FREQUENTLY ASKED QUESTIONS

No. The agency may opt to have a Medical Advisor.

The Medical Director can only sign the 485 and/or the Face to Face if the Medical Director is the patient’s certifying physician.

No. Frequencies must be written week specific. Example: SN 1w5, 2w4. A set number of prn visits may be added. The reason why the prn visit would be made must be specifically indicated in the 485.

Yes. You must provide at least one direct service. Other services may be provided thru a contracted provider.

Yes. The goals may be revised by submitting an interim order to the physician.

As long as the patient meets all the requirements for Medicare services and requires care, the agency must continue to service the patient until which time the patient does not qualify for services or the goals have been met.

Yes. When teaching is performed a patient response should be noted.

Yes.  The OASIS is a complete assessment tool that can be used for any patient population.  If the OASIS is used for the Pediatric patient, an additional tool that contains Pediatric specific assessments should be included.

No.

Yes.  When the patient is receiving skilled services and HHA services, the supervisory visit must be completed at least every 2 weeks.  The HHA does not have to be present. The RN must complete the supervisory section on the clinical note.

No.  The agency is not responsible to provide any prescription medications.  The patient is responsible to obtain any prescriptions from a retail pharmacy.

No.  This skill can only be performed by the RN or LPN.

The RN performs a supervisory patient visit for the LPN every month.  The RN makes the patient visit instead of the LPN. This visit cannot be done over the phone.  Yearly the RN will make a joint visit with the LPN to complete the yearly competency and performance evaluation.

The typical re-survey cycle is every 3 years.  CHAP may make unannounced surveys if a complaint is made or the agency has a significant event occur.

No. Under the Medicare PPS system you are paid a set amount based on the OASIS-C transmission.  Adjustments to the total payment are made when the discharge OASIS is submitted.  You do not bill for individual visits.

It is recommended that the post admission survey is completed after the 2nd week of service.  This survey may be done by phone. The discharge survey is given to the patient at the time of the last visit.  A return envelope should be provided.

No.  The patient is not required to sign.  It is recommended that the patient sign the HHA notes.

Yes.  Soap and water is always the preferred choice for hand hygiene, however gel is a better choice if the bathroom is not available.  The kitchen sink should not be used.