No 485, just discharge orders?

[James613]

Will be starting private duty nursing as an independent NY Medicaid provider. Client is to be discharged from hospital with new trach/vent, new to home nursing services. Hospital nurse liaison doesn't know what a 485 is, and that all the orders will be on the discharge paperwork sent home with family. Is it legitimate to go by the discharge orders?

[JustBeachyNurse, LPN]

No but agencies get the discharge orders to initiate the 485 but standard orders usually aren't included. And if not signed by the physician the discharge orders can't be use as initial orders . And the home care nurse provider creates the 485 for physician signature not the hospital social worker. Vent orders are usually conferred with pulmonologist and the DME respiratory company

[James613]

I am not working through an agency, I'm directly billing medicaid

[caliotter3]

If you don't have an agency providing a 485 for the case, then you would have to follow the discharge orders. If you are not comfortable with the lack of supervisory support in this private duty case, then you should consider seeking work with an agency.

[spitfire93]

James, you need to compile a 485 and have the pcp sign it, these are your orders you have initiated from the discharge orders and your assessment of the client.