In-Home Services and Consumer-Directed Services
revised 1/28/13
- Follow the current care plan as closely as possible
- Never serve more than approved units
- Intermittent changes: If the services provided do not substantially match the care plan, document why and attach the documentation to the time sheet.
- Permanent changes: If the units need to be decreased or increased contact DHSS and document the date of that contact in the participant record. If a participant does not want a certain service on the care plan, call DHSS for a care plan change. Example: A participant tells an aide that s/he does not want the aide to bathe her because s/he has made other arrangements. DHSS should be contacted to reduce the care plan. Document the date of that contact in the participant record.
- Listed below are the types of documentation MMAC Provider Review may request but are not limited to:
- Time sheets/telephony records
- Current care plan and LTACS/Web Tool
- Nurses
- Notes
- Training
- Records
- Employee
- Records
- Any other documents maintained by the provider that would support billings to MO HealthNet.
Residential Care Facilities:
- Provide the services that on the current care plan
- Bill only for the days that services are provided. This will not always be 31 days.
- Times sheets must be signed daily per regulation 13 CSR 70-91.010(4)(A)2.f.
- Intermittent changes: If the services provided do not match the care plan, document why and attach the documentation to the time sheet.
- Permanent changes: If the units need to be increased or decreased, contact DHSS and document the date of the contact in the participant record.
- Listed below are the types of documentation MMAC Provider Review may request but are not limited to:
- Service delivery logs
- Written notes and observations
- Daily nursing chart
- Medication Administration Records (MAR)
- Census records
- Current care plan and LTACS/Web Tool
- Any other documents maintained by the provider that would support billings to MO HealthNet.