Community Home Health and Restorative Care offers Skilled Nursing, Occupational, Physical, Speech Therapy, and other home health services to Atchison, Holt and parts of Nodaway, Andrew, Gentry, Daviess, Harrison, Buchanan and Platte Counties. Acceptance to Service Policy
Purpose:
To establish and maintain an approach to accepting referrals for care which ensures the agency accepts for treatment only those patients for whom there is a reasonable expectation of being able to meet their care needs by:
• Defining criteria and assessment processes related to the agency’s capacity to provide patient care.
• Setting guidelines for what and how to make available to the public, accurate information regarding the services offered by the agency. Policy:
All prospective patients referred to the agency will be accepted based on criteria related to the agency’s capacity to provide patient care ensuring a reasonable expectation of meeting the care needs of the patient in a timely admission process for the prospective patients (referrals). Criteria considerations that will be applied during the intake process:
• The anticipated needs and practitioner orders based on the referral
• Caseload and case mix of the agency
• Staffing levels and capacity of the agency
• Skilled and competencies of the agency staff
The agency will make available to the public the services offered based on licensure along with any limitations that may apply to types of specialty services and the frequency as necessary based on actual or anticipated changes but no less than annually. Procedure:
Intake personnel will consider all referrals for acceptance or declination using the outlined criteria listed within the policy and any other applicable policy the agency has in place related to “Home Health Referral Process,” or the like. The anticipated needs of the referral/prospective patient
• Intake or designated staff will review each referral/potential patient with a critical eye and use clinical judgment to anticipate the needs of each using the documentation provided from the referral source.
• Further clarification may be requested/required via communication (written, verbal or both) with the referral source, the potential patient(s), and/or the family/caregivers along with the review of the clinical medical record, as applicable.
• The agency will accept only those patients whose anticipated needs can be met, and the services can be provided. Caseload and case mix of the agency
• Intake personnel or designated staff will consider the clinical complexity of the referral/prospective patient, condition of the patient, resources, and discipline(s) needed/ordered, expected/necessary frequency and duration of home visits, rehabilitation potential, home support system and the need for available and willing caregivers.
• As needed, intake or designated staff will collaborate with the Clinical Leadership of the agency to assist with determining appropriateness of accepting the referral/potential patient
• The agency will accept referrals/potential patients based on capacity of caseloads and case mix and when the needs of the patient can be adequately med and goals achieved. Staffing Levels of the agency
• Intake personnel or designated staff and agency schedulers will have access to the clinicians’ work schedule including approved time off. This will assist in determining staffing and capacity.
• Intake personnel or designated staff and agency schedulers will have access to existing schedules and planned visits (specifically, SOC, ROC, Recertifications, other follow-up, etc.) as part of the process to ensure timeliness of initial scheduling of the initial evaluation/Start of Care) for each new referral/prospective patient.
• Current availability of anticipated start of care date will be communicated to the referral source and as part of the consideration when accepting the referral/prospective patient. Skills and Competencies of the Agency Staff
• The Agency Director will maintain a current listing of staff competencies and skills that have been checked off per agency policy for all skilled nursing. Community Home Health and Restorative Care will update page, publicly reporting changes to the Acceptance to Service Policy and notify referral sources via phone call, email or referral portal if agency is unable to accept the referral. References:
42 CFR 484.105
42 CF4 484.55
42 CF4 484.60
42 CF4 424.22
