Quality Management

Quality Management A. Waiver providers must follow applicable service specifications as referenced in the Assisted Living (AL) Waiver approved by the Centers for Medicare and Medicaid Services (CMS).The Waiver is available on the Division of Medicaid’s website, www.medicaid.ms.gov. B. Providers must maintain compliance with all current waiver requirements, regulatory rules and regulations and administrative codes as specified by the licensing agency. 1. If an AL Waiver provider fails to maintain compliance, the Division of Medicaid may halt the acceptance of Medicaid referrals or waiver admissions until the AL Waiver provider demonstrates compliance with the regulatory agency. 2. The decision to halt Medicaid referrals or waiver admissions is at the discretion of the Division of Medicaid. C. Waiver providers must report: 1. Changes in contact information, administrative staffing, ownership, and licensure within ten (10) calendar days to the Division of Medicaid. 2. Critical incidences of abuse, neglect and exploitation (including the unauthorized use of restraints, restrictive interventions, and/or seclusion) within twenty-four (24) hours of the occurrence or knowledge of the occurrence to the Division of Medicaid and other applicable agencies as required by law. 3. Any complaints not resolved within seven (7) days. D. A provider may not rely on any interpretation or exception to the Medicaid rules if it’s not provided, in writing, by the Division of Medicaid.