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overwhelmed

Posted

Has 24 years experience.

I am so glad I found this site and boy do I need some guidance. I have been a registered nurse for 15 years and I am comfortable with my clinical skills. I am now working at a home health agency as the director of nursing and we are currently seeking Medicare certification. Having submitted the application to the state and obtained the policy and procedure manual from our consultant, I am now in the process of organizing our patient charts. My first question is where do I obtain or order forms for such things as privacy statement, informed consent, emergency plan, ect..... up to now I have xeroxed forms from other home health companies and placed our logo on them. Once I have the source for ordering the forms required I will use them. please direct me to any resources you thing would help me.

thank you,

Marie

renerian, BSN, RN

Specializes in MS Home Health.

Copying other forms is not good. Try looking at Briggs for forms and health care concepts for med profiles. They are not cheap mind you.

Do you have a copy of your gtags?

renerian

Diamond Nurse

Has 24 years experience.

I did a search for Briggs and didnt get the right site, if in fact they have a web site.

I dont have G tags (we are not medicare certified yet)

Diamond Nurse

Has 24 years experience.

could you direct me to where I would find out more about g-tags

thank you for the links briggs had just what I was looking ffor

we do in home care and have 2 assisted living facilities that we work with, we have not had any shift work yet.

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 43 years experience.

Marie:

Have you ever worked in home care before or in a Medicare certified home care agency? Do you know OASIS, DRG coding??

Depending on your answers, can offer you advice.

Applying for Medicare Certification is not an easy task for a novice. Expect health department at your door within 30-days of application receipt, so you need to be prepared TOMORROW.

As 18 year veteran just need to be able to point you in right direction....

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 43 years experience.

The G-tags were developed by the Centers for Medicare and Medicaid Services (CMS). They break the Conditions of Participation into separately surveyable points of compliance. One condition, for example, may have 25 G-tags, each representing some compliance issue for surveyor evaluation. During the survey, the G-tags serve the purpose of identifying specific citations.

You'll find G-tags listed with the Interpretive Guidelines in the State Operations Manual.

Medicare Home Health Interpretive Guidelines to Surveyors: G-Tags

http://www.cms.hhs.gov/oasis/intguide.pdf

MUST READ INFO for HHA:

HIM-11: Coverage Guidelines for Medicare Home Health Services

http://www.cms.hhs.gov/manuals/pub_11.exe

Medicare Home Health Conditions of Participation

http://www.access.gpo.gov/nara/cfr/waisidx_00/42cfr484_00.html

Appendix Q: Immediate Jeopardy Medicare Guidelines (pdf file)

http://www.cms.hhs.gov/manuals/pub07pdf/AP-Q-R.pdf

CMS: Home Health Information Resource for Medicare

You can join the home health listserve here:

http://www.cms.hhs.gov/providers/hha/

Diamond Nurse

Has 24 years experience.

yes I have worked in home care before but i was always out in the field I didn't know all that went on behind the scenes..

I am sure the agency I worked for was Medicare certified. I have gone through the online Oasis training program. DRG coding I am not familiar with doing. I know I need alot of help.

We got a call last Friday that UGS is done with the perliminary check of our application and it will be in the hands of CMS this Monday. In Michigan we hear that it takes about 2 months for the state inspection.

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 43 years experience.

Michigan Regs:

Home Health Chapter III.doc

Michigan Department of Community Health Distribution: Home Health Agencies 03-I 0 Issued: December I, 2003 Subject: Chapter III Revised Effective: January I, 2004 ...

http://www.michigan.gov/documents/Home_Health_Agencies_03-10_80195_7.pdf

So much you need to know:

Most "soft" supplies used in homecare are bundled under PPS: wound care, catheter care, trach and ostomy---seach website here for links info. You will need supplier contact for these items.

Disposable supplies included in cost of SN Visit: alcohol swabs, sterile tong blades, gloves, plastic aprons, routine tape, thermometer etc

Develop agency specific list for routine bag and soft supplies to keep your costs under control.

Check out: Handbook of Home Health Care Administration

http://www.amazon.com/exec/obidos/tg/detail/-/0834209187/qid=1071984249/sr=1-1/ref=sr_1_1/104-6352531-4191933?v=glance&s=books

Directory of Home Care Resources:

http://www.providerconsult.com/resources/publications.htm

Pam Pohly's Net Guide:

Toolbox for Health Managers & Administrators

http://www.pohly.com/admin.html

Previous HH coding thread:

https://allnurses.com/forums/showthread.php?postid=543903#post543903

Strongly suggest you join state/national homecare organization:

National Association for Home Care and Hospice

http://www.nahc.org/

Michigan Home Health Association

http://www.mhha.org/

Let us know what else we can help you with!

renerian, BSN, RN

Specializes in MS Home Health.

