Random
These services: MSW and HHA
Which disciplines are dependent on other skilled services and can't stand alone?
An MD, DO, DPM
Who can sign the 485/POC?
Recertification for continued home health services is required at the end of a certain time period
What is 60 days?
These disciplines can keep a case open for services
What are PT, OT, ST, SN?
The Member is 58 year old female admitted to Home Health following a recent hospital stay. 5 PT visits have been ordered to assist with gait training and to establish a home exercise program. She attends church, and gets her hair done
What are non medical reasons to leave the home?
A TEAMS message is received from Bob Smith re: patient Edwin Wells. You do not know Mr. Smith. Reject the call and contact the patient or family for permission to speak with him.
What is following HIPPA guidelines?
OASIS is completed at start of care, return of care, transfer to inpatient facility, discharge of Member from HHA and at one more point.
What is 60-day follow-up/RECERTIFICATION
58 year old male with a 20 year history of C6 complete spinal cord injury was recently admitted to home health following acute hospital stay related to a urinary tract infection. PLOF noted he lived with his wife who provided assistance with all activities of daily living. Currently, he is independent with directing care but physically dependent. Skilled nursing is following the Member for treatment of a Stage II decubitus ulcer. Orders for a home health aid are denied
What is considered medically necessary personal care?
Physical therapy order reads 1w1, 2w3
What is a frequency?
A Member with severe arteriosclerotic heart disease is admitted to Home Health because heart disease is of such severity that he must avoid all stress and physical activity.
What constitutes a considerable and taxing effort for homebound status
Walker, bedside commode, shower chair, grab bars, wheelchair
What are durable medical supplies?
A Member's availability of assistance for ADLs
What is M1100, caregiver availability?
The physician order for Foley catheters is found here.
What is the Plan of Care (POC)
SN is ordered fewer than 7 days a week
What definies intermittent nursing services?
A 88 year old female has Home Health orders for skilled nursing for diabetic foot care. Documentation notes that the Member has not been recently hospitalized but was seen in her physicians office.
What is a direct referral?
A member has limited vision and unable to self-administer his eye drops and ointments for glaucoma. Physician has ordered SN.
What is a non skilled service even if needed?
The OASIS is a comprehensive assessment designed to collect information on nearly 100 items related to a home care recipient's demographic information, clinical status, functional status, and service needs. OASIS can have input from all disciplines during this time frame.
What is 5 days after the SOC?
A Member is admitted to Home Health. SN notes that the member has a history of a colostomy, 2018, and absent from complications. Nursing documents that during the visit the colostomy bag is changed because the Member is too fatigued to change his colostomy bag. Orders for SN colostomy care are denied.
What is medically necessary colostomy care.
Chapter 7, 40.1.1
John has Alzheimers disease and can't remember how to get back to his home and can get lost without assistance from another person for safety.
What is a reason for homebound status with dementia?
A Member was recently admitted to Home Health following hospital stay. He has requested that skilled disciplines visit both his primary residence and his vacation beach house.
Where can a patient be seen for home health?
Every 30 days each therapy discipline (PT/OT/SLP) must complete this
What is a reassessment n of care plan
The Member should be functionally reassessed with clear documentation of results along with the therapist's determination of the effectiveness of therapy, or lack thereof.
The 30-day clock begins with the first therapy service (of that discipline) and the clock resets with each therapist’s visit/assessment/measurement/documentation (of that discipline)
Chapter 7, 40.2.1
Each initial therapy assessment requires this licensed individual for completion.
What is a licensed physical therapist, occupational therapist or speech language pathologist? (Not an assistant)
Home Health services need to be reassesed for continuation during this time windows.
What is 5 days before the end of the episide?
A 58 year old Member was recently admitted to Home Health after hospital stay related to hyperglycemia. She now has insulin dependent diabetes. Prior to hospital admission she was checking her blood sugars 3 times/day with her glucometer. Now she requires Lantus to be given daily and has a sliding scale insulin for meals. Oasis notes that she has returned to work but only in a part time capacity at 10 hours/week. Previously she was working 40 hours/week. She is unwilling to inject herself that many times a day but has the logical ability to do so. Her spouse has severe arthritis and is physically unable to assist. Home Health SN services are denied.
Can a member get home health just because they want to and don't need assistance?
A Member was recently admitted to Home Health following hospital stay with cardiac valve repair. The PT evaluation noted that he now required CGA assistance when ambulating, with a walker and was notably short of breath and needed to pace his walking.
What is a homebound reason related to endurance/ breathing?