Filling out orders to include sup visits?

[spejsa]

Do you all have any ideas regarding how to write orders for starts of care to include sup visits, etc.?

[KateRN1]

RN to perform LPN supervisory visit every 60 days.

RN to perform HHA supervisory visit every 14 days.

[annaedRN, RN]

SOC orders do not need to include any orders for sup visits. They are a Medicare requirement when HHA are utilized but are not reimburseable visits by insurance. You need to find out if your agency pays you for them. If your SOC orders include a HHA then it is a given that you will do sup visits atleast every 14 days

[spejsa]

KateRN1: Is this true that I may not get paid for sup visits for LPN's?

[spejsa]

How often are supervisory visits due? Is it really every 60 days? I thought it was every 30 days?

[KateRN1]

Sup visits don't have to be included in your POC, but the agency I'm with now does include them in the 485, for both LPN and HHA. Sup visits may depend on your state. In FL, LPN sup visits are every 60 days, so we generally just do them at recert. If I have a HHA in the mix, I do a sup visit every time I'm in the home, just to make sure that I'm within compliance. I don't get paid any more to do a sup visit, it's just another box I check with the regular visit paperwork. A sup visit should be included in your regular visit schedule, you don't have to make an extra visit for a sup.

However, if for some reason you have to make a "non-visit sup" meaning that it's not a regular nursing visit and you're just doing the sup, you don't have to do anything other than ask about the person you're sup-ing. No vitals, no skill, no assessment. Just, "Hi, Mrs. Smith. I'm here for a supervisory visit to make sure that everything is still going well with Kelly, your home health aid. Do you have an questions or concerns?" Get signature on paperwork, and leave. Shouldn't take longer than 15 minutes, unless there's an issue. Your agency should pay you a nomial fee for this as well as mileage. It is not billable under Medicare, so most agencies try very hard to make sure it can be done during a reoutine scheduled nursing visit.

For example, you are seeing Mrs. Jones 3w2 and she has a HHA ordered 2w2 and you are putting an LPN on the case. You should schedule yourself to see the patient at least every-other-week while the HHA is involved in the care and you do a sup visit for the HHA along with the regular visit. If you have an LPN in and you're required to sup every 30 days, then you schedule yourself to see the patient at least once a month for a regular visit and do the LPN sup at that time.

Make sense?