NURSING SERVICES

We provide licensed nurses to help care for service recipients who are medically fragile and need skilled nursing services.This service is provided in the home of the recipients. Our well trained Nurses provide skilled nursing care with dignity in a manner that improves the quality of life; following the treatment plan as specified in the plan of care.

Nursing Services shall mean skilled nursing services that fall within the scope of Tennessee’s Nurse Practice Act and SERVICES that are directly provided to the enrollee in accordance with a plan of care. Nursing Services shall be ordered by the enrollee’s Physician, physician assistant or nurse practitioner, who shall document the medical necessity of the services and specify the nature and frequency of the nursing services. Nursing Services shall be provided face to face with the enrollee by a licensed registered nurse or licensed practical nurse under the supervision of a registered nurse. Nursing assessment and/or nursing oversight shall not be a separate billable service under this definition. Therapeutic goals and objectives shall be required for enrollees receiving Nursing Services. TPA shall provide this service in home and community settings, as specified in the Plan of Care, excluding inpatient hospitals, nursing facilities and Intermediate Care Facilities (ICF) for the service recipient. An enrollee who is receiving Medical Residential Services shall not be eligible to receive Nursing Services during the hours Medical Residential Services are being provided. Nursing Services are not intended to replace services available through the Medicaid State Plan/TennCare program or services available under the Rehabilitation Act of 1973 or Individuals with Disabilities Education Act. To the extent that such services are covered in the Medicaid State Plan/TennCare Program, all applicable Medicaid State Plan/TennCare Program services shall be exhausted prior to using the waiver service. TPA shall require Nurses to develop a nursing plan of care which must be consistent with outcomes specified in the Individual Support Plan (ISP). The nursing plan of care must be guided by the specific nursing activities ordered by the physician, including the amount, frequency and anticipated duration of services required. The nursing plan of care must be consistent with and reflective of the outcomes specified in the ISP. The nursing plan of care shall be included in the ISP in accordance with DIDS requirements.