Hi, I stumbled upon this website and now I'm addicted! I've learned more info r/t Home Health here than I did in orientation!
Okay, I need some advice. I recently took a position as a HH supervisor. Our prior sups are going through a messy trial over medicaid/medicare violation of homebound status. I feel these nurses are innocent and their lives have now been destroyed by what started out as a witchhunt by some disgruntled employees.
So after holding the positions open as long as possible our hospital had to post their positions. I didn't want to seem disloyal by placing a bid but didn't want to take a chance that someone from outside our dept get the job and make our lives miserable. So here I am, one of the new supervisors.
I would love any advice any of you have to share. We are a great team in the small hh dept I work in and I hope I will always keep in mind that being out on the road is no simple task. It's hard to stay positive when so many tell me I'm crazy, why take on more stress, and often feel as though I just sold my soul to the devil. (now that's a bit dramatic) I would especially appreciate any info on regulations, standards, etc to keep me out of the same legal trouble my collegues are in. Thanks!!!!
Mar 2, '02
by NRSKarenRN, BSN, RN Moderator
biggest thing for you is to encourage staff to go forward. insist on clinical documentation to reflect homebound status be clearly documented monthly in notes and with 60day summary. we include a checklist statement combined with clinical assessment in oasis recert package. minimum of weekly wound assessment using flow sheet. if no change/improvement in 3 weeks of treatments, consult to pcp/cetn re trying other treatment. daily wound care greater than 6 months, cut back to every other day to prove worsening status of wound without daily visits (1 week trial). daily wound care greater than 3 weeks must have end date statement from doctor or medicare won't pay. lab work on file prior to start of care + periodically (min q 3 months) for all clients getting b12, epogen, neupogen etc and documentation of why patient unable to self-inject initial note and q 60 day summary etc. for home alone patients over age 65 without caregiver, msw eval first admit to determine long term care needs. if followed, these documentation tips should keep you out of most trouble.
read and know rules: rev 8/23/14
CMS Medicare Benefit Policy Manual
Chapter 7 home health services
all medicare and medicaid rules + regs here. updates sent as transmittal memo's.
check out what medicare considers fraud and abuse
see if agency gets home health line
(hhl) or eli's report,
two weekly professional home healthcare publications providing home health news, legislation, and regulatory changes
pam pohly's net guide: toolbox for health managers & administrators
this toolbox for health administrators provides 13 pages which contain articles, information and links to other websites pertinent to managers and administrators working in healthcare. you can find information about health economics, medical and insurance legislation, industry news, legal issues, regulatory, compliance, policy, business planning resources, human resources, careers, terminology and more.
good luck! come back to vent anytime.
Last edit by NRSKarenRN on Aug 30, '14
: Reason: updated link