Virginia Skilled Nursing Services Policy Manual
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The Virginia ADM-1.0 Administration Policy establishes the framework for compliance with 12VAC30-122-520, which governs skilled nursing service documentation standards under Virginia’s Medicaid Waiver programs. This policy ensures that providers deliver medically necessary, physician-ordered skilled nursing services in a manner that aligns with state and federal regulations, including those set forth by the Department of Medical Assistance Services (DMAS). Skilled nursing services are designed to address complex medical needs, promote health stability, and support individuals in community-based settings.
Providers must maintain detailed and accurate documentation of all skilled nursing services, including initial assessments, individualized service plans (ISPs), progress notes, and supervisory visit reports. Documentation must clearly demonstrate medical necessity, outline interventions provided, and include measurable outcomes. All records must be completed promptly—typically within 24 hours of service delivery—and updated regularly to reflect changes in the individual’s condition or care plan. Providers are required to adhere to HIPAA privacy standards to ensure the confidentiality and security of participant information.
This policy emphasizes the importance of maintaining comprehensive records to support claims for reimbursement, facilitate audits, and ensure compliance with Medicaid requirements. By adhering to 12VAC30-122-520, providers can deliver high-quality skilled nursing services that prioritize person-centered care while meeting Virginia’s regulatory framework for Medicaid Waiver programs.