Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 480 - HOME AND COMMUNITY-BASED SERVICES › Chapter 4 - PROVIDER REQUIREMENTS › Section 480-4-002 - GENERAL PROVIDER REQUIREMENTS

Current through June 17, 2024
002.01
COMPLIANCE WITH MEDICAID PROVIDER REQUIREMENTS.
To
  participate in Nebraska Medicaid, providers of Home and Community-Based Waiver
  services must comply with all applicable provider participation requirements
  identified in 471 Nebraska Administrative Code (NAC) Chapters
  1-000,
  2-000 and
  3-000. In the event that provider
  participation requirements in 471 NAC Chapters
  1-000,
  2-000 or
  3-000 conflict with requirements
  outlined in this Chapter, the individual provider participation requirements in
  this chapter will govern.
002.02
SERVICE AUTHORIZATION.
Waiver services will be
  authorized for each participant up to a 12 month period. All authorized
  services are based on needs identified in the personcentered plan (PCP) and the
  results of ongoing monitoring activities. A copy of the authorization is
  supplied to both the participant and the provider identifying which tasks the
  provider is authorized to perform. Providers are responsible for knowing and
  understanding the tasks they are authorized to perform for each participant
  they serve. The service authorization must be complete before services are
  performed.
002.03
PROVIDER CAPABILITIES.
Providers must have the
  knowledge and skills to respond to emergency situations. Additionally,
  providers must have the physical and mental abilities to safely perform all
  requirements of the service that has been authorized. Failure to meet these
  standards will be grounds for termination or denial.
002.04
REASONABLE
  CAUTION.
Providers must exercise reasonable caution and care in
  the use and storage of participants' property, resources, equipment,
  appliances, tools, and supplies.
002.05
PROVIDER OWNED AND
  OPERATED SETTINGS.
If services are provided in a provider owned
  and operated setting, the provider must comply with the following requirements.
  Failure to meet these standards will be grounds for termination or denial of a
  Medicaid provider agreement.
(A) Ensure that
  the facility or home is architecturally designed to accommodate the needs of
  the participants being served;
(B)
  Have available an operable telephone;
(C) Post emergency phone numbers by the
  telephone;
(D) Ensure that the home
  or facility is accessible to the participant, clean, in good repair, free from
  hazards, and free of rodents and insects;
(E) Ensure that the facility or home is
  equipped to provide comfortable temperature and ventilation
  conditions;
(F) Ensure that toilet
  facilities are clean and in working order;
(G) Ensure that the eating areas and
  equipment are clean and in good repair;
(H) Ensure that the home or facility is free
  from fire hazards;
(I) Ensure that
  the furnace, water heater, any firearms, medications, and poisons are
  inaccessible to the participant;
(J) Ensure that any household pets have all
  necessary vaccinations;
(K) The
  unit or dwelling in which the participant resides must be a specific place
  owned, rented, or occupied under a legally enforceable residency agreement;
  and
(L) The provider must cooperate
  with the Department in completing any assessments regarding the community-based
  nature of the property.