Re: myhomehealth-l digest: December 13, 2016

Regarding keeping on for chronically stable condition. If the patient
qualifies for O&A you can keep on but the orders and documentation must
reflect and support. See the Coverage Guideline for HH under Observationion
and Assessment. If there is no recent exacerbation, med/TX change and
teaching goals have been met at the level that is realistic for the
patient, then yes, they are likely needing discharged due to a lack of
medical necessity to support a new episode. The RN can know the plan for
discharge 2 weeks prior through coordination/conferencing. I have heard
rumors about eventually being able to cover chronically stable conditions
but for now there must be a current skilled need. If an agency leaves them
on cert after cert without meeting this requirement they are seen by CMS as
trying to deliver long term care in an intermittent care environment and
the claims are at risk for denial and penalty. I have witnessed this in my
career and it is not pretty. On top of that, for as long as your patient is
on service any ER visit, hopsitalization, infection, fall or other adverse
event goes against your agency''s Outcomes. So while we are just waiting
for the next exacerbation or event, it is a double edged soared in many
respects and not worth it. I hope this helps.

On Dec 14, 2016 12:01 AM, "Multiple recipients of list MYHOMEHEALTH-L
digest" wrote:

> MYHOMEHEALTH-L Digest for Tuesday, December 13, 2016.
>
> 1. Recerting a patient
> 2. Question
> 3. RE: Question
> 4. RE: Question
> 5. Re: Question
>
> ----------------------------------------------------------------------
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