F-13-960 Supervision Requirements

Service	Supervision Requirement	Direct/ Non-Direct	Service Codes	Plan of Care
Client receiving HHA and skilled services	Can be done by any skilled professional who is familiar with the client and the client's plan of care At least every 14 days- aide does not need to be present. Virtual supervision by RN or therapist is only allowed in rare circumstances, not to exceed 1 in a 60 day period	If concern is identified during the 14-day non-direct sup visit, a direct sup visit with the HHA present needs to be made	__10N : Nonbill sup visit (no skilled services provided). __10: Sup visit completed during a skilled visit. __AOP: Phone Orientation to the care plan __97: Comp/ Skills Eval	Problem Statement: NEED FOR OTHER DISCIPLINES—> HOME HEALTH AIDE/HOMEMAKER SERVICES Aide Care Plan: Hands On (ADL Services) Care must be added Calendar: HH11, HH11H Service Codes Skills: Client Specific Competency, if indicated
Client receiving HHA with no skilled services	BEST PRACTICE: Schedule recert visit WITH direct sup Can be done by any skilled professional who is familiar with the client and the client's plan of care Every 60 days: HHA does not need to be present	If a concern is identified, the agency must conduct, a direct supervisory visit with the HHA present and the aide must complete, retraining and a competency eval for the deficiency and all related skills.	RN02X: Billable Non-OASIS Recert (Mark as non-billable when appropriate) __10N : Nonbill sup visit (no skilled services provided). __AOP: Phone Orientation to the care plan __97: Comp/ Skills Eval	Problem Statement: NEED FOR OTHER DISCIPLINES—> HOME HEALTH AIDE/HOMEMAKER SERVICES Aide Care Plan: Hands On (ADL Services) Care must be added Calendar: HH11, HH11H Service Codes Skills: Client Specific Competency, if indicated Medication Review: Required
Client receiving HMKR with no skilled services	RN or LPN may supervise homemaker. Supervision required every 60 days alternating home visit and phone supervision.	Homemaker *must be* present during annual on-site supervisory visit.	RN02X: Billable Non-OASIS Recert (Mark as non-billable when appropriate) __10N : Nonbill sup visit (no skilled services provided).	Problem Statement: NEED FOR OTHER DISCIPLINES—> HOME HEALTH AIDE/HOMEMAKER SERVICES (Delete Home Health Aide/Personal Care verbiage) Aide Care Plan: Hands Off (IADL Services) Services only Calendar: HMK11H Service Code Physical Assessment: Most assessment fields will be "not assessed" Medication Review: Not required
Client receiving services from a PTA	Every 6th visit made by the PTA must have a direct/joint sup visit with the PT PT may supervise two PTA at any time	PTA must be present during the sup visit with the PT This cannot be done at the same time as the 30 day therapy reassessment visit	PT10N: Nonbill supervisory visit PA11: PTA visit is billable	Calendar: PT10N visit should be plotted on same day as PA11
Client receiving services from a OTA	Every 10 intervention days OR every 30 days, whichever comes first	1:1 face-to-face contact with OTA (no phone supervision)	OT10N: Nonbill supervisory visit OTA SUPERVISION coordination note if outside of visit CT11: OTA visit is billable when conducted on visit
LPN Supervision	The skilled professional (RN) must periodically evaluate the effectiveness of the services furnished by the LPN to ensure the client’s needs are met.	No requirement for direct supervision, based on discretion of delegating RN.	RN10N: Nonbill supervisory visit SN11, LPN11

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