Documentation completion

What are your Home Health Agencies' requirements for your clinicians to complete their documentation for a patient assessment (realizing there are 5 days for all contributing disciplines to finalize the comp assess), but the actual eval/assess by a RN, then therapist... as well as the required time to complete documentation for a skilled visit (from the time they enter the patient's home until documentation is complete in the record).

We have point-of-care software but many times they are unable to complete in the home due to environment, etc. so they'll finish later.

Any requirements you're willing to share would be helpful.

Thanks!

Lisa D. Lopez
Executive Director Community Services
Med Center Health

270.796.5544 fax
270.535.6946 business cell




Comments

  • edited May 2017
    Routine notes should be completed same day.

    There was a story posted awhile back about a surveyor who cited an agency for not having documentation done same day. Her comment, if I am quoting right, was that you wouldn’t leave your shift in the hospital without your documentation done.

    The rest of the story the teller, if he reads this can share if he wishes. But I repeat it regularly to staff, that they risk their license and ours leaving it undone

    Susan G. Johnsen, RN, MSN, COS-C
    LLUMC Home Health Education & Informatics Specialist
    ph: 909 558 3285

  • Susan, that sounds like 42 CFR 484.12-c Which would be adherence to accepted professional standards and principles.


  • We also require all documentation be submitted by midnight on day of service. This includes all Oasis items, unless there is documentation that you are awaiting clarification from a physician to complete the Oasis.

    Annamarie Daley RN WCC
    Director Home Health Care
    Liberty at Home
    7002 W. Butler Pike
    Ambler, PA 19002
    (w) 267-464-1006
    (C) 215-206-4827
    (F) 267-464-1019
    24 Hour Referral line 1-844-651-5111
    www.libertylutheran.org




  • We require 48 hours for documentation to be entered. However they do have 5 days if needed to verify/clarify any orders / diagnosis with MD.

    Alberta Jewkes, RN
    Home Health Administrator, WV Division


  • edited May 2017
    So kind of stepping off of this conversation, could I ask you all how many total visits do your RN's typically do in a day? How many admits and/or recerts in a day per each RN?
    This is great conversation, so thank you for your input.


    Cathy Lovell, R.N., B.S.N.
    Director Home Health & Hospice/Case Management
    Sidney Regional Medical Center
    Phone: 308-254-8087
    Fax: 308-254-4225
    clovell@sidneyrmc.com

  • Our visits are weighted, each RN is required to have the visit equivalent of 6 visits a day or 30 a week.

    Alberta Jewkes, RN
    Manchester Memorial Hospital
    Home Health Administrator WV Division
    304.855.2440 Preferred Choice
    304.235.3010 Mingo Wayne
    304. 453.3590 Preferred
    304.785.5545 Cell
    Alberta.Jewkes@ahss.org
  • edited May 2017
    How do you weigh each type of visit and do you factor in the drive time for
    rural patients?



    Kathy



    Kathy Hamilton RN

    Administrator

    khamilton@acthhs.com







    395 Tillman Road, Lufkin, TX 75901

    Phone (936) 632-9400

    Fax (936) 632-9425

    Cell (936) 635-6465







  • They are weighted by type of visit with the base being a Reg visit which is weighted 1. The weights are dependent of where you are in the country. Very rural area's look at daily mileage to calculate if any added monies are due based on our regions chart. I hope this helps.


    Alberta Jewkes, RN
    Manchester Memorial Hospital
    Home Health Administrator WV Division
    304.855.2440 Preferred Choice
    304.235.3010 Mingo Wayne
    304. 453.3590 Preferred
    304.785.5545 Cell
    Alberta.Jewkes@ahss.org
  • Are your visits weighted just for an SN Eval = 2. Do you weight Recerts, Resumes, Discharges. If so what are they weighted at?
    Thanks in advance, always nice to find out what others are doing :)

    Thank you

    Meryl Wren-Saroyan RN
    Citrus Valley Home Health
    820 N Phillips Ave
    West Covina
    CA 91791
    626-974-0331
    mwren-saroyan@mail.cvhp.org

  • Yes, Recerts/SOC/DC/ROC are all weighted.
    SOC 2.5
    Recert 1.7
    ROC 1.9
    DC 1.7

