A Must Read for Every Home Health Nurse

Specialties Home Health

Published

To all home health nurses who have ever felt pressured by office staff regarding whether or not a patient needs recertified or not, the attached MedPAC Report to Congress dated March 2011 should shed some new insight for field RNs.

Also, to field RNs who have been sent out to admit questionable doctors' office referrals, the attached MedPAC Report to Congress dated March 2011 should also shed some new insight into this practice.

The stress related to the above two issues has resulted in numerous RNs leaving home health nursing. While field RNs have continued to voice their concerns to supervisors regarding the requirement of "Medical Necessity" for home health services to no avail, it is comforting to find out that MedPAC (the governmental agency that monitors Medicare spending and makes recommendations to Congress) has taken note of the same issues.

Home health RNs who feel uncomfortable admitting or recertifying patients who really do not qualify under the Medical Necessity requirement for home health services now can stand up to office pressure with adequate support when they, as the assessing RN, determine that home health is not warranted in certain conditions.

I find it very interesting that at a time when Medicare is predicted to go bankrupt by 2017 if no changes are made in the system, that home health agencies (on average according to the attached Report) are making a 17.5 or greater profit margin. Meanwhile, they do not want to pay nurses an appropriate salary--and, pay-per-visit payment practices continue. Until proven otherwise, this Report indicates that home health agencies do have financial resources available to pay all clinicians for unpaid time they spend on documentation in the evenings at home. Just my humble opinion.

I would appreciate only responses from those RN's who actually read the attached Report. Legitimate debate on these issues can only occur when those debating have all of the correct information before them.

Go to page 195 (Chapter 8 - Home Health Recommendations) to see what I am talking about.

http://medpac.gov/documents/Mar11_EntireReport.pdf

medpac.gov/documents/Mar11_EntireReport.pdf

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