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Referral Intake, Acceptance to Service, and Public Information About Services

The Agency’s patient acceptance-to-service policy under 42 CFR §484.105(i): how referrals are received and screened, the criteria applied consistently to every prospective patient (anticipated needs, case load and case mix, staffing levels, staff skills and competencies), how decisions are made and communicated, the non-admission log, the accurate public information about services and limitations, and the annual review.

Preview: full text with a package
About this policy
Policy number
OH-HH-ADM-01
Version
1.0
Main rule
42 CFR §484.105(i)
Library
Ohio home health · 59 policies
Category
Service delivery
Sections
19

In short

  • Record every referral on the intake form the same day it arrives.
  • The clinical manager decides on every referral using the same criteria: the patient’s needs, case load, staffing and staff skills.
  • Never refuse a referral because of race, disability, age, sex, national origin, language or, for Ohio Medicaid patients, source of payment.
  • Tell the referral source the decision promptly, and log every referral the Agency does not accept, with the reason.

What's inside

19 sections. The full text comes with the One-time Policy Pack.

Full text with a package
  • Terms of Reference
  • 1. Purpose
  • 2. Scope
  • 3. Definitions
  • 4. Policy Statement (42 CFR §484.105(i))
  • 5. Receiving a Referral
  • 6. Acceptance Criteria
  • 7. What Is Never a Reason to Refuse
  • 8. Making and Communicating the Decision
  • 9. The Non-Admission Log and Program Review
  • 10. Public Information About Services
  • 11. Annual Review of This Policy
  • 12. Responsibilities
  • 13. Records and Compliance Monitoring
  • 14. Staff Training
  • 15. References
  • 16. Related Policies and Forms
  • 17. Approval
  • 18. Revision History

An inspector may ask

  • Show me your acceptance-to-service policy and the record of its last annual review.
  • How do you decide whether you can accept a referral? Show me the decision record for this referral you did not accept.

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