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Discussion

Home Care

I have a question regarding home care. When we complete our 485 at start of care, are we required to add a summary to this 485? CMS instructions do not say a summary is needed at start of care. Our quality person says it is required. I disagree with the quality person because all of the pertinent information is already included within the 485 and it's not on the CMS instructions. Home care nurses are required to do a lot of detailed documentation. So if a summary isn't required, why do it?" Help!

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Summary on all initial 485's that I have ever seen. Bare minimum. Just a rendition of the type of patient with major presentation, initial physical assessment findings by admitting nurse. Nothing special the first time. What scares me is when I see the same summary every recert period with outdated info and/or little or no change at all, indicating to me that there is a lack of follow-up from one day to the next.

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