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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 29. PUBLIC WELFARE |
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Chapter 29-50. MEDICAID REIMBURSEMENTS FOR PERSONAL CARE AIDE SERVICES |
Section 29-5013. RECORDS
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5013.1Each Provider shall maintain complete and accurate records reflecting the specific PCA services provided to each beneficiary for each unit of service billed. Such records must be maintained for a period of ten (10) years or when all audits have been completed, whichever is longer.
5013.2Each Provider shall be responsible for maintaining the confidentiality of each beneficiary’s care, treatment, and records. The disclosure of personal health information by the Provider is subject to all of the provisions set forth in applicable District and Federal laws and rules.
5013.3Each beneficiary's record shall be readily retrievable and shall be kept in a locked room or file maintained and safeguarded against loss or unauthorized use at the location of the Provider's place of business that is identified on the Provider’s Medicaid Provider application.
5013.4Each Provider shall permit reviews and on-site inspections to be conducted by CMS and its agents, and DHCF, and its agents to determine Provider compliance with all applicable laws.
5013.5Each Provider shall comply with the terms of its Medicaid Provider Agreement with respect to the maintenance of all beneficiary and financial records.
5013.6Each beneficiary's record shall include, but is not limited to, the following information:
(a)General information including the beneficiary's name, Medicaid identification number, address, telephone number, age, sex, name and telephone of emergency contact person, authorized representative (if applicable), and primary care physician's or advanced practice registered nurse’s name, address, and telephone number;
(b)Health care information, including all referrals, assessments, service authorizations, plans of care, and progress notes;
(c)Dates and description of PCA services rendered, including the name and NPI of the personal care aide performing the services;
(d)Documentation of each supervisory visit of the R.N., including signed and dated clinical progress notes;
(e)Discharge summary, if applicable;
(f)Copies of any written notices given to the beneficiary; and
(g) Any other appropriate identifying information that is pertinent to beneficiary care.