RN supervisory visit Frequency?

  1. Does anyone know the reg on how often an RN has to supervise an LVN and HHA in Texas according to Medicare Hospice Benifit guidelines?
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  2. 27 Comments

  3. by   doodlemom
    Every 14 days is a Medicare requirement nationwide for RN's to make a supervisory visit with CNA's. I don't think there is a requirement for LVN's, but it is required that pt's be seen by the RN at least every 14 days. We use LVN's so infrequently and only for occasional visits when someone is out sick or on vacation.
  4. by   dosamigos76
    Once every two weeks is my understanding here in TX. I don't know if it is q 14 days or q 2 weeks. HTH.

    Cheryl
  5. by   aimeee
    Its a Medicare Condition of Participation that an RN must assess the patient and address the care plan with the IDT every 2 weeks.
  6. by   new2hospiceRN
    Thanks again. I just started using an LVN this week. What a lifesaver good help is. I think every 2 weeks is perfect. I will still be able to check in and stay aware of changes in the pts condition. I have been the only one seeing the pts, so I am nervous about being out of the loop. This way I will still be in the field and able to manage the pts care. A nice mix. It will take me time to trust my LVN's judgement, but so far she has been good at calling me with report.
  7. by   a21chdchic
    FYI - Medicare regs are federal regs, so the rules are the same in
    TX as they are everywhere else in USA. Q2 weeks for both LPN/LVN and CNA's.

    Ana
  8. by   Nancy the Nosy Nurse
    So the criteria is for the pt to be monitored by the RN, not Supervised visits? Or is that in addition...
    Thanks
  9. by   okielpn75
    Please tell the above to the RN's at my company as they go months without putting eyes on my patients!
  10. by   tewdles
    Hospice patients MUST be assessed by an RN at least once every 2 weeks...if they are not your agency is out of compliance with medicare regulations.
  11. by   okielpn75
    This I know....but how do I as an LPN supervise an RN? The RN's with our company are TERRIBLE...I keep waiting for the surveyors. Its very frustrating because at this time they are also asking the LPN's to do baths as the HHA are "full"....hmmmm...INTERESTING!
  12. by   tewdles
    Quote from okielpn75
    This I know....but how do I as an LPN supervise an RN? The RN's with our company are TERRIBLE...I keep waiting for the surveyors. Its very frustrating because at this time they are also asking the LPN's to do baths as the HHA are "full"....hmmmm...INTERESTING!
    Clearly you understand that you cannot supervise the RN and that your company will have some problems if they are surveyed.

    It is a normal expectation for nurses to complete baths if the nursing assistant (HHA) is not available...that is part of nursing's role.
  13. by   okielpn75
    Quote from tewdles
    Clearly you understand that you cannot supervise the RN and that your company will have some problems if they are surveyed.

    It is a normal expectation for nurses to complete baths if the nursing assistant (HHA) is not available...that is part of nursing's role.
    I was being sarcastic in that aspect of my response. We HAVE to constantly ask our RN's about everything to ensure it is done. If we don't it won't get taken care of. As far as baths I have no ISSUE doing a bath if it is needed but not to work as a HHA when I already have 36 visits of my own for the week plus updating med profiles, IDG forms, ordering of meds/ DME and following up with families and nursing facilities. Our company is going to have a LOT of problems when surveyed us asking the RN's constantly to do their job is only a very small part.
  14. by   rachelnrn
    (a) Standard: Supervision. A registered
    nurse must visit the home site at least
    every two weeks when aide services are
    being provided, and the visit must include
    an assessment of the aide services.
    This does not mean a joint visit, you can ask the pt/family how the cares are going. If there is a complaint, the aide must be pulled from that pt until a joint visit can be made to assess their skills

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