Medicaid Provider - Private Practice Nurse

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I have a client that would like me work in their home part-time without going through a nursing agency. I currently am a one on one nurse for their child at school. I am set up as a medicaid provider. Has anyone reading this done this before or have advice. It seems that there is much more responsibility involved with this than simply just putting in a few hours and billing medicaid.

* I can get audited up to one year after the child turns age 21.

* I need to keep notes... at their house and at mine for years, and preserve their privacy.

* More ... private practioner.

* Start a business to protect all my assets.

* I am unsure what to do if there is a significant change in members condition. Contact the parents or attending physician. eMedny suggests that I need to contact the physician but the rules are all pieced together, nothing is clear.

* I would be on my own. If I had a question, I wouldn't have a supervisor or a nurse on call as there is for an agency. I have not even been an RN for one year.

* There is no rate/schedule fee listed online, and when I call, I keep getting back and forth between two departments.

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Why would you want to do this? It sounds tricky, at best.

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Under who's (Whom's? Whose? I dunno I stink at the grammars until my 3rd cup of coffee and even then it is sketchy) medical authority would you operate? Private pay in-home nurses have to obtain orders that are endorsed by a physician otherwise it's practicing without a license. This sounds like a lot of potential personal liability to me but I am very risk-averse that way.

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