DON, Supervisor Medicare Certified Agency

[erroridiot]

It seems that the only full time jobs around in Medicare Certified Home Health Agencies in my area are DON or Clinical Supervisor positions.

These jobs are like revolving doors in most of the agencies they just fire, hire or quit, hire over and over.

I'd like to hear some feedback on these positions.

[KateRN1]

Trust your gut. You are not qualified for this position, although it may be something you could work into down the road. And training for administrators is not the same as training for a director of nursing, it's not the same job description at all. Maybe these people don't realize the difference between a nursing director and an administrator?

Thank for thinking so highly of you, but suggest that they find someone with more home health and/or managerial experience.

[erroridiot]

Here are some questions I would ask my potential employer and myself before even considering the job:

Can you identify a skilled payable visit including overutilization of therapy?

Can you teach the staff to make and document appropriate skilled visits to meet RAC audit requirements for retention of reimbursement?

Can you identify inappropriate ICD 9 coding?

Can you formulate and "build" a 485 plan of care to meet all regulations including the ICD 9 coding?

Is the agency under any conditional plan of correction from CMS?

When was the last survey?

Are the Infection Control, Utilization Review, PAC meetings, HHA 12 hr inservice/year and staff inservices complete and documented appropriately?

Are they accredited by CHAP or Joint Commission? Do you know those regulations?

Do you know where to find all the regulations you will need to meet?

Are they under Medical Review and how many ADRs have they had in the last 2 years?

Can you meet with surveyors and answer their questions when they visit your site to conduct a survey?

Have you looked at their OBQI reports?

Who is doing their coding?

Who is doing their billing?

Can you determine if the coder, QA and biller are doing their jobs correctly?

Who is doing QA and determining that an episode is OK for final billing?

What happened to the last DON?

Are you prepared to take call 24 hours a day and cover for as well as supervise field staff?

Who is tracking frequencies in the agency?

Have you reviewed 3 random charts to determine the "condition" of the agency.

Who is auditing their OASIS submission reports for errors? Can you do this?

Those are just a few questions to think about when looking at this type of position.

Hope this helps.

[KateRN1]

Wow, an excellent list of questions that covers the nitty-gritty, erroridiot. Thanks!

[erroridiot]

Wow, an excellent list of questions that covers the nitty-gritty, erroridiot. Thanks!

Thank you.

Sorry to say, but that is the SHORT list...........................

You never know what lurks behind the doors of a Medicare cert home health agency!