Published May 26, 2017
kembers
9 Posts
i just switched jobs and at my old job for hha recerts it was just called SN C-2 but the job im doing now has us doing oasis recerts for just HHA recerts @ 60 days ... i mean they wouldnt keep doing it if they werent getting paid for it.. right? but i thought the Recerts had to be skilled. ok so another question i had was if anyone knew if it is illegal to have a home health company only have one race of clients. (all of them are foreign and dont speak english so its acutally a good thing that our company is helping them or they wouldnt be able to get help from any other company)
artsmom, BSN, LPN
168 Posts
You cannot do an oasis recert just for an aide, you are correct that it needs to be skilled. As for your 2nd question, it sounds sketchy but I am unsure the legality behind it.
Amarillo1963
6 Posts
As artsmom stated you CANNOT do a recertification just for the HHA. Is there another skill in seeing the patient...Physical therapy, Occupational therapy, and or speech therapy? If there is then they can take over supervision of the HHA and do the recertification themselves. Nursing cannot continue to the patient if there is no nursing skill. Finally as to the language/race/cultural question, does the nurse going out to see the patient speak the same language as the patient, and if she does speak the same language are they certified as a medical interpreter. Finally if they don't speak the language do they have a video, telephone or in person interpreter available? CMS requires that one be provided at the agency's expense. I also know that some smaller Home Health Agency's specialize in race, culture, or language. I know of at least three in my area--they specialize in meeting the needs of specific elderly populations.
Does the nurse seeing the client every 60 days to recert count as a skill ? (We do check off skilled things in the recert but that is as often as the client is seen . No other visits by nurse and no therapy .). The other nurse does speak the language , she came from the country . She is not certified. An interpreter comes with me , they aren't certified , just an office filer who is also from the country.
If it wasn't legit then we wouldn't be getting reimbursed , and they would have realized this right ?
I should also add to my previous note that the HHA HAS to have a nursing or therapists supervisory visit every 14 days. This is not every two weeks, but every 14 days. Say you did a Monday HHA supervisory visit and you waited 14 days the next HHA supervisory visit would have to be done on a Sunday. My agency recommends HHA supervisory visits every week and that therapists be delegated in a note by nursing to also do the supervisory visits. Remember the nurse is in charge of supervising the HHA as long as the nurse is seeing the patient. HHA is part of the CMS rules of participation
A recert visit alone without any clinical need does not count as a skill. It seems like the company is just lucky at this time. I worked for a company that got bagged for massive Medicare fraud, your company's time will come if this is a common practice. Also, as Amarillo mentioned, the nurse/therapist needs to go in every 14 days for a supervisory visit. I have one patient that only has a skilled need q6 weeks (FC change) but since there is an aide I do a non bill visit as needed to meet the requirements.
I just want to say thank you guys for all the information! I thought it seemed odd but I am really new to home health , wasnt sure .. when that company got it for fraud , did they drag the nurses into that mess? .. I think this company has been around since at least march , so it's been a little bit .. so another quick thing that is on my mind .. when doing this oasis c-2 recert we do check off goals and interventions that nurses do (something I wouldn't have done at my other job for a hha recert) I chalked it down to , these are interventions we do when we see the patient Q 60 days for a hha recert.. but at the end of the assessment we do check no skilled services needed as well as an frequency Q 60 days for hha recert . I'm just surprised the insurance let it go so far ..
If you fill in an OASIS you are the one that they will come too and ask for more information--why did you recertify? what is the skilled need? You will bear some responsibility because of your license--ignorance is not bliss in this instance
ftcarenurse
2 Posts
Amarillo, it seems to me like the agency is using you as the skilled service to justify home home health aide services. As already stated your name is documented as the person confirming the need for service.
Medicare/CMS will not pay for just the HHA to see the patient. If a nurse is going out there must be a skilled need. I would not recertify just for the HHA
ftcarenurse Amarillo, it seems to me like the agency is using you as the skilled service to justify home home health aide services. As already stated your name is documented as the person confirming the need for service.
Guest1039141
It all depends on the payer... if it is Medicare, then just a recert every 60 is not a skill. HHA cannot be there without PT, OT, ST or SN.
Your agency has only been open since march? Honestly there is a lot of red flags, I would run, fast.