Home Health & Hospice

Home Health & Hospice Articles by Topic: Documentation

For some choices in review choice demo, there are no takebacks

  • Homecare Direction, Issue 11, November 5, 2018

    While agencies have choices when it comes to which claim review option to select for CMS&rsquo...

If an RN discharges a patient early in the day, can another discipline make a visit as long as the visit is the same day?

  • Homecare Q&A, Issue 15, October 19, 2018

    If the RN saw the client early in the day, another qualified discipline could see the client later...

Is a home health face-to-face visit required for Medicaid Advantage plans?

  • Homecare Q&A, Issue 15, October 19, 2018

    Generally, for Medicaid Advantage, the documentation is that the face-to-face date needs to be on...

Is a home health face-to-face visit required for Medicaid Advantage plans?

  • Homecare Q&A, Issue 0, October 19, 2018

    Normal 0 false false false EN-US X-NONE X-NONE...

What should I do if I take on a patient with a diagnosis that fits within one of the six clinical groups under PDGM?

  • Homecare Q&A, Issue 14, September 21, 2018

    The 2019 proposed PPS rule references this concern in several areas.

What recommendations/strategies do you have for gathering documentation fast so we can bill quicker under PDGM?

  • Homecare Q&A, Issue 14, September 21, 2018

    CMS estimates the median length of days for request for anticipated payment (RAP) submission is 12...

Is a home health face-to-face visit required for Medicare Advantage plans?

  • Homecare Q&A, Issue 14, September 21, 2018

    CMS doesn't require Medicare Advantage plans to have a face-to-face document for home health.

In the following scenario, should my agency write an order stating the patient is in compliance of taking medications as ordered?

  • Homecare Q&A, Issue 14, September 21, 2018

    In the scenario you describe, your agency admitted a patient when she was discharged home from the...

In this scenario, is my agency required to conduct a transfer then ROC, or not?

  • Homecare Q&A, Issue 14, September 21, 2018

    In the scenario you discuss, your agency had a patient that was a full admission to the hospital.

What advice do you have about how an agency could improve when it comes to timely initiation of care?

  • Homecare Q&A, Issue 13, September 4, 2018

    This is a difficult question to answer, not knowing your agency processes. But there are several...

Can you explain in this scenario whether our surveyor is correct and what our agency should do?

  • Homecare Q&A, Issue 13, September 4, 2018

    In the scenario you discuss, your agency is in Indiana and are currently going through a federal...

Is it acceptable for a physician to sign a home health plan of care when he/she is not the physician named in the locator box on the plan of care?

  • Homecare Q&A, Issue 13, September 4, 2018

    In the scenario you discuss, the signing physician is also the MD certifying the patient for home...

We have a conflict occurring related to documentation and billing. Can you help?

  • Homecare Q&A, Issue 13, September 4, 2018

    In the scenario you discuss, your agency’s billing department reviews documentation before...

Appeals backlog shrinks, but it won't be eliminated as quickly as ordered

  • Homecare Direction, Issue 9, September 1, 2018

    There’s good news for agencies caught up in the daunting backlog of appeals at the...

CMS considers eliminating estimate requirement for recertifications

  • Homecare Direction, Issue 8, August 1, 2018

    Seeking to eliminate what it considers an unnecessary burden, CMS plans to remove its requirement...

Are there things we should do differently with claims to prepare for PDGM?

  • Homecare Q&A, Issue 12, July 25, 2018

    PDGM is going to be such a rapid cycle flurry of action.

What's an example of a billing aberrancy that's prompting contractors to target agencies in targeted probe-and-educate reviews?

  • Homecare Q&A, Issue 12, July 25, 2018

    We see inappropriate recertifications all over the place.

Looking for some guidance on a patient with a closed stage IV pressure ulcer who now presents with non-blanchable redness to the same injury site but skin is intact.

  • Homecare Q&A, Issue 12, July 25, 2018

    Once the wound is fully granulated and the wound surface is covered with epithelial tissue, the...

