HI 00601.480 Fourteen Day Limit on Plan Establishment
For services prior to July 1, 1981, the plan for home health services must be established
within 14 days after the patient's discharge from the qualifying prior inpatient stay.
In determining the 14-day period, the day of discharge is not counted in the 14 days.
For example, a patient's plan is established within 14 days if he was discharged from
a hospital on August 1 and his plan was established on August 15.
There is no limitation on when a plan may be established before the patient's release
from the institution. However, it is unlikely that such a plan would be established
before the physician has determined the patient's approximate release date from the
hospital or SNF since it would be difficult to determine prior to that time just what
services will be required in the treatment of the individual's illness or injury upon
his discharge to the home setting.
In some cases, services are furnished after discharge from the hospital or SNF and
before the plan has been reduced to writing. Payment under Part A may be made for
such services if authorized by a physician, provided the plan is reduced to writing
within 14 days of the patient's discharge. Effective July 1, 1981, a plan does not
have to be established within 14 days of discharge since the prior inpatient stay
requirement for home health services is eliminated.