I was actually eagerly awaiting other agency responses, but haven’t seen any yet, so thought I would jump into the fray on this one.

 

This has been an ongoing debate within our agency as well and I will describe where we have landed – although I cannot say if it is the most regulatory compliant approach.

 

As a Medicare certified agency, we offer to provide that service to the client if they met Medicare eligibility and they require the service. It has always been my understanding the agency must provide the services required by the client which Medicare in fact covers. That is the client’s right.

 

If the client resides in assisted living there are considerations, for example:

  1. Is the client receiving the shower as part of a “package” rate and there will be no cost benefit to that client if our agency shifts to providing the shower?
  2. Does the client prefer the consistent staffing currently being provided by the assisted living and would they prefer not to switch to our agency while they are under a Medicare episode?

 

These considerations are evaluated on a case by case basis and the client decides.

 

But the short answer for us is, yes, we offer the shower as part of the Medicare episode of care if it is a necessary service to meet the clients needs during the episode of care – along with any other services covered by Medicare.

 

 

Lynette Oehlke Hoffman l Director of Operations l Comfort Health

 

web              www.comforthealth.org

office            507.281.2332

cell                507.202.1578

address       2746 Superior Dr NW, #200, Rochester, MN 55901

 

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From: billers@list.mnhomecare.org <billers@list.mnhomecare.org> On Behalf Of Patti Fladwood
Sent: Thursday, February 3, 2022 8:13 AM
To: billers@list.mnhomecare.org
Subject: question regarding HHA

 

Hi,

We are having a discussion in our agency regarding providing HHA services in AL when patients are already receiving showers from the AL.  Just wondering what other agencies do in these cases.  I know Insurance doesn’t pay in that case, but the are saying that it’s a Medicare reg to provide even in AL.

 

Thanks for any responses.

 

 

Patti Fladwood

BILLING SPECIALIST

OPTAGE HOMECARE

Presbyterian Homes & Services

2845 Hamline Avenue North, Roseville, MN 55113

Tel:(651)631-6198; Email: pfladwood@preshomes.org

Optage® is the home and community services division of Presbyterian Homes & Services.

 

optage

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