Home Health Discharge Orders

[Guest guest]

I am a new home health PT director in Ohio. I have been told that

if I do a start of care for a pt with Medicare who I do not intend

to follow for therapy (no need existed in this case), that I need to

get an order from the doctor for 1 time a week for 1 week and

discharge. I am confused becauase I already have an order to go in

and evaluate this pt. I called the dr's office to notify them of my

decision to not treat this pt because no need existed. Do I need

another order from the doctor with the frequency to reflect only the

eval appt?

Botkin, MPT, PT

Cardinal Home Care, Inc.

[Guest guest]

At our agency we do not write verbal orders to discharge patients. In the

case you described, we would write the 485/plan of care as a 1w1. Evaluated

and no need for continued therapy identified. The therapist would also

telephone the physician to notify of the discharge and that no need for

further home care was identified.

Marie DiTomas, PT

University Hospitals Health System Home Care

Cleveland, Ohio

Home Health Discharge Orders

> I am a new home health PT director in Ohio. I have been told that

> if I do a start of care for a pt with Medicare who I do not intend

> to follow for therapy (no need existed in this case), that I need to

> get an order from the doctor for 1 time a week for 1 week and

> discharge. I am confused becauase I already have an order to go in

> and evaluate this pt. I called the dr's office to notify them of my

> decision to not treat this pt because no need existed. Do I need

> another order from the doctor with the frequency to reflect only the

> eval appt?

>

> Botkin, MPT, PT

> Cardinal Home Care, Inc.

>

>

>

>

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[Guest guest]

,

I'm somewhat confused by the scenario you report. Is this patient not admitted

to home health services (in other words will she receive another qualifying

disciplines service)? If PT determined there was no need for services and no

other qualifying service will continue, it would seem the patient would be a

non-admit. In this scenario another order would not be necessary. It would

require documentation of consultation with the referring physician. If the

patient will be continued by another discipline, the order for the one visit of

PT can be placed on the 485 (plan of care). I am not aware of any reason for

obtaining an order for an evaluation only, but maybe it is relative to an agency

policy/procedure or an intermediary specific decision.

Jimmie Arceneaux, LOTR

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