reglab/statecodes huggingface dataset:
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 2 - AUTHORITY › Rule 15-16-1-54.2.1

Current through June 25, 2024
Administrative Hearings are held pursuant to Title 42 of
						the Code of Federal Regulations (CFR), Sections 483.156(a), Establishment of
						Registry, and 483.158(c), Registry Content.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.1 - Abuse

Current through June 25, 2024
Abuse.
Shall mean the willful infliction of
						physical pain, intimidation, injury or mental anguish on a long-term care
						resident, or the willful deprivation of goods or services which are necessary
						to attain or maintain the physical, mental, and/or psychosocial health of a
						long-term care resident. This presumes that instances of abuse of all
						residents, even those in a coma, cause physical harm, or pain or mental
						anguish. "Abuse" shall not mean conduct which is a part of the treatment and
						care of, and in furtherance of the health and safety of a patient or resident.
						However, it shall include, but not be limited to, exploitation, involuntary
						seclusion, physical abuse, psychological abuse, psychosocial well-being, sexual
						abuse and/or verbal abuse.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.2 - Exploitation

Current through June 25, 2024
Exploitation. Shall mean the illegal or improper use of a
						resident or his resources for another's profit or advantage.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.3 - Involuntary Seclusion

Current through June 25, 2024
Involuntary Seclusion.
Shall mean separation
						of a resident from other residents or from his or her room or confinement to
						his or her room (with or without roommates) against the resident's will, or the
						will of the resident's legal representative. Emergency or temporary monitored
						separation from other residents will not be considered involuntary seclusion
						and may be permitted if used for a limited period of time as a therapeutic
						intervention to reduce agitation as determined by professional staff and
						consistent with the resident's plan of care or until professional staff can
						develop a plan of care to meet the resident's needs.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.4 - Physical Abuse

Current through June 25, 2024
Physical Abuse.
Shall include hitting,
						slapping, pinching, kicking, etc..., by which physical and/or psychological
						harm or trauma occurs. It also includes controlling behavior through corporal
						punishment.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.5 - Psychological Abuse

Current through June 25, 2024
Psychological Abuse.
Shall include, but is
						not limited to, intentional humiliation, harassment, threats of punishment or
						deprivation, whereby individuals suffer psychological harm or
						trauma.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.6 - Sexual Abuse

Current through June 25, 2024
Sexual Abuse.
Shall include, but is not
						limited to, sexual harassment, sexual coercion, or sexual
						assault.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.7 - Verbal Abuse

Current through June 25, 2024
Verbal Abuse.
Is defined as any use of
						oral, written or gestured language that willfully includes disparaging and
						derogatory terms to residents or their families, or within their hearing
						distance, regardless of their age, ability to comprehend, or disability.
						Examples of verbal abuse include, but are not limited to: threats of harm,
						saying things to frighten a resident, such as telling a resident that he/she
						will never be able to see her/his family again.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.8 - Mental Abuse

Current through June 25, 2024
Mental Abuse.
Shall include, but is not
						limited to, humiliation, harassment, threats of punishment or
						deprivation.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.9 - Aide

Current through June 25, 2024
Aide.
Shall mean a certified nurse aide
						(CNA) who has met all requirements of the licensing agency and whose name
						appears on the Nurse Registry. For purposes of alleged violation(s) by a
						student/trainee nurse aide, said individual is to be considered under the same
						guidelines as an aide.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.10 - Court

Current through June 25, 2024
Court.
Shall mean the chancery court of the
						county in which the nurse aide resides or the First Judicial District Chancery
						of Hinds County.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.11 - Department

Current through June 25, 2024
Department.
Shall mean the Mississippi of
						Health.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.12 - Director

Current through June 25, 2024
Director. Shall mean the of Division of Health Facilities
						Licensure and Certification, Mississippi Department of
						Health.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.13 - Finding

Current through June 25, 2024
Finding.
Shall mean a determination made by
						the licensing agency that validates allegations of abuse, neglect,
						mistreatment, or misappropriation against a long-term care resident by an aide.
						The determination shall be based on clear and convincing
						evidence.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.14 - Hearing Officer

