rnhomeind

Have any of you had any problems with implementing the reg to have all verbal orders read back & verified? We have alot of docs that when we call them for a verbal their staff have to take the message & get back with us. The problem is playing phone tag, we don't use voicemails, we do have pagers, but we can't always depend on the Dr. getting back with us same day! We are on laptops & when entering all verbal orders, have to click a radio box that states the vo has been read back & verified. I've brainstormed & came up to have my staff when calling for a verbal order, to state "here's my pager number, if I don't hear back from you, I'll consider this order to be authorized", then we read back & verify. But I have some nurses that come up with reasons why this won't work....I get so frustrated that many people do not understand the homecare world we live in! How about when you call for a verbal order & the office nurse working for the MD asks for you to just fax the request to them after you've informed them your homecare!! I'm in the middle of a corn field...I'll get that fax right to you. We had a verbal order line for a while, but it was a nightmare, I spent all of my time, trying to solve what the orders were for, etc. Thanks...Angi

In our homecare, we clearly instruct medicare guidelines for homebound status. If they have private insurance, we usually know upon admit, if they are required to be homebound or not. Medicaid differs a little bit in our state, they are considered homebound, if they require an assistive device to leave the home. If it is medicare, I clearly state to the clients upon admit and reinforce afterwards, that they have to experience a taxing effort, but are allowed to leave for short infrequent periods that are not medical related. If I find out an elderly client went out for lunch, I dont immediately assume she is not homebound. I assess how she felt during and after. If she denies it being taxing, she may have just had a good day, so i make note to monitor homebound status. Everyone is different and there are multiple times, clients falsely say they are homebound to get our services, but I find, that eventually, the nurse will find out they are not homebound. If they request certain visit times, and I happen to attempt to call them for a new order and they are not home, but informed me yesterday, they would be home all day, without knowing I would be calling. Our agency is very consistent with monitoring this due to fraudulent billing under medicare guidelines. HAVE A NICE DAY! :)

Has your management went out and performed the work that they expect you to complete in a 8 hr period? It AMAZES me, the expectations upper management have for visits? The days I can complete 5 to 6 visits in a day and be completed with call, paperwork, etc. are far and few between....