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JOINT COMMUNITY VENTURE SAVANNAH, GEORGIACHATHAM COUNTY
SHONDRA DAVIS RN AMEDISYS HOME HEALTHDEE DEE SEAGRAVES RNST. JOSEPH’S/CANDLER HEALTH SYSTEM
Face-to-Face
What is Face-to-Face?
Documented face to face encounter with a physician or licensed non-physician practitioner (PA,NP, CNS) evaluating the patient to determine the patient meets guidelines to receive home health care
Guidelines for Face-to-Face
Must be related to the primary reason home health services are being received
Occurs within 90 days prior to or 30 days after date of home health services beginning with SOC date being day 1
Verifies need for skilled services & homebound status per CMS guidelines
Significance in Reducing Readmissions
o Establishes appropriate, patient-specific plan of care
o Enables continuity of care during transition from inpatient to home setting
o Promotes physician involvement
Issues Within Savannah/Chatham County
o Lack of understanding of importance of
FTF
o MD refusing to sign & order home healtho Patients discharged to community without
appropriate services leading to increased ER visits and avoidable hospital readmissions
Housekeeping Details
o Three local hospitalso Four primary home health agencieso One face to face meetingo Email discussionso Presented results to Savannah Coalition
Group
Universal Form
Documentation of Face to Face Encounter
(Required for Home Health Care Referral for Medicare Patients)
I Certify that this patient is under my care and that I, or a nurse practitioner or physician’s assistant working with me, had a face-to-face encounter with this patient on: ____/____/____ The encounter with the patient was for the following medical condition(s), which is the primary reason for home health care: I am ordering and certify that, based on my findings, the following services are medically necessary home health services (Check all that apply): ____ Skilled Nursing ____ Physical therapy ____ Occupational therapy ____ Speech language pathology My clinical findings support the need for the above services because:
Certification for Home Health Services Based on the above findings, I certify that this patient is confined to the home and needs intermittent skilled nursing care, physical therapy and /or speech therapy or continues to need occupational therapy. The patient is under my care, and I have initiated the establishment of the plan of care. This patient will be followed by a physician who will periodically review the plan of care. Physician Signature _____________________________ Date of Signature _________ Physician Printed Name __________________________________________________
Patient Name: ______________________________________________________________ Date of Birth: ______________________________________________________________
QUESTIONS
Contact Information
Shondra Davis, RN, BSN, MHA-GERDirector of OperationsAmedisys, Inc.- Savannah 8301Office Phone: 912-233-9800Fax: [email protected]
Dee Dee Seagraves RN, MSN, CCM, BC-NEDirector, Clinical Care CoordinationSt. Joseph’s/Candler Health SystemOffice Phone: 912-819-8262Mobile 912-657-3583Fax [email protected]
