Home Health & Hospice

Insider’s scoop | ’485’ versus supplemental therapy orders

Homecare Insider, April 4, 2016

Editor’s note: This week’s Insider’s scoop is from The Handbook to Home Health Therapy Documentation. Therapy utilization is under scrutiny by the federal government, making defensive and accurate therapy documentation crucial to home health agencies. This handbook, sold in convenient packs of 10, is your resource for frontline therapist education. Click here for more information.

Often referred to as the “485,” the plan of care generated at the time of admission or recertification is intended to be interdisciplinary and contains a defined set of information about the patient, including but not limited to biographical data, certification dates, physician information, diagnoses, homebound status, activity limitations, and frequency, duration, goals, and interventions for all ordered services. 

If all assessments occur within the first few days of the episode, then the therapy-specific information should be included in this form and sent for physician signature. If time has lapsed and the 485 has already been completed, then frequency, duration, goals, and interventions should be sent by each specific therapy to the ordering physician. It is routine practice to document “eval and treat” on the 485 as a placeholder for therapy services, but additional specific orders will have to be generated, because “eval and treat” will not cover a course of physical therapy, occupational therapy, or speech-language pathology.