+ ACTIVITIES OF DAILY LIVING / ADLS

Activities of Daily Living are daily tasks performed by the average person to take care of their bodies. Examples of ADLs are walking, bathing, toileting and dressing. ADL status and progress are evaluated and documented in the OASIS document.

+ADMINISTRATOR / ADMIN

This is the highest non-clinical position in home health. Every staff member of the agency, including the DPCS report to the Administrator.

+CASE MANAGER / CS

Case managers are responsible for patient care coordination. This term can be used to describe a person assigned to managing the patient’s care within a managed care organization, or someone working inside the home health agency. When referring to a person working in the home health agency, this term can refer to the QA assigned to this patient or the field staff who performed the most recent evaluation.

+CENTER FOR MEDICARE AND MEDICAID SERVICES / CMS

CMS is a federal government program that oversees Medicare, Medicaid the Children’s Health Insurance Program, and the Health Insurance Marketplace.

+CERTIFICATION PERIOD / CERT PERIOD

The certification period is the time range that the patient remains in the agency’s care. At the end of the certification period, the home health agency decides whether to discharge or recertify the patient. The agency can also discharge a patient prior to the end of the certification period, if the patient’s clinical status allows for it. This is also referred to as Episode.

+CERTIFIED HOME HEALTH AIDE / CHHA

This is a field staff member with limited clinical capacity. This field staff members’ duties include light housekeeping, light meal preparation, bathing and other personal care tasks.

+COMMUNICATION NOTE / COMM NOTES

Communication notes are memos used to document key communication points between office staff, field staff and patients throughout the patient’s treatment. Comm notes help explain why certain events took place within a chart. Communication notes are used for instances that are relevant to paint the picture of patient’s care, but do not adjust the originally prescribed treatment.

+COST REPORT

The Medicare cost report is an annual report all healthcare facilities are required to submit including information regarding the company’s utilization, costs and charges.

+DIRECTOR OF PATIENT CARE SERVICES / DPCS

This is the highest clinical position in the home health agency, and is usually held by a registered nurse. All clinicians working for a home health agency report to this person.

+DISCHARGE / DC

The discharge visit is the last visit by the home health agency to a patient. This visit type “closes” the home health patient, officially removing them from the agency’s care. For Medicare and Medicare Advantage patients, field staff are required to complete a discharge OASIS, documenting the patient’s progress and current status at the time of discharge. Managed care organizations have their own individual rules regarding the final discharge visit that may not include the completion of the OASIS document. Every discipline involved in the patient’s care is required to perform a discharge visit as their last visit to the patient, however only the last person seeing the patient from the agency is required to complete the discharge OASIS.

+FIELD STAFF / FS

Field staff are clinicians who work in the field. This term is used for staff who work directly for the agency. This type of staff can be comprised of both 1099 and W-2 employees.

+FREQUENCY

A frequency refers to the quantity and duration of visits. Frequencies are assigned at evaluation visits and can change throughout an episode. The standard format of a frequency is xty, in which x represents the number of visits, t represents the measurement of time and y represents the number of weeks. For example, 1m2, which means once a month for two months. Frequency strings are often combined for example, 1wk1, 3wk2, 2wk1, 1wk4 which means once a week for one week, three times a week for two weeks, twice a week for one week, and once a week for four weeks, creating a visitation plan for 8 weeks.

+HOME HEALTH COMPARE

The Home Health Compare website is a central database for Medicare certified home health agencies across America. The purpose of the Home Health Compare website is to provide patients and referral sources an assessment of the agency’s quality and effectiveness of services. To go the Home Health Compare website, please click here.

+HOME HEALTH CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS / HHCAHPS

HHCAHPS is a patient survey conducted by a CMS approved third party, unbiased company. The purpose of the survey is to understand patient perceptions regarding their healthcare. Home health agencies are required to provide HHCAHPS vendors a monthly list of all their patients to conduct these surveys.

+INSTRUMENTAL ACTIVITIES OF DAILY LIVING / IADLS

Instrumental Activities of Daily Living are daily tasks performed by the average person as part of an independent lifestyle. Examples of IADLs are cooking, managing medications, driving and using the telephone. IADL status and progress are evaluated and documented in the OASIS document.

