On this page you’ll find:

• “Home from the Hospital with VNSNY” Video
• Required Physician Referral Forms
• Home Care Eligibility Criteria

Share this video with your patients: http://www.vnsny.org/video.

Home from the Hospital with VNSNY

There are many cases in which expert home health care should be an integral part of your patients’ treatment and/or recovery process. In fact, research shows that hospitalized patients who don’t receive home health care are twice as likely to be rehospitalized as those who do.¹

But many patients don’t understand what home health care is, or what benefits it offers, or why you’ve prescribed it. To answer these questions, and to help you make sure they receive the care you’ve ordered, we’ve prepared this short video.

Required Physician Referral Forms

According to a provision in the Patient Protection Affordable Care Act, physicians wishing to order home health care services for patients covered by Medicare must schedule a face-to-face encounter with each patient. These visits must occur 90 days prior to, or within 30 days of the start of, a Medicare home health care episode, and each visit must also be documented using a Face-to-Face Encounter (FFE) Form.

Physician Referral Form
Includes FFE Form
Use this form to make a referral for VNSNY home care. You can also use this form to document an encounter between you and your patient related to their need for home care and medical qualifications as homebound. DOWNLOAD FORM >

Stand-Alone FFE Form
Includes FFE Completion Guide
This form can be used by those requiring a stand-alone version of the FFE form.
DOWNLOAD FORM >

Home Care Eligibility Criteria

If you answer yes to any of the following questions, your patient may be a candidate for home health care. VNSNY can help with a wide range of home health care solutions:

Does your patient require one or more of the following assessments?

• Wounds
• Pain
• Social surroundings
• Environmental home safety
• Self-care skills
• Response to new treatments/medicines

Does your patient require one or more of the following assessments?

• Wound care
• Catheter/tube care (insertion, removal, or maintenance)
• Drainage tubes
• Trach care (suctioning, oxygen)
• Suture/staple removal
• Infusion (antibiotics, pain management, and nutrition)

Does your patient require education on one or more of the following?

• Medication administration
• Disease management
• Self care
• Special diets
• Assistive device, DME

Does your patient require one or more of the following:

• Physical Therapy (PT)
• Occupational Therapy (OT)
• Speech-Language Pathology (SLP)

Is your patient “homebound” and unable to leave home without considerable and taxing effort?

To further refine your assessment of patient needs, VNSNY Candidate Cards can help evaluate which patients are candidates for specific services and programs.

Medicare Definition of Homebound

For Medicare and some commercial/managed care insurance patients, the patient must be homebound to receive home health care services.

A “homebound” patient is defined as unable to leave home without considerable and taxing effort and must meet Criteria 1 and Criteria 2 as outlined in the table below.

Keep in mind that patients who leave home infrequently for short durations or for health care may still be considered homebound. These situations may include (but are not limited to):

• Attending a religious service
• Going to get a haircut
• Walking around the block
• Attending a family event, funeral, graduation, or other unique event
• Receiving outpatient kidney dialysis
• Receiving outpatient chemotherapy or radiation therapy

¹ Topaz M, Kang Y et al. Higher 30-Day and 60-Day Readmissions Among Patients Who Refuse Post Acute Care Services. Am J Manag Care. 2015 June; 21(6):424-433.