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9/9/22  10:19 am
Commenter: Tracy Colvard / Maxim Healthcare

EPSDT and PDN
 

Both for RN and LPN Hiring

Have a satisfactory work history as evidenced by two (2) satisfactory reference checks from prior job experience, including no evidence of abuse, neglect, or exploitation of incapacitated or older adults or children, recorded in the nurse’s personnel file. If the RN has worked for a single employer, one (1) satisfactory reference from a prior job experience and one (1) personal reference both with no evidence of abuse, neglect, or exploitation of an incapacitated or older adults or children is acceptable

Maxim doesn’t necessarily a problem with references, but those can be difficult to capture and can be faked easily.  In addition, if we are able to connect with an employer, most of the time, we get shut down on any reference talk and only are able to get employment verifications done.  Additionally since the CPS checks are required, this seems duplicative.  We would prefer if there was language that states that employment verification versus reference. Maxim currently only requires previous employment to be verified.

 

The number of hours requested in the service authorization must not exceed the number of hours that the agency is able to adequately staff on a regular basis. For FFS members, if the number of hours that the agency is able to adequately staff is less than the number of hours specified in the plan of care (CMS-485 or equivalent), the nursing agency must alert 1) the DMAS Medical Support Unit of this shortfall as well as 2) the individual and/or family/caregiver of this shortfall so that the individual and/or family/caregiver can identify additional nursing agencies to cover the remaining hours. This information must be provided when the request for service authorization is submitted. For individuals enrolled with an MCO, identification of nursing agencies to cover the remaining hours will be performed by the MCO care coordinator/case manager.

This language is too loose.  From the way this reads, an agency would need to notify DMAS if we staff even one hour less than what a patient is authorized.  We don’t disagree necessarily with what DMAS is trying to do here, but more specifics such as “staffing less than 40% of the hours specified in the plan of care” would make more sense and would give an agency an actual metric to shoot for.

 

 

CommentID: 128537