Home Health & Hospice

Insider’s scoop | Admission criteria

Homecare Insider, July 18, 2016

Editor’s note: This week’s Insider’s scoop is from The Home Health Guide to Medicare Service Delivery, an economical, efficient, and informative resource for helping home health agencies understand and address Medicare regulations and compliance. Click here for more information.

Homecare agencies should develop and consistently implement admission criteria to ensure that they can, in fact, meet each patient’s needs in their home. When developing this policy, the following points should be considered:

•    Staffing must be adequate and competent, as should resources needed to provide services.
•    The patient’s residence must be a safe environment; patients who live in unsafe conditions should not be admitted to your agency, and your policy should include this information.
•    Patients must be under the care of a physician who will supervise their care and sign orders.
•    Satisfactory orders must be present for care to begin.
•    Medicare coverage and eligibility must be met.
•    Address any agency-specific issues that correlate with your agency’s mission and goals. For example, some agencies do not accept patients who have not had a face-to-face physician encounter within 90 days prior to the start of care to avoid payment issues. If this is your policy, it should be included in your admission criteria.  
•    The agency’s treatment week should be defined.