Hi Gladys,
This question regarding fill in HHA supervision for
unskilled episodes came up on the Medicare Workgroup last year after the HH Final Rule- we reached out to NAHC to get some clarification.
Here is the write up the group did:
Brianna Lindell
Regulatory Affairs Manager
Minnesota Home Care Association
1265 Grey Fox Road, Suite 2 | Arden Hills, MN 55112-6929
Direct: 651.240.3380 | Main: 651.635.0607
www.mnhomecare.org
|
blindell@mnhomecare.org
From: medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org>
On Behalf Of Jessica Downs
Sent: Wednesday, March 9, 2022 12:36 PM
To: Bakken,Gladys <GBakken@riverviewhealth.org>; medicarecompliance@list.mnhomecare.org
Subject: RE: [BULK] [EXTERNAL] Daily digest for medicarecompliance@list.mnhomecare.org
Hello!
Here is a ‘snip it’ from the State Operations Manual (SOM) regarding the annual HHA supervision requirement. It is an annul, on-site, direct visit for each home health aide. The 60-day and 14-day HHA supervision
is supervising the HHA services being provided per patient. The annual requirement is annual per home health aide and only needs to happen one time annually unless there are issues noted during service supervision.
In our practice, if a HHA fills in for a visit or two, the supervision visit doesn’t change and is still captured every 14 days or 60 days. We don’t supervise each HHA that is in the home every 14day or 60
day. Just once annually. Or within 30 days of first day worked when they are new to the agency.
Our agency practice:
14-day indirect supervision visit for HHA services with skilled services
60-day direct supervision visit for HHA only services
30-day direct supervision visit for an aide that is brand new to the agency (this is from first day worked)
Direct supervision of HHA annually
Hope this helps!
Jess
Jessica Downs, RN
| Executive Director of Clinical Operations
Corporate Office
2586 7th Ave E, Suite 302, North St. Paul MN 55109
Phone: 651.633.7300 | Fax: 651.633.7301
Visit us on the web:
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From:
medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org>
On Behalf Of Bakken,Gladys
Sent: Wednesday, March 9, 2022 8:17 AM
To: medicarecompliance@list.mnhomecare.org
Subject: Re: [BULK] [EXTERNAL] Daily digest for
medicarecompliance@list.mnhomecare.org
CAUTION: This email originated from outside your organization. Exercise caution when opening attachments or clicking links, especially from unknown senders.
Hi all
We do the same as you guys in regards to the questions listed. It's nice to feel we're all on the same page!
🙂
I'm also wondering though if anyone has received clarification regarding doing a direct supervision on each client, with each aide, annually? There was uncertainty in response to the question about
what to do when an aide fills in just one or 2 times while the regular aide is off. Does a direct need to be done? If so, how are you handling that?
Thanks
Gladys
From: MHCA Listserv Administrator <nobody@list.mnhomecare.org>
Sent: Tuesday, March 8, 2022 6:09 PM
To: medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org>
Subject: [BULK] [EXTERNAL] Daily digest for
medicarecompliance@list.mnhomecare.org
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|
Reporting Missed HHA Visits - Farrah Gajewski
(08 Mar 2022 21:20 UTC) |
|
Re: Reporting Missed HHA Visits - Jenifer Baker
(08 Mar 2022 21:58 UTC) |
|
RE: Reporting Missed HHA Visits - Kristin Sundgaard
(08 Mar 2022 22:01 UTC) |
|
RE: Reporting Missed HHA Visits - Farrah Gajewski
(08 Mar 2022 22:11 UTC) |
|
RE: Reporting Missed HHA Visits - Jaime Bergren-Hanish
(08 Mar 2022 22:03 UTC) |
|
RE: Reporting Missed HHA Visits - Farrah Gajewski
(08 Mar 2022 22:21 UTC) |
Reporting Missed HHA Visits by
Farrah Gajewski (08 Mar 2022 21:20 UTC)
Reply to list
Hi All!
Now that COVID is not consuming all of my day, I am taking some time to review some processes we have. I have a couple of questions:
1. If a home health aide missed a visit to a client’s home for a shower, do you notify the PCP every time?
a. Would we be in compliance with CMS if we notified the PCP monthly?