How should I act in the following scenario involving power of attorney (POA)?

  • Homecare Q&A, Issue 12, July 25, 2018

    First determine if the POA is medical and if the patient is incapacitated.

If a patient requires assistance to complete ADLs but is independent with all gait and mobility, can the person still be considered homebound per Medicare guidelines due to the taxing effort of getting ready to leave the home?

  • Homecare Q&A, Issue 11, July 15, 2018

    This question cannot be answered, as each eligibility is established with each particular patient.

What if the PT and OT are ordered at SOC and the PT does an evaluation and no further treatments are ordered/planned but the OT does an eval and stays in alone for the episode?

  • Homecare Q&A, Issue 11, July 15, 2018

    Per §1814(a)(2)(C) and §1835(a)(2)(A) of the Social Security Act, the patient must be in...

Our agency has had difficulty getting documentation for the F2F requirement from certain physicians. Should we deny the referrals?

  • Homecare Q&A, Issue 11, July 15, 2018

    Denying a referral should be a determination based on agency policy and physician...

How do we determine if it's worth it to submit a request for redetermination?

  • Homecare Q&A, Issue 11, July 15, 2018

    First step, ask your biller for the remarks that are submitted by the reviewer at the MAC.

Providers scoff at CMS' estimated burden for agencies during claim choice demo

  • Homecare Direction, Issue 7, June 29, 2018

    CMS’ estimate for the money agencies will spend and resources they’ll use to...

Is it OK to accept a doctor's signature on one page of a multi-page order as being signed?

  • Homecare Q&A, Issue 10, June 11, 2018

    It is important for the pages of the plan of care to be clearly numbered if there is more than one...

Is it necessary to document the RVVO piece of a verbal order?

  • Homecare Q&A, Issue 10, June 11, 2018

    The Joint Commission (TJC) includes a requirement under the Provision of Care, Treatment and...

How should we handle cases when there are diagnoses presented on the assessment that weren’t in physcian documentation?

  • Homecare Q&A, Issue 10, June 11, 2018

    Diagnoses listed in M1011 (Inpatient diagnosis), M1021 (Primary diagnosis) and M1023 (Other...

What advice could you provide when it comes to responding to the two new J items proposed for OASIS-D?

  • Homecare Q&A, Issue 10, June 11, 2018

    Review what instruction have provided for J1900C in the MDS 3.0 Resident Assessment Manual for...

What suggestions do you have for how agencies can achieve success on pre- or post-payment reviews?

  • Homecare Q&A, Issue 10, June 11, 2018

    Agencies need to begin now to ensure that they are getting valid face-to-face documentation with...

Say an agency is starting from scratch on the process of responding to ADRs. What is the first thing that should be put in place?

  • Homecare Q&A, Issue 9, May 12, 2018

    First off, know on the front end that the biller is looking for those requested records. Ensure...

What is the best way to comply with the patient rights requirement?

  • Homecare Q&A, Issue 9, May 12, 2018

    Several agencies have provided this information through a secure portal either through their EMR or...

When it comes to the face to face requirement, what can/should be done and documented differently when the visit is performed by a nurse practitioner or a physician's assistant?

  • Homecare Q&A, Issue 9, May 12, 2018

    Documentation from the non-physician practitioner (NPP) must meet all the required elements for the...

Do agencies have the right to tell patients we require a written request for patient records if the patient asks for a record over the phone?

  • Homecare Q&A, Issue 9, May 12, 2018

    Agencies may require patients to make a written request for copies of the medical record. This is a...

Early survey results show individualized plans of care are a major target

  • Homecare Direction, Issue 5, May 2, 2018

    Break your agency’s clinicians of their mentality to rely solely on generic language or...

New self-care and mobility items among biggest concerns in proposed OASIS-D

  • Homecare Direction, Issue 4, April 12, 2018

    To ensure communication and consistency across assessments, have physical therapists cross-train...

