Achieving
Medicaid Compliance Using PrecisonCare
| REGULATION | PRECISIONCARE SOLUTION |
| 14 NYCRR 635-10.4 (IV)(f)(4)(iii)(b) Habilitation services are designed to provide general assistance to persons, in accordance with their individualized service plan, to acquire and maintain those life skills that enable them to cope more effectively with their environments. …These services include activities and tasks required to design, implement and support the individualized service plan. The individualized service plan includes specifically stated objectives and tasks related to physical, social, psychological, and pre-vocational skills or supports which are designed to achieve performance levels associated with the specified objectives. | PrecisionCare
Requires that all services identified on the ISP include
valued outcomes specific to the Service. The ISP is
linked to all subsequent plans automatically displaying
the most up to date valued outcome for the service. Users are alerted to any discrepancies between the ISP and subsequent plans. |
| 14 NYCRR 686.16 (a)(6)(iv) The establishment of a process whereby the person's continuing need for the originally recommended amount and type of protective over-sight can be periodically reviewed, and modified as necessary. | Protective oversight plans are created within PrecisionCare and linked to the information on the ISP. Users are alerted to expiration dates. |
| 14 NYCRR 686.14(4) A personnel record for each staff member shall be maintained in accordance with the agency/facility policies/procedures. The personnel records for staff may be kept at a centrally located place in accordance with agency/facility policies/procedures | PrecisionCare’s human resources area stores staff in a central database and secured with a customizable security system. Trainings and Certifications are tracked within the system and reminders are generated as needed. |
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NYCRR 624.5 (4)(b)(i) A written report of
any serious reportable incident shall be sent to
the DDSO on Form OMR 147(I), Reportable Incident
Reporting Form, Reportable Incident Reporting Form
within 24 hours of observation or discovery, and
shall contain such information as is known at the
time the form is completed. (ii) A written report of any allegation of client abuse shall be sent to the DDSO on Form OMR 147(A), Report of Alleged Client Abuse, within 24 hours of occurrence or discovery, and shall contain such information as is known at the time the form is completed |
Incidents
are entered into PrecisionCare and stored in the central
database. Users are guided through a series of questions
which will automatically generate internal reportable
incident reports, OMRDD 147I and 147A as needed. The system will track all incident information including notifications made and investigation details. |
| 14 NYCRR 624.5(4) Agency policy shall require that internal reports are made on a standardized form(s) (which may have been designed for that purpose or may be multi-purpose), as selected by the agency. | All reports including Internal Incidents generated by PrecisionCare will follow a standardized format based on regulations and agency choosing. |
| 635-99.1(b)(c)(2) The ISP contains at a minimum: Identification of each service , service provider (including type), the amount, frequency and duration of each service, and effective dates for service delivery. | PrecisionCare requires that all requisite information is documented for all services identified on the ISP. |
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NYCRR 635-10.5 (b)(5) Total reimbursable
residential habilitation shall be related to the
service specifications of each person’s (ISP) 14 NYCRR 635-10.5(c)(iii) Day Habilitation reimbursement shall be contingent upon documentation that those participating in the program have received the services as specified in each person’s (ISP) |
PrecisionCare will block erroneous billing for any Services where there are inconsistencies between documented service delivery, habilitation plans, and the ISP. |
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NYCRR 635-10.5 OMRDD shall verify that
individual program plans are maintained in a confidential
manner and that the plans contain at least: (1) identification information about the person and his or her family, and services received… (2) source of referral, date service commenced, and the name of the party responsible for treatment coordination. (3)initial, interim, and/or final diagnosis(es), as applicable, set forth in appropriate official terminology, including those related to the person's developmental disability, other mental disability(ies) if present, and medical condition/diagnoses. |
PrecisionCare’s
flexible and customizable security system secures all
records within a central data base. Availability is
made only to those individuals that are approved. 1)Information is centralized and shared with all documents and users that require it. 2)Intake information is tracked, referral follow reminders are generated as well as statistical reports including waiting times. 3)Diagnosis are centralized with corresponding codes (ICD9, DSM etc.) These diagnoses are updated and displayed on all required reports. |
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NYCRR 635-10.5 OMRDD shall verify that
individual program plans of persons admitted to the
day facility include: (1) progress notes describing the person's response in terms of the established objectives; (3) summaries specific to the person's goals and objectives prepared or reviewed and approved by qualified professionals providing or supervising services and reviewed by the treatment coordinator of the person's program plan; or a summarization, by the treatment coordinator, of all services being provided to the person. (5) identification of the staff members responsible for providing each service |
PrecisionCare
ensures the documentation of service delivery in that
reflects the individual’s goals and objectives
as identified within a valid service plan. PrecisionCare will generate Progress notes and data collection check sheets based on only valid ISPs and program plans. Reviews can then be created based on services delivered. |
