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Conducting Home Visits to Private Pay Patients of a Home Health Agency (HHA)

PDF Version of BQA 99-061 (PDF, 5 KB)

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Date: October 15, 1999 DSL-BQA-99-061

To: Home Health Agencies HHA 29

From: Sue Schroeder, Director, Bureau of Quality Assurance

The purpose of this memorandum is to inform home health providers that the federal Health Care Financing Administration (HCFA) has clarified the policy related to conducting home visits to non-Medicare/Medicaid patients of an HHA.

Home visits may be conducted to any skilled patient who grants permission, according to the guidelines in section 2200 of the State Operations Manual, not only for initial surveys, but for re-certification and complaint surveys as well.

HCFA instituted this policy in January 1998 after the HHA moratorium was lifted. Recently, it came to their attention that Wisconsin, along with other states believed the policy was limited to initial surveys only. This was not the intention.

HCFA believed that expanding the policy to all HHA surveys allows surveyors the opportunity to assess that all patients are receiving care as indicated by the assessed needs of the patient and the established plan of care. Since the conditions of participation for home health agencies apply to all patients being served by the entity, regardless of payor source, this policy is based on the premise that it is the provider that is being approved or re-certified, not just the care provided to Medicare and Medicaid beneficiaries.

Please direct any questions you may have to Juan Flores, Supervisor, Health Care Regulatory Unit (replaced by Jan Heimbruch (608) 243-2086) or Barbara Woodford, Nurse Consultant, Provider Regulation and Quality Improvement Section (replaced by Marianne Missfeldt, (715) 836-4036).

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