Our agency sometimes admits the same patient as another facility, which messes up our payment. How do we avoid this?

  • Homecare Q&A, Issue 7, April 3, 2018

    When two agencies admit the same beneficiary within the same general timeframe, the common working...

New online training for surveyors highlights the importance of a detailed plan of care

  • Homecare Direction, Issue 3, March 29, 2018

    CMS’ newly posted surveyor training reiterates the need for home health agencies to ensure...

New targeted probe info shows need to scrutinize therapists' documentation

  • Homecare Direction, Issue 3, March 19, 2018

    Conduct a quality audit of documentation your therapists submit. CMS’ targeted...

How can we better collaborate on OASIS?

  • Homecare Q&A, Issue 6, March 17, 2018

    Agencies must abide by certain regulations in order to participate in the Medicare program, as...

How can we better answer OASIS item M1810?

  • Homecare Q&A, Issue 6, March 17, 2018

    Follow these tips:

For OASIS items where a dash is a valid response, should a dash be used on the discharge OASIS, or should the item be answered based on findings from that last visit?

  • Homecare Q&A, Issue 5, March 5, 2018

    AIn the case of an unexpected discharge, the last qualified clinician to see the patient should...

How can we develop performance improvement goals as part of our clinical documentation improvement (CDI) program?

  • Homecare Q&A, Issue 5, March 5, 2018

    Developing performance improvement goals is an essential part to the CDI program. Goals will be...

Home Health Quality Reporting Program: Revised logic for the Timely Initiation of Care measure

  • Homecare E-News, Issue 10, March 5, 2018

    The Medicare Conditions of Participation (CoPs) for home health agencies that became effective...

What is required for medication update during weekly visits?

  • Homecare Q&A, Issue 4, February 19, 2018

    A Q&A around drug regimen review items was provided by CMS.

Improve documentation, avoid pitfalls ahead of tar-geted probe-and-educate review

  • Homecare Direction, Issue 1, January 15, 2018

    Between the cost of denials and additional staffing expenses to cover the time in-volved in...

Documentation tip: Copy-and-paste documentation requires monitoring

  • Homecare Direction, Issue 12, December 22, 2017

    Many EHR systems allow clinicians to “copy and paste” relevant information from a...

How can we improve wound documentation?

  • Homecare Q&A, Issue 24, December 17, 2017

    Take advantage of supplies that require fewer visits. For example, use of silver dressings or a...

How can I effectively audit and monitor risk areas of my agency?

  • Homecare Q&A, Issue 24, December 17, 2017

    With the myriad of responsibilities a home health administrator must discharge each day, auditing...

How can good clinical documentation improvement (CDI) help us outside of compliance?

  • Homecare Q&A, Issue 24, December 17, 2017

    As payment models evolve for providers across the healthcare continuum, the focus must be on...

We are revamping our job descriptions. What advice do you have for creating good job descriptions?

  • Homecare Q&A, Issue 23, December 1, 2017

    Job descriptions that do not reflect the reality of what staff members actually do or are expected...

We can't seem to get our digitized Medicare forms to exactly match the paper forms' font or format. Would these differences make us out of compliance on those forms?

  • Homecare Q&A, Issue 23, December 1, 2017

    There are specific formatting requirements for each of the forms. Below are the individual...

We are creating CDI policies. What should we include?

  • Homecare Q&A, Issue 22, November 17, 2017

    The CDI department should have its own set of policies and procedures to govern its...

In which format and structure should we conduct our physician queries?

  • Homecare Q&A, Issue 22, November 17, 2017

    Choosing the right format will depend on what information is lacking. Queries are not “one...

How do we identify a new ADR in hospice?

  • Homecare Q&A, Issue 21, November 2, 2017

    MACs use the Fiscal Intermediary Standard System (FISS) to process Medicare Part A claims...

CMS seeks to add 15 OASIS items for special services such as cancer treatment

  • Homecare Direction, Issue 10, October 23, 2017

    Get ready to collect as many as 15 new OASIS data elements involving cancer, respiration, IVs and...

