Policy Manual sample

MDT Home Health Care Agency, Inc. MAJOR DECLINE OR IMPROVEMENT IN HEALTH STATUS POLICY (for other Follow up assessments) Other Follow Up OASIS assessment will be completed within 48 hours of the knowledge of a major decline or improvement in a patient’s health status; At least 3 of the following criteria must be met to qualify as a major improvement: a) Total resolution of a wound before planning discharge; b) stopping infusion therapy, not longer needed before planning discharge or programmed frequency; c) Total stopping enteral nutrition; not longer needed d) Five or more medications discontinued as not necessary; e) major improvement in caregiver ability or availability or environment; or f) major improvement in 4 or more Activities of Daily Living (ADL). At least 3 of the following criteria must be met to qualify as a major decline; a) New 2 or more diagnosis with new orders; b) Initiation of two or more disciplines in same day (new orders, frequency); c) New stage 3 + wound formation; d) Starting new infusion therapy with order for more that 4 weeks services; e) Starting enteral nutrition; f) Five or more new medications started in same single order; g) Increase of 5 or more visits per week in same discipline; h) Major decline in functional status affecting 3 or more ADLs i) Major deterioration in caregiver ability or availability; j) Major deterioration in the environment; or k) 2 unscheduled physician appointments in one week. RESUMPTION OF CARE OASIS: 1. The resumption of Care OASIS form is completed within two (2) days of patient hospital discharge, or within two (2) days of when agency notified of hospital discharge (and the episode not ends). 2. Follow steps 3 through 6 of ADMISSION OASIS procedure. PLEASE NOTE: Resumption of Care OASIS form is not necessary for patient with less than 24 hour hospitals admit, or if the admission was for diagnostic testing only. If Hospital discharge is after episode ends see Discharge OASIS. TRANSFER OASIS: 1. OASIS FORM is completed if patient is transferred to an inpatient facility for 24 hours or more. 2. Form is completed within 2 calendar days following transfer/Agency notification of transfer. 3. Follow steps 3 through 6 of ADMISSION OASIS procedures. DISCHARGE OASIS: 1. Completed when patient has been assessed and no further visits are planned; no visit is required to perform discharge. 2. Completed when patient continues to be hospitalized and the episode ends; no visit required. 3. Completed when patient is discharged from the Agency but NOT to inpatient facility; visit required. 4. Discharge is completed within 2 calendar days of discharge/notification of discharge/death. 5. Follow steps 3 through 6 of ADMISSION OASIS procedures. EVALUATION OF DATA FOR PERFORMANCE IMPROVEMENT (QAPI) 1. On a quarterly basis, designated person will provide Agency administrative staff with reports, Home Health Agency Policies A-77