Current through June 25, 2024
Hearing Officer.
Shall mean an individual
						appointed by the Director to preside over the Administrative Hearing with power
						to administer oaths, take testimony, rule on questions of evidence and make
						agency determinations of fact. The may be employee of the Department or the
						Licensing Agency provided this individual is not directly involved in the
						investigation.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.15 - Investigator

Current through June 25, 2024
Investigator. Shall mean an employee of the licensing
						agency who is a surveyor assigned to collect information regarding all alleged
						charges of resident abuse, resident neglect or misappropriation of resident
						property by an aide towards a resident.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.16 - Licensing Agency

Current through June 25, 2024
Licensing Agency.
Shall mean the Division
						of Licensure and Certification of the Mississippi Department of Health, which
						is the Mississippi Survey Agency.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.17 - Long-Term Care Resident

Current through June 25, 2024
Long-Term Care Resident.
Shall mean any
						resident of a skilled nursing facility (SNF) and/or nursing facility (NF). For
						the purposes of these regulations, "resident" shall mean resident of a
						long-term care facility.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.18 - Misappropriation of Resident Property

Current through June 25, 2024
Misappropriation of Resident Property.
Is
						defined as the patterned or deliberate misplacement, exploitation, or wrongful,
						temporary or permanent use of a resident's belongings or money without the
						resident's consent.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.19 - Neglect

Current through June 25, 2024
Neglect. Shall mean the failure to supply the long term
						care resident with the care, food, clothing, goods, shelter, health care,
						supervision, or other services which are necessary to maintain his/her mental
						and physical health. occurs on an individual basis when a resident does not
						receive care in one or more areas (e.g., absence of frequent monitoring for a
						resident known to be incontinent, resulting in being left to lie in urine or
						feces).
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 3 - DEFINITIONS › Rule 15-16-1-54.3.20 - Surveyor

Current through June 25, 2024
Surveyor. Shall mean an individual who has successfully
						completed the Health Care Financing Administration approved training and passed
						the Minimum Qualifications Test (SMQT).
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.1

Current through June 25, 2024
Whenever information is received, or when the licensing
						agency has cause to believe that an aide has abused, neglected, or
						misappropriated the property of a long-term care resident, the licensing agency
						shall investigate the same. Documentation of said investigation shall be made
						including, but not limited to, the nature of the allegation and the evidence
						that led the licensing agency to conclude that the allegation was valid or
						not.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.2

Current through June 25, 2024
Once an allegation that resident neglect, resident
						abuse, or misappropriation of resident property is found valid, based on oral
						or written evidence and investigation, the State completes the following
						notification procedures: The State notifies the following in writing within ten
						(10) working days of the investigation:
1. Aide(s) implicated in the
					 investigation;
2. The current
					 administrator of the facility in which the incident occurred; and
3. Nurse Aide Registry.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.3

Current through June 25, 2024
Upon receipt of a copy of the notice of right to hearing
						by the Nurse Aide Registry, a disciplinary flag will be entered in the Nurse
						Aide Registry to indicate that an investigation has been conducted, allegations
						have been found valid by the licensing agency, and the aide has been notified
						of his/her right to a hearing. No specific details are entered on the Nurse
						Aide Registry at this time.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.4

Current through June 25, 2024
Notice of Right to Hearing is sent to the aide at
						his/her last known address registered with the nursing home or the licensing
						agency. Attached to the notice shall be a written finding by the Licensing
						Agency stating the reasons for its determination. The notice is sent via
						regular United States Postal Services mail and Certified Mail, Return Receipt
						Requested.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.5

Current through June 25, 2024
The notice will include the following
						information:
1. A statement informing
					 the aide of the nature of the allegation and his/her conduct constituting the
					 violation and confirmation of the findings by the licensing agency's
					 investigator;
2. Date and
					 approximate time of the occurrence;
3. A statement that the aide has a right to a
					 hearing and must request a hearing in writing within thirty (30) days from the
					 date of the notice;
4. A statement
					 that the "Request for Hearing Form" accompanying the notice may be used to
					 request a hearing;
5. A statement
					 that if the aide fails to request a hearing in writing or the time to request a
					 hearing has expired, it will be interpreted as a waiver of his/her right to a
					 hearing and the Licensing Agency's findings will be reported to the Nurse Aide
					 Registry;
6. A statement of the
					 Licensing Agency's intent to place substantiated findings by an Administrative
					 Hearing Officer on the Nurse Aide Registry;
7. A statement advising the aide of the
					 consequences of waiving the right to a hearing and/or the consequences of a
					 finding by the hearing officer that the resident abuse or resident neglect or
					 misappropriation of resident property did occur (e.g., findings must be
					 included and remain in the registry permanently, unless the finding was made in
					 error, the individual was found not guilty in a court of law, or the State is
					 notified of the individual's death);
8. A statement that any prospective employer,
					 or others, checking the aide's status on the Nurse Aide Registry will be
					 advised of any pending hearing and/or final decision;
9. A statement that whether or not a hearing
					 is requested, the aide has the right to submit a written statement disputing
					 the allegations if he/she chooses to do so; and
10. Right of the accused aide to be
					 represented by an attorney at the individual's own expense.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.6