How would we bill the following scenario?

  • Homecare Q&A, Issue 20, October 17, 2017

    On Monday, a nurse assesses the patient’s condition, assesses the wound, and applies a new...

CMS shifts from denials to RTPs for home health claims with no matching OASIS

  • Homecare E-News, Issue 39, October 16, 2017

    Home health agencies will now have their claims returned when Medicare systems fail to match those...

Documentation tip: Importance of establishing a records management program, Part 2

  • Homecare Direction, Issue 10, October 16, 2017

    Last month, we discussed the benefits to establishing a solid records management program, which...

If a patient has an established stoma and cares for it independently (the agency is not providing any care), does stoma care need to be included on the 485/plan of care?

  • Homecare Q&A, Issue 19, October 3, 2017

    If the agency is not performing any care for the stoma (including any assessment, etc.) then you...

What should we do to better handle Additional Development Requests (ADR)?

  • Homecare Q&A, Issue 18, September 19, 2017

    Here’s how to improve on ADRs:

Hospice Provider Preview Reports Available

  • Homecare E-News, Issue 34, September 11, 2017

    Hospice providers are encouraged to preview their quality measure results based on Quarter 1- 2016...

Declaration of Public Health Emergency for United States Virgin Islands, Commonwealth of Puerto Rico and State of Florida, CMS waivers enacted

  • Homecare E-News, Issue 34, September 11, 2017

    The President declared a state of emergency for the United States Virgin Islands, Commonwealth of...

Documentation tip: Importance of establishing a records management program

  • Homecare Direction, Issue 9, September 11, 2017

    Agencies need to understand all of the regulations that govern documents maintained throughout...

What do we do if we think Medicare might be a secondary payer?

  • Homecare Q&A, Issue 17, August 31, 2017

    Focus on documentation. CMS believes it is the responsibility of the homecare provider to attempt...

How do we support the decision to discharge if the patient resumes services?

  • Homecare Q&A, Issue 17, August 31, 2017

    If an agency discharges a patient and that patient resumes services, there may be questions about...

How do we go about an admission that was visited only by a nurse during start of care then transferred to the hospital?

  • Homecare Q&A, Issue 17, August 31, 2017

    Q46.1. If we admit a Medicare patient to our home health agency and complete a SOC...

How can we create effective physician queries for better clinical documentation improvement (CDI)

  • Homecare Q&A, Issue 16, August 17, 2017

    Why are physician queries so critical to accurate documentation and coding? The answer can be...

We are a hospice. What should our response process be to an ADR?

  • Homecare Q&A, Issue 15, August 3, 2017

    When a hospice discovers a new ADR, staff should review the time frame for the ADR, assemble...

What constitutes medical necessity when it comes to psychiatric care?

  • Homecare Q&A, Issue 15, August 3, 2017

    The proof of medical necessity strictly relies on the MD documentation and diagnosis and the...

How can we prepare for the pre-claim demo?

  • Homecare Q&A, Issue 5, August 3, 2017

    Become more proactive. You no longer can wait for face-to-face documentation to arrive within...

How can our agency get started on implementinga clinical documentation improvement (CDI) program? We already have a CDI specialist/committee to lead the effort. How can we rally in external sources of better documentation?

  • Homecare Q&A, Issue 15, August 3, 2017

    The first decision for the CDI committee is to establish which CDI program model to adopt. The...

What does a psychosocial assessment need to include?

  • Homecare Q&A, Issue 14, July 17, 2017

     The CoPs make clear that the plan of care will continue to be based on the comprehensive...

How can we improve on timely initiation of care?

  • Homecare Q&A, Issue 14, July 17, 2017

    As part of a monthly or quarterly quality assurance review, agencies should closely monitor...

Changes to make with new Medicare cards

  • Homecare E-News, Issue 27, July 17, 2017

    The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove social security...

