Homebound guidelines

[cny4rn]

I have worked in home health for about 8 years now. Most as a part time RN in the field but some as a full time case manager. Recently I refused to recert a patient that had current medical changes but was driving daily. I was told by my supervisor that it was within medicare guidelines for a patient to do this. Please let me know if this is correct. I feel if a patient is able to drive without exerting a taxing effort and is able to do this on a daily basis then they do not need home health care.

[mel1213]

Good for you OP.

This is typical fraud and is happening as we write.

This is a typical patient found often in HH agencies and are often seen parimarily by LPNs and have frequent changes in case managers to keep them by the companies because they have daily (often) visits. Just awful.

I am wondering what you mean by primarily seen by LPNs? I am an LPN and have the judgement to tell when someone needs to be discharged. Just because I am an LPN doesnt mean I dont know the boundries. And when someone should be a d/c I let my supervisor know. LPNs do have a a license to worry about as well. But I guess because we dont have an RN behind our name makes us dummies! whatever.

[tewdles, RN]

I am wondering what you mean by primarily seen by LPNs? I am an LPN and have the judgement to tell when someone needs to be discharged. Just because I am an LPN doesnt mean I dont know the boundries. And when someone should be a d/c I let my supervisor know. LPNs do have a a license to worry about as well. But I guess because we dont have an RN behind our name makes us dummies! whatever.

I hope she was referring to the fact that the RN case managers have (in some agencies) almost no face to face time with the patients on their census. The RNCMs are creating recertification data from the assessments, many times, of the LPNs with whom they (the RNCMs) also spend very little time. It is, for many agencies, a system designed to provide the minimal amount of nursing care for the longest period of time with the fewest RNs as possible, in order to generate profit in increasing amounts. As RNCMs in CHC we DEPEND upon the skills and professionalism of the LPNs on our teams.

[anticoagulationurse]

The way I see it is, why should Medicare (or another insurance company) pay extra for a patient to receive home care when the patient is able to get care (without a taxing effort) to a lower cost on an outpatient basis?

[caliotter3]

The way I see it is, why should Medicare (or another insurance company) pay extra for a patient to receive home care when the patient is able to get care (without a taxing effort) to a lower cost on an outpatient basis?

Hi, anticoagulationurse. Long time, no see!