Home Health & Hospice

Insider’s scoop | Verbal order

Homecare Insider, April 18, 2016

Editor’s note: This week’s Insider’s scoop is from The Home Health Guide to Medicare Service Delivery, 2016 Edition. Newly updated to reflect the 2016 home health PPS final rule, this ubiquitous resource offers a one-stop solution for home health professionals looking for answers to their Medicare compliance questions. Click here for more information.

The Interpretive Guidelines for §484.18(a) state that an agency can receive verbal orders communicated from an institution’s discharge planner, nurse practitioner, physician’s assistant, or other authorized staff member, followed by written, signed, and dated physician orders. That means the physician generates the order, but the physician’s representative can convey the order to the homecare agency. Nurse practitioners and physician assistants cannot generate or sign orders for homecare patients. Homecare staff can provide the services or treatments contained in a verbal order while awaiting the physician’s signature.

A verbal order is an order that is:
•    Communicated from the physician, prior to rendering the services
•    Recorded and signed by a person authorized to accept verbal orders
•    Reviewed by a nurse or qualified therapist
•    Countersigned and dated by the physician

Documentation of the verbal order must include:
•    The date the order is received
•    Discipline(s), including frequency and duration of visits, duties, and responsibilities
•    Details of medications and treatments
•    Signature of staff member accepting the verbal order
•    Signature of the registered nurse or therapist reviewing the order