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It’s Official: Physician Must Place a Date on ALL Medicare Home Health Orders

By hcafadmin

Sadly it is official, in the state of Florida a physician must place a date on all Medicare home health orders that he/she signs.  This includes the 485 (initial certifications and recertification) along with all interim orders!

No longer can the agency apply a date or stamp the date on the order if the physician inadvertently leaves off the date. On or after January 1, 2011 all orders are subsequent services/claims based upon those orders would have to have the physician signature dated by the physician or those claims could be denied.

Change your processes immediately so that physicians and referral sources can start to realize that a order not dated will simply have to be sent back to them! It would also be beneficial to make sure that the physician and his/her office staff clearly understand that the date has to be provided by the physician, not written in by the physician’s  staff or stamped on the document by the physician’s staff.

Home care providers will need to protect themselves from unsubstantiated claim denials or from having to prove to a surveyor that the stamped date on the document, or the different colored ink was places there by the physician not the homecare agency.

Finally, maker sure the aggravated physician understands that this frustrating, ridiculous requirement is being forced upon them and the home care industry by CMS!

A Patient may be Homebound if:

  • A Patient would be considered homebound if she/he has an illness or injury that restricts his/her ability to leave his/her place of residence.
  • A Patient is paralyzed from a stroke who is confined to a wheelchair or requires the aid of crutches in order to walk; a patient who is blind or senile and requires the assistance of another person to leave his/her residence; a patient who has lost the use of his/her upper extremities and, therefore, is unable to open doors.
  • A Patient who has just returned from a hospital stay involving surgery suffering from the resultant weakness and pain and, therefore, his/her actions may be restricted during specified and limited activities.
  • A Patient with arteriosclerotic heart disease of such severity that he/she must avoid all stress and physical activity.
  • A Patient with a psychiatric problem if the illness is manifested in part by refusal to leave home or in such nature that it would not be considered safe to leave home unattended.
  • A Patient in the late stages of ALS or neurodegenerative disabilities.
  • The Patient is unable to leave the home and, consequently, leaving home would require a considerable amount of taxing effort and infrequent or for periods of relatively short duration, or attributable to the need to receive health care treatment.
  • Absences attributable to the need to receive healthcare treatment include, attendance at an adult day centers to receive mental care, ongoing receipt of outpatient kidney dialysis, and the receipt of outpatient chemotherapy or radiation therapy.
  • Occasional absences from the home for nonmedical purposes, e.g., an occasional trip to the barber, walk around the block, a drive, and attendance at a family reunion, funeral, graduation, or other infrequent or unique event.

Preventing Falls

Home Accidents are a major cause of injury. As people grow older, they may be less agile and their bones tend to break more easily. All patients need to take special precautions to ensure a safe living environment.

  • Stairways and halls are well lighted.
  •  Night-Lights are used in the bathroom, halls and passageways.
  • Throw rugs are removed or have a nonskid backing and are not placed in traffic areas.
  • All clutter is cleared from the house, especially from pathways.
  • Electrical and telephone cords are placed along walls – not under rugs- and away from traffic areas and do not cross pathways.
  • Handrails are used on stairs and securely fastened.
  • The shower, tub or toilets install grab bars.
  • Outside walks are kept clear of debris and clutter.
  • Outside steps and entrances are well lighted.
  • You are aware of any medications being taken which may cause dizziness or unsteadiness.
  • Steps are in good condition and are free of objects.
  • Steps have nonskid strips or carpeting is securely fastened and is free from holes and fraying.
  • Light switches are located at the tope and bottom of stairways and at both ends of long halls.
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