2. How do you handle supervisory visits of a HHA within your agency to ensure Medicare compliance?
a. Do you do an indirect supervision every 14 days on all clients, including all non-Medicare clients?
I really would like to streamline some of the processes all while being compliant. Some of the things done seem cumbersome.
Thank you in advance for your time!
Farrah
Farrah Gajewski, RN
Adult Health Supervisor
Kanabec County Community Health
905 East Forest Avenue
Mora, MN 55051
320-679-6338
320-679-6333(fax)
farrah.gajewski@co.kanabec.mn.us
This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message
is not the intended recipient or the employee or agent for delivering the message to the intended recipient, you are hereby notified that dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication
in error, please notify us immediately by replying to this message and delete the original message and its contents. Thank You.
Re: Reporting Missed HHA Visits by
Jenifer Baker (08 Mar 2022 21:58 UTC)
Reply to
list
We notify the certifying MD on all patients for each MV yes. We do this by faxing it to them the same day with documentation of the reason for MV and other pertinent information.
And yes we do an indirect supervisory visit on all, regardless of payer, unless we can have both clinicians scheduled around the same time on the same day, then we will coordinate
a direct supervision. We utilize SN, PT, OT for these visits, but mainly SN for supervisory visits unless therapy needs to complete some training with the HHA.
On Tue, Mar 8, 2022 at 3:20 PM Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us> wrote:
Hi All!
Now that COVID is not consuming all of my day, I am taking some time to review some processes we have. I have a couple of questions:
1. If a home health aide missed a visit to a client’s home for a shower, do you notify the PCP every time?
a. Would we be in compliance with CMS if we notified the PCP monthly?
2. How do you handle supervisory visits of a HHA within your agency to ensure Medicare compliance?
a. Do you do an indirect supervision every 14 days on all clients, including all non-Medicare clients?
I really would like to streamline some of the processes all while being compliant. Some of the things done seem cumbersome.
Thank you in advance for your time!
Farrah
Farrah Gajewski, RN
Adult Health Supervisor
Kanabec County Community Health
905 East Forest Avenue
Mora, MN 55051
320-679-6338
320-679-6333(fax)
farrah.gajewski@co.kanabec.mn.us
This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message
is not the intended recipient or the employee or agent for delivering the message to the intended recipient, you are hereby notified that dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication
in error, please notify us immediately by replying to this message and delete the original message and its contents. Thank You.
--
Jenifer Baker, OTR, PTA, COS-C
Agency Director
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N,
Suite A
Maplewood, MN 55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214
Our Mission is to Provide Comprehensive, Compassionate, Family Centered Care Dedicated to Enriching the Lives of our Employees, our Patients, their Loved Ones and the Community We Serve.
RE: Reporting Missed HHA Visits by
Kristin Sundgaard (08 Mar 2022 22:01 UTC)
Reply
to list
To add to Jenifer’s comments, if you plan on moving the visit to another day, or making up the HHA visit during your Medicare week, no missed visit notification is necessary. It is only needed for visits that don’t meet the weekly
total number of visits for the discipline.
Please let me know how I may best help you.
Thank you,
Kristin Sundgaard, PT, COS-C | Compliance Field Specialist, HH
Phone: 651.247.9689
KristinSundgaard@accentCare.com |
www.accentCare.com
From:
medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org> On Behalf Of Jenifer Baker
Sent: Tuesday, March 8, 2022 3:59 PM
To: Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us>
Cc: medicarecompliance@list.mnhomecare.org
Subject: Re: Reporting Missed HHA Visits
BE ADVISED:This email originated from outside of AccentCare’s email system. DO NOT CLICK LINKS or ATTACHMENTS until you have validated the sender and verified the content is safe.
We notify the certifying MD on all patients for each MV yes. We do this by faxing it to them the same day with documentation of the reason for MV and other pertinent information.
And yes we do an indirect supervisory visit on all, regardless of payer, unless we can have both clinicians scheduled around the same time on the same day, then we will coordinate a direct supervision. We utilize SN, PT, OT for these
visits, but mainly SN for supervisory visits unless therapy needs to complete some training with the HHA.
On Tue, Mar 8, 2022 at 3:20 PM Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us> wrote:
Hi All!
