PivotChart — Compliance Engine

Minnesota-specific regulatory rules · MDH · DHS Medicaid · Medicare CoP

🏛 MN Specific
MDH Licensing
92%
8 of 9 rules passing
Medicare CoP
87%
2 warnings
MN Medicaid
83%
3 items to review
EVV Compliance
98%
1 exception
MN Dept of Health — Home Care License (MN Stat. 144A)
Basic Home Care License on File
Agency holds valid MDH Basic Home Care license. Required to provide homemaker, companion, or home health aide services.
MN Stat. 144A.471
Pass
⚠️
Comprehensive License Application Pending
Comprehensive license required to provide skilled nursing, PT, OT, or SLP services. Application should be filed before providing these services.
MN Stat. 144A.472
Action
Client Rights Notice Provided
Clients receive MN Home Care Bill of Rights at start of care. Documented in consent records.
MN Stat. 144A.44
Pass
Grievance Process Documented
Written grievance procedure available to all clients and caregivers. Response required within 5 business days.
MN Stat. 144A.4791
Pass
Caregiver Background Checks
All caregivers have current DHS background study clearance via NETStudy 2.0. No disqualifications on file.
MN Stat. 245C
Pass
MDH Caregiver Training Requirements
Orientation Training Completed
All caregivers completed agency orientation (client rights, abuse reporting, emergency procedures) before first client contact.
MN Stat. 144A.4796
Pass
Annual In-Service Training — 8 Hours
Home health aides complete minimum 8 hours annual in-service training. Records on file for all active staff.
MN Rule 4668.0060
Pass
⚠️
Competency Evaluation Due — 2 Caregivers
Maria J. and Kevin L. are due for annual competency evaluation by Jul 15, 2026. Schedule skills demonstration.
MN Rule 4668.0060 Subp. 5
Due Soon
Mandatory Reporter Training
All staff trained as mandatory reporters for vulnerable adult abuse/neglect. Certificates on file.
MN Stat. 626.557
Pass
Conditions of Participation — Clinical (42 CFR Part 484)
OASIS Completed at SOC/ROC/Discharge
OASIS-E assessments completed and transmitted to iQIES within 30 days. No overdue assessments.
42 CFR 484.55
Pass
⚠️
2 Physician Orders Pending Countersignature
Verbal orders from Dr. Chen (Jun 2) and Dr. Patel (May 28) require countersignature within 30 days. Both due by Jul 2 and Jun 27.
42 CFR 484.60(b)
Action
Plan of Care Updated Every 60 Days
All active patient care plans updated and physician-signed within 60-day certification period.
42 CFR 484.60
Pass
Supervisory Visits — HHA Patients
RN supervisory visits completed every 14 days for all HHA patients. Documentation on file.
42 CFR 484.80(h)
Pass
⚠️
CMS-485 Signed by Attending Physician
1 CMS-485 (Jane TestClient, recertification period starting Jun 1) awaiting physician signature. Required before Medicare billing.
42 CFR 484.60(c)
Action
Conditions of Participation — Administrative
QAPI Program Active
Quality Assurance & Performance Improvement program documented with quarterly reviews and outcome tracking.
42 CFR 484.65
Pass
Infection Control Policy
Infection prevention and control program in place. Hand hygiene and PPE protocols documented and distributed.
42 CFR 484.70
Pass
Emergency Preparedness Plan
Emergency preparedness plan updated annually. Includes patient risk stratification and communication protocols.
42 CFR 484.102
Pass
ℹ️
Medicare Enrollment — PECOS
Verify PECOS enrollment is current and NPI is linked to your Medicare provider number. Revalidation required every 5 years.
42 CFR 424.515
Verify
Minnesota DHS — Medicaid / Waiver Compliance
Provider Enrollment — MN MMIS
Agency enrolled in Minnesota Medicaid Management Information System (MMIS). Provider ID on file.
MN DHS Home Care Provider Manual
Pass
⚠️
CADI Waiver — Prior Auth Renewal Due
3 CADI waiver clients have prior authorizations expiring within 30 days. Submit renewal requests to lead agencies now to avoid billing gaps.
MN DHS Waiver Policy Manual
Action
PCA Assessment — MnCHOICES
All PCA clients have current MnCHOICES assessment on file. Assessments conducted by county or lead agency.
MN Stat. 256B.0659
Pass
⚠️
PCA Supervisor Visit — 180-Day Requirement
2 PCA clients are due for RN supervisory visit within the next 14 days (180-day cycle). Schedule now.
MN Stat. 256B.0659 Subd. 11
Due Soon
⚠️
Personal Care Agreement — Annual Update
1 client personal care agreement not updated in 12 months. Required annually or when services change.
MN DHS PCA Manual
Overdue
EVV Transmitted to HHAeXchange
All Medicaid visits transmitted to MN DHS EVV aggregator (HHAeXchange). 98% transmission success rate.
MN DHS EVV Policy, 21st Century CURES Act
Pass
EVV — 21st Century CURES Act Compliance
EVV System Operational
Electronic Visit Verification active for all Medicaid personal care and home health services. GPS check-in/out captured.
42 USC 1396b(l)
Pass
6 Required Data Elements Captured
All 6 federally required EVV elements captured: (1) service type, (2) individual receiving service, (3) caregiver, (4) location, (5) start time, (6) end time.
42 USC 1396b(l)(3)
Pass
Aggregator Transmission — HHAeXchange
Visits transmitted to MN DHS aggregator within 24 hours. 98.1% success rate this month.
MN DHS EVV Bulletin
Pass
⚠️
1 Visit with GPS Override
Jun 2 visit (Robert Johnson) used manual GPS override. Supervisor sign-off documented. Review for pattern — repeated overrides trigger DHS audit flag.
MN DHS EVV Policy 2024
Monitor
EVV Statistics — June 2026
Total visits this month47
EVV captured46 (97.9%)
Transmitted to aggregator46 (100%)
GPS overrides1
Anomalies flagged2
Missing EVV1
HIPAA — Administrative, Physical & Technical Safeguards
HIPAA Privacy Officer Designated
Privacy and Security Officer designated. Contact information posted in agency policy manual.
45 CFR 164.530(a)
Pass
BAA with Medplum (EHR Vendor)
Business Associate Agreement in place with Medplum. Required before storing PHI in their system.
45 CFR 164.308(b)
Pass
Notice of Privacy Practices
NPP provided to all patients at SOC. Acknowledgment of receipt documented in consent records.
45 CFR 164.520
Pass
ℹ️
Annual HIPAA Training Due — Jul 2026
Annual HIPAA workforce training due by July 31, 2026. Schedule training sessions for all staff.
45 CFR 164.530(b)
Upcoming
ℹ️
Security Risk Assessment
Annual security risk assessment due. Documents electronic PHI safeguards. Required for HIPAA Security Rule compliance.
45 CFR 164.308(a)(1)
Schedule