Barriers to DC statement
Current Problem
MD Review
Where to document
Outliers
100

Good or Bad

Barriers to D/C: Member is diabetic and takes blood sugar readings very sporadically, healing surgical wound with blisters.


What is a Bad Barrier to DC ?

100

Accurate or Inaccurate documentation for this section

New medication was added to the plan of care to include Lisinopril (7/22/2022) and Atorvastatin (8/18/2022) for high blood pressure.

What is inaccurate documentation?

100

A conversation between a naviHealth Medical Director and the ordering Practitioner for the patient to discuss the need for skilled services 

What is a P2P?

100

The following statement is documented in what location of nH Coordinate when HHCC has changed/corrected information within the Clinical Note? For Auth XXXXXXX (nH Auth number on back page to the right of  auth header), the information within the Clinical Note was changed/corrected to reflect the actual clinical documentation received from the provider to support the request.

What is comments folder?

100

You receive an ASR for add-on MSW, what is the  next step(s) before reviewing the auth?

What is verify orders & if there is still at least 1 skilled discipline providing services?

200

Good or Bad

Barriers to DC: Inability to ambulate household distances, caregiver assistance for transfers and self-care; non healing surgical wound right foot.

What is a Bad Barrier to DC?

200

Accurate or Inaccurate documentation for this section

Relevant PMH include HTN, CAD, and neuropathy, SOC 5/27/2022

Recertification 7/26/2022

What is inaccurate documentation 

200

If after completing a review of the clinical documentation the HHCC determines the patient does not appear to meet for 1/3 disciplines requested for, what process does this trigger?

What is an IDN?

200

Where would you document wound measurements? 

What is the medical Tab?

200

If I accidentally x the case from the team queue, how can I get it back?

What is Go to your search history, access the back page, and send it back into the queue?

If it has been several days, reach out to your CTM 

300

Good or Bad 

Barriers to D/C: Barriers to discharge include need for wound care.

What is a Bad barrier to D/C?

300

True or False

This section is used to provide a summary of the patient 

What is False?

That is the clinical impression 

300

How many attempts are made for NOMNC retrieval?

What is 3 attempts?

After 3rd attempt without successful retrieval, wait 24 hours, escalate to CTM 

300

Spoke with Ronnie CM who confirmed that the patient DC on 8/31/2022

What is the administrative communications in the engagement tab

300

Can visits not used in a certification period be carried over to the next certification period?

What is No, there is no carryover of visits?

400

Good or Bad 

Barriers to D/C: patient is at high risk for skin breakdown and wound reopening due to lymphedema, morbid obesity and newly healed wound; SN for monitoring and further training 

What is a Good barrier to DC ?

400

True or False

This section includes information about the current episode of care, as well as relevant information about the patient's prior level of function and living settings

What is False?

The Clinical Summary tab includes all of this information information about the current episode of care, as well as relevant information about the patient's prior level of function and living settings

400

Once a NOMNC is received, it is essential that the HHCC completes what process?

What is a NOMNC validation?

400

Patient is an 82 year old female being seen by home health following hospital discharge on 07/20/2022 for R side hemiplegia secondary to probable microvascular ischemic changes with no infarct indicated.
SOC: 07/26/2022.

What is  the Current Problem?

400

Can I give the Provider/Agency my PureCloud extension #?

What is No, You can provide your first name and last initial 

500

Good or Bad

Barriers to D/C: Patient requires wound care 3x/week - patient unable to access the wound and does not have a caregiver to provide training to.

What is a good barrier to D/C?

500

True or False 

This section should include the reason for acute admission, level of care change, or problem at home. Including SOC, ROC, Weightbearing status

What is True?

500

IDN case has been sent to the MD to review pending P2P, but additional information came from agency and needs to be communicated to MD.

What is MD form- Clinical Review section?

500

Age/Gender: 91 y/o male

Primary Diagnosis: Fracture ribs, OA Bilateral knee, weakness

Disciplines Requested: PT

Why skilled services are needed: Patient is ambulating 200' with SBA and Moderate verbal cueing for foot clearance, posture, step length.  Patient still requiring SBA to CGA for transfers for Sit to stand.  Patient previously IND with ADLs and mobility including uneven surfaces.  PT plan is to advance to dynamic balance activities and ambulation to uneven surfaces to work on improving strength in LE and reduce falls risk.  Patient is completing HEP and has been instructed in balance and fall precautions with ability to recite and teach back at 50%.

Homebound Statement: Patient requires need of AD of walker or WC and one person if he leaves his residence.   Taxing effort to leave home due to pain, SOB, difficulty with transfers, and high risk of falls.

Discharge Considerations/Barrier: Pt to be discharged to ALF with staff and daughter assisting as needed under the care of his physician.

CMS Chapter 7: Appears to meet

HHCC

What is the clinical impression? 

500

Who completes a 3rd additional clinical requests and where can I find the information on completing this process?

What is HHCC and The Medical Director Review for Home Health Reference guide?