SAMPLE POLICY WORK

Follow-Up Communication:

– In the event TennCare requests additional clarification, the liaison collaborates with the assessment team to compile further supporting information. – All communications and updates are logged in real time in the PAE’s digital record.

Step 5: Ongoing Record Maintenance and Audit 1. Centralized Documentation:

– All PAE reports, submission logs, and related communications are maintained in an electronic repository that is designed for secure access and version control. – Records are stored in compliance with HIPAA, state licensing regulations, and TennCare guidelines, ensuring confidentiality and integrity. 2. Scheduled Internal Audits: – The Compliance and Regulatory Affairs team conducts quarterly audits to verify that PAE documentation is current, complete, and compliant with regulatory standards. – Audit results are reviewed by executive leadership, with any deviations promptly addressed and corrective action plans implemented. 3. Feedback and Continuous Improvement: – A structured feedback process allows staff and external stakeholders to provide input on the PAE process. – Feedback is integrated during regular process review meetings. Revisions to procedures are documented and included in the next update cycle.

f. Regulatory References and Compliance Integration

The entire Level of Care Assessment process is underpinned by stringent adherence to regulatory mandates. Key regulatory resources include:

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Tennessee CAC Waiver (TN.0357.R05.00): All aspects of the PAE — ranging from assessment tools to documentation practices — must meet the criteria outlined in this waiver. TennCare Guidelines: The submission and communication process with TennCare ensures that recommendations for the ICF/IID level of care are in full compliance with state guidelines.

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Federal and State Licensing Standards: The evaluation process, as well as all documentation associated with PAEs, is