Visit Frequency

[Zee_RN, BSN, RN]

When you order visit frequency for the RN upon admission, do you count the admission assessment visit as a visit? In other words, if you admit a patient and order RN visits 2 times a week, do you schedule one more visit or two more visits for that week?

We currently do not count the admission assessment as a visit as that is when the Plan of Care is developed and is not counted in the visit frequency. Is this common practice?

Thank you!

[toomuchbaloney]

In hospice the SOC visit is separate from the frequency of visits going forward, as you have suggested. Further, the frequency of visits is a much more variable and flexible portion of the care in Hospice vs. Home Care.

I recommend a higher frequency the first few weeks for education and creation of a therapeutic care environment in the home. Follow that with a frequency that is as low as the patient and family can accomodate and still meet the goals of the POC. Finally, the frequency is again increased as the patient nears death.

Good luck.

[Zee_RN, BSN, RN]

Thank you! That has been our organization's approach as well. I've seen it done differently in another agency. The new reimbursement plan, as well, will be based on the frequency model as you described...higher reimbursement initially, then decreased, then higher again when imminent death approaches.

[nrcnurse]

In my agency an RN and SW from the assigned Team see the patient within 24h of admission, if admitted M-Thurs. If admitted late Friday, Saturday or Sunday, Weekend Team will call to see if they need anything immediately, and the weekend team sees the pt w/in 48h. The Team f/u on Monday with a RN/SW visit.