    Alberta Jewkes, RN
    Manchester Memorial Hospital
    Home Health Administrator WV Division
    304.855.2440 Preferred Choice
    304.235.3010 Mingo Wayne
    304. 453.3590 Preferred
    304.785.5545 Cell
    Alberta.Jewkes@ahss.org
  • Our agency is weighing the idea of requiring nurses who are paid hourly will not receive their paychecks unless their documentation is done. I think I may have read before this is not legal though. Does anyone do this or know if it is legal to do so?
    Diana Yoesel

    From: Wren-Saroyan, Meryl
    Sent: Tuesday, September 27, 2016 1:38 PM
    To: Multiple recipients of list MYHOMEHEALTH-L
    Cc: Okoro, Gertrude
    Subject: RE: [myhomehealth-l] Documentation completion

    Are your visits weighted just for an SN Eval = 2. Do you weight Recerts, Resumes, Discharges. If so what are they weighted at?

    Thanks in advance, always nice to find out what others are doing J



    Thank you



    Meryl Wren-Saroyan RN

    Citrus Valley Home Health

    820 N Phillips Ave

    West Covina

    CA 91791

    626-974-0331

    mwren-saroyan@mail.cvhp.org



  • I am not an HR expert, but I believe that you cannot withhold their paychecks for service they have provided, but I certainly understand that “money talks” and it is very tempting! I think about the only time this is acceptable is when an employee resigns and you are waiting for all documentation to be completed and agency property to be handed in.

    Carrie Birch, RN
    Director of Nursing-Home Health
    Horizon Home Health & Hospice
    Ph: 208-888-7877
    Cell: 208-376-6227

  • I understand you cannot withhold pay, but can you withhold the next day’s assignments until the previous day’s work is completed?

    Alberta Jewkes, RN
    Manchester Memorial Hospital
    Home Health Administrator WV Division
    304.855.2440 Preferred Choice
    304.235.3010 Mingo Wayne
    304. 453.3590 Preferred
    304.785.5545 Cell
    Alberta.Jewkes@ahss.org
  • Well when they are paid hourly its not very good incentive to withhold next days work I’m afraid.
    Diana Yoesel

  • Or I think you could reduce their pay to minimum wage until you receive the paperwork. Be sure to check your state dept. of labor though.

    Jan Fulfs, RN, BSN, President
    American Home Health
    1660 N. Farnsworth Ave., Suite #3
    Aurora, IL 60505
    Phone: 630.236.3501
    Fax: 630.236.3505
    Jan.fulfs@ahhc-1.com

  • Lori,
    While some ideas may seem harsh, after years of trying to get clinicians to turn in accurate paperwork in a timely fashion many of us are trying to come up with anything that works. And unfortunately money is usually the thing that gets people’s attention; explaining and reasoning and begging and pleading don’t seem to elicit the same response. ☺

    Karen Smith, RN, COS-C
    OASIS/Coding Specialist
    Resource Group
    Horizon Home Health & Hospice
    karsmith@horizonhh.com
    208.401.1072

  • Amen to that. I have been in home health for years and it is a constant battle. We are still paper based with our documentation. My question to agencies that have gone to computerized charting has this helped resolve this issue?
    Diana Yoesel

  • How does this relate to the pay

    Rita Krett

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  • All routine visits are completed in the home. The Initial assessment is completed by the end of day unless there is a something that has not been completed.

    Sincere Thanks,
    Cheryl

  • edited May 2017
    That is part of the problem, I am having. Not submitting documentation in a timely manner. Does anyone out there pay by the number of visits instead of hourly?

  • Diane

    You would have to pay minimum wage in your state for hours worked. You
    would also have to change your policy and procedure manual and have the nurses
    sign off they agree with this policy

    James Plonsey
    President
    Medicare Training & Consulting


    In a message dated 9/28/2016 9:05:43 A.M. Central Daylight Time,
    CLovell@SidneyRMC.com writes:


    That is part of the problem, I am having. Not submitting documentation in
    a timely manner. Does anyone out there pay by the number of visits instead
    of hourly?


  • edited May 2017
    We do not pay hourly. We pay by the visit. It’s common in different parts of the US. Visit are weighted, sorry I’m not allowed to discuss the weight, and different visits are paid differently

    Susan G. Johnsen, RN, MSN, COS-C
    LLUMC Home Health Education & Informatics Specialist
    ph: 909 558 3285

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