Quote from RNBecky84
I work in home care. Normally a physician will send our company a referral for home care. We contact the patient, ask to go to their home for the initial Start-of-Care visit, then start services at that agreed upon visit. Recently our intake team said we are now required to drive out to a patient's home if they don't answer our phone calls/ return our phone calls. Their thought is "we need to do a well check on them". My thought is "they are not our patient's yet a well-check should be completed by the police".
Is this violating HIPAA by having us go to a patient's home without their consent?
I'm disagreeing with majority of above advice based on 30yrs in homecare and 10+yrs as Central Intake Mgr: There is no HIPAA violation as written/verbal order obtained from physician/hospital/SNF/insurance company for home care service eval.
Home Health agency is obligated to provide evaluation visit once homecare referral is accepted.
For Medicare certified agencies, Medicare requires initial homecare eval within 48hrs of ordered start of care date to determine if patient meets homecare criteria especially homebound status and admission to homecare. Well check IS required with outcome documented along with notifying referral source inablity to reach patient.
Registered Nurse is admitting service when multi-disciplines requested. PT/ST may admit only when they are the primary service being requested. In our Philadelphia urban/suburban area, about 1/4 of our referrals have incorrect phone numbers/ phone service disconnected despite our community/hospital liaisons meeting patients prior to discharge due to forgetfullness, lengthy inpatient stay so bill not paid, financial issues, old age, fear of admitting home issues, cell phone voice mail full/out of minutes,etc.
Difficulty contacting patients has escalated over the past 5 years in my area.
Recommended strategies to decrease patient not found/wellness checks:
1. Referral source needs to provide patient and emergency contact info, so 2 sources to call.
2. Inner city hospitals with highly transient + homeless population: liaisons call phone numbers provided to see if working prior to sending referral to agency, immediately followup with patient to get alternate emergency contact # then possible.
Frail elderly often taken to different home upon children arriving to bring parent home from facility when they see condition of parent so liaisons try to get next of kin #.
3. When prior agency patient. Intake staff compare address+ phone numbers to prior address/phone to see if misplaced digits.
4. Physician referrals: When multiple calls left over 2 days, we contact the physician to request office staff contact patient that homecare being requested: patients often will recognize doctors office # / voice mail left then call agency to arrange eval visit.
6. Liaisons contacted in 24hrs when unable to reach patient: they will make double check phone #, attempt to locate another contact # in chart and male outreach call too reminding patient of request/consent to homecare visit.
5.. When patient unable to be contacted, wellness visit e.g drive-by is done AND we leave printed door knob card which is often successful in getting patient to contact agency:
ABC agency visited your home ______ (date) at request of __________ (insert physician name/hospital) to start home care service for Nursing / Physicial Therapy/ Speech Therapy (circle discipline).
Please call our toll free number: 888-888-8888, a nurse is on call 24hrs a day.
_______________________ (Professional prints name).
Hope this helps other homecare staff.