CSM
True or False?
It is ok to decline, reschedule/reassign a visit without notifying my CSM.
False
Please do not decline or reassign visits without notifying your CSM. An email or text notification is required when declining, rescheduling/reassigning visits. We are not notified when visits are sent back.
How many weeks of supplies can be ordered at one time to satisfy a treatment order?
2 weeks
True or False?
There is a brand new directive that says when a SOC is completed for a client with a new ostomy, the opening clinician must call the driveway report into Derrick or Precious.
True
See Slide
When a QA auditor reviews an occurrence report that states "MD's office called. Office member, Pam notified", what will the auditor look for next?
The auditor will look for further documentation that shows we closed the loop on the client problem.
This includes documenting the physician's response.
How often must an RN supervisory visit occur for clients without a wound?
Every 30 days. Plotted every 3rd week.
This visit is always plotted early by CMs to allow for unforeseen circumstances.
Tony Stark was scheduled for an RN01 on 3/9 at 2pm. Upon arrival for the visit, Mr. Stark is unable to reach via the phone, or at the door. You reach out to the CSM and ask them to call from the office level and the client is still unable to reach. You mark the visit as missed "no answer on client phone". Is marking the visit missed the final step in the missed visit process?
No.
In addition to sending a visit back as missed, a missed visit note but also be entered into the chart. This note must include the following:
1) The date of the missed visit
2) The visit code i.e. RN01
3) The reason the visit was missed.
4) The method of physician notification. *You must list the name of the admin or physician you spoke to in the office! This is crucial, especially for QA
If a client is admitted to Home Health Services following a R TKR with staples that must be removed by a Bayada clinician in a week, what item(s) should the SOC clinician Order?
1) Staple Remover
2) Steri-Strips
True or False?
Even though a new stoma will shrink significantly over the next 6-8 weeks, it is important to measure its size and enter it into the ICC for tracking.
True
See Slide
True or False?
During a QA survey, LVV will be required to conduct (3) in-home visits. Each visit will begin with the auditor requesting to see the contents of the Red Folder. He or she will check to see if the appropriate forms are complete and legible.
True
These forms are required by the state and Bayada policy.
(See Slide)
How often must an RN assess a client with an active wound?
A minimum of every other week
What is the purpose of our on-call number?
On-call is an emergency line used for changes in medical status, questions about medications etc. To improve the client home health experience, clinician calls for scheduling should be done between 5-7pm the night before a client's visits will be held. Utilizing the red SOC book calendar for client's visits helps clarify when visits are intended.
If a client is admitted onto service with a foley catheter, what supplies should the SOC clinician order?
1) Replacement foley(s)
2) Insertion kit(s)
3) Saline
4) Flushing syringe
True or False?
It is critically important to document when a client has settled on a particular stoma appliance, or that the client is trialing a particular appliance.
Appliance ID #'s should be included.
True
The more specific information provided for our client's with a new stoma, the more efficient care will be.
True or False?
For our clients who receive wound care management, it is Bayada Policy that a written copy of the wound care instructions be present in the home.
True
This is always requested by the QA Auditor
See Slide
Considering the fact that every wound care referral is accepted based on the availability of a willing and teachable caregiver, what are two critical elements that should be evident in nursing's documentation?
1) Documented progress of the client/caregiver's ability to perform the treatment based on hands-on demonstrations.
2) Decrease in visit frequency
Weekend Schedule: What is the protocol in the event SOC/visits do not confirm for the weekend?
If you have a SOC fall off, protocol is to contact the CSM on call via phone call by 9am the day the visit is scheduled and that CSM will replace that SOC with another SOC visit.
Visits for both RNs and LPNS may also be scheduled outside of their regular territories.
Why is there a limit on how many supplies can be ordered at one time?
Supplies/Resources are lost when clients are:
1) Rehospitalized
2) Have treatment orders changed by a physician
See Slide
How should the SOC clinician plot skilled nursing calendar visits to begin management of a client with a new stoma?
Skilled nursing should plan to visit 2x weekly for the first 2-3 weeks plotting visits to coincide with the appliance change schedule.
Why is it so important to routinely reconcile every client's medications throughout an episode?
See Slide
In the SOAP documentation format that should be used by all clinicians, this section contains measurable or observable data such as vital signs, wound measurements, med rec findings and physical exam observations.
The Objective section
(See Slide #12)
When a client is admitted to services, we must have them sign consent forms in the SOC packet. On the Client Agreement Form, if the client has an insurance plan that is NOT Medicare, which option should be selected on the form to ensure we document the appropriate payor information?
Other 3rd party payor!
In addition, enter the name of the payor, i.e. Humana and amount of the co-pay/deductible.
Example: Humana $120 deductible/0 Met
Have the client sign and date as well.
A client is being treated with targeted NPWT using a Solventum KCI VAC. The nurse notes that the client has only one week's worth of dressings and cannisters remaining. What should the clinician do?
Call 1-800-275-4524 to order supplies
See Slide
A client on caseload for a new stoma is ready for discharge. The client asks "How will I get my supplies now that Bayada is discharging me?"
See Slide
How long does a clinician have to complete documentation for any given visit?
What is LVV's current percentage goal for documentation completion in 24 hour or less?
24 hours
LVV's Goal is 75%
Nursing is currently at 53.7%
A client receiving home health services after a knee replacement normally requires a walker and significant effort to leave the home due to pain and limited mobility. Most of the time family members drive the client to medical appts. However, on rare occasions when feeling well, the client drives themselves a short distance to the grocery store, pharmacy and/or hair salon. Does this client meet the Homebound Criteria?
YES
(See Slide #13)