hha employee patient visit report

Are there any FAQs for the HHA conditions of participation?

The Centers for Medicare & Medicaid Services is providing a list of FAQs for the Home Health Agency (HHA) Conditions of Participation (CoPs) that became effective on January 13, 2018. Each question includes a response to further clarify the Medicare requirements.

How is the HHA survey conducted?

The HHA survey is conducted in accordance with the appropriate protocols and substantive requirements in the statute and regulations to determine whether a citation of non-compliance is appropriate.

What are the interpretive guidelines for home health agencies?

The Interpretive Guidelines serve to interpret and clarify the Conditions of Participation for home health agencies (HHAs). The Interpretive Guidelines merely define or explain the relevant statute and regulations and do not impose any requirements that are not otherwise set forth in statute or regulation.

Does the HHA have to provide a hard copy of plan?

The CoPs require that the HHA provide the patient with written instructions regarding home visits, medications, treatments, and HHA clinical manager contact information. The CoPs do not require the HHA to provide the patient with a hard copy of the entire plan of care. See 484.60(e). Q. When must orders from relevant physicians be approved?

How long is skilled observation covered?

Where a patient was admitted to home health care for skilled observation because there was a reasonable potential of a complication or further acute episode, but did not develop a further acute episode or complication, the skilled observation services are still covered for 3 weeks or so long as there remains a reasonable potential for such a complication or further acute episode.

Is retraining necessary for a patient?

Re-teaching or retraining for an appropriate period may be considered reasonable and necessary where there is a change in the procedure or the patient's condition that requires re- teaching, or where the patient, family, or caregiver is not properly carrying out the task. The medical record should document the reason that the re-teaching or retraining is required and the patient/caregiver response to the education……. The reason why the training was unsuccessful should be documented in the record.

How often do you have to visit a nurse for HHA?

For patients receiving only HHA aide services, a registered nurse must make an onsite supervisor visit to the location where the patient is receiving care , no less frequently than every 60 days. This visit must occur for each patient in order to observe and assess the aide while performing care. See §484.80(h)(2).

What is the role of the HHA clinical manager?

Orders from relevant physicians are incorporated into the plan of care and the HHA clinical manager or other staff are responsible for integrating orders from both the responsible physician and any relevant physicians. If the HHA staff have concerns regarding the integration of orders, the staff would work with the relevant physician issuing the order and the responsible physician to resolve those concerns. The revised plan of care may be approved by the responsible physician at the next recertification cycle provided those orders are still active at that time. Short duration orders that are added to the plan of care that are no longer active at the recertification period only need to be approved by the responsible physician if those orders are for services that will be provided by the HHA. The HHA should have policies for the co-signature of orders for services to be provided until the plan of care is signed at the next recertification period. See §484.60.

What is the requirement for an annual supervisory visit?

The requirement for the annual supervisory visit is for each aide to have an observation and assessment while performing care. This ensures that each aide is observed during the provision of care at least once annually. See §484.80(h)(1).

What is home health aide training?

Home health aide training must include classroom and supervised practical training in a practicum laboratory or other setting in which the trainee demonstrates knowledge while providing services to an individual under the direct supervision of a registered nurse, or a licensed practical nurse who is under the supervision of a registered nurse. Alternative formats for classroom training, such as online course material or internet based interactive formats are acceptable delivery methods for the classroom training. These alternative formats should also provide an interactive component that permits students to ask questions and receive responses related to the training. See §484.80(b).

How long does it take to get a clinical record?

A patient’s clinical record (whether hard copy or electronic form) must be made available to a patient, free of charge, upon request at the next home visit, or within 4 business days (whichever comes first). The 4 day clock starts from the time that the patient or representative makes an oral or written request for the clinical record. See §484.110(e).

What is a patient representative?

A patient’s legal representative, such as a guardian, has been legally designated or appointed to make health-care decisions on the patient’s behalf. Evidence that there is a legal representative may include guardianship, a power of attorney for health care decision-making, or a designated health care agent. A patient-selected representative participates at the request of a patient in decisions related to the patient’s care or well-being but is not legally designated or appointed to do so. The patient determines the role of the patient-selected representative.

Can a home health aide be a skilled care patient?

No, a patient receiving home health aide personal care services only is not receiving skilled services. When nurse conducts the supervisory visit for non-skilled services, the patient does not become a skilled care patient. §484.80(h)(1).