Current through June 25, 2024
If a hearing is requested, the same shall be held within
						sixty (60) days of the request. A "Notice of Administrative Hearing" shall be
						sent stating the date, time, and place of the hearing.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.7

Current through June 25, 2024
The notice will be sent to the following
						individuals:
1. Aide(s) implicated in
					 the investigation;
2. The current
					 administrator of the facility in which the incident occurred; and
3. Attorney for the aide (if
					 applicable).
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.8

Current through June 25, 2024
The notice will include the following
						information:
1. A statement that the
					 aide may appear with or without counsel, shall have the right to cross-examine
					 all witnesses, present evidence/testimony, either written or oral, on his or
					 her own behalf, and to refute any testimony or evidence presented;
2. A statement that formal rules of evidence
					 and procedure will not apply, but a record of said hearing shall be made. The
					 licensing agency shall present its case, and the aide will then present his/her
					 case; and
3. A statement that if
					 the aide requests a hearing but fails to appear for the scheduled hearing, this
					 will be interpreted by the Licensing Agency as a waiver of the aide's right to
					 a hearing and findings against the aide will be placed on the Nurse Aide
					 Registry.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 4 - PROCEDURE › Rule 15-16-1-54.4.9

Current through June 25, 2024
The notice will be sent via United States Postal Service
						regular and Certified Mail, Return Receipt Requested. A copy of the
						"Regulations Regarding Placement of Findings of Resident Abuse, Resident
						Neglect, and/or Misappropriation of Resident Property Against a Nurse Aide
						Registry" will be included with the notice.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 5 - CONDUCT OF HEARING › Rule 15-16-1-54.5.1

Current through June 25, 2024
A Hearing Officer will be appointed by the
						Director.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 5 - CONDUCT OF HEARING › Rule 15-16-1-54.5.2

Current through June 25, 2024
The State must hold a hearing and complete the hearing
						record within 120 days from the date of receipt of the hearing
						request.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 5 - CONDUCT OF HEARING › Rule 15-16-1-54.5.3

Current through June 25, 2024
The State must hold the hearing in a manner consistent
						with State practice, at a time and place established by the licensing
						agency.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 5 - CONDUCT OF HEARING › Rule 15-16-1-54.5.4

Current through June 25, 2024
Formal rules of evidence and procedure will not apply,
						but a record of said hearing shall be made. The licensing agency shall present
						its case, and the aide will then present his/her case. In order for the
						licensing agency's decision to be upheld, the facts constituting the violation
						must be proved by substantial evidence.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 5 - CONDUCT OF HEARING › Rule 15-16-1-54.5.5

Current through June 25, 2024
At the close of the hearing, the Administrative Hearing
						Officer shall, within sixty (60) days, prepare written findings and
						conclusions, and an order. This order will be the final agency
						decision.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 5 - CONDUCT OF HEARING › Rule 15-16-1-54.5.6

Current through June 25, 2024
If the Administrative Hearing Officer finds that the
						aide neglected or abused a resident or misappropriated a resident's property,
						the substantiated findings must be reported in writing within ten (10) days
						to:
1. Aide;
2. Attorney for aide (if
					 applicable);
3. Current
					 administrator of the facility in which the incident occurred;
4. The administrator of the facility that
					 currently employs the individual, if it is not the same facility in which the
					 incident occurred;
5. The Division
					 of Medicaid; and
6. The Nurse Aide
					 Registry.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 5 - CONDUCT OF HEARING › Rule 15-16-1-54.5.7

