home health care

[tinamd0730]

What should a home health agency do if hey do not have signed 485's from the physician. Should they continue to see the patients even though it is technically working without a physicians order ? Or is that considered abandonement?

[Libby1987]

if we absolutely can't get it signed with any type of communication we find a physician who will. I'm trying to think if we've ever had to close someone due to no physician taking responsibility but it's very rare that we can't persuade someone to sign after receiving a hospital referral by either an attending who saw the patient during hospitalization or the PCP if we get the patient in for a office visit.

[caliotter3]

Most agencies deal with physicians that 'cover' several of their clients so they know that the signature will be forthcoming. If new, someone should call and follow up, perhaps the document was misplaced and a new one needs to be sent.

[KelRN215, BSN, RN]

What should a home health agency do if hey do not have signed 485's from the physician. Should they continue to see the patients even though it is technically working without a physicians order ? Or is that considered abandonement?

Well technically you have a verbal order to provide care. I've never not been able to get a physician signature on a 485. Is the MD refusing to sign it in your case or has it just not been returned yet? Most of my patients are seen in the same clinic, we call the nurses or case managers to help us if we don't get them faxed back in a timely manner.

[Atownshend]

We have this problem all they time. It's not that the doctor is refusing to sign, they just won't get back to us for days. We have to hold visits until we get a call back. Lately we've had to do work arounds to get a verbal from the ma to get fax over to be signed, because for some reason the doctors can sign those so much quicker than just calling and saying, "yes that's fine". So frustrating.