Pts think Home Health is permanent


I have been doing Home Health for over 4 years now. All through this time, I have dealt with SO MANY patients that just can't understand why we are talking about discharge, if they are chronic they really don't qualify but the agency I am with wants them to stay because they are sick and need to be taken care of. I believe we are there to take care of SKILLED needs listed on the 485. So many older patients have friends or family who apparently have a DHS sponsored program who provide 5 day week visits for a year at a time. I try my best to talk about the ACUTE care but it just makes no sense to them. Since my administrators are non medical and only want to keep them for their census so there is NO support there. Can anyone help?


38,333 Posts

If you are the one responsible for client flow and you can not convince the administrators to follow the rules, maybe you should reconsider whether this is the agency you should be working for.


1,191 Posts

Specializes in COS-C, Risk Management. Has 20 years experience.

Assuming that you are doing Medicare-paid intermitten visits, refer the adminis the Medicare Benefit Policy Manual, Chapter 7 as well as the Medicare Conditions of Participation for Home Health Agencies, and any state/local laws you have.

Make sure that you get an MSW in for each of your patients to address long-term care planning and community resources, plan for discharge at admission, and discuss discharge at each visit.


10 Posts

How is your agency not getting denials if you are keeping patients that do not require skilled care? Our intermediary checks everything so closely that we get denials on wound patients if it is not a particular kind of wound care. It is hard to work in an environment where you feel like you are having to fight to do what is right. Patients should be educated concerning discharge on admission. I Know they get selective hearing but discharge plans should be discussed every visit by every discipline.