Last Minute Gifts for the Home Health Field Staff


It’s not too late to get your favorite nurse, home health aide or therapist the perfect gift for Christmas.  We took an informal poll and here are the top five favorite gifts of all time for the foot soldiers on the front lines of home health and hospice care.

  1. A deluxe Fix-a-Flat kit.  The standard kit which includes a very muscular specimen of a man is okay for most nurses but in order to accommodate the influx of men into the field of home health, the deluxe kit includes a Swedish Bikini Volley Ball Team player to serve refreshments while waiting for the vehicle to be restored to its fully operational state.
  2. A insanely organized elf who prepares all documents, fixes computer glitches, reviews paperwork for signatures and listens intently without interruption when the field employee flashes out in traffic on his way to her six year old daughter’s T-ball game.
  3. Two fully loaded syringes of Haldol.  One for the patient and one for the nurse, therapist or home health aide.
  4. A HIPAA pass so the nurse can go to dinner with her friends and say, ‘You are NOT going to believe who I took care of today. Y’all should see him without his shirt on!  Wait!  you don’t want to.  I’m gonna tell you everything.  Let’s go get a table.’
  5. A cellular and Wi-Fi signal blocker.  You can find one at Jammers Factory.  The key is to discreetly place it in range to allow your favorite nurse, therapist or aide to get some rest.  If they realize that it’s there, they will compulsively flip the switch off and back on again every three minutes.

Please note that this advice is not a substitution for a consultation with an attorney.  The legalities of offering major psychotropic pharmaceutical compounds without appropriate documentation of authority has been questioned in various courts of law.  Federal law prohibits the operation, marketing, or sale of any type of jamming equipment, including devices that interfere with cellular and Personal Communication Services (PCS), police radar, Global Positioning Systems (GPS), and wireless networking services (Wi-Fi). If you find a compulsively organized elf who is willing to ride along with your favorite nurse, consider increasing the number of syringes in suggestion 3 to 3.  A person who knowingly violates the HIPAA privacy rules shall be fined not more than $50,000, imprisoned not more than 1 year, or both.  The severity of the penalty increases substantially if the intent of the disclosure was for commercial advantage. Not withstanding the low cost of room and board and free food in federal prisons, many health care workers find prison to be a career limiting choice of residences.

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Revisions per Request


As always, we listen and take to heart what others are saying.  There were many legitimate points made by our readers regarding the layout of the quiz.  Honestly?  It was the first one listed and we had no idea it would be that difficult to read.

The question about bathing has been taken off the quiz.  Many of you found it very difficult to understand so it has been removed.  I have also reset the quiz to show the results against my better judgment.  For those of you who have already taken the quiz, you can find the answers Answers.  Let me know if it doesn’t work.

What we remain adamant about are the definitions of the time points.  We don’t make this stuff up.  I promise.  According to the OASIS manual, chapter 1,

Day of assessment is defined as the 24 hours immediately preceding the home visit and the time spent by the clinician in the home.

If the patient’s ability or status varies on the day of the assessment, report the patient’s “usual status” or what is true greater than 50% of the assessment time frame, unless the item specifies differently (e.g., for M2020 Management of Oral Medications, M2030 Management of Injectable Medications, and M2100e Management of Equipment, instead of “usual status” or “greater than 50% of the time,” consider the medication or equipment for which the most assistance is needed).

Most times, the definition of the time frame will not change the answer but it can change it dramatically in some situations.

Patient 1

Patient 1 is scheduled for a recertification visit on day 56 of the episode.  His wife calls you the day before and asks if you can reschedule for the following day because Pt. 1 is having major dental work.  When you arrive on day 57, you learn that he was heavily sedated and in a great deal of pain for most of the prior day.  He took a pain pill before going to sleep and woke up better.  Currently he using Advil to control his pain and he is awake and alert and at no risk related to the oral surgery the day before.

Patient 2

Patient 2 is admitted after a cardiologist calls your agency.  Patient 2 was out playing golf yesterday and had a cardiac cath this morning.  His physician found a greater degree of heart failure than he anticipated and the patient was a very difficult stick.  He has a moderate hematoma at the insertion site and the physician asks if you could please admit the patient as soon as possible.   You arrive at the house late in the morning just as the patient is arriving home from the cath lab.

Can you see how the definition of ‘day of assessment’ would affect the responses to each of these questions?

When referencing our beloved Chapter 3, the instructions do mention that if ability varies, consider what the patient is able to do greater than 50% of the time.  Chapter 3 does not go on to clarify what a day is.   We are supposed to know what a day is.  So, pull out chapter 1 and have a look and meanwhile, I pulled out question 10.  Let me know if you still have problems with the layout.

Medicare Trivia


Is it ever acceptable to bill Medicare for health services for a patient other than the Medicare Beneficiary?
The surprising answer is Yes!  Should you ever decide to be a live donor for an organ transplant to a Medicare Beneficiary, your care is covered under their eligibility.  Now you have no reason not to offload a kidney that’s just taking up room that could be used for something else.