A benefit episode or period, in a nutshell, is the defined period during which a patient receives home health or hospice care. Episode management is a continuous and proactive episode review process that consists of an ongoing weekly analysis of open Home Care near Marina Del Rey CA episodes. Key components include risk assessments, objectives of care, analysis of the use of visits, the use of disciplinary measures, the accuracy of OASIS, and care plans. According to CMS, in the PDGM, the first 30-day episode is early. All subsequent periods in the sequence are classified as late until there is an interval of at least 60 days between discharge and the start of care for the next Home Care near Marina Del Rey CA episode. If 60 days have elapsed between episodes, the first 30 days of that start of treatment are considered early and subsequent sequences and episodes are considered late.
Keep in mind that this is automatically corrected in the claim, so agencies can't change late to early to get an additional refund. Risk assessments include the risk of falls, the risk of skin breakage, the evaluation of pain, the detection of depression, and the risk of hospitalization in intensive care and of going to the emergency department. When reviewing an episode of care, it was observed that a patient's frequency of skilled nursing (SN) visits was greater than would be expected for the primary diagnosis and the reason for the services. The vast majority of HHA patients attended skilled nursing visits (90.1 percent), while approximately one in three received care from a home health aide (35.2 percent) or a physical therapist (32.8 percent).
Early identification of the need for therapeutic services allowed for early intervention, improving the knowledge and safety of patients and caregivers through transfers, mobility and pressure reduction measures. Several factors contribute to the recent growing interest in understanding the role of home health care in the range of services for Medicare beneficiaries. Finally, the incentives of the Medicare hospital prospective payment system (PPS) have also helped to increase its use; the reduction in stays and the increase in care needs at discharge have helped to increase the demand for home care after discharge (Noether, 198). The data for this analysis was obtained in 1987 from a sample of Medicare-certified HHAs that the Health Care Financing Administration (HCFA) had hired in 1985 to participate in a demonstration of potential HHA payments that was not implemented at that time.
In home health, over time, the intensity of care should decrease as the patient's condition improves. The doctor referred the patient to CNS home care services to treat a stage 2 buttock pressure ulcer. The doctor re-certified the patient for a new 60-day episode to continue treatment of the wound caused by an abscess in the buttock. Table 2 shows the distribution of allowed visits and total episode charges during 1986 for these HHA Medicare customers.
The home health care plan, or care plan, is the framework upon which the interdisciplinary team bases their care. Despite these technical difficulties, HCFA forms 485 and 486 are particularly useful for this type of policy research, as these forms are still used in the Medicare home health care program. For successful treatment of episodes, develop the care plan with these goals and benchmarks in mind.
