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Agency quality of care
How well an agency helps clients to improve
Payment from episodic payors
Items that survey and auditors should review
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79 yo receiving ST post stroke under his PrimeWest MSHO insurance
31 yo receiving wound care post C-section under her Medicaid insurance
92 year old receiving HCA and HM services under his VA benefit
21 yo receiving PT under his parent's private BCBS insurance
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TRF effective 5/10/16, ROC effective 5/10/16
No OASIS required
TRF effective 5/5/16, ROC effective 5/10/16
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True
False
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True
False
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Diagnosis codes
OASIS responses
Number of therapy visits
Number of nurse and home health aide visits
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True
False
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Only needs to be documented for Medicare Patients
Only needs to be documented in SOC, ROC, or Re-cert visits
Needs to be charted in every visit
Only needs to say yes or no
Needs to have patient specific, detailed proof as to their homebound status
Should be updated with specific examples as they occur to support homebound status
Needs to be documented on every patient, regardless of payor
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True
False
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Improvement rates will affect our payment in the future
Referral sources choose which agencies to send patients to based on their improvement rates
They really don't matter, we're the only ones that can see them
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