Handbook of Home Health Standards: Quality, Documentation, and Reimbursement » (5th Edition)

Handbook of Home Health Standards: Quality, Documentation, and Reimbursement includes everything the home care nurse needs to provide quality care and effectively document care based on accepted professional standards. This handbook offers detailed standards and documentation guidelines including ICD-9-CM (diagnostic) codes, OASIS considerations, service skills (including the skills of the multidisciplinary health care team), factors justifying homebound status, interdisciplinary goals and outcomes, reimbursement, and resources for practice and education. The fifth edition of this “little red book” has been updated to include new information from the most recently revised Federal Register Final Rule and up-to-date coding. All information in this handbook has been thoroughly reviewed, revised, and updated.

• Offers easy-to-access and easy-to-read format that guides users step by step through important home care standards and documentation guidelines
• Provides practical tips for effective documentation of diagnoses/clinical conditions commonly treated in the home, designed to positively influence reimbursement from third party payors.
• Lists ICD-9-CM diagnostic codes, needed for completing CMS billing forms, in each body system section, along with a complete alphabetical list of all codes included in the book in an appendix.
• Incorporates hospice care and documentation standards so providers can create effective hospice documentation.
• Emphasizes the provision of quality care by providing guidelines based on the most current approved standards of care.
• Includes the most current NANDA-approved nursing diagnoses so that providers have the most accurate and up-to-date information at their fingertips.
• Identifies skilled services, including services appropriate for the multidisciplinary team to perform.
• Offers discharge planning solutions to address specific concerns so providers can easily identify the plan of discharge that most effectively meets the patient’s needs.
• Lists the crucial parts of all standards that specific members of the multidisciplinary team (e.g., the nurse, social worker) must uphold to work effectively together to achieve optimum patient outcomes.
• Resources for care and practice direct providers to useful sources to improve patient care and/or enhance their professional practice.
• Each set of guidelines includes patient, family, and caregiver education so that health care providers can supply clients with necessary information for specific problems or concerns.
• Communication tips identify quantifiable data that assists in providing insurance case managers with information on which to make effective patient care decisions.
• Several useful sections make the handbook thorough and complete: medicare guidelines; home care definitions, roles, and abbreviations; NANDA-approved nursing diagnoses; guidelines for home medial equipment and supplies.
• Small size for convenient carrying in bag or pocket!

• Provides the most up-to-date information about the newest and predominant reimbursement mechanisms in home care: the Prospective Payment System (PPS) and Pay For Performance (P4P).
• Updated terminology, definitions, and language to reflect the federal agency change from Health Care Financing Administration (HCFA) to Centers for Medicare & Medicaid Services (CMS) and other industry changes.
• Includes the most recent NANDA diagnoses and OASIS form and documentation explanations.
• New interdisciplinary roles have been added, such as respiratory therapist and nutritionist.

Doody Review Services

Reviewer:Regina King, BSN(Richard L. Roudebush VA Medical Center)
Description:Home care has entirely changed over the past decade, necessitating this update of a 2001 book on standards and quality.
Purpose:The purpose is to reiterate the importance of clinical documentation, quality of care, and appropriate reimbursement of services. In today's ever-changing healthcare environment, these objectives must be achieved in order to maintain accreditation.
Audience:The book is written for healthcare providers who specialize in home health, including nurses, social workers, therapists, providers, and administrators.
Features:Helpful guidelines for use describe the organization of the book in a very useful eight-page summary. This well-organized book is divided into 10 sections and five appendixes. The author focuses on quality, reimbursement, and documentation. Reimbursement documentation suggestions are numerous and helpful throughout the various sections.
Assessment:This handbook needed to be updated because of the numerous changes in the prospective payment system in homecare. While one section of the book is directly from the Medicare Benefit Manual, it is helpful to have it on hand for reference purposes.

Part Two Clinical Practice in Home Care

Part Three Adult Clinical Guidelines: A Systems Approach for Assessment, Care Planning and Documentation

Part Four Hospice and Palliative Care: Clinical Guidelines for Assessment, Care Planning and Documentation

Part Five Maternal/Child Care: Clinical Guidelines for Assessment, Care Planning and Documentation

Part Six Medicare Home Care Guidelines for Coverage of Services

Part Seven NANDA-I-Approved Nursing Diagnoses

Part Eight Home Care Definitions and Abbreviations

Part Nine Guidelines for Home Medical Equipment and Supply Considerations

Part Ten Directory of Evidence-Based and Other Resources

Appendix A Home Care Orientation: Important Foundation for Success

Appendix B Sample Case-Mix Grouper Worksheet

Appendix C Non-Routine Supplies (NRS) Case-Mix Adjustment Variables and Scores

Appendix D Home Health Prospective Payment System Final Rule

Appendix E Draft of OASIS C