MN Dept of Health — Home Care License (MN Stat. 144A)
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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
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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
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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
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Grievance Process Documented
Written grievance procedure available to all clients and caregivers. Response required within 5 business days.
MN Stat. 144A.4791
Pass
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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
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Orientation Training Completed
All caregivers completed agency orientation (client rights, abuse reporting, emergency procedures) before first client contact.
MN Stat. 144A.4796
Pass
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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
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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
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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)
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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
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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
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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
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Supervisory Visits — HHA Patients
RN supervisory visits completed every 14 days for all HHA patients. Documentation on file.
42 CFR 484.80(h)
Pass
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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
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QAPI Program Active
Quality Assurance & Performance Improvement program documented with quarterly reviews and outcome tracking.
42 CFR 484.65
Pass
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Infection Control Policy
Infection prevention and control program in place. Hand hygiene and PPE protocols documented and distributed.
42 CFR 484.70
Pass
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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
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Provider Enrollment — MN MMIS
Agency enrolled in Minnesota Medicaid Management Information System (MMIS). Provider ID on file.
MN DHS Home Care Provider Manual
Pass
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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
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PCA Assessment — MnCHOICES
All PCA clients have current MnCHOICES assessment on file. Assessments conducted by county or lead agency.
MN Stat. 256B.0659
Pass
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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
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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
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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
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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
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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
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Aggregator Transmission — HHAeXchange
Visits transmitted to MN DHS aggregator within 24 hours. 98.1% success rate this month.
MN DHS EVV Bulletin
Pass
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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.