cash Flow $27,911 Location Nebraska Profit Margin Employees 1 RN, 1 LPN, 5 CNA s Lease $1,890 Reason
More informationSummary of Benefits Advantra Freedom PEBTF
Advantra Freedom is a Medicare Advantage Private Fee-For-Service (PFFS) Plan. This Summary of Benefits tells you some features of our Plan. It doesn't list every service that we cover or list every limitation
More informationPsychological Specialist
Job Code: 067 Psychological Specialist Overtime Pay: Ineligible This is work performing psychological assessments or counseling students. Administers intelligence and personality tests. Provides consultation
More informationMeeting the NEW RCN Standards for Infusion Therapy in practice
Meeting the NEW RCN Standards for Infusion Therapy in practice sumanshrestha@nhs.net Suman Shrestha MSc BSc RN Advanced Nurse Practitioner Intensive Care Frimley Park Hospital suman_sr FRIMLEY PARK HOSPITAL
More informationCMNs Chapter 4. Chapter 4 Contents
Chapter 4 Contents 1. Certificates of Medical Necessity (CMNs) and DME MAC Information Forms (DIFs) 2. CMN and DIF Completion Instructions 3. CMNs as Orders and Claim Submission 4. Oxygen CMNs 5. CMN Common
More informationMaryland MOLST. Guide for Patients. Maryland MOLST Training Task Force
Maryland MOLST Guide for Patients Maryland MOLST Training Task Force May 2012 Health Care Decision Making: Goals and Treatment Options Explanatory Guide for Patients Contents Introduction Section I Section
More informationHOME AND COMMUNITY CARE POLICY MANUAL
CHAPTER: 4 HOME HEALTH SERVICES NUMBER: 4 SECTION: CHAPTER CONTENTS PAGE: 1 OF 1 SUBSECTION: EFFECTIVE: JUNE 19, 2018 4.A General Description and Definitions 4.B Home Support Services 4.B.1 Service Needs
More informationJoint Statement on Ambulance Reform
Joint Statement on Ambulance Reform Policymakers Should Examine Short- and Intermediate-Term Policies to Promote Innovation in the Delivery of Emergency and Non- Emergency Care Provided by Ambulance Services
More information