Home Care – An ever changing world…

The world of home care is changing at a rapid pace affecting the nurses and doctors and everyone else involved in the health care field. How can we possibly stay on top of all of them? This is where information and education come in. The more we know as medical professionals, the better we can do our jobs, right?

The goal of this blog is to do just that by keeping you abreast of all of the changes taking place at Minnesota Home Care on a monthly basis. We welcome your comments, questions, concerns and any feedback you might have.

 

Plan Of Treatment For Therapy

Questions:

1) Is it acceptable for therapy to use a range of frequencies on their Plan Of Treatment, ie: 1-3 times a week for three weeks, or 2 times a week for 2-4 weeks, or 1-3 times a week for 2-5 weeks.

2) When a Physical Therapist performs a supervisory 6th visit of a Physical Therapy Assistant must it be on exactly the 6th visit or could it occur on the 5th PTA visit?

 

Answers:

1) Per the Medicare Benefit Policy Manual – Chapter 7, here is the regulation on using ranges

“Orders for care may indicate a specific range in the frequency of visits to ensure that the most appropriate level of services is provided during the 60-day episode to home health patients. When a range of visits is ordered, the upper limit of the range is considered the specific frequency.” 

So, if you 2-3x/week for 2 weeks – it would mean you intend to provide 3x/week for 2 weeks. If your agency consistent is using ranges for order and not providing the upper limit of the range, it may be a red flag for survey when auditing your compliance with the ordered frequency and duration.

2) It may occur anytime on or before the 6th.  Your supervisory visit just should not be beyond the 6th visit.

 

If you are interested in getting free access to our Nurse Consultants, free web-based training through Rochester Community and Technical College, the ability to network and get free education at our Region or Team Meetings and more, visit our website to find out more information about joining!

Home Health Aides and Medication

Question:   I have a question about HHA’s and medication.  I know the regulations about HHA’s not being allowed to administer medications, but we keep getting questions about eye drops either OTC or prescription and applying prescription creams for clients.  If this is a need can the HHA assist under the training and monitoring of an RN, IF….1) RN trains the HHA on the special treatment and documents her training and return demo, 2) if the RN ads it to the care plan and reviews and make changes as necessary? I just want to clarify this as its more of a grey area.

Answer: 

Members: View the answer here

Non-Members: Please discuss in the comments or become a member for 24/7 access to our nurse consultants!

How Do We Explain to the Client that We Don’t Provide the Supplies they Need?

Dear Readers,

It’s been ages since we posted questions, but we’re back on track now. MHCA members can get questions like these answered by our Nurse Consultants.

Q: I am about to take on a client who has a new colostomy. She wears custom made appliances so they are not part of our normal inventory. We will not provide her bags like she needs during this episode. Is there a letter and form that agencies are using to explain that? It has not come up for us before. Do I just do a HHABN for the Ostomy bags?

A: If your Clinical Operations Policy and Procedures state that you use a specific formulary for your supplies and that you do not go outside your formulary for ostomy supplies, you do not have to provide supplies that are outside the formulary.  The client must be informed of this in writing prior to admitting them to your agency.  If this is the case, issuing a HHABN stating the specialized ostomy bag is not part of the agency’s formulary, would meet the requirement of informed consent.

If your Policy and Procedures do not identify specifically that you have a formulary for your supplies, you also have a right to refuse the patient due to the high cost of “specialized” ostomy supplies and that you do not carry them in your system.