Current through June 25, 2024
The notification sent to the aide will be mailed via
						United States Postal Service regular and Certified Mail, Return Receipt
						Requested. A copy of the Administrative Hearing Officer's decision will be
						attached to the notice. The notification will include the following:
1. A statement that the Administrative
					 Hearing Officer found that the aide did abuse a resident, neglect a resident,
					 and/or misappropriated a resident's property;
2. A statement that the aide is not eligible
					 to work in a long-term care facility in Mississippi;
3. A statement that if an aide is aggrieved
					 of the final decision, the aide may appeal on the record to the appropriate
					 chancery court; and
4. A statement
					 that the aide will bear the cost of transcription of the earlier proceedings,
					 and preparation of the record, should an appeal be taken.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 6 - REPORTING FINDINGS TO THE NURSE AIDE REGISTRY › Rule 15-16-1-54.6.1

Current through June 25, 2024
The licensing agency must notify the Nurse Aide Registry
						of the findings.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 6 - REPORTING FINDINGS TO THE NURSE AIDE REGISTRY › Rule 15-16-1-54.6.2

Current through June 25, 2024
The Administrative Hearing Officer's findings of
						resident abuse, resident neglect or misappropriation of resident property must
						be included in the Nurse Aide Registry within ten (10) working days of the
						Administrative Hearing Officer's decision.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 6 - REPORTING FINDINGS TO THE NURSE AIDE REGISTRY › Rule 15-16-1-54.6.3

Current through June 25, 2024
The following information must be included and remain in
						the registry permanently, unless the findings was made in error, the individual
						was found not guilty in a court of law, or the State is notified of the
						individual's death:
1. Documentation
					 of the investigation, including the nature of the allegation and the evidence
					 that led to the conclusion that the allegation was valid;
2. The date of the hearing, if such request
					 was made, and its outcome;
3. The
					 date of the court decision (i.e., review of Hearing Officer's decision by a
					 court or criminal conviction by a court), and its outcome; and
4. A statement by the individual disputing
					 the allegation if the individual chose to make one.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 6 - REPORTING FINDINGS TO THE NURSE AIDE REGISTRY › Rule 15-16-1-54.6.4

Current through June 25, 2024
If an aide is found guilty by a court of law or pleads
						nolo contendere for abusing or neglecting a resident or misappropriating a
						resident's property, it is not necessary to offer an administrative hearing
						concerning the same incident before making a notation in the registry. The
						trial and court order satisfy the Social Security Act's requirements for a
						hearing. In this case, the findings of the court will be placed on the Nurse
						Aide Registry.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 6 - REPORTING FINDINGS TO THE NURSE AIDE REGISTRY › Rule 15-16-1-54.6.5

Current through June 25, 2024
If the Administrative Hearing Officer finds that the
						aide did not neglect or abuse a resident or misappropriate a resident's
						property, the disciplinary flag will be removed and the aide's name restored to
						full capacity on the Nurse Aide Registry.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 7 - CONFIDENTIALITY OF RECORDS › Rule 15-16-1-54.7.1

Current through June 25, 2024
Information relating to complaints/allegations that are
						found to be invalid shall not be disclosed.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 54 - MINIMUM STANDARDS FOR CERTIFIED NURSE AIDES › Subchapter 7 - CONFIDENTIALITY OF RECORDS › Rule 15-16-1-54.7.2

Current through June 25, 2024
Prior to a hearing or the opportunity for hearing,
						information relating to complaints/allegations that are found to be valid will
						be disclosed as set forth in paragraph 103.02 above. Along with the fact that
						adverse findings against a nurse aide have been placed on the Nurse Aide
						Registry, other information shall be released pursuant to Title 42 of the Code
						of Federal Regulations, Section 483.156(d), Disclosure of Information. The
						records and documentation concerning the investigation and findings will be
						permanently maintained by the licensing agency. These records shall include,
						where applicable, documentation of the investigation, including the nature of
						the allegation and evidence that led the licensing agency to conclude that the
						allegation was valid; any statements made by the aide in writing, disputing the
						allegation; and the date and outcome of the hearing.
Miss. Code Ann.
						§
												43-11-13
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 1 - AUTHORITY AND PURPOSE › Rule 15-16-1-82.1.1

