A visit is a personal contact in the place of residence of a patient made for the
purpose of providing a covered service by a health worker on the staff of the HHA,
by others under contract or arrangement with the HHA, or a visit by a patient on an
outpatient basis to a hospital, SNF, or rehabilitation center, or outpatient department
affiliated with a medical school when arrangements have been made by the HHA for one
or more covered services.
HHA's are required to have written policies concerning the acceptance of patients
which include, consideration of the physical facilities available in the patient's
home, attitudes of family members, and availability of family members to help in the
care of the patient.
When personnel of the agency make such an initial evaluation visit, the cost is not
chargeable as a visit since at this point the patient has not been accepted for home
care. If, however, during the course of the initial visit, the patient is determined
to be suitable for home health care by the agency, and is also furnished a skilled
service as ordered under the physician's plan of treatment, this visit would become
the first billable visit.
Evaluation visits may be made by a nurse to determine the specific personal care needs
of the patient which will be assigned to a home health aide or to review the manner
in which the personal care needs of the patient are being met by the aide. Such visits
are also considered an administrative function and are not chargeable to the patient
as skilled nursing visits.
If in the course of carrying out a home health plan of treatment for a patient, a
nurse visits the patient for the purpose of evaluating the continuing skilled nursing
needs of the patient or to teach and counsel the patient and family members regarding
the nursing care needs and related problems of the patient at home, the visit would
be chargeable as a skilled nursing visit.