485's Home Health Plan of Care

DutchgirlRN, ASN, RN · Jul 14, 2006

Hello everyone. I'm working as a DON for a new home health agency. What was I thinking.....this really is a lot of work; however, I enjoy learning. I was wondering if anyone can guide me in the right direction to obtain a computerized template form 485 for our PDN patients. Also I want to clarify to make sure I'm on the right track. The form 485 is it just for PDN? And I need to have a separate plan of care for home health aide only patients? Any assisstance with this matter would be greatly appreciated.
Thanks again!

I don't have a computerized template form 485 but would love to have one also or an example of what your agencies use. Ours sux. It definately needs to be redone. E-mail me your form if you cannot put it on this site. Thanks so very much, Dutchie!

homehealth43130 · Jul 16, 2006

We use the 485 form for all our patients, you should be able to get a copy on the cms web site or form your intermediary. Ours is built into our billing system so I don't have an electronic version of one.

DutchgirlRN, ASN, RN · Jul 17, 2006

We use the 485 form for all our patients, you should be able to get a copy on the cms web site or form your intermediary. Ours is built into our billing system so I don't have an electronic version of one.

Not to sound ignorant but what is the cms website? Thanks.

homehealth43130 · Jul 22, 2006

The Centers for Medicare and Medicaid. - http://www.cms.gov

Ms. RN'02 · Aug 10, 2006

Ok I think I've been all over the cms website and others trying to get a download of some sort of the form 485; however, I've been quite unsuccessful. I did come across a page on the website that stated that the 485 has been deleted and is an optional form. Well I know these forms are still being used because I used it at my old agency. Does anyone out there that knows of any other way I can get the 485 form? Otherwise I guess I'll just order some care plans from healthcare concepts or Briggs.

Thanks in advance!

Home Health Columnist / Guide · Aug 11, 2006

medicare stopped having form available ~ 2003 -2004 for download or ordering.

if you are small startup agency, can always create in excel format for clerk to type info from written Plan of Care (POC) from nurses/therapists.

home health certification and plan of care (POC)

cms regulations require completion of a home health certification and plan of care. the following are the requirements for information that must be included:

according to the title 42 of the code of federal regulations (cfr) 424.22, the record must contain the following:

physician certifies the need for intermittent skilled home health servic
physician certifies the patient's homebound status
poc be reviewed at least every 60 days

according to 42cfr484.18, the following items are also required:

all pertinent diagnoses
mental status
types of services and equipment required
frequency of visits
prognosis
rehabilitation potential
functional limitations
activities permitted
nutritional requirements
medications and treatments
any safety measures to protect against injury
instructions for timely discharge or referral
any other appropriate items
orders for therapy services include the specific procedures and modalities to be used and the amount, frequency, and duration

Medicare Home Health Manual:

30.2 - Services Are Provided Under a Plan of Care Established and Approved by a Physician

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c07.pdf

Home Health Columnist / Guide · Aug 11, 2006

Can you clairy term "PDN" is that private duty nursing?

Home health aide private pay patients DO NOT need signed physician orders unless required by state regs. They DO NEED HHA care plan with written policy on frequency of review. Ours reviewed every 90 days.

Spot check HHA notes to make sure match care plan EXACTLY to make sure followed and avoid getting dinged by state.

Advise your agency subscribing to "Home Health Line", industry newsletter as they had great example last month of such forms and provide info re regs requirements.

Ms. RN'02 · Aug 11, 2006

Thank you so much NRSKarenRN. You have helped me tremendously(in both of my posts). My owner has allowed me to purchase either the PDN POT or the HHA plan of care. I chose the HHA plan of care in hopes to get a hold of the cms form 485. I will now just create my own plan of treatment for skilled nursing and format it similar to the cms form 485. I'm also going to check out cahabagba.com. Now lets see who knows how to use excel...hmmm...lol. Thanks again!!

lamazeteacher · Aug 16, 2006

Dear DON:

What agency hired you with no HH experience? (You don't need to answer that....)

The 485 must be completed at the time of the admission HV, and later typed for the office chart. A copy must be in the home, and be specific to frequency of HV, goals, nursing problems, etc.

I've been a HH Registered Public Health Nurse for over 20 years, and I kniow that this form causes the most concern at audits. Look in older charts for it, and hopefully you'll see how it is completed. Check with an established agency for recent changes, as they're ongoing.

I sure pray that you have experienced HH Nurses on your staff. Go with them to observe visits, and how paperwork is completed. Assure them that you want to learn from them, and don't fake knowing when you don't!:groupwelcome: :groupwelcome:

Ms. RN'02 · Aug 16, 2006

Dear Lamazeteacher:

To inform you, I know the process and the purpose of the POT and when it's supposed to be completed. I've been in case management for a home health agency for a while now. I'm now working for a brand spanking new agency, who does not have anything here; therefore, I'm starting from scratch. This in turn means, I must either create or purchase all the forms, policies and procedures, etc. for this agency to be able to function legally. Because I am used to using the CMS form-485, of course I was then searching for computerized access to it.

Also want to add that there's no need for this type of attitude towards fellow nurses. If you had read my profile you would see that I do have home health experience in case management. Now I have followed my career path into director of nursing.

Thanks to everyone else on the forum who has been helpful!

DutchgirlRN, ASN, RN · Aug 17, 2006

Dear Lamazeteacher:
Also want to add that there's no need for this type of attitude towards fellow nurses. If you had read my profile you would see that I do have home health experience in case management. Now I have followed my career path into director of nursing. Thanks to everyone else on the forum who has been helpful!

:yeahthat: :yeahthat: :yeahthat: :yeahthat: :yeahthat: :yeahthat: :yeahthat:

Best of luck to you in your new position!!