Frequently Asked Question of the Month:
Is a qualifying hospital stay required to qualify for Medicare Part A home health?
No. Access to the Medicare Part A home health benefit does not require the same three day/midnight qualifying stay as SNFs, but rather is dependent on homebound status, being under the care of a physician who establishes and periodically reviews the plan of care, need for skilled nursing on an intermittent basis or physical therapy/speech language pathology or continued occupational therapy services. There are two types of admissions under PDGM, Institutional and Community. Institutional refers to those admitted from an inpatient acute care, such as a hospital or a post-acute facility, such as a SNF, LTCH, or IRF. Admissions from these sources must be within 14 days of admission to the HHA. Community admissions include patients with no acute or post-acute care stay 14 days prior to HH admission but qualify for skilled home health care. Therefore, timing of post-acute care discharge and HHA admission are critical time points.
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.