SAMPLE POLICY WORK

– Manage follow-up requests for additional information or re-assessment where discrepancies arise.

3. Compliance and Regulatory Affairs Team • Key Responsibilities: –

Monitor the PAE process continuously and coordinate periodic internal audits ensuring compliance with TN.0357.R05.00 and TennCare rules. – Act as the primary contact for regulatory inquiries, ensuring that all queries from state and federal bodies are addressed. – Maintain a regulatory watch on any updates to the CAC Waiver and related guidelines, and ensure that PAE procedures are amended accordingly. – Oversee the communication process with TennCare, ensuring that all documentation is forwarded promptly and comprehensively. Review and approve final PAE reports following initial approval by the assessment team. – Ensure that any adjustments or enhancements recommended by the Compliance Team are incorporated into the final patient record. – Provide additional oversight to complex cases by convening interdisciplinary case review meetings where necessary. – Ensure that all procedures are thoroughly documented and that any deviations from standard protocols are recorded along with corrective actions taken. Maintain the digital repository that houses all PAE records with robust security measures in accordance with HIPAA guidelines. – Ensure that any changes, updates, or version modifications to the PAE documentation are logged consistently. – Guarantee that approved PAEs and related documents are easily retrievable for internal audits, external reviews, and regulatory inspections. – Facilitate secure digital communication channels for transmitting PAE summaries and supplemental data to TennCare and external auditors.

4. Management and Supervisory Staff • Key Responsibilities: –

5. IT and Records Management Personnel • Key Responsibilities: –

e. Step-by-Step Procedural Guidance The following procedure outlines the step-by-step process for conducting a Pre- Admission Evaluation (PAE) to determine the appropriate ICF/IID level of care.