Skilled Nursing Services

Skilled nursing – health assessments and evaluations; medical treatments and procedures; administering and/or monitoring medication needed by the student during school hours; and consultation with licensed physicians, parents and staff regarding the effects of the medication. Skilled nursing services eligible for Medicaid reimbursement only includes those services the student requires to remain in school in order to benefit from Special Education services. This does not include first aid that is not related to the student's disability. Skilled nursing services should not appear on the IEP unless there is a specific need or a suspected need based on a medical condition of the child. [Also, see Appendix B]

To claim Medicaid reimbursement, providers must abide by the following:

· Services must be indicated on the IEP. The specific service or required medication need not be specified, the term “skilled nursing services” will be sufficient. These services can be reported under Medical Alerts, under Related Services, or under Support Services on the IEP wherever appropriate.

· There should be nursing notes, if applicable, prepared by the service providers in accordance with the Nurse Practice Act. Quarterly notes are not required.

· An Individual Health Care Plan (Appendix A-1) should be maintained, when appropriate, for the student receiving the skilled nursing service, signed by a Registered Nurse (RN). All skilled nursing services must be provided in accordance with the Nurse Practice Act.

· Health history must be on file.

· Medication log must be maintained.

· Skilled nursing services may be performed by a NYS Registered Nurse or a NYS Licensed Practical Nurse (LPN), under the supervision of an RN within the scope of the Nurse Practice Act.

· Skilled nursing services must be supported by a written order, signed and dated by a NYS licensed and registered physician, a physician’s assistant, or a licensed nurse practitioner within the scope of their practice. Orders are required when the student enters school for the first time during the school year and new orders are required when there are any significant changes in the student’s condition.

· Written protocols for each procedure should be available when appropriate.

· Skills checklist approved and signed by the parent or guardian when appropriate.

· Recorded documentation of nursing services delivered and dates of service signed and dated by the RN.

The credentials of the registered nurses and licensed practical nurses should be kept on file.

Codes and Fees:

SSHSP Monthly Fee	5304	$ 177
PSHSP Individual Monthly Fee	5372	$ 132
PSHSP Center based Monthly Fee	5373	$ 177