Current through June 25, 2024
The following Rules and Regulations for Utilization
						Review in Mississippi are duly adopted and promulgated by the Mississippi State
						Board of Health pursuant to the authority expressly conferred by Section
						41-83-1 et
						seq., Mississippi Code of 1972 Annotated.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 1 - AUTHORITY AND PURPOSE › Rule 15-16-1-82.1.2

Current through June 25, 2024
The purpose of these rules and regulations is to promote
						the delivery of quality health care in a cost effective manner; foster greater
						coordination between payors and providers conducting utilization review
						activities; protect patients, business and providers by ensuring that private
						review agents are qualified to perform utilization activities and to make
						informed decisions on the appropriateness of medical care; and to ensure that
						private review agents maintain the confidentiality of medical
						records.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 2 - SCOPE › Rule 15-16-1-82.2.1

Current through June 25, 2024
In the State of Mississippi, every health insurance plan
						or every insurer proposing to issue or deliver a health insurance policy or
						contract or administer a health benefit program which provides for the coverage
						of hospital and medical benefits and the utilization review of those benefits;
						every health insurer proposing to issue or deliver in this state a group or
						blanket health insurance policy or administer a health benefit program which
						provides for the coverage of hospital and medical benefits and the utilization
						review of such benefits shall:
1. Have
					 a certificate in accordance with these regulations;
2. Contract with a private review agent that
					 has a certificate in accordance with these regulations.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 2 - SCOPE › Rule 15-16-1-82.2.2

Current through June 25, 2024
Notwithstanding any provisions of these regulations, for
						claims where medical necessity of the provision of a covered benefit is
						disputed, an insurer that does not meet the requirements of this section shall
						pay any person or hospital entitled to reimbursement under the policy or
						contract.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 4 - APPLICATION FOR CERTIFICATION › Rule 15-16-1-82.4.1

Current through June 25, 2024
A private review agent who approves or denies payment or
						who recommends approval or denial of payment for hospital or medical services
						or whose review results in approval or denial of payment for hospital or
						medical services on a case by case basis, may not conduct utilization review in
						this state unless the Mississippi Department of Health has granted the private
						review agent a certificate.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 4 - APPLICATION FOR CERTIFICATION › Rule 15-16-1-82.4.2

Current through June 25, 2024
The Mississippi Department of Health shall issue a
						certificate to any applicant that has met all the requirements and all
						applicable regulations of the department.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 4 - APPLICATION FOR CERTIFICATION › Rule 15-16-1-82.4.3 - A certificate is not transferable

Current through June 25, 2024
When there is a change of ownership of the Certified
						Organization, a new application will be required and a new number will be
						issued.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 4 - APPLICATION FOR CERTIFICATION › Rule 15-16-1-82.4.4

Current through June 25, 2024
Any information required by the Department with respect
						to customers, patients or utilization review procedures of a private review
						agent shall be held in confidence and not disclosed to the
						public.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 4 - APPLICATION FOR CERTIFICATION › Rule 15-16-1-82.4.5

Current through June 25, 2024
A Private Review Agent applying for a certificate shall
						submit the following documentation to the Department:
1. A completed application, signed and
					 verified by the applicant;
2.
					 Application fee of $1,000.00; and
3. A utilization review plan which shall
					 include all of the following components used by the private review agent to
					 approve or deny payment or recommend approval or denial of payment in advance
					 for proposed or delivered inpatient or outpatient care or retrospectively
					 approve or deny under certain circumstances:
a. Elements of review for:
i. Preadmission
ii. Admission
iii. Preauthorization
iv. Second Surgical Opinion
v. Discharge Planning
vi. Concurrent Review
vii. Retrospective Review
viii. Readmission Review
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 5 - RENEWAL OF CERTIFICATION › Rule 15-16-1-82.5.1

Current through June 25, 2024
A certificate expires on the second anniversary of its
						effective date unless certification has been renewed for a two (2) year
						term.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 5 - RENEWAL OF CERTIFICATION › Rule 15-16-1-82.5.2

Current through June 25, 2024
Before the certification expires, the certified private
						review agent may renew its certification for an additional two (2) year term,
						if the certified private review agent:
1. Is otherwise entitled to be
					 certified;
2. Pays to the Director
					 the renewal fee of $1,000.00; and
3. Submits to the Director:
a. A renewal application on the form that the
					 Director requires
b. An update of
					 information as required under Part IV of these rules and regulations
c. An annual report.
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 5 - RENEWAL OF CERTIFICATION › Rule 15-16-1-82.5.3