Wonderful supportive post. renerian:D

Hellllllo Nurse, BSN, RN

Has 15 years experience.

found this on the Briggs site:

Know Someone Starting a New Home Health Agency?

CMS currently projects hundreds of new home health agencies are in the process of, or will be, established and certified soon. Starting an agency is always a challenge with hundreds (if not thousands) of decisions required to gain certification.

To help the new agency owner/administrator simplify many of these difficult decisions, Briggs has assembled "Start-Up Kits" comprised of the essential tools needed to gain regulatory compliance and operational effectiveness, all from one trusted source. New agencies can save thousands of dollars and hundreds of man-hours because the Briggs Start-Up Kits include a clinical documentation system, clinical procedures, operational policies and procedures, OASIS tools, corporate compliance tools, even HIPAA compliance tools!

The solutions for Home Health Start-Up Agencies are a phone call away - 1-877-307-1744.

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Havin' A Party!, ASN, RN

Specializes in ICU, CM, Geriatrics, Management. Has 10 years experience.

Wow, Karen! You're a heck of a resource!

Very much impressed. Thanks!

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 43 years experience.

For Nurses New to Home Care

CEU Article:

http://nsweb.nursingspectrum.com/ce/ce109.htm

Starting a home care agency:

http://www.nahc.org/Tango/Start/

Home Health Nuggets

https://allnurses.com/forums/showthread.php?postid=497092#post497092

Home Care Resources

https://allnurses.com/t35713.html

Medicare Reference Guide For Home Health Agencies:

75 page document from CAHABA intermediary:

http://www.iamedicare.com/provider/newsroom/refguide/hha/hhcoverage.pdf

Coding and Icd-9 Codes

https://allnurses.com/t31402-10-1.html

List of non-routine medical supplies to be bundled in with cost of Medicare visits: go to page 59

(these need to be listed under supplies on 485 form, and itemized as part of care)

Also discusses billing under PPS:

http://cms.hhs.gov/medlearn/hhppsch4.pdf

Wound Care Words of Wisdom:

https://allnurses.com/t16242.html

Let me know what else you are interested in...will post links.

Diamond Nurse

Has 24 years experience.

well the more I learn the more I realize I don't know. Thank you for the info and links. I am now more overwelmed than I was....

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 43 years experience.

My knowledge of Home Health has expanded over the past 18 years.

I am sure you are very clinically savy. I learned the BUSINESS of homecare just within the past six years.

Each year in nursing management bring you new ideas, challenges and learning. No one masters this at one time.

Heading a Medicare certified agency is extremely difficult due to all the rules and reg---which change yearly.

Get the Handbook of administration--new edition coming out in Sping 2004, order used copy of current book online till its available.

Start by reading Medicare regulations posted as that is what you will be measured against. Read a section each day--bookmark to come back when needed.

Then move onto Medicare Reference Guide For Home Health Agencies---find out what your intermediary for your state is and peruse their guidlelines. Learn about coding as that will determine how your agency gets paid under PPS.

Read which supplies included in nursing visits next.

Look at cost of Briggs start up kit vs items offered by NAHC.

Join your states HH organization --ask for mentor from them. If you do not have many agencies in your area (no threat from competition) then you should be able to find a frendly face.

If you start out smalll, you should be ok. Expect to have a headache for the first 6 months-year. It gets easier after that.

We are here to support you but you do need to know these things to avoid legal and professional trouble from the get go.

I am assuming this is a forprofit private concern that is Medicare startup. It can be done but is costly and time consuming endeavor these days. If you think of these as a giant adventure and are up to a challenge, you can find some great rewards.

PM me if you want to chat. Good Luck!

Diamond Nurse

Has 24 years experience.

Well I have good news, we hired a new lady for the office where I have been working, helping out on the staffing agency side. Now I will be able to concentrate on our home health care agency. I thank you for the leads and links, suggestions and ideas. we also got the letter from CMS that they recieved our application. In Michigan we expect to have survey in 2 months.

renerian, BSN, RN

Specializes in MS Home Health.

Good for you!

renerian:D

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