Now that COVID is not consuming all of my day, I am taking some time to review some processes we have. I have a couple of questions:
1. If a home health aide missed a visit to a client’s home for a shower, do you notify the PCP every time?
a. Would we be in compliance with CMS if we notified the PCP monthly?
2. How do you handle supervisory visits of a HHA within your agency to ensure Medicare compliance?
a. Do you do an indirect supervision every 14 days on all clients, including all non-Medicare clients?
I really would like to streamline some of the processes all while being compliant. Some of the things done seem cumbersome.
Thank you in advance for your time!
Farrah
Farrah Gajewski, RN
Adult Health Supervisor
Kanabec County Community Health
905 East Forest Avenue
Mora, MN 55051
320-679-6338
320-679-6333(fax)
farrah.gajewski@co.kanabec.mn.us
This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message
is not the intended recipient or the employee or agent for delivering the message to the intended recipient, you are hereby notified that dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication
in error, please notify us immediately by replying to this message and delete the original message and its contents. Thank You.
--
Jenifer Baker, OTR, PTA, COS-C
Agency Director
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N,
Suite A
Maplewood, MN 55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214
Our Mission is to Provide Comprehensive, Compassionate, Family Centered Care Dedicated to Enriching the Lives of our Employees, our Patients, their Loved Ones and the Community We Serve.
Information contained in this e-mail and any attachments thereto is intended solely for use of the recipient(s) named above and may be privileged, confidential, and/or proprietary.
If you are not the intended recipient, please do not read, distribute, or reproduce this transmission. You are advised that unauthorized use of this e-mail by any unintended recipient may be unlawful and could subject the user to civil damages and other penalties.
If you have received this e-mail transmission in error, please notify the sender immediately by reply e-mail and then delete this e-mail.
RE: Reporting Missed HHA Visits by
Farrah Gajewski (08 Mar 2022 22:11 UTC)
Reply
to list
Great!
Thank you for the help! We do send MV to PCP via fax for every MV. It seems like a lot so I was hoping to minimize it.
We also do indirect sups on all clients every two weeks. I am too worried about missing someone.
Sounds like we are all on the same page, THANK YOU!
From: Kristin Sundgaard [mailto:KristinSundgaard@AccentCare.com]
Sent: Tuesday, March 8, 2022 4:02 PM
To: Jenifer Baker <jbaker@firstatmn.com>; Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us>
Cc: medicarecompliance@list.mnhomecare.org
Subject: RE: Reporting Missed HHA Visits
To add to Jenifer’s comments, if you plan on moving the visit to another day, or making up the HHA visit during your Medicare week, no missed visit notification is necessary. It is only needed for visits that don’t meet the weekly
total number of visits for the discipline.
Please let me know how I may best help you.
Thank you,
Kristin Sundgaard, PT, COS-C | Compliance Field Specialist, HH
Phone: 651.247.9689
KristinSundgaard@accentCare.com |
www.accentCare.com
From:
medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org> On Behalf Of Jenifer Baker
Sent: Tuesday, March 8, 2022 3:59 PM
To: Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us>
Cc: medicarecompliance@list.mnhomecare.org
Subject: Re: Reporting Missed HHA Visits
BE ADVISED:This email originated from outside of AccentCare’s email system. DO NOT CLICK LINKS or ATTACHMENTS until you have validated the sender and verified the content is safe.
We notify the certifying MD on all patients for each MV yes. We do this by faxing it to them the same day with documentation of the reason for MV and other pertinent information.
And yes we do an indirect supervisory visit on all, regardless of payer, unless we can have both clinicians scheduled around the same time on the same day, then we will coordinate a direct supervision. We utilize SN, PT, OT for these
visits, but mainly SN for supervisory visits unless therapy needs to complete some training with the HHA.
On Tue, Mar 8, 2022 at 3:20 PM Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us> wrote:
Hi All!
Now that COVID is not consuming all of my day, I am taking some time to review some processes we have. I have a couple of questions:
1. If a home health aide missed a visit to a client’s home for a shower, do you notify the PCP every time?
a. Would we be in compliance with CMS if we notified the PCP monthly?
2. How do you handle supervisory visits of a HHA within your agency to ensure Medicare compliance?
a. Do you do an indirect supervision every 14 days on all clients, including all non-Medicare clients?
