Aides play a vital role in the delivery of home health and hospice care as they are the ones most frequently in contact with patients. In the performance of their role, it is critical they carry out tasks strictly in accordance with the patient’s Plan of Care (POC) as assigned by the RN. To evaluate whether aides are adequately meeting the patient’s and the family’s needs as identified in the POC, RN supervisory visits were established by the Centers for Medicare and Medicaid Services (CMS) as a requirement under the Conditions of Participation (COP) for home health and hospice agencies.
To know how you can better keep track and comply with this requirement, here are some quick information on the supervisory visits.
The Registered Nurse (RN) responsible for the patient’s nursing care oversees the home health aide services. During a supervisory visit, the RN must assess if the aide is following the POC, if the POC itself is meeting the patient’s needs, and if the patient or caregiver is satisfied with the POC and the aide’s performance.
CMS requires that for patients receiving skilled care, supervisory visits should take place at least once every two weeks or 14 days. Whether the home health aide should be present or not during the visit will depend on the aide’s experience level, abilities, and performance as well as the patient’s needs. For those not receiving skilled care, supervisory visits must take place at least once every 60 days while the aide is present and delivering care. In addition to these, an annual supervisory visit with direct observation measures must be performed for each aide that provides services on behalf of your agency.
In the hospice arena, RN supervisory visits for hospices must take place no less frequently than every 14 days. For example, if the visit was conducted on a Tuesday, the next one should be done no later than the Tuesday that falls exactly two weeks after. In addition to the evaluation of the aide’s adherence to the POC, as well as his or her performance, the supervision process should ensure the aide develops a compassionate interpersonal relationship with the patient and the family, complies with infection prevention and control policies, reports changes in the patient’s conditions, and honors the patient’s rights.
Should concerns arise during a visit wherein the aide is not present, the RN will conduct a separate supervisory visit to observe and evaluate the aide while he or she is performing care. Should a performance concern arise during this separate visit, a competency evaluation must be completed on the hospice aide based on the RN’s feedback. An annual on-site RN supervisory visit is also required to perform direct care observation for each hospice aide.
It is important to note that CMS has temporarily waived the requirement for both the two-week and annual supervisory visits for the duration of the Public Health Emergency (PHE). As more people get vaccinated however, we are drawing near to the expiration of the PHE which means the resumption of these supervisory visits. Proactive visit planning and documentation is critical to complying with this Medicare requirement.
In this regard, Data Soft Logic with its intelligent solutions can provide you with an ultra-efficient planning tool, the Interactive Patient Calendar. It is a dynamic and data-driven calendar which gives you a quick but comprehensive snapshot of each patient’s care schedule, level of care, number of visits, assigned disciplines, and relevant documentation. This feature, which is available in both Home Health Centre and Hospice Centre, is a launching pad for your documentation and SmartNotes, including the visit notes, wound notes, and collaboration notes. With the Interactive Patient Calendar, you can readily plot supervisory visits, create visit documentation, and provide quality healthcare. To know how you can take full advantage of this feature for your agency’s efficiency, schedule a demo with us now.
References: Centers for Medicare and Medicaid Services. State Operations Manual Appendix B -Guidance to Surveyors: Home Health Agencies Part I -Investigative Procedures. , 2015.
Medicare Learning Network. FACT SHEET ENHANCING RN SUPERVISION of HOSPICE AIDE SERVICES PRINT-FRIENDLY VERSION HOSPICE SERVICES. , July 2020.