+LICENSED OFFICE STAFF / LOS

This is a licensed clinician who works inside the agency. The only difference between their account type and a regular office account type in FasterNotes is that LOS can also sign clinical documents.

+MANAGED CARE ORGANIZATION / MCO

Managed care organizations are insurance companies. The term managed care comes from the insurance company’s role in directly managing the care of the patient. Unlike Medicare, managed care organizations require pre-approval of all treatment performed on a patient. Also referred to as “Private Insurance”.

+MD ORDERS / ORDERS

MD orders are memos that require the doctor’s signature because they adjust the originally prescribed treatment. Home health agencies have 30 calendar days from the day of the order to have the signed (by the MD) order in the patient’s chart. Common reasons to use MD orders are hospitalizations, changes to the patient’s medications, changes in frequency, and major clinical events like falls or patient abuse.

+MEDICAL SOCIAL WORK / MSW

Medical social work is one of the disciplines provided by a home health agency. This discipline includes the Medical Social Worker (MSW) and Medical Social Work Assistant (MSWA) license types. This license category is focused on assessing the patient’s home environment for safety and coordinating social assistance programs for patients in need.

+NOTES

Documents created to describe patient treatment.

+OASIS EXPORTS

Home Health Agencies are required to submit OASIS data to CMS to determine the effectiveness of the treatment provided to patients. Results of OASIS submissions are displayed on the Home Health Compare website

+OCCUPATIONAL THERAPY / OT

Occupational therapy is one of the disciplines provided by a home health agency. This discipline includes the Occupational Therapist (OT) and Certified Occupational Therapy Assistant (COTA) license types. This license category is focused on activities of daily living such as hair brushing and mainly upper body movements.

+OFFICE STAFF / OS

Employees who work inside the home health agency office.

+OUTCOME AND ASSESSMENT INFORMATION SET / OASIS

OASIS documents are comprehensive assessments that contain mostly multiple choice questions with the purpose of evaluating the patient’s condition at various points in their treatment. OASIS documents are the basis for many reporting requirements and billing processes for state and federal insurance agencies.

+PLAN OF CARE / CARE PLAN / POC / 485

The plan of care is a detailed MD order describing the patient’s current condition, including the functional status, medications and diagnoses, the goals for the patient’s treatment and the plan to achieve those goals. The POC is usually based on the OASIS document and is used by all the field and office personnel as a reference point for the patient’s treatment. The plan of care is altered every 60 days or at every new evaluation. Changes to the plan of care are documented in the form of MD orders.

+PHYSICAL THERAPY / PT

Physical therapy is one of the disciplines provided by a home health agency. This discipline includes the Physical Therapist (PT) and Physical Therapy Assistant (PTA) license types. This license category is focused on mainly lower body movements.

+QUALITY ASSURANCE SPECIALIST / QA

A QA is a home health agency staff member who is responsible for the clinical oversight of treatment documentation. This staff member is not necessarily licensed.

+RECERTIFICATION / RECERT / RC

The recertification visit must be completed within the last 5 days of a patient’s episode for Medicare and Medicare Advantage patients. This visit type requires a recertification OASIS to be completed in order to extend the patient’s treatment for another 60 days.

+SKILLED NURSING / SN

Skilled nursing is one of the disciplines provided by a home health agency. This discipline includes the Registered Nursing (RN) and Licensed Vocational Nursing (LVN/LPN) license types.

+SPEECH THERAPY / ST

Speech therapy is one of the disciplines provided by a home health agency. This discipline includes the Speech Therapist (ST) and Speech Therapy Assistant (STA) license types. This license category is focused on speaking, eating, chewing, swallowing and breathing.

+STAFFING COMPANY / SC

This is a company that provides supplemental clinical field staff to home health agencies.

+START OF CARE / SOC

The start of care is the first visit from agency to the patient. During this visit, the patient signs the agency’s consent forms and agrees to the terms of service. This visit is also when the agency field staff conducts their first evaluation of the patient. For Medicare and Medicare Advantage patients this is done by completing an OASIS form, a medication list and other clinical evaluation forms. Managed care organizations have their own individual procedures for conducting this visit type and usually don’t require an OASIS form to be submitted. This visit is the start date of the patient’s treatment in the home health agency.