I am currently in the same situation with the company I now work for . At my past agency I rarely did re-CERT's .. now that is the majority of my visits . They keep patients on service for years most are therapy only.. I am constantly trying to discharge people that are not home health appropriate and I'm getting told to keep them when I ask why they will say well they've had a lot of hospitalizations this year they need monitoring etc... monitoring for that long is not a skilled need ... unless I'm missing something.. then they will tell me oh well therapy can keep them because it's maintenance ... but I thought maintenance had to be a very specialized plan and in writing and it also has to end not go on for years ? Or am I wrong? Thanks!