Visit Frequency

OCRN3 · Aug 24, 2014

When I did home health I would front load the frequency and closer to the end, depending on the patient, I would to every other week the last few weeks. It was very personalized to the patient.

NurseBeefcake · Aug 25, 2014

Thank you for the response

I<3H2O, BSN, RN · Aug 26, 2014

Someone who is likely to return to the hospital (CHF, pneumonia, etc) within 30 days should be seen as frequently as your company will agree. Probably at least 3x week for the first week and twice for the 2-3rd weeks. Those who are just started b/c they went to ER too many times for constipation, you could probably see a couple times the first week and then weekly and ultimately every other week. This all should be based on dx, number of medications they take, how familiar they are with the dx and medications, and how many disciplines you have in the home.

NurseBeefcake · Aug 26, 2014

Thank you I

KelRN215, BSN, RN · Aug 27, 2014

I don't see how the frequency necessarily has anything to do with how many medications the patient is taking. I might have a patient who is only on one medication who I see WAY more often than the patient who is on 10. Perhaps the patient who takes one medication has a daily injection and incompetent parents. And the patient who takes 10 has a mother who is an RN and a father who is an MD and are more than competent to manage her meds.

I do not have a standard, the visit frequency is what the patient's needs demand. I have patients who are seen as frequently as daily and others who are seen once every 60 days.

I<3H2O, BSN, RN · Aug 31, 2014

KelRN215, I think you may have missed my point. :) Maybe I was not clear. However, if you have someone who takes a BP med and they know the purpose, action, and side effects of that med, the likelihood of them returning to the hospital due to a medication error is slim. However, if you have a pt. who takes 10 meds, 3 of which are brand new and they need teaching, I would think you would see that patient a little more frequently. If the patient has several medications including high risk medications, the likelihood of a readmission due to improper med admin is a lot higher. That is what I meant by considering the meds in to the picture. Occasionally, you will find a pt. who knows more than you know about every single medication they take. Those are rare.

cubrnjvm, MSN, RN · Sep 1, 2014

It all depends on the company you work for. The minimum if just nursing is providing services should be 5 visits, to avoid LUPA, then if the patient has been discharged from the hospital always have more visits at the begining then start decreasing the visits by the end of the cert period.On the other hand, if the patient only needs regular assessments you can visit twice the first week, then once a week then once every other week and such. If a wound then always try to teach someone in the house if the patient is unable to perform the care and if not then use appropriate supplies that will allow less dressing changes, decreasing infection rates and increasing healing time.

NurseBeefcake · Sep 1, 2014

Thank you for the reply cubrnjvm. What is LUPA?

I<3H2O, BSN, RN · Sep 4, 2014

LUPA is low utilization payment adjustment

brillohead, ADN, RN · Sep 13, 2014

This page explains LUPA and a few other reimbursement issues:

Home Health PPS - Centers for Medicare & Medicaid Services

guaguachong · Sep 14, 2014

depends on pt situation, doctor order with your judgement. if pt just out of hospital, at least i will do twice a week for 3 weeks if they seems not all stable, maybe 3 times per week for 3 weeks if doctor prove that. if they have wound care definitely need follow up the same week. if they have wound vac, check doctor order either 3 times a week or 2 times a week usually. if they have IV antibiotics by PICC, definitely need follow up next day until they fully understand. if peripheral, doctor will order frequency. things change, so we have to use our judgement.