Published
check out cahaba's:
coverage guidelines for home health agencies (aug 06 revision)
94 pages of great advice in easy to read format.
medicare reference guide: home health coverage guidelines updated link 5/15/2008
especially helpful is:
70 conditions the patient must meet (pg. 23)
70.15 documentation of homebound status (pg.26)
70.10 beneficiaries who are not homebound (pg. 25+26)
80.30 prn orders (pg.34)
80.40 verbal/oral orders (pg.35)
90 covered skilled nursing services (pg. 38 -40)
90.5 principle one: requires the skills of a nurse
90.10 principle two: service is not skilled because performed by a nurse
90.15 principle three: service does not become unskilled because it is taught
90.20 principle four: reasonable and necessary
100 skilled nursing services (pg. 40)
100.10 management and evaluation of the care plan(pg. 41)
100.5 observation and assessment (pg. 42)
110 teaching and training activities (pg. 43)
110.5 administration of medications (pg. 44)
110.40 prefilling syringes (pg. 46)
110.70 catheters (pg. 48)
110.75 wound care (pg49)
110.115 diabetes outpatient self-management training (dsmt) (effective 1/1 2004) (pg. 51)
110.120 foot care (pg. 53)
110.130 psychiatric nursing (pg. 54)
140.30 safety dependence/secondary complications (pg. 59)
150 general principles for reasonable and necessary physical, speech, and occupational therapy (pg. 60)
200.5 covered home health aide activities (pg. 71)
210 drugs & biologicals
drugs and biologicals are generally excluded from coverage under the medicare home health benefit. there are a few exceptions from this exclusion.
210.5 drugs covered by medicare part b (pg. 73)
these drugs include hepatitis b vaccine, hemophilia clotting factors, calcitonin, pneumococcal pneumonia vaccine, influenza virus vaccine, and intravenous immune globulin (ivig)
220 coverage exclusions (pg. 76)
240.20 blood glucose monitor (pg. 80)
240.35 protime test systems (pg. 81) * not covered
240.75 covered medical supplies (pg. 82)
240.80 routine medical supplies (pg..83) * not covered
from kaiser foundation feb 06
a new tutorial on medicare/medicaid dual eligibles reviews eligibility, benefits, and financing for duals and discusses their transition into the new medicare prescription drug coverage program.
I've worked in a hospital for about 5 years now. I'm really sick of all the short staffing. I feel like pts and family members can be very demanding but thought if I got into Home Health it might be better....after all I would be meeting them on their turf. Any comments would be appreciated!
Do you want to do pt care or be in the office? I've been doing home health part time for about a year and I love it. I worked 40 years in med-surg and finally retired from hospital nursing....and I will NEVER go back. I feel appreciated and respected much more now. I do both shifts and visits and the only negative is that if it's your only income, it's not always steady. For instance, my private-duty pt went into the hospital so I couldn't work and they don't always have a replacement pt. For me it's supplemental income to my social security so I just waited until he came home. Tomorrow will be my last day with him after 6 months because my hubby and I go to Canada for the summer. I'm going to miss both the pt and his family. They're always so thankful for anything you do. For the first time in years I feel like a REAL nurse giving EXCELLENT care!
I graduated Dec. 2006 and worked 6 wks in two different hospitals. The first I had 9 pt. working up to 18 - there was just so little patient care time. The second the nurses were definitely "young eaters" and the bickering amongst themselves and back biting about me (I overheard a conversation that still makes me feel bad) and only 5 days with a preceptor made me hate myself for spending the money, time, and effort it took to become an RN. Anyway, I've been reading the posts on allnurses for three months and would really like to go into home health, but is that a good idea for a new nurse? Our state health department is hiring Home Health Nurse I now. My strongest asset when I worked was my patient relationships - even as a student the patients would say I was going to be a great nurse, many said I was compassionate and they were so glad I was there nurse. BUT, I know experience makes a really great nurse and that's what I want to be.
I graduated Dec. 2006 and worked 6 wks in two different hospitals. The first I had 9 pt. working up to 18 - there was just so little patient care time. The second the nurses were definitely "young eaters" and the bickering amongst themselves and back biting about me (I overheard a conversation that still makes me feel bad) and only 5 days with a preceptor made me hate myself for spending the money, time, and effort it took to become an RN. Anyway, I've been reading the posts on allnurses for three months and would really like to go into home health, but is that a good idea for a new nurse? Our state health department is hiring Home Health Nurse I now. My strongest asset when I worked was my patient relationships - even as a student the patients would say I was going to be a great nurse, many said I was compassionate and they were so glad I was there nurse. BUT, I know experience makes a really great nurse and that's what I want to be.
hello,
I was just reading your message. I graduated in May 07 and i'm currently working at a hospital in PCU. I also have a very strong interest in home health for the same reasons you mentioned, and I'm wondering how things worked for you. Do I have a chance even though I don't have much experience? I'd appreciate if you could drop me an email at [email protected].
Thank you very much,
Lia
hello,I was just reading your message. I graduated in May 07 and i'm currently working at a hospital in PCU. I also have a very strong interest in home health for the same reasons you mentioned, and I'm wondering how things worked for you. Do I have a chance even though I don't have much experience? I'd appreciate if you could drop me an email at [email protected].
Thank you very much,
Lia
I would strongly advise both of you to stick it out for about 6 months to a year, preferably med surg experience or cc. Then you will be better able to handle the home environments and your critical thinking skills will be tuned. But home health is definitely a blessing from the negative atmosphere in most hospitals. Only prob is the paperwork!
Revised links in thread.
OASIS info found: I found a good Oasis website...if you like that kind of stuff!
cms technical info now under : home health agency (hha) center
i updated the first link.
cahaba pa's intermediary just revamped their website
see: https://www.cahabagba.com/rhhi/coverage/home_health/index.htm
cms has new home health agency center: http://www.cms.hhs.gov/center/hha.asp
go to cms internet-only manuals , then to 100-07 state operations, click on appendices then home health agencies to open pdf file to see what surveyers are looking for re documenation/poliy standards.
761 kb
jkaee
423 Posts
thanks karen! i just ordered these books, i want to go over them before i start my ft job as an rn case manager in home health. i'm new to this field, and i'll need all the help i can get. i paid about $70 for both the books (not including shipping) but i think the peace of mind of having some sort of idea as to what i'm facing is well worth the cost.
thanks again!