Service Delivery Procedures and Characteristics 650-25-50-05
(NEW 7/1/19 ML #3552)
Legal References:
- North Dakota Century Code Chapter 50-06 (Department of Human Services)
- Public Law 114-144, Older Americans Act (OAA) of 1965, as amended in 2016
- 45 CFR part 1321, Grants for State and Community Programs
- 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as applicable
- Older Americans Act Policies and Procedure Manual 650-25
Other References:
North Dakota Department of Human Services Contract
A contract entity may subcontract for health maintenance services; however, subcontractors may not subcontract with another subcontractor.
A nurse supervisor who is a licensed registered nurse, with a minimum of two years of nursing experience preferred, shall direct/coordinate the services and provide nursing supervision to all other healthcare personnel. Trained, licensed, and certified healthcare professionals may conduct health maintenance services.
Health maintenance services must be performed as outlined below:
Blood Pressure/Pulse/Rapid Inspection – 1 Unit of Service
Individual Preparation
- Update individual’s health history and medical record.
- Review medications.
Education
- Explain procedures.
- Discuss test results and implications.
- Discuss preventive health measures.
Procedures
- Provide nursing assessment.
- Provide blood pressure and pulse readings
Documentation
- Complete documentation.
- Complete correspondence, referrals, and follow-up.
Foot Care – 7 Units of Service
Individual Preparation
- Update individual’s health history and medical record.
- Review medications.
Education
- Explain procedures and risks.
- Discuss preventive health measures.
Procedures
- Prepare equipment.
- Provide foot and nail care.
- Clean and sanitize equipment.
Documentation
- Complete documentation.
- Complete correspondence, referrals, and follow-up.
Medication Set-up – 4 Units of Service
Individual Preparation
- Update individual’s health history and medical record.
- Review medications.
Education
- Review purpose and function of medications.
- Assess compliance to medication regimen.
Procedure
- Prepare equipment.
- Set-up medications in container.
- Assess need for refill and reorder of medications.
Documentation
- Complete documentation.
- Complete correspondence, referrals, and follow-up.
Home Visit – 6 Units of Service
Health maintenance services are provided to individuals in their home if homebound.
The healthcare professional must complete an initial assessment with the option to complete follow-up assessments as needed. An individual may be assessed using the Health Maintenance Assessment form provided by Aging Services Division or using the entity’s own assessment form. If using the entity’s assessment form, this must be documented in the narrative section of the web-based data collection system. At a minimum, the required information from the Health Maintenance Assessment form, Section I-General Information and Section II-Demographics, must be completed.
Individuals must have their own record and at a minimum the following must be included:
- Date of service.
- Information provided to the individual as applicable to the service.
- Other contact with the individual and the individual’s physician.
Individuals records must be:
- In its own individualized file.
- Secured in a locked file cabinet, in a locked area, or in
- A secure computer that requires an access code.
The contract entity must:
- Use the service billing unit system for each service procedure.
- Record each billable unit of service received by an individual in the individual’s record in the web-based data collection system by the 15th of the month following service delivery.
- Record the type of health maintenance service provided.