Weekly Roundup

  • Homecare E-News, Issue 40, October 24, 2016

    New communication ruling for home health and hospices takes effect. This week, the Centers...

Can you please review what is needed for documentation (in terms of payment) for the plan of care?

  • Homecare Q&A, Issue 18, September 17, 2016

    Patients of the Medicare-certified agency who are under the care of a physician and receiving home...

I have a question regarding how to write frequencies for services when the discipline only does the evaluation visit and no other visits that week.

  • Homecare Q&A, Issue 18, September 17, 2016

    Thank you for your question and your commitment to compliance.  Per the CMS Survey Manual...

What does the summary report on the clinical record need to entail?

  • Homecare Q&A, Issue 14, July 17, 2016

    The Conditions of Participation (CoP) mandate the agency to send a summary report to the physician...

What can the physician write for duration of care with patients who open and close with leg ulcers?

  • Homecare Q&A, Issue 14, July 17, 2016

    According to the National Association for Homecare & Hospice (NAHC):

How should our documentation system for patient care plans work?

  • Homecare Q&A, Issue 13, July 3, 2016

    The patient care plan (485) is not a stand-alone documentation system; it is the legal record of...

What tips do you have for therapy assistants in terms of clinical documentation?

  • Homecare Q&A, Issue 10, May 17, 2016

     As is true for the qualified therapist, the amount of information and regulation that the...

Can a discharge planner pull information from a patient's record and document the clinical findings for the need for each discipline and homebound clinical findings?

  • Homecare Q&A, Issue 10, May 17, 2016

    As a representative of the physician, the discharge planner could gather all information. As long...

What is the best way to comply with the new Medicare regulation that took effect on August 11, 2015, which is the recertification attestation by MDs?

  • Homecare Q&A, Issue 8, April 17, 2016

    What is the best way to comply with the new Medicare regulation that took effect on August 11...

Is an "MDD" classification sufficient for coding a homecare patient?s depression?

  • Homecare Q&A, Issue 7, April 4, 2016

    No. ICD-10-CM classifies depression under Disorder, depressive, major (MDD), but more information...

What is the best approach to a summary report?

  • Homecare Q&A, Issue 7, April 4, 2016

    The Conditions of Participation (CoP) mandate the agency to send a summary report to the physician...

When should we conduct chart audits?

  • Homecare Q&A, Issue 7, April 4, 2016

    You can never conduct too many chart audits. However, there are certain time points when you...

What are some standardized approaches to care planning?

  • Homecare Q&A, Issue 7, April 4, 2016

    Although it plays an important role in care planning, delivery, and coordination, the care plan...

Question on physician signatures

  • Homecare Q&A, Issue 6, March 18, 2016

    We have been getting complaints from physicians regarding too much paperwork that we send to them...

What are some plan of care pitfalls to avoid?

  • Homecare Q&A, Issue 4, February 18, 2016

    What are some plan of care pitfalls to avoid?

Weekly roundup

  • Homecare E-News, Issue 7, February 15, 2016

    CMS intends to start a Medicare Probable Fraud Measurement Pilot for home healthcare services...

Can the OASIS then be updated (by the assessing clinician) within the five-day window, using information gathered from that collaboration, if the M0090 date is also updated?

  • Homecare Q&A, Issue 3, February 3, 2016

    Thank you for your question and commitment to compliance. You are correct that the assessment must...

May we accept orders for labs from a physician assistant (PA) who is listed on the 485?

  • Homecare Q&A, Issue 3, February 3, 2016

    Thank you for your question and your commitment to compliance. According to the Medicare Benefit...

Which assessments should the nurse do when the patient receiving only personal care services now needs and qualifies for Medicare coverage? What about when the patient switches from Medicare to Medicaid?

  • Homecare Q&A, Issue 24, December 17, 2015

    The first step in answering these questions is to know the requirements for data collection and...

Are clerical staff able to enter written orders from the MD into the electronic medical record if the RN verifies the entry in both Michigan and Wisconsin?