Current through June 25, 2024
The Director shall renew the certification of each
						certified private review agent, if the requirements of these regulations are
						met.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 6 - DENIAL OR REVOCATION OF CERTIFICATION AND PENALTY › Rule 15-16-1-82.6.1

Current through June 25, 2024
The Director shall deny a certificate to an applicant if
						the Department finds that the applicant does not:
1. Have available the services of a
					 sufficient number of registered nurses, that are supervised by appropriate
					 physicians to efficiently carry out its utilization review
					 activities;
2. Meet any applicable
					 provisions of these rules and regulations relating to the qualifications of
					 private review agents or the performance of utilization review the Department
					 adopts relating to the qualifications of private review agents or the
					 performance of utilization review;
3. Have policies and procedures which protect
					 the confidentiality of medical records in accordance with applicable state and
					 federal laws; or
4. Make itself
					 accessible to patients and providers five (5) working days a week during normal
					 business hours in this state.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 6 - DENIAL OR REVOCATION OF CERTIFICATION AND PENALTY › Rule 15-16-1-82.6.2

Current through June 25, 2024
The Director may revoke the certification of a private
						review agent if the Department finds that the agent:
1. Does not comply with performance
					 assurances;
2. Violates any
					 provision of these rules and regulations;
3. Fails to substantially meet the standards
					 and qualifications adopted by the Director; or
4. Fails to comply with the regulations
					 adopted by the Department.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 6 - DENIAL OR REVOCATION OF CERTIFICATION AND PENALTY › Rule 15-16-1-82.6.3

Current through June 25, 2024
Before denying or revoking a certificate, the Director
						shall provide the applicant or certificate holder:
1. Written notice of the reasons for the
					 denial or revocation;
2. Thirty
					 (30) days in which to supply additional information demonstrating compliance
					 with the requirements; and
3. The
					 opportunity to request a hearing in accordance with the Mississippi
					 Administrative Procedures Law, Section 25-43-17, Mississippi Code of
					 1972.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 6 - DENIAL OR REVOCATION OF CERTIFICATION AND PENALTY › Rule 15-16-1-82.6.4

Current through June 25, 2024
If the applicant requests a hearing, the Director shall
						send a hearing notice by certified mail, return receipt requested, at least
						thirty (30) days before the hearing.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 6 - DENIAL OR REVOCATION OF CERTIFICATION AND PENALTY › Rule 15-16-1-82.6.5

Current through June 25, 2024
A private review agent may not disclose or publish
						individual medical records or any other confidential medical information
						obtained in the performance of utilizaition review activities without the
						patient's authorization or an order of a county, circuit or chancery court of
						Mississippi or a U. S. District Court. It is provided, however, that nothing in
						these regulations shall prohibit private review agents from providing
						information to the third party with whom the private review agent is under
						contract or acting on behalf of.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 6 - DENIAL OR REVOCATION OF CERTIFICATION AND PENALTY › Rule 15-16-1-82.6.6

Current through June 25, 2024
A person who violates any provision of these regulations
						is guilty of a misdemeanor, and on conviction is subject to a penalty not
						exceeding $1,000.00.
Miss. Code Ann.
						§41.83.1
Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 82 - MINIMUM STANDARDS FOR UTILIZATION REVIEW AGENTS › Subchapter 7 - UTILIZATION REVIEW STANDARDS › Rule 15-16-1-82.7.1 - Responsibility for Obtaining Certification

Current through June 25, 2024
1. In the
					 absence of any contractual agreement to the contrary, the enrollee is
					 responsible for notifying the private review agent in a timely manner and
					 obtaining certification for health care services. A private review agent shall
					 allow any licensed hospital, physician, or responsible patient representative,
					 including a family member, to assist in fulfilling that
					 responsibility.
2. To assure
					 confidentiality, a private review agent must, when contacting a physician's
					 office or hospital, provide its certification number, the caller's name, and
					 professional qualification to the designated utilization review representative
					 in the physician's office or hospital.
Miss. Code Ann.
						§41.83.1