Get Private Duty Nursing Paperwork Requirement For New Cases. General Information System - Health Ny

This guide provides essential information and step-by-step instructions for completing the Private Duty Nursing Paperwork Requirement for new cases in New York. By following these guidelines, users can ensure they submit all necessary documentation accurately and efficiently.

Follow the steps to fill out the paperwork effectively.

1. Click the ‘Get Form’ button to obtain the Private Duty Nursing Paperwork Requirement for New Cases form and access it in your preferred program.
2. Fill in the Medicaid ID number at the top of the form. If you do not have a Medicaid ID, please contact the appropriate authority to obtain one.
3. Obtain a letter of medical necessity from the ordering physician detailing all skilled needs, level of care (LPN or RN), and the number of recommended hours of nursing care.
4. Complete the nursing assessment section, ensuring that a registered nurse performs a comprehensive head-to-toe assessment. If the client is hospitalized, the assessment may be conducted by in-house staff, while those at home should have it completed by a certified home health agency.
5. Include a back-up/training statement signed and dated by the primary caretaker, indicating their responsibility in case nursing shifts are unfulfilled and confirming their training in all necessary skilled tasks.
6. Document training information by facility staff for clients who are in a hospital or rehabilitation setting.
7. Complete the psychosocial assessment, including details of all household members, caregiver work schedules on company letterhead, school schedules if applicable, and any college course schedules for the primary caregiver.
8. For clients who require ventilator support, submit the respiratory company's home assessment along with the ventilator settings.
9. If the client has primary insurance, attach an explanation of benefits (EOB) from the insurance carrier. Ensure that this insurance is disclosed on the Medicaid system to avoid issues with approval for nursing hours.
10. In the skilled tasks section, precisely specify the frequency and timing of tasks, avoiding vague terms. For example, state specific times for tube feedings instead of general terms such as 'PRN'.
11. For cases staffed by independent LPNs, include a signed 'letter of oversight' from the ordering physician, acknowledging the independent staffing arrangement.
12. If the private duty nursing is for school settings, attach a letter from the school district confirming that the child cannot attend without one-on-one nursing support that the district cannot provide.
13. Review the completed form to ensure all fields are accurately filled. Once all information is verified, save changes, download, print, or share the form as needed.

Complete your documents online to streamline the submission process and ensure timely approval.