  • Homecare Q&A, Issue 24, December 17, 2015

    It is not prohibited but will require tight controls in place. Please review practice brief about...

Do we need to do a Transfer and Resumption of Care for a patient that was in the hospital for observation longer than 24 hours but not as an inpatient?

  • Homecare Q&A, Issue 24, December 17, 2015

    The following is a clarification by CMS regarding this subject:

In Focus | Improper payments remain an issue

  • Homecare E-News, Issue 47, November 30, 2015

    The U.S. Department of Health and Human Services released its Agency Financial Report for fiscal...

Can we accept physician verbal orders to begin home health services?

  • Homecare Q&A, Issue 22, November 17, 2015

    We are seeking clarification on whether we can accept a physician’s verbal order to begin...

Do we need documentation regarding the legitmacy of a discharge planner?

  • Homecare Q&A, Issue 22, November 17, 2015

    Our agency is asking for clarification of whether an agency relationship exists between hospital...

In focus | NAHC submits comments on face-to-face clinical templates

  • Homecare E-News, Issue 41, October 19, 2015

    Last Tuesday, NAHC submitted official comments to CMS on a pair of proposed clinical templates (one...

We are in disagreement about whether that is an appropriate frequency.

  • Homecare Q&A, Issue 20, October 16, 2015

    We are in disagreement about whether that is an appropriate frequency.  

What kind of events count as "potentially avoidable"? What will and should be in the CASPER Outcome-Based Quality Improvement Report?

  • Homecare Q&A, Issue 20, October 16, 2015

    What kind of events count as "potentially avoidable"? What will and should be in the...

Is it true that the following documentation is an improper certification statement on our home health agency's plan of care?

  • Homecare Q&A, Issue 20, October 16, 2015

    Is it true that the following documentation is an improper certification statement on our home...

I have a question regarding the face-to-face requirements for homecare.

  • Homecare Q&A, Issue 20, October 16, 2015

    I have a question regarding the face-to-face requirements for homecare...

The Inside Story | Start-of-Care and Resumption-of-Care Assessments

  • Homecare E-News, Issue 40, October 12, 2015

    The start-of-care (SOC) assessment is completed as a patient is being admitted to a home health...

We are having an issue with noncoverage for therapy. What are the rules for therapy services to be covered? Could you explain and expand, providing some examples?

  • Homecare Q&A, Issue 19, October 2, 2015

    We are having an issue with noncoverage for therapy. What are the rules for therapy services to be...

We have been told that the following documentation would position us for a potential claim denial. Can you help explain?

  • Homecare Q&A, Issue 19, October 2, 2015

    We have been told that the following documentation would position us for a potential claim denial...

How do we update the comprehensive assessment for a major deterioration in status with the PPS payment requirements?

  • Homecare Q&A, Issue 18, September 17, 2015

     This patient’s change in condition has a real impact on resource utilization—an...

What does a comprehensive assessment include for non-OASIS patients, according to the Conditions of Participation (CoP)?

  • Homecare Q&A, Issue 18, September 17, 2015

    The CoPs identify several key components for this assessment. Here are the components and some...

What should be our frequency of visits?

  • Homecare Q&A, Issue 18, September 17, 2015

     We have an 87-year-old woman who was referred by the wound care center for care of a wound...

Do regulations mandate any particular form or format for documentation or confirmation of verbal orders?

  • Homecare Q&A, Issue 17, September 8, 2015

    No. The regulations do not mandate any particular form or format for documentation or confirmation...

We discharged a patient who then resumed services. Are we going to have troubles receiving reimbursement?

  • Homecare Q&A, Issue 17, September 8, 2015

    If an agency discharges a patient and that patient resumes services, there may be questions about...

If the patient does not require a skilled bath, can our agency continue to provide this under the state personal care program?

  • Homecare Q&A, Issue 15, August 3, 2015

    Medicare doesn’t differentiate between skilled and unskilled personal care because there...

