Question about admission.

[dragonfly954]

I had my first admission on my own today. Post surgical wound care for back surgery on the referral.ok this will be simple i thought.:) She had multiple serious health problems not listed on the referral.Is this common?You don't know what you are REALLY getting into until you get there?These other conditions will affect and change the primary dx.Also on the admission does medicare really want to know all major medical hx even if it has 0 to do with referral?Just curious what everyone deals with daily.

[Traveler]

Welcome to home health! You never really know what you're dealing with until you get into the home. As far as Medicare wanting to know about all of the history, it depends on the dx that you will be seeing the pt for. I try to give as much history as possible because it helps other nurses in the office that may be going into the home.

If you're seeing her for the wound and she has COPD that was stable until recently then that should be included. If there are med changes down the line r/t the COPD then that would be a reason to recert the pt.

My most recent admission is a pt who had surgical deb. of an infected diabetic foot ulcer. The doc ordered whirlpool (I'm not sure why) followed by dsg. The fact that his well only works sometimes and he is on well water with potential contamination sort of complicates matters.

You mentioned that in light of the other health problems her primary dx would be different. Depending on what you put for the primary could change the HHRG a lot so make sure you talk to the office about that.

Good luck!

Ann

[renerian, BSN, RN]

That is home health to the T! Sometimes you do not even know a wound is out there until you start digging in. LOL.

I do not like things that are old unless the client exacerbates or it has to do with the plan of care. If a client has a fractured lumbar disc or something and the client is getting PT then I would list it.

Do you like home health?

renerian

[dragonfly954]

I like it better than my agency job,that's for sure!It has been an experience for the last 2 weeks.I have never done medicare h.h,so i have a lot to learn.Trying to track the md down is the best part when I'm out driving around......all the back and forth phone calls to the office.I'm still taking paperwork home at night to finish up,but they said that is to be expected for awhile.Just trying to get used to all the rules and regs.

[renerian, BSN, RN]

Actually for alot of people that is the norm. I always liked doing it at home because I was HOME and not in my car or at the office LOL. It never bothered me. I bring tons of paperwork/reading home now in my job.

renerian