Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement

What this rule requires your agency to do

• 1Services provided by the home health agency, except for the initial evaluation visit, must be furnished under a physician's plan of care; the physician establishes a written plan of care and supervises the plan in conjunction with the home health agency (Reimbursable Services).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)
• 2Home health aide personal duties must be provided in accordance with the written plan of care (Personal Duties).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)
• 3Skilled nursing services must be performed by or under the direct supervision of a licensed nurse in accordance with the current Nurse Practice Act and individual home health agency policy; LPN services must be provided under the direction of the registered nurse (Registered Nurse / LPN Services).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)
• 4The plan of care must cover all pertinent diagnoses and include mental status, types of professional services needed, frequency of visits, prognosis, rehabilitation potential, functional limitations, activities permitted, nutritional requirements, medication and treatments, safety measures, and instruction for timely discharge or referral (Reimbursable Services).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)
• 5Providers enrolled in Vermont Medicaid must document that a face-to-face encounter occurred for the initial ordering of home health services (Face-to-face requirements).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)
• 6The home health aide is assigned to a particular patient by the nurse or therapist, and written instructions for the patient's care are prepared by a registered nurse or therapist; best practice is a supervisory visit by an RN or appropriate therapist every 2 weeks (Home Health Aide Services).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)
• 7All Home Health Agency Services are subject to the requirements of Health Care Administrative Rule 4.231 Home Health Services and related administrative rules (Section 2).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)
• 8If Medicare conditions are met and the patient is Medicare eligible, Medicare must be billed before Vermont Medicaid reimbursement is requested (Conditions for Payment).(Vermont Medicaid Home Health Agency Services, Assistive Community Care Services and Enhanced Residential Care Supplement)