If the patient has an ostomy, cannot change it, and there are no caregivers to learn, does the agency stay in indefinitely?

  • Homecare Q&A, Issue 15, August 3, 2015

    Changing an ostomy bag, even if the patient can’t do it and there’s no caregiver...

When does Medicare consider a wound as chronic/nonhealing and no longer pays for services?

  • Homecare Q&A, Issue 15, August 3, 2015

    You won’t find any mention in the Medicare coverage criteria about chronic or nonhealing...

Is it an appropriate use of Medicare to do three weeks of assessment and venipuncture for a patient hospitalized with DVT?

  • Homecare Q&A, Issue 15, August 3, 2015

    Since 1997, venipuncture has not been a qualifying service for Medicare coverage. However, once the...

Is it permissible for a hospital discharge planner to make an entry into a patient hospital record and have the physician sign the entry (to support home health eligibility)?

  • Homecare Q&A, Issue 15, August 3, 2015

    Is it permissible for a hospital discharge planner to make an entry into a patient hospital record...

How to score an incomplete OASIS?

  • Homecare Q&A, Issue 15, August 3, 2015

    I am specifically looking for the guidance indicating that, when an OASIS assessment is not...

If there are verbal orders at start of care, do we need to use Locator 23?

  • Homecare Q&A, Issue 14, July 16, 2015

    This locator applies only if verbal orders are involved in the start of care process. It...

Is it true that we must receive the signed plan of care and all verbal orders prior to submitting the claim?

  • Homecare Q&A, Issue 14, July 16, 2015

    Yes, it’s true. You can find that requirement in CMS Publication 100-2, Chapter...

I have read that CMS in 2015 has added to the Medicare manual that physicians need to estimate how much longer the skilled services will be required. Is there any clarification on this, and are we seeing any claims being denied due to this?

  • Homecare Q&A, Issue 14, July 16, 2015

    According to the final rule for 2015, physicians must state the length of skilled services for...

Can physical therapy go out and have consents signed and perform an evaluation before the nurse gets to the home to complete the OASIS as long as it is all done the same day?

  • Homecare Q&A, Issue 14, July 16, 2015

    The only similar guidance found was according to CMS’ OASIS Q&A:

I am wondering how to answer OASIS assessment "M" items when an OASIS assessment is needed for a payer change, but one does not exist.

  • Homecare Q&A, Issue 14, July 16, 2015

    Thanks for your question and commitment to compliance. In cases where you learn after the fact...

How do we get paid when we have two different payers?traditional Medicare (Part A) and MA?within the same 60-day episode?

  • Homecare Q&A, Issue 13, July 2, 2015

    If a patient switches from traditional Medicare to MA, the agency will receive a partial episode...

Would NA (not applicable) be the correct response to M0110 and M2200 for MA patients?

  • Homecare Q&A, Issue 13, July 2, 2015

    AM0110, Episode Timing, and M2200, Therapy Need, apply when the assessment will determine the...

We continue to have confusion over what is considered a ?nonroutine supply.? Can you help clarify?

  • Homecare Q&A, Issue 13, July 2, 2015

    The coverage of nonroutine supplies is probably the most confusing component of the consolidated...

Will Medicare cover lymphedema therapy?

  • Homecare Q&A, Issue 13, July 2, 2015

    Lymphedema therapy is an extensive treatment involving a combination of manual decongestive therapy...

Can physical therapy be considered the qualifying service to establish a need for ongoing occupational therapy?

  • Homecare Q&A, Issue 13, July 2, 2015

    Occupational therapy cannot qualify a patient for coverage initially, but after the patient has had...

What can trigger an ABN, and what must be documented? What about an HHCCN?

  • Homecare Q&A, Issue 13, July 2, 2015

    The ABN (CMS-R-131) is a written notice that the agency must provide to a PPS Medicare-eligible...

Should there be one signature per order, or can orders be batch signed?

  • Homecare Q&A, Issue 13, July 2, 2015

    As long as the order is a complete order for a treatment or therapy, you may have more than one...