I really would like to streamline some of the processes all while being compliant. Some of the things done seem cumbersome.
Thank you in advance for your time!
Farrah
Farrah Gajewski, RN
Adult Health Supervisor
Kanabec County Community Health
905 East Forest Avenue
Mora, MN 55051
320-679-6338
320-679-6333(fax)
farrah.gajewski@co.kanabec.mn.us
This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message
is not the intended recipient or the employee or agent for delivering the message to the intended recipient, you are hereby notified that dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication
in error, please notify us immediately by replying to this message and delete the original message and its contents. Thank You.
--
Jenifer Baker, OTR, PTA, COS-C
Agency Director
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N,
Suite A
Maplewood, MN 55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214
Our Mission is to Provide Comprehensive, Compassionate, Family Centered Care Dedicated to Enriching the Lives of our Employees, our Patients, their Loved Ones and the Community We Serve.
Information contained in this e-mail and any attachments thereto is intended solely for use of the recipient(s) named above and may be privileged, confidential, and/or proprietary. If you are not the intended recipient, please do
not read, distribute, or reproduce this transmission. You are advised that unauthorized use of this e-mail by any unintended recipient may be unlawful and could subject the user to civil damages and other penalties. If you have received this e-mail transmission
in error, please notify the sender immediately by reply e-mail and then delete this e-mail.
RE: Reporting Missed HHA Visits by
Jaime Bergren-Hanish (08 Mar 2022 22:03 UTC)
Reply
to list
I was tagged 4 years ago for not notifying the MD “timely” and tried to argue that “timely” was up for interpretation, but ultimately didn’t win the argument. Since then, I have been updating MD’s with each missed visit via fax.
We also do indirect supervision every 14 days on everyone regardless of payer.
From:
medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org> On Behalf Of Jenifer Baker
Sent: Tuesday, March 8, 2022 3:59 PM
To: Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us>
Cc: medicarecompliance@list.mnhomecare.org
Subject: Re: Reporting Missed HHA Visits
BE ADVISED:This email originated from outside of AccentCare’s email system. DO NOT CLICK LINKS or ATTACHMENTS until you have validated the sender and verified the content is safe.
We notify the certifying MD on all patients for each MV yes. We do this by faxing it to them the same day with documentation of the reason for MV and other pertinent information.
And yes we do an indirect supervisory visit on all, regardless of payer, unless we can have both clinicians scheduled around the same time on the same day, then we will coordinate a direct supervision. We utilize SN, PT, OT for these
visits, but mainly SN for supervisory visits unless therapy needs to complete some training with the HHA.
On Tue, Mar 8, 2022 at 3:20 PM Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us> wrote:
Hi All!
Now that COVID is not consuming all of my day, I am taking some time to review some processes we have. I have a couple of questions:
1. If a home health aide missed a visit to a client’s home for a shower, do you notify the PCP every time?
a. Would we be in compliance with CMS if we notified the PCP monthly?
2. How do you handle supervisory visits of a HHA within your agency to ensure Medicare compliance?
a. Do you do an indirect supervision every 14 days on all clients, including all non-Medicare clients?
I really would like to streamline some of the processes all while being compliant. Some of the things done seem cumbersome.
Thank you in advance for your time!
Farrah
Farrah Gajewski, RN
Adult Health Supervisor
Kanabec County Community Health
905 East Forest Avenue
Mora, MN 55051
320-679-6338
320-679-6333(fax)
farrah.gajewski@co.kanabec.mn.us
This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message
is not the intended recipient or the employee or agent for delivering the message to the intended recipient, you are hereby notified that dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication
in error, please notify us immediately by replying to this message and delete the original message and its contents. Thank You.
--
Jenifer Baker, OTR, PTA, COS-C
Agency Director
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N,
Suite A
Maplewood, MN 55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214
Our Mission is to Provide Comprehensive, Compassionate, Family Centered Care Dedicated to Enriching the Lives of our Employees, our Patients, their Loved Ones and the Community We Serve.
Information contained in this e-mail and any attachments thereto is intended solely for use of the recipient(s) named above and may be privileged, confidential, and/or proprietary.
If you are not the intended recipient, please do not read, distribute, or reproduce this transmission. You are advised that unauthorized use of this e-mail by any unintended recipient may be unlawful and could subject the user to civil damages and other penalties.
