Gommer

I think what surveyors focus on varies region to region, depending on what the prevalence of issues/citations are for that area. Our last survey here they focused on Human Resources, documentation related to case management communication and always always always, are your nurses following the plan of care. Therpay communication and timeliness of 13/19th visit evals I'm sure will be assessed as well.

Hmm, that's interesting. I always figured duplication of services applied to a client having a duplicate service where BOTH are being paid for by Medicare.

Howdy all, say you have a current client coming out of hospital and your nurse does a ROC with new DX of hyperkalemia, ESRD with Dialysis, new peritoneal dialysis tube, with previous dx of copd, htn and cad. First question is can you use esrd code 585.6 in home care? Also, I've been told that I cannot code ANYTHING to code related to dialysis, IE HTN, fluid status etc etc. Help anyone?

My understanding is that there is no conflict here. I have provided HHa services for clients with paid chore providers, etc etc. The HHABN states that ifa client qualifys for HHA services, but wants services above and beyond what Medicare will pay for, they can have it of they want to pay out of pocket. Just make sure the client understand that 80% of you aides time MUST be spent on personal care, or your agency could get a citation.

It is my understanding this is one of the responsibilities of the medical director of your agency. If you need orders for a client and cannot get a response from the ordering physician, go through your chain of comand and aak if the med. Director wil sign orders temporarily. As an ADON I try, not always successfully to use these opportunities to educate doctors offices on state and Medicare regulations for home care. Another suggestion is faxing requests/ orders with a follow up call. Sometimes having hard copy gets results. I've even stopped in at offices and dropped off orders to be signed. Helps put new to faces and makes you a person instead of a voice on the phone.

I am being asked to complete a non-visit discharge oasis from last december that was never done. The nurse is no longer here, and it was before my hire to this company. Is this ok? I really dont think so.

My company in Michigan Pays $40 per routine skilled visit for lpn's, dont know about med set ups.