Frequently Asked Question of the Month:
Does nursing have to be involved in every home health episode?
No. Under Home Health Part A benefits, nursing involvement is not required in every patient case. Medicare covers various home health services, including skilled nursing care, physical therapy, speech therapy, occupational therapy, and certain medical supplies. While nursing care is often a component of home health services, it is not mandatory for every patient. The need for nursing involvement is determined based on the patient’s condition, the prescribed treatment plan, and the assessment of their healthcare provider. Some patients may require primarily therapy services, while others may require a combination of nursing and therapy services. Physical Therapists and Speech Therapists are allowed to perform the initial OASIS. On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2022 Home Health Prospective Payment System (HH PPS) Final Rule and finalized proposed provisions allowing occupational therapists to perform the initial and comprehensive assessments required to open Medicare home health therapy cases beginning on January 1, 2022.
The new rule updates Section 484.55 of the home health conditions of participation to allow an occupational therapist to conduct the initial assessment visit and complete the comprehensive assessment under the Medicare program:
- When occupational therapy is on the home health plan of care, with either physical therapy or speech therapy, and
- When skilled nursing services are not initially on the plan of care
Symbria is committed to maintaining a high standard and level of communication with our clients and employees regarding clinical education, PDGM understanding, patient assessment, home health regulations, and coding efficiency. As a result, the Home Health Insider was born. In this monthly offering, we hope to provide some valuable information that can foster a quality level of care that meets the needs of the patients that we serve.