If you have received this e-mail transmission in error, please notify the sender immediately by reply e-mail and then delete this e-mail.
RE: Reporting Missed HHA Visits by
Farrah Gajewski (08 Mar 2022 22:21 UTC)
Reply
to list
We were tagged for it in 2020. However, state showed up to do our survey on day 10 of my employment so I was a little clueless about a lot of the processes. Since then, we have done it for every missed visit J
Thanks again!
From: Jaime Bergren-Hanish [mailto:JaimeBergren-Hanish@accentcare.com]
Sent: Tuesday, March 8, 2022 4:03 PM
To: Jenifer Baker <jbaker@firstatmn.com>; Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us>
Cc: medicarecompliance@list.mnhomecare.org
Subject: RE: Reporting Missed HHA Visits
I was tagged 4 years ago for not notifying the MD “timely” and tried to argue that “timely” was up for interpretation, but ultimately didn’t win the argument. Since then, I have been updating MD’s with each missed visit via fax.
We also do indirect supervision every 14 days on everyone regardless of payer.
From:
medicarecompliance@list.mnhomecare.org <medicarecompliance@list.mnhomecare.org> On Behalf Of Jenifer Baker
Sent: Tuesday, March 8, 2022 3:59 PM
To: Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us>
Cc: medicarecompliance@list.mnhomecare.org
Subject: Re: Reporting Missed HHA Visits
BE ADVISED:This email originated from outside of AccentCare’s email system. DO NOT CLICK LINKS or ATTACHMENTS until you have validated the sender and verified the content is safe.
We notify the certifying MD on all patients for each MV yes. We do this by faxing it to them the same day with documentation of the reason for MV and other pertinent information.
And yes we do an indirect supervisory visit on all, regardless of payer, unless we can have both clinicians scheduled around the same time on the same day, then we will coordinate a direct supervision. We utilize SN, PT, OT for these
visits, but mainly SN for supervisory visits unless therapy needs to complete some training with the HHA.
On Tue, Mar 8, 2022 at 3:20 PM Farrah Gajewski <Farrah.Gajewski@co.kanabec.mn.us> wrote:
Hi All!
Now that COVID is not consuming all of my day, I am taking some time to review some processes we have. I have a couple of questions:
1. If a home health aide missed a visit to a client’s home for a shower, do you notify the PCP every time?
a. Would we be in compliance with CMS if we notified the PCP monthly?
2. How do you handle supervisory visits of a HHA within your agency to ensure Medicare compliance?
a. Do you do an indirect supervision every 14 days on all clients, including all non-Medicare clients?
I really would like to streamline some of the processes all while being compliant. Some of the things done seem cumbersome.
Thank you in advance for your time!
Farrah
Farrah Gajewski, RN
Adult Health Supervisor
Kanabec County Community Health
905 East Forest Avenue
Mora, MN 55051
320-679-6338
320-679-6333(fax)
farrah.gajewski@co.kanabec.mn.us
This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message
is not the intended recipient or the employee or agent for delivering the message to the intended recipient, you are hereby notified that dissemination, distribution or copying of this communication is strictly prohibited. If you received this communication
in error, please notify us immediately by replying to this message and delete the original message and its contents. Thank You.
--
Jenifer Baker, OTR, PTA, COS-C
Agency Director
Firstat Nursing Services
Comprehensive Home Care and Therapy Services
2395 Ariel St. N,
Suite A
Maplewood, MN 55109
Office: 651-288-0222 ext. 2003
Direct Number: 651-409-4378
Fax: 651-288-0214
Our Mission is to Provide Comprehensive, Compassionate, Family Centered Care Dedicated to Enriching the Lives of our Employees, our Patients, their Loved Ones and the Community We Serve.
Information contained in this e-mail and any attachments thereto is intended solely for use of the recipient(s) named above and may be privileged, confidential, and/or proprietary. If you are not the intended recipient, please do
not read, distribute, or reproduce this transmission. You are advised that unauthorized use of this e-mail by any unintended recipient may be unlawful and could subject the user to civil damages and other penalties. If you have received this e-mail transmission
in error, please notify the sender immediately by reply e-mail and then delete this e-mail.
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