{"ref":"LA-HH-ADM-01","title":"Admission Criteria, Referral Intake, and Acceptance to Service","category":"Service delivery","summary":"Sets out the written criteria the Agency uses to decide whether to accept a referred patient (the ability to provide services on a timely basis and available within 24 hours unless the authorized healthcare provider specifies otherwise; the patient's and caregiver's willingness to take part in the plan of care; needs that can be met safely at home; and payer criteria), how referrals are received at all times and recorded, who decides, how capacity is checked so that no patient is accepted when the Agency cannot care for him or her, and what happens when a referral is not accepted. If the Agency is Medicare-certified, it is also the acceptance-to-service policy required by 42 CFR §484.105(i).","inShort":["We accept referrals at all times; after hours they go to the on-call RN at (225) 555-0199.","Write down the date and time every referral arrives; it starts the 24-hour clock.","Only the clinical manager or alternate decides whether to accept a referral.","We accept a patient only if we can start within 24 hours (unless ordered otherwise) and meet every ordered need.","If we cannot accept, tell the referral source the same day and give the family other agencies."],"primaryCitation":"LAC 48:I §9123.A","citations":["LAC 48:I §9123.A","LAC 48:I §9123.B","LAC 48:I §9115.B.1.e","LAC 48:I §9115.B.1.g","LAC 48:I §9115.B.1.j","LAC 48:I §9115.B.1.m","LAC 48:I §9111.C.5","LAC 48:I §9101","R.S. 40:2116.36(C)(5)","R.S. 40:2116.31(B)(1)"],"federalCitations":["42 CFR §484.105(i)","42 CFR §484.60","42 CFR §484.105(c)(3)"],"surveyorAsks":["Show me your written admission criteria. Who decides whether a referral is accepted?","How do you receive referrals after hours and on weekends?"],"forms":[{"ref":"LA-HH-ADM-01-A","title":"Referral Intake and Acceptance Decision Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (LAC 48:I §9123.A)","5. Receiving Referrals at All Times","6. Written Admission Criteria","7. Capacity Check","8. The Acceptance Decision","9. Referrals Not Accepted","10. Public Information About Services","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"la-hha","state":"Louisiana","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}