Homecare Q&A

  • Homecare Q&A, Issue 13, July 2, 2015

    July 3, 2015

If an agency discharges a patient with goals met but then readmits him or her within 60 days of discharge, would the new episode be an early or later one for M0110, episode timing?

  • Homecare Q&A, Issue 12, June 15, 2015

    If an agency discharges a patient with goals met but then readmits him or her within 60 days of...

How do we determine diagnosis and priority?

  • Homecare Q&A, Issue 12, June 15, 2015

    Q: We are seeing a patient with Alzheimer’s disease, who was hospitalized for advanced...

What about goals, rehabilitation potential, and discharge plans? What are some key points we need to keep in mind while entering those into the 485?

  • Homecare Q&A, Issue 12, June 15, 2015

    What about goals, rehabilitation potential, and discharge plans? What are some key points we need...

What is the proper way to enter in orders for disciplines and treatments on the 485?

  • Homecare Q&A, Issue 12, June 15, 2015

    What is the proper way to enter in orders for disciplines and treatments on the 485?

Where can I find that it would be illegal to charge a Medicare home health patient prior to rendering services, while reimbursing patient once CMS has paid the claim?

  • Homecare Q&A, Issue 12, June 15, 2015

    Assignment of benefits - This term means that the facility or the physician agrees to accept...

What does Patient Care 484.60: Care Planning, Coordination of Services and Quality of Care mean for agencies?

  • Homecare Q&A, Issue 8, June 9, 2015

     First, let’s review for everyone reading what the current CoP is and what is being...

What are some tips when evaluating our documentation system?

  • Homecare Q&A, Issue 11, June 3, 2015

     What are some tips when evaluating our documentation system?

Are other agencies billing for the final skilled visit when the discharge reason is no longer homebound?

  • Homecare Q&A, Issue 11, June 3, 2015

     A clinician arrives at the home, where skilled services are provided. Based on the...

How are we supposed to use observation and assessment for patients on telemonitoring?

  • Homecare Q&A, Issue 10, May 17, 2015

    How are we supposed to use observation and assessment for patients on telemonitoring?

How can extended daily visits be justified and covered?

  • Homecare Q&A, Issue 10, May 17, 2015

    How can extended daily visits be justified and covered?

Where can I find the rule about physician cosigning of a nurse practitioner's order so the order is valid?

  • Homecare Q&A, Issue 10, May 17, 2015

    Where can I find the rule about physician cosigning of a nurse practitioner’s order so the...

Can you shed some light on specific circumstances that warrant the resumption of care assessment?

  • Homecare Q&A, Issue 7, April 3, 2015

    The ROC assessment is completed any time a patient has returned home following an inpatient stay of...

Where in the CMS guidelines does it indicate that there should be short-term and longterm goals for therapy?

  • Homecare Q&A, Issue 7, April 3, 2015

    Palmetto and CGS have specific local coverage determinations (LCD) regarding shortand long-term...

Does the start of the VFOs for the HCA need to begin on the day of the new cert period, or can it begin the following week?

  • Homecare Q&A, Issue 7, April 3, 2015

    You can write orders for when the services begin.

Any tips for preventing future legal fallout in such cases?

  • Homecare Q&A, Issue 7, April 3, 2015

    Unfortunately, when a fall occurs in the presence of agency staff, people assume that it...

How do you encourage reporting and open communication?

  • Homecare Q&A, Issue 6, March 17, 2015

    What you are looking for is a nonpunitive, “just” culture for your agency, or a...

Is a patient who is toileted every two hours covered under Medicare?

  • Homecare Q&A, Issue 6, March 17, 2015

    In combination, the nurse and HHA can provide up to 35 hours a week in medically necessary...

Will home health remain exempt from overtime compensation in most circumstances like it has for 40 years?

  • Homecare Insider, Issue 1, January 5, 2015

    Will home health remain exempt from overtime compensation in most circumstances like it has for 40...