Medicare HH Nurses

[mochelle]

I have been doing CBA visits and have just started a job doing the Medicare Skilled Home Visits. The way they write their notes are different I'm told. Can you help me by suggesting a nursing book that demonstrates the differences, or examples of a SNV nursing note. I'm lost on this one!!

[Cattitude]

Medicare is much stricter than medicaid so you must chart correctly so that your agency is able to bill and get paid.

Think of it this way, skilled nursing and charting means you better have a darn good reason for being in there, LOL. Chart a lot of teaching and not fluff teaching either, diet teaching, disease process teaching, wound care, etc.

Your agency should be giving you some info on what skilled care is so you know what to chart. You must be teaching at every visit. if there is nothing left to teach or do, there is no reason for visits!

I wish I could be more help, it's just something you learn as you go along I think.

[CapeCodMermaid, RN]

Your documentation must show you have provided a SKILLED service...assessment, wound care,teaching and training.

For instance, if your patient is status post hip replacement what is the nursing skill? Assessing the surgical incision, assessing the level of pain, safety, knowledge of disease process and medications especially new anticoagulant therapy, THEN TEACHING about wound care, coumadin therapy, etc. Try to think about why you are there and make sure you document that. Your agency certainly should be able to give you some guidelines as well. Good luck.

[mochelle]

Thanks so much!! The pts. I have seen mainly need to be taught about their med's. I guess it's really easier than the CBA program, the SNV form is totally different. Your advice is great! Thanks! Mochelle

[NRSKarenRN, BSN, RN]

several articles in this thread deal with documentaiton standards and understanding medicare homecare regs

4/06: update: new to homecare? read these articles to get you started