Feel Good Visits

[britmess]

We do a lot of 'feel good visits' ie. not paid for. Patients that have been recerted twice but still need help yet medicare would probably not reemburse? What is our liability if something should happen during our visit? What responsibility are we encurring because of these visits?

[NRSKarenRN, BSN, RN]

Any home care visits provided by any home health staff member should be documented on a clinical note--- doesn't matter if billable or non-billable.

Medicare/Medicaid conditions of participation in PA require home health aide supervision visits for private pay or non-billable clients every 60 days. Each agency must have a policy for aide supervision visits (doen't matter re paying client or not) and follow it to the letter.

Please CYA with documentation.

[NRSKarenRN, BSN, RN]

These are visits to Medicare patients who had previously been certified for a 60 day episode. There was no valid medical reason to continue skilled nursing care therefore they were discharged. However, they still needed assistance for ADL's. How can we leave these people unattended yet still stay legally 'safe'

If clients still need assistancewith ADL's towards end of care, you are responsible for making arrangements to have that need meet.

This would include:

[*]MSW referral for evaluation and linkage to community services.

[*]Referr client to office of aging programs.

[*]Inform client of availability of private pay agencies in your area and provide list.

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Doccument in discharge note what you have done to have continuing ADL need covered; especially note any refussal of the above and inform PCP of client's ongoing need.

This will leave you in good legal standing for having attempted to meet this need.