TN 9 (10-22)

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 the patient was discharged from a hospital on August 1 and their 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 their 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.