{"ref":"NC-HH-ADM-02","title":"Start of Care, Initial Assessment Visit, and Referral-Source Notification","category":"Service delivery","summary":"Requires a registered nurse (or, for a therapy-only patient, the therapist) to make the initial assessment visit within 48 hours of referral or of the patient’s return home, or on the ordered start of care date, and within the Agency’s own shorter start-of-care time frame; sets what happens at that visit (rights, consent, eligibility, immediate needs, safety); allows care to start on a verbal order; and requires the referral source and physician to be told whenever the time frame cannot be met.","inShort":["A registered nurse makes the first visit; a therapist may make it only when therapy is the only service ordered.","Make the first visit within 48 hours of receiving the referral, and never later than 48 hours after referral or return home, unless the doctor ordered a later date.","Give and explain the rights papers and get consent before any hands-on care.","If you cannot make the visit in time, tell the supervising nurse at once so the referral source and doctor are told.","Care can start on a verbal order; write it down, sign it and send it for the doctor’s signature."],"primaryCitation":"42 CFR §484.55(a)","citations":["10A NCAC 13J .1101(6)","10A NCAC 13J .1102(a)","10A NCAC 13J .1103(c)","10A NCAC 13J .1105(c)","10A NCAC 13J .1107(d)","10A NCAC 13J .1107(e)","10A NCAC 13J .1302(a)","NC Medicaid Clinical Coverage Policy 3A"],"federalCitations":["42 CFR §484.55(a)","42 CFR §484.55","42 CFR §489.102(b)"],"surveyorAsks":["When was this patient referred, and when did the nurse make the initial assessment visit?","What is your own start-of-care time frame, and how do you track it?"],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.55(a))","5. Who Makes the Initial Assessment Visit","6. Time Frames","7. Before the Visit","8. At the Initial Assessment Visit","9. Starting Care on a Verbal Order","10. When the Time Frame Cannot Be Met","11. Resumption of Care and Prior Approval","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":"nc-hha","state":"North Carolina","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}}