{"ref":"MI-HH-ADM-02","title":"Initial Assessment Visit and Start of Care","category":"Service delivery","summary":"Sets out who makes the initial assessment visit, when it must happen (within 48 hours of referral, within 48 hours of the patient's return home, or on the ordered start-of-care date), what the clinician does at that visit before any care is given, how Medicare eligibility and homebound status are first checked, how the start of care is set and documented, and what to do when the visit cannot be made on time. It adds the Michigan Medicaid rules on the date of first visit, pre-existing orders and eligibility checks.","inShort":["A registered nurse makes the first visit (a therapist only if therapy is the only service ordered).","The first visit must happen within 48 hours of referral or of the return home, or on the start date the doctor ordered.","If the visit cannot be made on time, tell the clinical manager before the deadline so the doctor can be called.","Give the rights, advance directive and consent papers before any hands-on care.","Give care only as ordered. For Medicare patients, check and record homebound status."],"primaryCitation":"42 CFR §484.55(a)","citations":["Michigan Medicaid Provider Manual, Home Health, Sections 1, 3, 10.1.C and 13.3","Michigan Medicaid Provider Manual, General Information for Providers, Section 9.3"],"federalCitations":["42 CFR §484.55","42 CFR §484.55(a)","42 CFR §484.50(a)","42 CFR §484.60(a)(1)","42 CFR §484.60(b)(1)","42 CFR §489.102(b)(3)(i)","42 CFR §409.43(c)"],"surveyorAsks":["For this patient, when was the referral received and when was the initial assessment visit made? Show me the documentation.","Who made the initial assessment visit? If it was a therapist, what services were ordered?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.55(a))","5. Who Makes the Visit","6. Scheduling the Visit on Time","7. At the Initial Assessment Visit","8. When the Agency Cannot Meet the Patient’s Needs","9. Orders Before Care","10. Eligibility Checks at Start of Care","11. Resumption of Care After an Inpatient Stay","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"mi-hha","state":"Michigan","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}}